b. Invasive procedures, such as the myelogram, arthrocentesis, and
arthroscopy, require the application of sterile dressings over the puncture sites. The
puncture sites must be observed for signs and symptoms of infection and the dressings
changed in accordance with the physician's orders or local Department of Nursing
standing operating procedures. Additionally, the patient may be required to remain on
bed rest for a period of time after the procedure.
c. Basic nursing considerations in the care of patients undergoing diagnostic
examinations include the following:
Ensure that any pre-procedural patient prep has been completed.
Have the right patient in the right place at the right time.
(3) Bring previous X-rays, the patient's chart, or any other materials required
by the department performing the procedure.
(4) Have an attendant available to remain with the patient, if required by
local policy or circumstances.
Comply with post-procedural physician's orders.
(6) Observe the patient for pain and/or other side effects or reactions
associated with the procedure.
(7) Enter appropriate documentation of all that has been done in the
a. Most patients with disorders of bones, joints, and muscles experience pain.
Orthopedic nursing assessment and management of pain must be individualized as
each person will have a different threshold and tolerance for pain.
b. Bone pain is described as a deep, dull, boring ache, as opposed to muscle
pain, which is described as a soreness or aching.
c. Increasing pain may indicate an infectious process, malignancy, or vascular
problem. Pain that increases only with activity may indicate joint or muscle sprain.
d. Sharp pain may be related to a bone infection with muscle spasm, pressure
on a sensory nerve, or fracture pain, which is both sharp and piercing.
e. Radiating pain is seen in conditions where pressure is exerted on a nerve