Published Jan 18, 2005
nurseholden
2 Posts
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
6,011 Posts
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