Mobility Flashcards
The nurse is conducting health screening for osteoporosis. Which client is at greatest risk of developing this problem?
- A 25-year-old woman who runs
- A 36-year-old man who has asthma
- A 70-year-old man who consumes excess alcohol
- A sedentary 65-year-old woman who smokes cigarettes
- A sedentary 65-year-old woman who smokes cigarettes
Rationale:
Risk factors for osteoporosis include female gender, being postmenopausal, advanced age, a low-calcium diet, excessive alcohol intake, being sedentary, and smoking cigarettes. Long-term use of corticosteroids, anticonvulsants, and/or furosemide also increases the risk.
A client is complaining of low back pain that radiates down the left posterior thigh. The nurse should ask the client if the pain is worsened or aggravated by which factor?
- Bed rest
- Ibuprofen
- Bending or lifting
- Application of heat
- Bending or lifting
Rationale:
Low back pain that radiates down 1 leg (sciatica) is consistent with herniated lumbar disk. The nurse assesses the client to see whether the pain is aggravated by events that increase intraspinal pressure, such as bending, lifting, sneezing, and coughing, or by lifting the leg straight up while supine (straight leg-raising test). Bed rest, heat (or sometimes ice), and nonsteroidal antiinflammatory drugs (NSAIDs) usually relieve back pain.
The nurse is caring for a pediatric client who just arrived at the emergency department with an extremity fracture. The nurse uses the 5 “Ps” to assess the extent of the client’s injury. What are some of the 5 “Ps”? Select all that apply.
- Pallor
- Pain and point of tenderness
- Paralysis distal to the fracture site
- Pulses proximal to the fracture site
- Sensation distal to the fracture site
- Pallor
- Pain and point of tenderness
- Paralysis distal to the fracture site
- Sensation distal to the fracture site
Rationale:
If a child sustains a fracture, the extent of the injury is immediately assessed using the 5 “P’s”–pain and point of tenderness, pulses distal (not proximal) to the fracture site, pallor, paresthesia (sensation) distal to the fracture site, and paralysis (movement distal to fracture site).
Ms. Yong shares with the nurse that she often experiences knee pain. The nurse asks Ms. Tong about other common joint symptoms. On which symptoms should the nurse focus? (Select all that apply.)
- Stiffness
- Swelling
- Cramping
- Numbness
- Warmth
- Stiffness
- Swelling
- Warmth
Rationale:
Stiffness, swelling and warmth are common joint symptoms related to acute inflammation or arthritis.
When observing the client from the side, the nurse observes a slightly convex thoracic curve and a slightly concave lumbar curve. What action should the nurse take in response to these findings?
- Ask the client how long she as had a “Dowager’s hump.”
- Record these symptoms of osteoporosis in the client’s chart.
- Document the normal spinal curvature on the assessment form.
- Note the client’s poor posture as a possible cause of her back pain.
- Document the normal spinal curvature on the assessment form.
Rationale:
The curvatures observed are normal spinal curvatures, so no action is needed other than documentation of the finding.
What are joints (or articulations)?
The place of union of two or more bones.
What is cartilage?
Avascular, resilient, and stable connective tissue that cushions the bones and gives a smooth surface to facilitate movement.
What are ligaments?
Fibrous bands running directly from one bone to another bone that strengthen the joint and help prevent movement in undesirable directions.
What are tendons?
Strong fibrous cord that attaches skeletal muscle to bone.
Flexion vs. Extension
Bending a limb at a joint vs. straightening a limb at a joint.
Abduction vs. Adduction
Moving a limb away from the midline of the body vs. moving a limb toward the midline of the body.
Pronation vs. Supination
Turning the forearm so the palm is down vs. turning the forearm so the palm is up.
What is a functional assessment?
Screens the safety of independent living, the need for home health services, and quality of life.
How do you perform the Ortolani maneuver?
With the infant supine, flex the knees holding your thumbs on the inner midthighs and your fingers outside on the hips touching the greater trochanters. Adduct the legs until your thumbs touch. Then gently lift and abduct, moving the knees apart and down so their lateral aspects touch the table.
Positive Ortolani sign: hip instability; feels like a clunk as the head of the femur pops back into place.
Negative Ortolani sign: smooth with no sound.
While examining a child’s posture, the nurse notes a pronounced protuberant abdomen and pronounced lumbar curve. How would the nurse document?
- Kyphosis, normal curvature for age range.
- Scoliosis, abnormal curvature for age range.
- Lordosis, normal curvature for age range.
- Lordosis, abnormal curvature for age range.
- Lordosis, normal curvature for age range.
Rationale:
From the side lordosis is common throughout childhood.
