Chapter 18 Flashcards
What are the four types of bones?
Short, long, flat and irregular
A small fluid- filled sac that provides a cushion at friction points in the joints
Bursa
A union of two or more bones; moves freely
joint
Striated muscles surrounded by a connective tissue sheath
Skeletal muscle
Fibrous tissue that connects muscle to bone
Tendon
Connect bone to cartilage
Ligament
Fibrous connective tissue; acts as a cushion
Cartilage
What are the functions of muscles?
Can stretch; can be stimulated to contract electrically or to extend elastically
What happens with your body as you age?
*Bone mass loss may lead to osteoporosis (more severe in woman)
*Loss of bone density predisposes the elderly to fractures
*Muscle cells are lost and replaced by fat cells
*Elasticity of muscle fibers is decreased, limiting flexibility
*Joint motion may decrease, limiting motion and mobility
What is the most common injury that health care workers get?
Lower back strain
How can injuries be prevented?
Proper body movement is essential to prevent injuries.
What are the benefits of core exercises as related to your back?
Core exercises can help keep your back healthy and strong. Core exercises train the muscles in your abdomen, pelvis, lower back, and hips to work together, leading to improved balance and stability.
What should you do if you have difficulty finding a staff person to help you?
It is always better to wait for help than to risk injury.
What are the two basic principles?
-Maintain correct anatomic position
-Change position frequently
What are the hazards of improper alignment and positioning
-Interference with circulation, which may lead to pressure ulcers
-Muscle cramps and possible contractures
-Fluid collection in the lungs
What are contractures?
Resistance to stretch in damaged muscle that pulls a joint into a fixed or “frozen” position
How can contractures be prevented?
Body positioning
What is shearing force?
Shearing is an applied force that causes a downward and forward pressure on the tissues beneath the skin. Shearing forces occur when a patient slides down in a chair, bedclothes are pulled from beneath the patient, or the patient is slid up to the head of the bed without lifting the body.
_____ Also known as decubitus ulcers, or bedsores
Pressure ulcers
What questions would be asked during the assessment of the standing patient’s body alignment?
Is the head centered and erect? Are the shoulders and hips parallel? Are the knees and ankles slightly flexed and parallel to the hips and shoulders? Do the arms hang comfortably at the patient’s side? Are the feet slightly apart to provide a base of support?
What is symmetry?
Equality in size, form, and arrangement of parts on the opposite sides of a plane; a mirror image
What are commonly used problem statements?
-Potential for injury
-Altered mobility
-Potential for altered skin integrity
What are some therapeutic exercise?
-Prevent injury and immobility
-Restore function of muscles, nerves, bones, and joints
-Prevent deformity and stimulate circulation
-Build tolerance and endurance
When moving a patient, it is important to use proper body mechanics. Which of the following is not a proper body mechanic?
A)Using your leg muscles
B)Keeping your feet together to provide stability for movement
C)Using smooth, coordinated movements instead of jerking or sudden movements
D)Keeping loads as well as your elbows close to the body
B)Keeping your feet together to provide stability for movement
Leann is teaching her patient’s husband how to lift his wife safely. Which of the following is true regarding lifting the elderly?
A)As the body ages, there is no change in posture.
B)There is usually an increase in muscle mass as we age.
C)Whatever items that could be lifted in your youth should be lifted in later years.
D)Joint motion may decrease, limiting mobility.
D)Joint motion may decrease, limiting mobility.
How can a nurse maintain a patient’s privacy during positioning?
Proper draping
Patient lying on back
Supine
Supine with HOB elevated 60 to 90 degrees
Fowler’s position
Supine with HOB elevated 30 to 60 degrees
Semi- fowler’s position
Supine with the HOB elevated 15 to 30 degrees
Low Fowler’s position
For what conditions or purposes are these positions used?
Supine =_____
Fowler’s, semi-Fowler’s, and low Fowler’s= _______
-Supine = after spinal surgery and after administering spinal anesthetics
-Fowler’s, semi-Fowler’s, and low Fowler’s = improve cardiac output/respiration, promote urinary and bowel elimination
Why is elevation of the knees above 15 degrees contraindicated in elderly and postoperative patients?
Often causes decreased circulation in lower extremities
What is the dorsal lithotomy position?
