Ch. 22 Musculoskeletal System Subjective/Objective Data

What is the 5 components that make up questions for the subjective data for the system? - 1. Joints (pain, stiffness, swelling, heat, redness, limitation of movement) 2. muscles (pain, cramps, weakness) 3. bones (pain, deformity, trauma, fractures, sprains, dislocation) 4. functional assessment (activities of daily living) 5. self-care behaviors Joint-any problems with your joints or any pain? Location? Quality? Severity? Onset? Timing? Swelling, heat, redness and limited of movement? Pain associated with chills, fever, sore throat, recent sore throat, trauma, repetitive activity? - Rationale: joint pain and loss of function are most common musculoskeletal concerns that prompt a person to seek care. Rheumatoid arthritis involves symmetric joints or tender with acute inflammation. Worse RA in the morning, tendinitis worse in the morning but improves during the day. Joint pain 10-14 days after untreated strep throat and rheumatic fever. RA stiffness, acute inflammation, decreased ROM due to joint injury to cartilage, capsule, or muscle contracture. Muscles-pain? cramping? weakness? location? smaller? - Rationale: myalgia is carmping or aching, sometimes accompanied by viral illness. Atrophy Bones-bone pain? deformity? accidents/traumas? back pain? bone pain? numbness or tingling? - Rationale: fracture causes sharp pain that increases with movement. Bone pain that is dull and deep and unrelated to movement. Functional assessment (ADL)-your joint pain causes any limits on daily ADLs? Such as bathing, toileting, dressing, grooming, eating, mobility, and communicating? - Rationale: screens for safety of independent living and need for home health services. Impaired in physical mobility and verbal comunication. Self-care behavior-occupational hazard that affects muscles and bones? Chronic stress? Chronic disability or crippling illness? Weight gain? Medications for musculoskeletal system? - Rationale: assess risk for back pain/ carpal tunnel syndrome, self-care behaviors, assess for self-esteem disturbance, loss of independence, body image disturbance, role performance disturbance and social isolation. Inspection of Skin - -note the size and contour of joint. Note for color, swelling and any masses/deformity. abnormal findings: swelling due to excess joint fluid, dislocation, subluxation, contracture and ankylosis. Palpation of Joint - normal findings: no heat, tenderness, swelling or masses. No palpable synovial membrane. abnormal findings: dough, boggy synovial membrane. Warm and tenderness signal inflammation. Range of Motion of joint - normal findings: passive motion with person's muscle and normal active voluntary range of motion. No pain, tenderness or crepitation