Placement : II Year
Hours of Instruction
Theory : 150 Hours
Practical : 950 Hours
Total : 1100 Hours
Course DescriptionThis course is designed to assist students in developing expertise and indepth
understanding in the field of orthopedic nursing. It will help students
to develop advanced skills for nursing intervention in various orthopedic
conditions. It will enable the student to function as orthopedic nurse
practitioner/specialist providing quality care. It will further enable the
student to function as educator, manager, and researcher in the field of
orthopedic nursing.
Objectives
At the end of the course the students will be able to:
1. Appreciate the history and developments in the field of orthopedic
nursing
2. Identify the psycho-social needs of the patient while providing
holistic care.
3. Perform physical and psychological assessment of patients with
orthopedic conditions and disabilities.
4. Describe various disease conditions and their management
5. Discuss various diagnostic tests required in orthopedic conditions
6. Apply nursing process in providing care to patients with orthopedic
conditions and those requiring rehabilitation.
7. Recognize and manage orthopedic emergencies.
8. Describe recent technologies and treatment modalities in the
management of patients with orthopedic conditions and those
requiring rehabilitation.
9. Integrate the concept of family centered, long term care and
community based rehabilitation to patients with orthopedic
conditions.
10. Counsel the patients and their families with orthopedic conditions
11. Describe various orthotic and prosthetic appliances
12. Appreciate the legal and ethical issues pertaining to patients with
orthopedic conditions and those requiring rehabilitation.
13. Appreciate the role of alternative system of medicine in care of
patients with orthopedic conditions
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14. Incorporate evidence based nursing practice and identify the areas of
research in the field of orthopedic nursing.
15. Recognize the role of orthopedic nurse practitioner and as a member
of the orthopedic and rehabilitation team.
16. Teach orthopedic nursing to undergraduate students and in-service
nurses.
17. Prepare a design and layout of orthopedic and rehabilitative units.
Course Content
Unit Hours Content
I 5 Introduction
�� Historical perspectives – History and trends in orthopedic nursing
�� Definition and scope of orthopedic nursing
�� Anatomy and physiology of Musculo-skeletal system
�� Posture, Body landmarks Skeletal system Muscular system.
Nervous system - Main nerves
�� Healing of - Injury, bone injury,
�� Repair of ligaments
�� Systemic response to injury
�� Ergonomics, Body mechanics, biomechanical measures
�� Orthopedic team
II 8 Assessment of Orthopedic Patient
�� Health Assessment: History, physical examination- Inspection,
palpation, movement, Measurement, muscle strength Testing.
�� Diagnostic studies – Radiological studies, Muscle enzymes,
serologic studies
III 10 Care of patients with devices
�� Splints, braces, various types of plaster cast
�� Various types of tractions,
�� Various types of orthopedic beds and mattresses
�� Comfort devices
�� Implants in orthopedic
�� Prosthetics and Orthotics
IV 15 Injuries
Trauma & Injuries
�� Causes, pathophysiology, clinical types, clinical features,
diagnosis, prognosis, management, medical surgical and nursing
management of :
• Early management of Trauma
• Fractures
• Injuries of the
�� Shoulder and arm
�� Elbow, fore arm, wrist, hand
�� Hip, thigh, knee, leg, ankle, foot
�� Spine
�� Head injury
�� Chest injury
• Polytrauma
• Nerve injuries
• Vascular injuries
• Soft tissue injuries
• Sports injuries
• Amputation
V 8 Infections of Bones and Joints
�� Causes, pathophysiology, clinical types, clinical features,
diagnosis, prognosis, management, medical surgical and nursing
management of :
• Tuberculosis
• Osteomyelitis
• Arthritis
• Leprosy
VI 5 Bone Tumours
�� Causes, pathophysiology, clinical types, clinical features,
diagnosis, prognosis, management, medical surgical and nursing
management of:
• Bone tumors – Benign, Malignant and metastatic
• Different types of therapies for tumors
VII 10 Deformities
�� Causes, pathophysiology, clinical types, clinical features,
diagnosis, prognosis – medical surgical and nursing management
of:Scoliosis, Kyphosis,Lordosis
�� Congenital disorders: Congenital dislocation of hip(CDH),
Dislocation of patella, knee,
�� Varus and valgus deformities,
�� Deformities of digits,
�� Congenital torticollis.
