Group 1

Nursing Care A-Class

Musculoskeletal
System
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 MUSKULOSCELETAL
SYSTEM

OSTEOPOROSIS OSTEOMYELITIS
Anamnese
a)Identity
1. Client identity
Includes name, age, gender, ethnicity / nation, religion,
education, occupation, date of entry, date of study, register
number, medical diagnosis, address, all data regarding the
client's identity to determine further action.
2. The identity of the person in charge
The identity of the person in charge is very necessary to
facilitate and be responsible for the client during treatment, the
data collected includes name, age, education, occupation,
client relationship and address.
b) Medical History
In assessing medical history, nurses need to identify the presence
of:
a. Pain or back pain (lower part), neck and waist
b. Decreased body weight
c. Usually over 45 years
d. Gender is often in women
e. Exercise and activity patterns
c) Patterns of daily activities
Sport can form a good person and the individual will feel better.
In addition, exercise can maintain muscle tone and joint
movement. The elderly need adequate activities to maintain
bodily functions. Body activities require complex interactions
between nerves and musculoskeletal.
Some changes that occur in connection with decreased joint
motion are agility (the ability to move quickly and smoothly)
decreases, and decreased stamina
2. Physical Examination
a. B1 (Breathing)
Inspection: There is asymmetry in the chest cavity and spine
Palpation: tactile fremitus balanced right and left
Percussion: Resonant weather throughout the lung
Auscultation: In the case of elderly, usually a crackling sound is
obtained
b. B2 (Blood)
Capillary refill in less than 1 second, cold sweat and dizziness
often occur. The presence of peripheral pulsus means that there is
impaired blood vessels or edema associated with the effect of the
drug.
c. B3 (Brain)
Consciousness is usually compost mentis. In more severe cases,
clients may complain of dizziness and anxiety.
a) Head and face: cyanosis
b) Eyes: Sclera is usually not jaundice, conjunctiva is not anemic
c) Neck: Usually JVP in normal
Back pain accompanied by conscious and subtle spinal movements
is an indication of one or more fractures, vertebral compression
fracture
d. B4 (Bladder)
Urine production is usually within normal limits and there is no
complaint in the urinary system.
e. B5 (Bowel)
For cases of osteoporosis, there is no elimination disorder but it
needs to be assessed for frequency, consistency, color, and feces
odor.
f. B6 (Bone)
On inspection and palpation of the vertebral column area.
Osteoporosis clients often show kyphosis or gibbus (dowager’s
hump) and decrease in height and weight. There are changes in gait,
bone deformity, leg-length inequality and spinal pain.
c) Patterns of daily activities
Sport can form a good person and the individual will feel better.
In addition, exercise can maintain muscle tone and joint
movement. The elderly need adequate activities to maintain
bodily functions. Body activities require complex interactions
between nerves and musculoskeletal.
Some changes that occur in connection with decreased joint
motion are agility (the ability to move quickly and smoothly)
decreases, and decreased stamina
2. Physical Examination
a. B1 (Breathing)
Inspection: There is asymmetry in the chest cavity and spine
Palpation: tactile fremitus balanced right and left
Percussion: Resonant weather throughout the lung
Auscultation: In the case of elderly, usually a crackling sound is
obtained
b. B2 (Blood)
Capillary refill in less than 1 second, cold sweat and dizziness
often occur. The presence of peripheral pulsus means that there is
impaired blood vessels or edema associated with the effect of the
drug.
a. Anamnesis
1) Identity:
name, gender, age, address, religion, language used, marital
status, education, employment, insurance, blood type,
registration number, date of hospital admission, and medical
diagnosis.
2) Current disease history
Assess for a history of open fracture trauma (damage to blood
vessels, edema, hematoma, and relationship of the fracture to the
outside world so that open fractures commonly occur), history of
bone surgery with internal fixation and external fixation
(bacterial invasion caused by the surgical environment) and in
acute osteomyelitis which is not given adequate treatment to
allow the process of suppuration in bone.
3) Past medical history
There is a history of bone infection, usually in the thoracic-
lumbar vertebrae that occurs due to thoracentesis or urological
procedures. A history of diabetes mellitus, malnutrition, drug
addiction, or immunosuppressive treatment can be found.
4) Psychosocial history - spiritual
In the case of osteomyelitis, there will be a fear of disability and
the client must undergo health management to help bone healing

b. Physical examination
1.) General circumstances include:
a.) Level of consciousness (apathy, sopor, coma, anxiety, compos
mentis that depends on the client's condition).
b.) Pain or disease (acute, chronic, mild, moderate, and in the
case of osteomyelitis is usually acute).
c.) Vital signs are not normal, especially in osteomyelitis with
complications of septicemia.
2.) B1 (Breathing)
Upon inspection, it was found that the osteomyelitis client did
not experience respiratory abnormalities. In palpation of the
thorax, tactile fremitus is found right and left. On auscultation,
no additional breath sounds are obtained.
3.) B2 (Blood)
on inspection, there is no visible cardiac ectus. Palpation shows
increased pulse, not palpable iktus. In auscultation, a single S1
and S2 sound was obtained, no murmurs.
4.) B3 (Brain)
The level of consciousness is usually compos mentis.
5.) B4 (Bladder)
assessment of the state of urine including, color,
amount, characteristics, and specific gravity. Usually
osteomyelitis does not experience abnormalities in
this system.
6.) B5 (Bowel)
for cases of osteomilitis there is no elimination
disorder but it needs to be assessed for frequency,
consistency, color and feces odor.
7.) B6 (Bone)
The presence of acute hematogenous osteomelitis will
be found interruption of joint movement because joint
swelling will interfere with the motor function of the
client. Damage to the integrity of the tissue on the
skin due to injury accompanied by the discharge of
pus or clear-smelling clear liquid
c. Look
In acute hematogenous osteomelitis, joint movement disorders
will be found due to joint compression and the disorder gets
worse when local spasms occur. Impaired joint movement can
also be caused by joint effusion or joint infection (septic
arthritis). In general, chronic osteolelitis clients show a
characteristic wound accompanied by the removal of pus or clear
fluid originating from the infected bone and the suppuration
process. Clinical manifestations of osteomelitis due to open
fractures usually include fever, pain, swelling in the fracture
area, and pus secretion in the wound.
d. Feel
Assess for tenderness.
e. Move
This check determines whether there is mobility or not. The
movements seen are active and passive movements. Examination
obtained is a disturbance or limitation of joint motion in acute
osteomelitis.
Sleep and rest patterns. All osteomelitis clients feel pain so that it
can interfere with sleep patterns and needs., Mood, habits, and
difficulties and the use of sleeping pills.
Thank You
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