Assessment of Musculoskeletal System Flashcards
Decreased bone density (osteopenia)
Increased bone prominence
Kyphotic posture - can lead to a widened gain and shift in the center of gravity
Cartilage degeneration
Decreased ROM
Slowed movement
Musculoskeletal changes with aging
Imp because safety - decrease risk fractures
Fall more likely bones break
More weight-bearing exercises - increases bone density
Decreased bone density (osteopenia) - Musculoskeletal changes with aging
Increased risk for pressure ulcers
Precautions - skin things and turning frequently
Increased bone prominence - Musculoskeletal changes with aging
Increased risk for falling and injury
Leaned over posture
Do proper body mechanics
Kyphotic posture - can lead to a widened gain and shift in the center of gravity - Musculoskeletal changes with aging
Wear and tear - less cartilage
Moist heat - increase blood flow and decrease pain
Cartilage degeneration - Musculoskeletal changes with aging
Assess safety; how IADLs and ADLS
Decreased ROM - Musculoskeletal changes with aging
Be patient and do not rush
Slowed movement - Musculoskeletal changes with aging
Patient - lifestyle, how get around, exercise
Nutrition - Ca and vitamin D: decreased bone density; protein - keep muscle mass; overeating
Family and genetic risk - bone cancers and osteoporosis
Current health problems - pain (common) and weakness (issues getting around)
Assessment: history
Muscle strength and Range of motion
Observe patient’s posture and gait
Mobility
Assessment: Physical Assessment
Assess for crepitus (grating sound in joints with movement) - limited ROM - is diminished as age but want check
Feelings sponginess if effusion in joint
Muscle strength and Range of motion
Assess balance, steadiness, symmetry of stride (limping) and ease and length of stride (shuffle) - smooth
Observe patient’s posture and gait
Assess need for ambulatory devices
Asses ability to perform ADL’s and IADLS
Mobility
Increases: bone cancer, Paget’s disease, healing bone fracture
Decreases: osteoporosis, osteomalacia
Gen Decreased in older adults
Serum calcium (9.0-10.5)
Increases: healing bone fractures, bone tumors, acromegaly
Decreases: osteomalacia
Gen Decreased in older adults
Serum phosphate (3.0-4.5)
Increases: bone cancer, Paget’s disease, osteomalacia
Slightly increased in older adults
Alkaline phosphatase ALP (30-120)
Standard x-rays-can see bone density, alignment bones, and swelling in joints - fracture
Myelography-inject contrast media into subarachnoid space in spine - see if issues in vertebral column
Arthrogram-x-ray of joint after contrast media or air injected
CT
Radiography
Bone scan-radioactive material injected and entire skeleton is viewed
Gallium and thallium scans-another type of scan with use of radioactive injection; more time
Inject then do scan
No precautions before/after
Nuclear scans
Better diagnostic tool for joints, soft tissue and bony tumors
Go-to for MS probs
MRI
Used for soft tissue, traumatic joint injuries, and osteomyelitis
Ultrasonography
Bone or muscle
Suspect cancers/presence of weakness
Biopsies
Not commonly used today
Used to evaluate diffuse or localized muscle weakness
Usually accompanied by nerve conduction studies for determining the electrical potential generated in an individual muscle - see nerve innervation of muscle
May cause temporary discomfort when subjected to episodes of electrical current
Mild sedation is prescribed for selected patients
Skeletal muscle relaxants may be held several days prior to procedure - testing func of muscle
Electromyography (EMG)
May be used as a diagnostic test or surgical procedure
Fiberoptic tube inserted into a joint for direct visualization or surgical repair - see and do diagnostic tests
Nursing care after procedure:
Arthroscopy
Assess neurovascular status of the affected limb every hour or according to protocol - perfusion
Monitor and document distal pulses, warmth, color, capillary refill, pain, movement, and sensation
Mild analgesic or opioid (not often), follow orders for activity, ice for 24 hours, elevation of extremity for 12 to 24 hours
Observe for complications which may include swelling, increased joint pain, thrombophlebitis, infection - diminished circ: clot
Nursing care after procedure: - Arthroscopy