Easy motor exam

[nurseholden]

Hi All!

I am new to the board but I need some insight from those who are "seasoned" ortho nurses. I am an new educator on an ortho unit.We are doing alot of back surgeries now and need to improve our neurologic assessments (i.e Motor function, strenght/reflexes and grading them)

I need an easy way to teach the nurses how to do a quick yet thorough exam of their postoperative spinal surgery pt. Any tips or advice?

[P_RN, ADN, RN]

I'm pretty well "seasoned" (or is that decayed?) :) Would 30 yrs as an ortho RN do?

I'd start with teaching the various pulses that would apply:

Radial

Brachial

Ulnar

Popliteal

Tibial

A nice chart is always useful. A reminder that not all people have all their pulses in those particular places.

Then the various nerves, the norms of sensation and movement, and what could indicate problems .

Radial nerve

Medial nerve (one of my favorites)

Ulnar nerve

Peroneal

Posterior tibialis

Know ABduction and ADduction. and we said it like that: A B duction.

Know plantar flexion (plant your foot down)

Know dorsiflexion (raise your foot (toes usually) toward your nose)

Teach Compartment syndrome. VERY IMPORTANT...CAN LOSE A LIMB IN JUST A SHORT TIME.And a fasciotomy is not a pretty thing to happen.

Paraesthesia

Pain

Paralysis

Pallor

Pulselessness.

If you can locate one the naon Core Curriculum is fantastic. It's a BIG book with outlines of every possible ortho thing you can imagine. It should be in your hospital library

There is a lot more but my moldy old brain can't pull any more up right now.

http://www.med.umich.edu/lrc/Hypermuscle/Hyper.html#foot

Another nice one form eMedicine

http://www.emedicine.com/orthoped/topic389.htm