Text A

1. Strains: These involve the stretching or tearing of muscles or tendons (tissues connecting muscles to bones) due to overuse or sudden exertion. Pain, tenderness, and reduced mobility are common symptoms, often localized to the affected area.

2. Sprains: Unlike strains, sprains occur when ligaments, the fibrous bands stabilizing joints, are stretched or torn. Sprains typically cause pain, swelling, bruising, and instability around the affected joint, like the ankle or wrist.

3. Tendonitis: This condition involves inflammation of a tendon, often caused by repetitive movements that irritate the tendon sheath (protective tissue surrounding the tendon). Symptoms include pain, tenderness, and sometimes a grinding sensation near the affected joint.
Text B
Managing Musculoskeletal Injuries
While early diagnosis by a healthcare professional is essential, here’s a basic overview of immediate management for common musculoskeletal injuries:
General Measures:

1. Rest:  Reduce activity that aggravates the injury. Strains and sprains often benefit from temporary immobilization with a splint or sling to promote healing.

2. Ice: Apply ice packs wrapped in a thin cloth to the injured area for 15-20 minutes at a time, several times a day. This helps reduce inflammation and pain.

3. Compression: Use a gentle compression bandage to minimize swelling and provide support. Avoid wrapping too tightly, which could restrict circulation.

4. Elevation: Elevate the injured limb above the heart whenever possible to reduce swelling and promote blood flow.

Seeking Medical Attention:

If the pain is severe, there’s significant swelling or bruising, deformity of the affected area, or loss of function, consult a healthcare professional promptly.  They will perform a thorough examination, potentially including X-rays or other imaging tests, to diagnose the specific injury and determine the most appropriate treatment plan.

Additional Considerations:

• Medication:Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage pain and inflammation. However, consult a healthcare professional before taking any medication, especially if you have pre-existing medical conditions or take other medications.
• Rehabilitation:  Following the initial healing phase, physical therapy exercises are often recommended to regain strength, flexibility, and full range of motion in the affected area.

Text C
Drug Therapy Protocol:

Licensed Clinical Nurse Specialist (CNS) must consult with the Attending Physician or Nurse Practitioner (NP). Registered Nurse (RN) in specialized settings may proceed.

Drug	Form	Strength	Route of administration	Recommended dosage	Duration
Pain Relief A	IV		IV	Initial dose of 100 mg then 50-100 mg increments slowly, repeated every 1-2 hours if required to a max. of 400 mg	For elderly patients (≥65 years), start with the lowest effective dose and monitor closely for adverse effects.

Provide Patient Medication Guide: Caution against operating heavy machinery or driving while taking medication. Potential side effects include dizziness, drowsiness, and constipation. In the event of respiratory depression, administer naloxone and notify prescriber immediately.

Text D

Technique for Plaster Back slab for Leg Fractures (Similar principles to arm fracture)

1. Measure and Pad:

Measure non-compression stockinette from **mid-calf** to just above the **ankle**. Width should be 2–3 cm wider than the ankle. Wrap cotton padding over the entire stockinette length – 2 layers with 50% overlap.

2. Plaster Preparation:

 Measure plaster of Paris 1 cm shorter than the padded/stockedinette at each end. Fold the roll in about ten layers to match the length. Submerge the folded plaster in a bowl of room temperature water, holding both ends. Gently squeeze out excess water.

3. Patient Preparation:

Ensure removal of any jewellery from the injured leg.

4. Cast Application:

• Gently mold the slab to the contours of the leg and foot in a neutral position (e.g., slight ankle dorsiflexion).
• Avoid pressure on bony prominences like the shin or ankle. Add extra padding if needed.

5. Securing the Back slab:

Wrap a crepe bandage firmly but comfortably around the plaster back slab.

Note: This is a general guideline. A medical professional should assess and treat any fracture.

END OF PART A

---