Module 1 test
NUR 275
Assessments
Deformity -Amelia → something is missing
& -Meromelia → partial absence of a limb
Alignment -Phocomelia → bone is missing (hand is attached near elbow, foot is attached near knee)
-Syndactyly → webbed digits
-Polydactyly → extra digit
-Metatarsus adductus → pigeon toed
-Tx: gentle manipulation, passive stretching, serial casting, wheaton brace, & special shoes. Dr.
Chong’s orthosis can be used in place of serial casting
-Club foot: Tx with serial casting if not too severe & sx (shortens longer ligament and lengthens
shorter one)
Spine -Scoliosis: uneven shoulders & hips, S-Shaped spine
-Tx: Brace → 14-16 hours a day, spinal fusion with steel rods & bone grafts
-Kyphosis: hunchback (typically seen in elderly women)
-Lordosis: exaggerated lumbar curve (typically seen in pregnant women & muscular dystrophy)
-Congenital Hip Dysplasia: Assess in babies → gluteal folds asymmetric
Articular -Evaluate ROM, note deformities, palpate joints (may have nodules)
System -Goniometer → measures ROM in degrees
-Extension is harder to get to after sx than flexion
-Torticollis: Wry neck (muscle gets stiff) → don’t have complete function. Tx with side to side
stretches
-Palpate joint while joint is being passively moved
-Will hear crepitus with arthritis
-Snap or crack may indicate ligament slipping over bony prominence
-Nodules in joints will be seen with osteo & rheumatoid arthritis as well as gout
-Heberden Nodules: nodules in first joints of fingers right before nails (signifies osteoarthritis)
Muscular -Test muscle strength by having patient fully extend or flex extremity against resistance
System -Simple handshake for hand grasp strength
-Measure extremity girth to monitor for edema or bleeding (DVT)
→ Mark tape measure so other nurses measure the same point of the leg
-Palpate muscle for tone → have pt tighten muscle, and then palpate
Gait -Unsteadiness or irregular movements abnormal
-Limping: Ask pt if & where it hurts (could also be from one extremity shorter than the other
-Neuro conditions associated with abnormal gaits → spastic hemiparesis gait with stroke,
shuffling with Parkinson’s
Skin -Assess for cuts, bruises, & evidence of ↓ circulation,
-Assess for edema & differences in skin temp;
-Assess peripherals; pulses, color, temp & cap refill (CMS)
1
NUR 275
Assessments
Deformity -Amelia → something is missing
& -Meromelia → partial absence of a limb
Alignment -Phocomelia → bone is missing (hand is attached near elbow, foot is attached near knee)
-Syndactyly → webbed digits
-Polydactyly → extra digit
-Metatarsus adductus → pigeon toed
-Tx: gentle manipulation, passive stretching, serial casting, wheaton brace, & special shoes. Dr.
Chong’s orthosis can be used in place of serial casting
-Club foot: Tx with serial casting if not too severe & sx (shortens longer ligament and lengthens
shorter one)
Spine -Scoliosis: uneven shoulders & hips, S-Shaped spine
-Tx: Brace → 14-16 hours a day, spinal fusion with steel rods & bone grafts
-Kyphosis: hunchback (typically seen in elderly women)
-Lordosis: exaggerated lumbar curve (typically seen in pregnant women & muscular dystrophy)
-Congenital Hip Dysplasia: Assess in babies → gluteal folds asymmetric
Articular -Evaluate ROM, note deformities, palpate joints (may have nodules)
System -Goniometer → measures ROM in degrees
-Extension is harder to get to after sx than flexion
-Torticollis: Wry neck (muscle gets stiff) → don’t have complete function. Tx with side to side
stretches
-Palpate joint while joint is being passively moved
-Will hear crepitus with arthritis
-Snap or crack may indicate ligament slipping over bony prominence
-Nodules in joints will be seen with osteo & rheumatoid arthritis as well as gout
-Heberden Nodules: nodules in first joints of fingers right before nails (signifies osteoarthritis)
Muscular -Test muscle strength by having patient fully extend or flex extremity against resistance
System -Simple handshake for hand grasp strength
-Measure extremity girth to monitor for edema or bleeding (DVT)
→ Mark tape measure so other nurses measure the same point of the leg
-Palpate muscle for tone → have pt tighten muscle, and then palpate
Gait -Unsteadiness or irregular movements abnormal
-Limping: Ask pt if & where it hurts (could also be from one extremity shorter than the other
-Neuro conditions associated with abnormal gaits → spastic hemiparesis gait with stroke,
shuffling with Parkinson’s
Skin -Assess for cuts, bruises, & evidence of ↓ circulation,
-Assess for edema & differences in skin temp;
-Assess peripherals; pulses, color, temp & cap refill (CMS)
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