Page 2106 - Saunders Comprehensive Review For NCLEX-RN

1. Strains are an excessive stretching of a muscle or
tendon.
2. Management involves cold and heat applications,
exercise with activity limitations, antiinflammatory
medications, and muscle relaxants.
3. Surgical repair may be required for a severe strain
(ruptured muscle or tendon).
B. Sprains
1. Sprains are an excessive stretching of a ligament,
usually caused by a twisting motion, such as in a fall
or stepping onto an uneven surface.
2. Sprains are characterized by pain and swelling.

3. Management involves rest, ice, a compression

bandage, and elevation (RICE) to reduce swelling, as
well as joint support. RICE is considered a first-aid
treatment, rather than a cure for soft tissue injuries.
4. Casting may be required for moderate sprains to allow
the tear to heal.
5. Surgery may be necessary for severe ligament damage.
C. Rotator cuff injuries
1. The musculotendinous or rotator cuff of the shoulder
can sustain a tear, usually as a result of trauma.
2. Injury is characterized by shoulder pain and the
inability to maintain abduction of the arm at the
shoulder (drop arm test).

3. Management involves nonsteroidal anti-

inflammatory drugs (NSAIDs), physical therapy,
sling support, and ice–heat applications.
4. Surgery may be required if medical management is
unsuccessful or a complete tear is present.
V. Fractures
A. Description: A break in the continuity of the bone caused by
trauma, twisting as a result of muscle spasm or indirect loss of
leverage, or bone decalcification and disease that result in
osteopenia.
B. Types of fractures (Box 60-2)

C. Assessment of a fracture of an extremity

1. Pain or tenderness over the involved area
2. Decrease or loss of muscular strength or function
3. Obvious deformity of the affected area
4. Crepitation, erythema, edema, or bruising
5. Muscle spasm and neurovascular impairment

D. Initial care of a fracture of an extremity

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