SPRAIN & STRAIN

NURSING MANAGEMENT

STRAIN
Adalah rudapaksa yang merupakan mekanisme terjadinya trauma
pada sendi
Tergantung dari derajat kuatnya, maka srain dapat memberikan
akibat sprain
SPRAIN
Ialah meregangnya daerah jaringan lunak sendi dan terjadi
kerusakan jaringan lunak sendi (simpai sendi,

Definisi
Kapsula sendi adalah lapisan berserabut yang melapisi
sendi. Di bagian dalamnya terdapat rongga.
Ligamen (ligamentum) adalah jaringan berbentuk pita
yang tersusun dari serabut-serabut liat yang mengikat
tulang satu dengan tulang lain pada sendi
Tendon adalah urat keras yang menghubungkan otot
dengan sendi atau yang menghubungkan otot dengan
tulang

What's ??

Assessment/clinical
manifestation
SPRAINS
Pain and discomfort, especially on joint movement
Edema, possibly ecchymoses
Decreased joint motion and function
Feeling of joint looseness with severe sprain
STRAINS
Edema
Ecchymoses developing several days after injury
Pain
-Acute strain - pain may be sudden, severe, incapacitating.
-Chronic strain gradual onset of soreness and tenderness
Laboratory and diagnostic study findings
Radiographs are commonly done to rule out fracture or dislocation.

Severity
A physician categorizes sprains and strains
according to severity. A Grade I (mild) sprain or
strain involves some stretching or minor tearing of
a ligament or muscle. A Grade II (moderate) sprain
or strain is a ligament or muscle that is partially
torn but still intact. A Grade III (severe) sprain or
strain means that the ligament or muscle is
completely torn, resulting in joint instability

Pathophysiology
The affected ligament is unable to stabilize the joint when
the client is applying weight and attempting to mobilize
the affected joint. The blood vessels may be ruptured and
edema produced.

Treatment
Grade I injuries usually heal quickly with rest, ice, compression, and
elevation (RICE). Therapeutic exercise can also help restore strength
and flexibility. Grade II injuries are treated similarly but may require
immobili-zation of the injured area to permit healing. Grade III sprains
and strains usually require immobilization and possibly surgery to
restore function.
The key to recovery is an early evaluation by a medical professional.
Once the injury has been determined, a treatment plan can be
developed. With proper care, most sprains and strains will heal without
long-term side effects.

Medical management
Treatment of strains and sprains consists of resting and elevating the affected part,
applying cold and using a compression bandage.
The acronym RICE Rest, Ice, Compression, Elevation is helpful for remembering
treatment intervention.
Rest prevents additional injury and promotes healing.
If the sprain is severe (torn muscle fibers and disrupted ligaments), surgical repair
or cast immobilization may be necessary so that the joint will not lose its stability.
After the acute inflammatory stage (24 to 48 hours after injury), heat may be
applied intermittently (for 15 to 30 minutes four times a day) to relieve spasm and
to promote vasodilation, absorption and repair.
Splinting may be used to prevent reinjury.

Nursing diagnosis
Acute pain
Impaired mobility
Risk for injury

Nursing management
Provide nursing care for a client who sustains a sprain
-Elevate or immobilize the affected joint, and apply ice packs immediately
-Assist with tape, splint or cast application, as necessary
-Prepare the client with a severe sprain for surgical repair or reattachment,
if indicated.
Provide nursing care for a clients suffering muscle or tendon strain.
-Instruct the client to allow the muscle or tendon to rest and repair itself by
avoiding use for approximately week and then by progressing activity
gradually until healing is complete.
-Teach appropriate stretching exercises to be performed after healing to
help prevent reinjury.
-Prepare the client for surgical repair in severe injury.
Administer prescribed medications, which may include nonopioid analgesics.