Chapter 23: Musculoskeletal System Flashcards
Multiple health problems can be avoided with maintenance of an __ __.
active state
Maintaining physical activity can be a challenge in late life due to:
effects of aging and common chronic health conditions
there is a decline in ___ & ___ of muscle fibers, & a reduction in __ __
size & number
muscle mass
Aging also contributed to decreased ___ __ and a persons __ declines.
body strength
endurance
The connective tissue changes, resulting in reduced ___ of joints and muscles.
flexibility
Age-related reduction of muscle mass or function resulting from a reduction in protein synthesis & an increase in muscle protein degeneration
sarcopenia
Retirement is associated w/ __ __.
decreased activity
Sarcopenia can lead to __.
disability
Decline in walking speed or grip strength is seen in patients with ___.
sarcopenia
Downsizing home promotes less housework & further reduces ___.
activity
Cause of ___: disease, immobility, poor blood flow to muscles, decreased caloric intake, mitochondrial dysfunction, increase in proinflammatory cytokines, & decline in anabolic hormones
sarcopenia
All exercise programs should address what 3 things:
- cardiovascular endurance
- flexibility
- strength training
Health assessment includes __ and __ of exercise.
quality and quantity
You want to __ goals and make them __.
individualize
achievable
Maximum heart rate equation:
220-age (220 minus their age)
The maximum number that someone should reach during exercise.
Maximum heart rate
Target heart rate equation:
maximum heart rate x 75%
Target heart rate range:
65% to 80% of maximum heart rate
Age-related changes affect a person’s ____ to exercise
ability
Importance of assessment prior to starting a program & monitoring status during physical activity could include a ___ ___.
physician clearance
When exercising, you want to ___ exercise throughout the day.
pace
When exercising, you should begin ____ & then ___ over time.
gradually
increase
Patients should also __ after activity.
rest
Cognitive & emotional states can influence __ __.
physical activity
Inactivity can promote __ __ of immobility .
ill effects
Inactivity can result in ___.
deconditioning
__ __ is crucial when it comes to prevention of inactivity.
Public education
You enhance motivation by demonstrating ___.
interest
With activity, you want to avoid ____ people and assuming they can’t do a certain activity due to their age.
stereotyping
You may have to arrange ___ to and from activities.
transportation
For promotion of activity, you should do an assessment of what 4 things?
capacities, limitations, interests, & abilities
Well-balanced diet helps maintain the structure of ___ & ___
bones
muscles
Obesity places strain on the ___.
joints
Discomfort, disability, deformity, & functional impairment result from _____ disorders.
musculoskeletal
What is an assessment of the musculoskeletal system & functional abilities?
How is their walking ability, do they need devices to walk, etc.
How can you prevent musculoskeletal conditions?
adequate nutrition, avoid obesity, remain active, hydration
Aggressive intervention is used to minimize the impact of ___ ___.
functional impairment
What are some risk factors & potential causes for fractures? (3)
dizziness, change in center of gravity, postural changes
What’re the common sites of fractures? (3)
femur, neck, wrist (Colles’ fracture)
___ bones fracture more easily & heal at a slower rate.
Brittle
The potential for complications is associated with ___.
immobility
Interventions for fractures are aimed at ___.
prevention
___ should be suspected when an older adult falls or has trauma to their bones.
Fractures
T/F: The absence of typical signs of fracture guarantees no fracture present
FALSE
Treatment for fractures:
Immobility of the injured site
Progressive deterioration of joint cartilage with the formation of new bone at the joint surface.
Osteoarthritis
Osteoarthritis increases w/ age, mostly persons over ___ years or older, and occurs in more ___ than the other gender.
55
women
What is this pathophysiology of?
Joint changes & imbalance between matric metalloproteinase enzymes & tissue inhibitors of matrix metalloproteinase
osteoarthritis
Causes of osteoarthritis?
excessive use of joint, low vitamin D + C, trauma, obesity,, genetic factors.
Signs & symptoms of osteoarthritis:
Crepitation over the joints, boney nodules (Heberden nodes),
Nursing interventions for osteoarthritis:
- educate weight reduction (if its needed)
- nutritional benefits (maintaining a healthy diet, vitamin D and C supplements)
- exercise
- reduce fractures
A chronic inflammatory disorder that can affect more than just your joints. (the skin, eyes, lungs, heart and blood vessels, etc).
rheumatoid arthritis
Incidence of rheumatoid arthritis is mostly ___ years of age, and decreases after age of __, occurs more in __ & w/ __ history
20-40
65
women
family
Deformities & disability begin at an ___ age & peak during ___ age.
early
middle
Pathophysiology of __ __ is hypertrophied & edematous synovium. Projections of synovial tissue into joint cavity.
rheumatoid arthritis
Signs & symptoms: Subcutaneous nodules &/or bursae present over bony prominences, pain, redness, warm, stiffness,
rheumatoid arthritis
Most prevalent metabolic disease of the bone
osteoporosis
Risk factors for osteoporosis:
-Inactivity or immobility
Diseases: Cushing’s syndrome
-Reduction in anabolic sex hormones (decreased estrogen & androgen)
-Diet: calcium deficiency
-Drugs: Heparin, furosemide, thyroid supplements, antacids, corticosteroids, tetracycline
excessive glucocorticosteroids by adrenal gland
Cushing’s syndrome
Osteoporosis can cause __ __, and __.
kyphosis, spinal pain, & fractures
Osteoporosis is often ___.
asymptomatic
To diagnose osteoporosis, they do a __ __ scan. aka (DEXA)
bone density
To treat osteoporosis, you want a diet rich in __ and __.
protein & calcium.
Nursing interventions for osteoporosis:
education, avoid heavy lifting, ROM exercises & ambulation
Metabolic disorder in which excess uric acid accumulates in the blood
Gout
Pathophysiology of __: uric acid crystals deposit in & around joint
Gout
Signs/symptoms of gout?
Pain (severe), redness, swelling, warmth
Exacerbations & remissions of gout:
Exacerbations can last weeks-months, with long remissions between
Treatment for gout includes reducing sodium ___ w/ low purine diet and avoid ___.
urate
alcohol
Age-related reduction in __ __ of the foot.
fat padding
Common podiatric conditions:
Calluses (plantar keratoses) Corns (heloma) Bunions (hallux valgus) Hammer toe (digiti flexus) Plantar fasciitis Infections (onychomycosis; tinea pedis) Ingrown nails (onychocryptosis)
Degenerative changes cause __ pain
joint
__ pain affects independence & quality of life
Unrelieved
Nursing interventions to decrease pain essential in promoting optimal __, ___, and __ function.
physical, mental, & social
For musculoskeletal conditions, you want to promote __ and prevent __.
independence
injury