ch. 21 - musculoskeletal Flashcards
1
Q
- Bone mineral density decreases
- ROM of joints decreases
- Muscle cells are lost and not replaced
- Lean body mass decreases while adipose tissue increases
- Progressive loss of cartilage occurs
A
musculoskeletal changes in older adults
2
Q
- porous bone and is characterized by a low bone mass causing your bones to become brittle and frail, placing the patient more at risk for fractures.
- It is considered a silent disorder because a patient may never know they have this condition until they experience a fracture.
- loss of bone mineral density accelerates after menopause
men can have this condition too, but women are most likely at risk
A
osteoporosis
3
Q
- Back pain that occurs after lifting, bending, or stooping
- Back pain that increases with palpation
- Pelvic or hip pain with weight bearing activities
- Problems with balance
- Decline in height from vertebral compression
- Kyphosis of the dorsal spine, also called a “Dowager’s hump”
A
assessment findings of osteoporosis
4
Q
- condition where bone mineral density is lost but it is not as severe as in osteoporosis
- most likely at risk for developing osteoporosis
A
osteopenia
5
Q
- softening of the bones.
- A lack of vitamin D is the most significant risk factor.
- Encourage the patient to get sunlight exposure, increase food sources of vitamin D (dairy and fish).
- This patient can have pain in the pelvis region, lower back, and legs. We are worried about their ability to ambulate and preventing fractures
A
osteomalacia
6
Q
- low calcium and vitamin D intake
- Long term use of steroid medications and anticonvulsants
- inactive lifestyle (leads to weaker bones)
- excessive alcohol intake (increases risk for bone loss and fractures)
- smoking (affects the bones, heart, and lungs), it decreases the body’s absorption of calcium
- hormone levels (low testosterone in men, low estrogen in women)
- underweight (anorexia)
A
modifiable risk factors of osteoporosis
7
Q
- Thin (small framed) females
- Older adults (post-menopausal women)
- Caucasian, Asian, African American, Hispanic ethnicity
- Family history
A
non-modifiable risk factors of osteoporosis
8
Q
- Diagnosis is based on a DEXA scan & comprehensive assessment
- BMD tests can:
Detect low bone density before a fracture occurs.
Confirm a diagnosis of osteoporosis if you already have one or more fractures.
Predict your chances of fracturing in the future.
Determine your rate of bone loss, and monitor the effects of treatment if the test is conducted at intervals of a year or more.
A
diagnosis of osteoporosis
9
Q
dorsal spine, a.k.a. “Dowager’s hump”
A
kyphosis
10
Q
- Perform weight bearing activity such as brisk walking with light weights
performing weight bearing exercises helps to maintain bone mass by applying mechanical force to the spine and long bones (walking, hiking, jogging, climbing stairs, playing tennis, dancing, using weight machines) - Increase intake of calcium and vitamin D
- Smoking cessation
- Avoid heavy drinking of alcohol
- Avoid excessive caffeine
- Fall prevention! (We are most concerned about preventing fractures!!!)
- Perform a home safety inspection
A
education for osteoporosis
11
Q
- increase intake of calcium rich foods
- calcium and vitamin D supplements
- get exposure to sunlight for vitamin D
- Bisphosphonate meds
A
treatment for osteoporosis
12
Q
- Use a cane or walker for added stability if needed.
- Wear rubber-soled shoes for traction.
- Walk on grass when sidewalks are slippery.
- In winter, carry salt or kitty litter to sprinkle on slippery sidewalks.
A
home safety outdoors
13
Q
- rooms MUST be free of clutter, ESPECIALLY on floors.
- floor surfaces = smooth BUT not slippery
- supportive, low-heeled shoes must be worn even when at home.
- socks, stockings, or slippers must be avoided when walking (the 3 Ss)
- carpets and area rugs = skid-proof backing or tacked to the floor.
- stairwells should be well lit and stairs have handrails on both sides
- grab bars = installed on bathroom walls near the tub, shower, and toilet
- rubber bathmat must be used in the shower or tub.
- flashlight with fresh batteries must be kept beside your bed.
- If using a step stool for hard-to-reach areas, use a sturdy one with a handrail and wide steps.
- ceiling fixtures must be added to rooms lit by lamps.
- cordless phone is considered for purchase so that there wouldn’t be no rush answering the phone when it rings, or if you fall, you can call for help
- highly polished floors = be very cautious and careful b/c they can become slick and dangerous when wet.
A
home safety indoors
14
Q
- pt should hold cane on the stronger side of the body
- place it forward 6-10 inches and move his weaker leg forward to the cane
distributing his weight between the cane and the stronger leg - then he should move the stronger leg forward beyond the cane and distribute his weight
between the cane and weaker leg
A
canes
15
Q
- The nurse should stand adjacent to the client on the AFFECTED (weak) side
- Instruct the client to put all 4 points of the walker FLAT on the floor BEFORE putting weight on the hand pieces
- Instruct the client to move the walker forward, followed by the affected or weaker foot and then the unaffected foot
A
walker
