Activity, Exercise, and Musculoskeletal Assessment Flashcards
Elevates mood and attitude.
Enables physical fitness.
Helps one to quit smoking and stay tobacco-free.
Boosts energy levels.
Helps in the management of stress.
Promotes a better quality of sleep.
Improves self-image and self-confidence.
physical activity
is the physiological changes that occur from periods of inactivity and patients who are hospitalized are at increased risk for this because they are less active.
deconditioning
describes the coordinated efforts of the musculoskeletal and nervous systems.
body mechanics
similar to posture, refers to the positioning of joints, tendons, ligaments, and muscles. If a patient has good body alignment, their center of gravity is stable. This reduces strain on musculoskeletal structures, promotes comfort, and contributes to balance and energy conservation.
body alignment
is required for maintaining position and for movement. Diseases, injury, pain, physical development, life changes, and many medications can compromise balance. Poor balance can compromise mobility, physical safety, and can create a fear of falling that reduces activity.
balance
Patients can fall if their center of gravity is unbalanced, because of the gravitational pull on their weight. To lift safely, you must overcome the weight of the object and know its center of gravity. People’s center of gravity is not directly center of their body. It is usually midline at 55% to 57% of their standing height.
gravity
is a force that occurs in a direction to oppose movement. The greater the surface area of an object being moved, the greater the ______
friction
. When friction is exerted against the skin, while the skin remains stationary and the bony structures move, it is called _____
shear
This can damage underlying blood vessels and tissue, causing decreased blood flow and pressure injuries
shear
Using full body slings and mechanical lifts can prevent ______ ______, as well as protect healthcare workers from injury.
friction and shear
are a region where two bones connect.
joints
are elastic, they bind joints and connect bones and cartilage.
ligament
connect muscle to bone and are strong, flexible, and inelastic.
tendons
is nonvascular supporting connective tissue that sustains weight and serves as a shock absorber between articulating bones.
cartilage
isometric
maximum HR formula
maximum HR formula
220-age
makes us aware of our body’s position
proprioception
physical activity
is a subset of PA that is planned, structured, and repetitive and has a final or an intermediate objective, such as the improvement or maintenance of physical fitness.
physical excercise
cause muscle contraction and change the muscle length
isotonic
Increase muscle mass, tone, and strength; promotes osteoblastic activity to strengthen bones; enhance circulatory and respiratory function.
isotonic exercise
tightening or tensing of the muscles without moving the body parts
isometric excercise
Not ideal for patients who do not tolerate increased activity
isometric exercise
Increase muscle mass, tone, and strength; increase circulation to that body part and osteoblastic activity.
isometric exercise
contracting a muscle while pushing against a stationary object or resisting the movement of an object. (push-ups). Promote muscle strength and osteoblastic activity.
resistive isometric exercise
t/f: face direction of movement
true
t/f: Leverage, rolling, turning, or pivoting require less work than lifting.
true
what does SPHM stand for?
safe patient handling and mobility
Evidence-based research has shown that__________ interventions significantly reduce overexertion injuries by replacing manual patient handling with safer methods guided by ergonomics
SPHM
is the design of work tasks to best suite the capabilities of the workers.
ergonomics
includes: standardized assessment tools to identify a patient’s mobility level;
an ergonomics assessment of patient rooms and health care environments;
Assessment algorithms to select the right equipment and number of staff for each patient handling/mobility task;
Unit peer leaders who act as patient handling experts and staff trainers;
Safety huddles to share safety information with staff and a minimal lift policy.
SPHM
They also improve patient outcomes with fewer falls, skin tears, and pressure injuries occurring.
SPHM techniques
____________ lack the coordination, strength, and stability to sit or stand
newborns
they grow and develop their bones and muscles, and can support their weight, sit, stand, then walk.
infants
still have an awkward posture with a swayback and larger abdomen
Toddlers
the musculoskeletal system continues to grow and develop, allowing better coordination for fine motor skills.
third year to adolescence
growth is sporadic, which can make them appear awkward and uncoordinated.
adolescents
should have full musculoskeletal function and the ability to carry out ADLs and physical exercise.
middle aged adults
may experience bone loss, walk more slowly and incorrectly, and appear less coordinated. Many are afraid of falling.
older adults
t/f: consider the pt’s knowledge of exercisea and activity, their values and beliefs about exercise and health, barriers to activity and exercise andcurrent exercise behaviros or habits
true
with work, people often don’t have the time to exercise. Some employers will provide exercise opportunities by doing things like installing on-site walking tracks.
environmental factors
t/f: Children today are less active, but many schools have been good with providing fitness opportunities and encouraging exercise.
Communities may have fewer or more facilities and programs for access to fitness and exercise
true
t/f: Patients are more likely to incorporate an exercise program if those around them are supportive.
Having a friend or significant other to exercise with.
Parents supporting their children’s physical activities by encouraging them, providing transportation to sporting events, and participating in family outings.
true
what are the five stages of change int he TTM model?
Precontemplation - Aware of the problem but do not intend to change their behavior in the next 6 months.
Contemplation - Aware of the need for change and intend to take action within 6 months but lack commitment.
Preparation - Have decided to take action in the immediate future (within the next month). Often have a plan.
Action - Have made specific changes in their life-styles within the past 6 months.
Maintenance - Have shown the desired behavior over 6 months and are working to prevent relapse.
Aware of the problem but do not intend to change their behavior in the next 6 months.