Patient lies on back, legs are separated, thighs are acutely flexed on abdomen and legs on thighs; buttocks brought to the edge of the bed or table
How is the distribution of weight in the Sims position different from the distribution in the side-lying position?
The distribution of weight is different from in the side-lying position because in the Sims position the weight is distributed over the anterior ileum, humerus, and clavicle.
What are the three-side lying lateral?
Patient lying on her side, Oblique side-lying position, sims position
What is prone position
Patient lying face down
What are the 6 positiong devices
1) Pillows
2)Boots or splints
3)Trochanter rolls
4)sandbags
5)hand rolls
6) trapeze bars, side rails, and bed boards
What is the procedure for logrolling a patient with a lift sheet?
When using a lift sheet, the nurse and preferably two assistants stand on opposite sides of a locked, flat bed at waist level. Leave a pillow under the patient’s head and lower the side rails. Place pillows, if needed, between the patient’s legs. All workers face the bed with one foot slightly in front of the other. Roll the lift sheet close to the patient’s body and, on the count of 3, lift the patient to one side of the bed, keeping the patient’s body in straight alignment. By lifting the patient to one side of the bed first, the patient should be centered in the bed after being logrolled. Position the tallest nurse on the far side of the bed, at the middle portion of the patient. The other two nurses are positioned one at the shoulders and neck and one at the legs and feet of the patient so that they can control movement of these parts. The nurse on the far side of the bed grasps the lift sheet. Again, hold the sheet as close to the patient’s body as possible, and on the count of 3, roll the patient in one smooth, coordinated, even motion with the body in straight alignment. Rearrange the pillow under the patient’s head and place any other positioning devices before lowering the bed and putting the call bell within the patient’s reach.
What is logrolling usually used?
For patients with injuries or surgery to the spine, and for patients who must avoid twisting.
How do nurses perform logrolling without a lift sheet?
Evenly space three nurses along one side of a locked, flat bed at waist level. One nurse supports, braces, and rolls the head, neck, and shoulder region as one unit; one supports and rolls the waist and hips; and the third supports and rolls the thighs and lower legs.
Why does transferring a patient from a supine position to the chair require bedside dangling
The purpose of this is to accustom the body gradually to the position change.
What is the purpose of transfer or gait belt?
A transfer belt or gait belt should be used to ambulate or transfer the weak or unsteady patient. It is made of a tightly webbed canvas material and is very sturdy.
Dr. Tingle called the unit and asked the nurse to put his patient in Fowler’s position. Which of the following correctly describes Fowler’s position?
A)Place the patient on her back and elevate the head of the bed 30 to 60 degrees.
B)Place the patient on her back and elevate the head of the bed 60 to 90 degrees.
C)Place the patient on her back and place the feet in stirrups.
D)Place the patient in a side-lying position.
B)Place the patient on her back and elevate the head of the bed 60 to 90 degrees.
Dr. Tingle is now requesting you place his patient in the prone position. Which position best describes the prone position?
A)Place the patient on her back.
B)Place the patient on her back with knees bent.
C)Place the patient on her abdomen.
D)Place the patient on her abdomen with knees tucked in and elbows at a 90-degree angle on
C)Place the patient on her abdomen.
Which of the following is not a position device?
A)Pillows
B)Boots
C)Footboards
D)Blankets
D)Blankets
Also called body mechanism
Kinesiology
Arrangement in a straight line, brining a line into order
Alignment
Turn or change direction with your feet while remaining in a fixed place
Pivot
Walk
Ambulate
Tissue injuries that form from local interference with circulation
Pressure injuries
is a variation of the side-lying position
Sims position
Resistance to stretch in damaged muscle that pulls a joint into a fixed or “frozen” position
Contractures
Is an applied force that causes a downward and forward pressure on the tissues beneath the skin
Shearing force
Style of walking
Gait
Local death of tissue from disease or injury
Necrosis
Is achieved by having patients rest on their side
Side-lying or lateral position
The patient is lying face down
Prone position
is turning the patient as a single unit while maintaining straight body alignment at all times.
Logrolling
___ should be used to ambulate or transfer the weak or unsteady patient
Transfer belt or gait belt
Is the term used for the patient position of sitting on the side of the bed with the legs and feet over the side
Dangling
