Musculoskeletal Disorders, Fractures, & Joint Care — NCLEX-PN Orthopedic Nursing Review | Chapter 57: Saunders

Musculoskeletal Disorders, Fractures, & Joint Care — NCLEX-PN Orthopedic Nursing Review | Chapter 57: Saunders

Chapter 57 of Saunders Comprehensive Review for the NCLEX-PN® Examination (7th Edition) by Linda Anne Silvestri and Angela E. Silvestri provides a detailed review of musculoskeletal anatomy, common injuries, disorders, and critical nursing interventions. From bone healing and joint anatomy to fracture care and arthritis management, this chapter equips students with the knowledge and skills necessary for safe orthopedic nursing and NCLEX-PN success.

Watch the lecture above for a complete musculoskeletal systems review, then read the breakdown below for exam-focused study points.

Saunders NCLEX-PN Examination Review book cover

Musculoskeletal Anatomy & Physiology

  • Axial vs appendicular skeleton, types of bones and joints, synovial fluid function.
  • Muscle contraction: actin, myosin, acetylcholine, ATP, and calcium roles.
  • Bone healing stages: hematoma, callus formation, ossification, remodeling.

Diagnostics

  • X-ray, MRI, CT scan for fracture and joint injury assessment.
  • Arthroscopy, arthrocentesis for joint evaluation and treatment.
  • Bone density scan, bone biopsy, electromyography (EMG).

Soft Tissue Injuries

  • Strains, sprains, rotator cuff tears — RICE protocol and surgical repair.

Fracture Care

  • Classification: closed, open, comminuted, spiral, pathological.
  • Reduction methods: closed (manual) and open (surgical).
  • Fixation: internal (plates, screws) and external (frames, pins).

Traction

  • Skin vs skeletal traction: Buck’s, Russell’s, pelvic, cervical.
  • Pin site care, alignment maintenance, pressure injury prevention.

Casting

  • Drying times: plaster vs fiberglass.
  • Neurovascular checks, pressure point monitoring, infection signs.

Complications

  • Fat embolism: hypoxemia, petechiae, mental status changes.
  • Pulmonary embolism: dyspnea, chest pain, hemoptysis.
  • Compartment syndrome: 6 Ps (pain, pallor, pulselessness, paresthesia, paralysis, pressure).
  • Osteomyelitis: infection requiring IV antibiotics.
  • Avascular necrosis: bone death from loss of blood supply.

Mobility Aids

  • Crutch gaits: 2-point, 3-point, 4-point, and swing-through.
  • Safe cane and walker use; stair navigation techniques.

Joint Conditions

  • Dislocations and subluxations — emergency reduction, immobilization.
  • Herniated disks — cervical and lumbar, spinal precautions, logrolling.

Amputations

  • Postoperative stump care, phantom limb pain management.
  • Contracture prevention and prosthetic preparation.

Arthritis

  • Rheumatoid arthritis: autoimmune, systemic inflammation, joint deformity.
  • Osteoarthritis: degenerative, Heberden’s/Bouchard’s nodes, pain after activity.

Osteoporosis

  • Risk factors: menopause, low calcium, sedentary lifestyle.
  • Fall prevention, weight-bearing exercises, calcium/vitamin D supplementation.

Gout

  • Uric acid buildup, acute joint inflammation.
  • Low purine diet, uricosuric medications, avoidance of alcohol/organ meats.

NCLEX Nursing Priorities

  • Early complication recognition and emergency intervention.
  • Safe use of mobility aids and prevention of falls.
  • Infection prevention in surgical and orthopedic clients.
  • Patient teaching for home safety and chronic joint condition management.

Conclusion

Chapter 57 strengthens musculoskeletal nursing knowledge, equipping students to assess, manage, and prevent complications in orthopedic care. Mastery of these skills ensures safety and effectiveness in both clinical practice and NCLEX-PN success.

Subscribe to Last Minute Lecture for more NCLEX-focused lectures and orthopedic care preparation.

View the complete Saunders Comprehensive Review for the NCLEX-PN® Examination (7th Edition) playlist here: Complete NCLEX-PN Review Playlist

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