Precontemplation
Aware of the need for change and intend to take action within 6 months but lack commitment.
contemplation
Have decided to take action in the immediate future (within the next month). Often have a plan.
preparation
Have made specific changes in their life-styles within the past 6 months.
action
Have shown the desired behavior over 6 months and are working to prevent relapse.
maintenance
Access to facilities or a public park and walking area? How much time do they believe they have to exercise during the day? Do they have social support?
assess socioeconmonic factors
This will include aspects of the musculoskeletal assessment that we will be talking about today. Review the medical record for any conditions that may affect their ability to be mobile and active, or that affects their body alignment.
physical health assessment
Try to help the patient be at ease so that they will display their normal body positioning.
assess body alignment
Note whether they can sit upright in bed or in a chair. Allow them to use the siderails of the bed, if present.
Don’t just take their word for it that they can stand. Let them use their assistive devices if they are typically used. They should be able to raise their buttocks off the bed and hold for a count of five.
assess their ability to sit and stand
t/f: determine the patient preferred form of exercise level of intensity and frequency
true
should be = 2 hours and 30 minutes of moderate intensity _______per week, such as brisk walking
aerobic exercise
they should have ______ or more days/week of muscle strengthening exercises for all muscle groups.
2
is the type and amount of exercise or work a person can do without undue exertion or injury. Observe patients after they perform ADLs, ambulate, or sit up in a chair for several hours.
Look for difficulty breathing, assess heart rate and blood pressure. Compare to baseline rates at rest.
activity tolerance
what is the target H formula?
(max HR)(0.6) and (max HR)(0.9)
how much time do you warm up and cool down for?
5, 10 minutes
prevent deconditioning?
stretching excercises,
how soon to you admin pain med before exercise?
30 minutes
what do you want to do with your feet while helpin them fall?
feet apart to provide a broad base of support
The ______is the only one who knows if exercise has been beneficial and effective for them.
patient
When the expected outcomes are not met, explore the reason why so that you can adjust the plan with them accordingly.
which side do you stand on ?
the unaffected side
know patient level of mobility
assess patient risks for activiy intolerance
mentally review transfer steps before beginning
stand on unafffected side
determine transfer equipment needed
raise eds side rail on opposite side
arrange equipment
valuate for correct body allignment
understand equipment before starting
safety guidelines for nusing skills
You will be assessing the patient’s range of motion, muscle strength and tone, and joint and muscle condition.
muskuloskeletal assessment
musko skeletal assessment is Especially important when the patient _____________________
reports pain or a loss of joint or muscle function.
t/f:Ask the patient if they have had any history of bone, joint, or muscle problems, what their normal activity pattern is, and about their ability to perform their activities of daily living.
true
You want to do this discretely, so that they a patient is unaware, or it will change the natural way they ____
walk. assess their gait
arms swinging freely at the sides, with the head leading the body
normal
often walk with smaller steps and a wider base of support
older adults
Observe while they are standing, from their side, behind, and while facing them.
posture
upright with the hips and shoulders aligned. An even contour of the shoulders, level of scapulae, and iliac crests. The head should upright and aligned center. The extremities should be symmetrical
normal standing posture
tend to have a stooped posture with hips/knees slightly flexed and arms bent at the elbows.
older adults
increase in lumbar spine curvature.
lordosis (swayback)
exaggerated posterior curve of the thoracic spine.
kyphosis (hunchback)
lateral curve of the spine
scoliosis
loss of bone mass and bone tissue
decrease in heigh
bone fractures associated
consider risk factors
osteoporosis
Systemic skeletal condition, where the bone mass decreases, and the bone tissue deteriorates. This makes the bones fragile, leading to fractures.
osteoporosis
A loss in height is usually the first clinical sign of this disease
osteoporosis
women, over the age of 50, have not had children, enter menopause before age 45. Having a family hx of osteoporosis, being smaller, or thinner.
uncontrollable osteoporosis
Poor diet (low calcium, vitamin D, fruits/vegetables; high protein, caffeine, and sodium), inactive lifestyle, smoking, drinking too much alcohol, losing weight, long-term use of some medications
(antiseizure, chemotherapy).
controllable osteoporosis
feels soft and boggy when palpated.
atrophied muscle (reduced size
where the patient independently moves their joints, passive, where you move the joint for them, or active assistive, where the patient moves their joint with some assistance.
range of motion (includes active range of motion)
ask the patient to relax and you passively move the extremities
passive ROM
during this exercise, you do not force the joint into a painful position
passive ROM
extremities through their ROM. Do not force the joint into a painful position. Be familiar with the normal range of each joint. T
Noted as the slight muscular resistance felt as you move a relaxed extremity passively through the Range of Motion.
muscle tone
there should be just a slight resistance to movement.
normal muscle tone
there will be considerable resistance with any sudden passive movement of a joint.
hypertonicity muscle tone
the muscle feels flabby, and the extremity hangs loosely to gravity.
hypotonicity
Have the patient perform maneuvers to demonstrate strength in major muscle groups. See Table 30.33 in your books (page 580). You will gradually be increasing resistance against their muscle flexion.
VolunteerElbow pull down on forearm as pt attempts to flex. Then as the forearm is flexed, apply pressure against the forearm as they try to straighten it.
Hip With pt sitting, apply downward pressure to thigh and ask them to raise their leg up. Then, with their leg flexed, hold their shin and ask the patient to straighten their leg.
Hands Have the patient squeeze your fingers with their hands, bilaterally.
Feet Place your hand against the bottom of the patient’s foot and ask them to press down, like they are pressing on the gas in their car.
muscle strength
loss of bone mass and bone tissue
decrease in heigh
bone fractures associated
consider risk factors
osteoporosis