�� Meningocele, meningomyelocele, spina bifida,
�� Chromosomal disorders.
�� Computer related deformities
VIII 5 Disorders of the spine
�� Intervertebral disc prolapse, Fracture of the spine
�� Low back disorder – Low back pain, PND, spinal stenosis,
spondylosis
IX 5 Nutritional/Metabolic and Endocrine Disorders
�� Causes, pathophysiology, clinical types, clinical features,
diagnosis, prognosis, medical surgical and nursing management
of:
• Rickets,
• Scurvy,
• Hyper vitaminosis A and D,
• Osteomalacia,
• Osteoporosis
• Paget’s disease,
• gout,
• Gigantism,
• Dwarfism,
• Acromegaly.
• Therapeutic diets for various orthopedic disorders
X 8 Neuro-Muscular Disorders:
�� Causes, pathophysiology, clinical types, clinical features,
diagnosis, prognosis, medical surgical and nursing management
of:
• Poliomyelitis, Cerebral Palsy
• Myasthenia gravis
• Spina bifida.
• Peripheral nerve lesion,
• Paraplegia, Hemiplegia, Quadriplegia.
• Muscular dystrophy
XI 8 Chronic/Degenerative Diseases of Joints and Autoimmune
Disorders:
�� Causes, pathophysiology, clinical types, clinical features,
diagnosis, prognosis – medical surgical and nursing management
of:
• Osteo Arthritis
• Rheumatoid Arthritis
• Ankylosing spondylitis.
• Spinal disorders.
• Systemic Lupus Erythematosus
XII 5 Orthopedic Disorders in Children:
�� General and special consideration on pediatric orthopedics
�� Genetic disorders
�� Congenital anomalies
�� Growth disorders
�� Genetic counseling
�� Nurses role in genetic counseling
XIII 5 Geriatric Problems
�� Geriatric population, types of disabilities, causes, treatment and
Management – Hospitalization, rest, physiotherapy, involvement of
family members, social opportunities.
�� Care at home – involvement of family and community, follow up
care and rehabilitation
XIV 6 Pharmacokinetics
�� Principles of drug administration
�� Analgesics and anti inflammatory agents
�� Antibiotics, Antiseptics,
�� Drugs used in orthopedics and neuromuscular disorders
�� Blood and blood components
�� Care of drugs and nurses role
XV 30 Nurses Role in Orthopedic Conditions
�� Gait analysis
�� Urodynamic studies
�� Prevention of physical deformities
�� Alteration of body temperature regulatory system and immune
systems
�� Immobilization – cast, splints, braces and tractions
�� Prevention and care of problems related to immobility
�� Altered sleep patterns
�� Impaired communication
�� Self care and activities of daily living
�� Bladder and bowel rehabilitation
�� Sensory function rehabilitation
�� Psychological reaction related to disabilities and disorders.
�� Coping of individual and family with disabilities and disorders
�� Maintaining sexuality
�� Spirituality – A rehabilitative prospective
Orthopedic Reconstructive Surgeries
�� Replacement surgeries – Hip, Knee, Shoulder
�� Spine surgeries
�� Grafts and flaps surgery
�� Deformity correction.
Physiotherapy
�� Concepts, Principles, purpose,
• Mobilization – Exercises: types, re-education in walking:
Crutch walking, wheel chair, Transfer techniques,
• Types of gaits: Non-weight bearing, partial weight bearing,
four point crutch, tripoid, walking with sticks, calipers
• Forms of therapies: Hydrotherapy, electrotherapy, wax bath,
heat therapy, ice, helio therapy, radiant heat,
• Chest physiotherapy
XVI 8 Rehabilitation
�� Principles of rehabilitation, definition, philosophy, process,
�� Various types of therapies
�� Special therapies and alternative therapies
�� Rehabilitation counseling
�� Preventive and restorative measures.
�� Community based rehabilitation (CBR)
�� Challenges in rehabilitation.
�� Role of the nurse in rehabilitation,
�� Legal and ethical issues in rehabilitation nursing
�� Occupational therapy
XVII 5 National Policies and Programmes
�� National programmes for rehabilitation of persons with disability -
National Institutes, artificial limbs manufacturing Corporation,
District Rehabilitation Centers and their schemes
�� Regional rehabilitation centers etc.
�� Public policy in rehabilitation nursing
�� The persons with disabilities act 1995,
�� Mental rehabilitation and Multiple disabilities act 1992,
�� The National Trust Rules 1999 and 2000
�� Rehabilitation Council of India
�� Legal and ethical aspects in orthopedic nursing
�� Rehabilitation health team and different categories of team
members.
XVIII 4 Quality assurance
�� Standards, Protocols, Policies, Procedures
�� Nursing audit
�� Staffing
�� Design of orthopedic, physiotherapy and rehabilitation unit
Practicals
1. Clinical practice in Orthopedic, physiotherapy and Rehabilitation
Units.
2. Application of tractions and plaster casts and removal of tractions and
plaster casts and other appliances.
3. Apply Theories and Nursing Process in the management of patients
with orthopedic conditions.
4. Provide various types of physical and rehabilitative therapies
5. Provide health education on related disease conditions.
6. Unit management and plan - designing
Clinical Experience
Total = 960 Hours
1 Week = 30 Hours
S. No. Deptt./Unit No. of Week Total Hours1 Orthopedic Ward 8 240 Hours
2 Orthopedic Operation theatre 4 120 Hours
3 Neurosurgical Ward 2 60 Hours
4 Orthopedic O.P.D. 4 120 Hours
5 Casualty/Emergency and Trauma 4 120 Hours
6 Rehabilitation Units 2 60 Hours
7 Physiotherapy Unit 4 120 Hours
8 Paediatric /paediatric surgery unit 2 60 Hours
9 Field Visit 2 60 Hours
Total 32 Weeks 960 Hours
Procedures Observed
1. X Ray
2. Ultrasound
3. MRI
4. C T Scan/bone scan
5. Arthroscopy
6. Electrothermally – assisted capsule shift or ETAC (Thermal
capsulorrhaphy)
7. Fluroscopy
8. Electromyography
9. Myelography
10. Discography
11. Others
Procedures Assisted
1. Blood Transfusion
2. IV cannulation and therapy
3. Ventilation
4. Various types of tractions
5. Orthopedic surgeries – Arthrocentesis, Arthroscopy, Bone lengthening,
Arthrodesis, grafting, Fractures fixation, reconstructive,
reimplantation, replantation, spinal decompression, transplantation of
bone, muscle or articular cartilage, autografting, allografting.
6. Injection – Intra articular, intra osseous.
7. Advance Life Support
Peocedures Performed
1. Interpretation of X ray films.
2. Application and removal of splints, casts, and braces.
3. Care of tractions – skin and skeletal traction, pin site care.
4. Cold therapy.
5. Heat therapy
6. Hydrotherapy
7. Therapeutic exercises
8. Use of TENS (Transcutaneous electrical nerve stimulation)
9. Techniques of transportation
10. Crutch walking, walkers, wheel chair.
11. Use of devices for activities of daily living and prevention of
deformities.
12. Administration of drugs: IV injection, IV cannulation, and Blood
transfusion.
13. Procedures for prevention of infections: disinfection and sterilization,
surveillance, fumigation.
14. Special skin/ part preparations for orthopedic surgeries.
15. Surgical dressings – Debridement.
16. Bladder and bowel training
Other Procedures
