Module 5 Flashcards
Moving a body part away from the midline of the body
abduction
Moving a body part toward the mid-line of the body
adduction
The surgical removal of part or all of a body part
amputation
A general term that refers to inflammation of the joints
arthritis
Weakening or wasting away of muscles
Atrophy
Rigid connective tissues that make up the skeleton, lend support to body structures, allow the body to move, and protect the organs
bones
Tiny sacs of fluid that are located near joints and help reduce friction
bursae
A condition in which the bursae become inflamed and painful
bursitis
The protective substance that covers the ends of bones and makes up the discs that are found between vertebrae
carilage
bending a body part
flexion
a broken bone
fracture
a doctors order stating that a person has the ability to support full body weight on both legs and has no weightbearing limitations
full weight-bearing (FWB)
The points where two bones meet; provide movement and flexibility
joints
strong bands of fibrous connective tissue that connect bones or cartilage and support the joints and joint movement
ligaments
groups of tissues that contract and relax, allowing motion, supporting the body, protecting organs, and creating heat
muscles
an inherited, progressive disease that causes a gradual wasting away of muscle, resulting in weakness and deformity
muscular dystrophy
a doctors order stating that a person is unable to touch the floor or support any body weight on one or both legs
non-weight-bearing (NWB)
a type of arthritis that usually affects weight-bearing joints, especially the hips and knees; also called degenerative joint disease
osteoarthritis
A condition in which the bones have reduced density, but not enough to be classified as osteoporosis
osteopenia
a condition in which the bones become brittle and weak, causing them to break easily
osteoporosis
A doctor’s order stating that a person is able to support some body weight on one or both legs
partial weight-bearing (PWB)
Pain in a limb (or extremity) that has been amputated
phantom limb pain
warmth, itching, or tingling from a body part that has been amputated
phantom sensation
an artificial device that replaces a body part, such as an eye, hip, arm, leg, tooth, or heart valve; used to help improve function and /or appearance
prosthesis
a type of arthritis in which joints become red, swollen, and very painful; movement is restricted and deformities of the hands are common
rheumatoid arthritis
a bandage or piece of material that is suspended from the neck for the purpose of holding and supporting a forearm
sling
tough fibrous bands that connect muscle to bone
tendons
a surgical replacement of the head of the femur (long bone of the leg) and the socket it fits into where it joins the hip with artificial materials
total hip replacement (THR)
a surgical replacement of a damaged or painful knee with artificial materials
total knee replacement (TKR)
A condition in which the macula degenerates, gradually causing central vision loss
age-related macular degeneration (AMD)
the state of being excited, restless, or troubled
agitated
A progressive, degenerative, and incurable disease that causes proteins to build up in and around nerve cells, which results in memory loss, cognitive impairment, and behavioral changes
Alzheimer’s disease (AD)
A type of mental health disorder that causes a person to have mood swings and changes in energy levels and the ability to function
bipolar disorder
the part of the nervous system housed in the skull that is responsible for motor activity, memory, thought, speech, and intelligence, along with regulation of vital functions, such as heart rate, blood pressure, and breathing
brain
mental or physical exhaustion due to a prolonged period of stress and frustration
burnout
a condition in which the lens of the eye becomes cloudy, causing vision loss
cataract
reacting to something in an unreasonable, exaggerated way
catastrophic reaction
part of the nervous system made up of the brain and spinal cord
central nervous system
a condition caused when the blood supply to the brain is cut off suddenly by a clot or a ruptured blood vessel; also called stroke
cerebrovascular accident (CVA)
the abiity to think clearly and logically
cognition
a type of psychotherapy that is usually short-term and focuses on skills and solutions that a person can use to modify negative thinking and behavior patterns; often used to treat anxiety disorders
cognitive behavioral therapy (CBT)
a head injury that occurs from a banging movement of the brain against the skull
concussion
a belief in something that is not true or is out of touch with reality
delusion
a serious, progressive loss of mental abilities such as thinking, remembering, reasoning, and communicating
dementia
any behavior that disturbs others
disruptive behavior
in medicine, when a person with Alzheimer’s disease wanders away from a protected area and does not return on his own
elope
a disorder that causes recurring seizures
epilepsy
the ability to see distant objects more clearly than objects that are near; also called hyperopia
farsightedness
a condition in which the pressure in the eye increases, damaging the optic nerve and causing blindness
glaucoma
seeing, hearing, smelling, tasting, or feeling things that are not there
hallucinations
a small device placed in the ear that amplifies sound
hearing aid
loss of vision in one-half of the visual field, due to CVA, tumor, or trauma
hemianopsia
collecting and putting things away in a guarded way
hoarding
a way to improve or change an action or development
intervention
uable to be reversed or returned to the original state
irreversible
unable to be reversed or returned to the original state
irreversible
a disorder of the inner ear caused by a buildup of fluid, which causes vertigo, hearing loss, tinnitus (ringing in the ear), and pain or pressure
meniere’s disease
the normal functioning of emotional and intellectual abilities
mental health
a disorder that disrupts a person’s ability to function in the family, home, or community and often causes inappropriate behavior
mental health disorder
a progressive disease in which the protective covering of the nerves, spinal cord, and white matter of the brain breaks down over time; causes problems with balance, walking, and many other symptoms
multiple sclerosis (MS)
the ability to see objects that are near more clearly than distant objects; also called myopia
nearsightedness
the basic nerve cell of the nervous system
neuron
a type of mental health disorder characterized by intrusive, repetitive thoughts or behaviors that cause anxiety or stress
obsessive-compulsive disorder (OCD)
an infection in the middle ear that causes pain, pressure, fever, and reduced ability to hear
otitis media
walking back and forth in the same area
pacing
a type of mental health disorder characterized by panic attacks, which are repeated episodes of intense fear, along with physical symptoms such as rapid heartbeat, dizziness, chest pain, shortness of breath, and an upset stomach
panic disorder
the loss of function of the lower body and legs
paraplegia
a progressive disease that causes a portion of the brain to degenerate; causes rigid muscles, shuffling gait, pill-rolling, mask-like face, and tremors
Parkinson’s disease
part of the nervous system made up of the nerves that extend throughout the body and connect to the spinal cord
peripheral nervous system
the repetition of words, phrases, questions, or actions
perseveration
an intense, irrational fear of or anxiety about an object, place or situation
phobia
a type of mental health disorder caused by witnessing or experiencing a traumatic event
posttraumatic stress disorder (PTSD)
something that continually gets worse or deteriorates
progressive
a method of treating mental health disorders that involves talking about one’s problems with mental health professionals
psychotherapy
the loss of function of the legs, trunk, and arms
quadriplegia
type of therapy that encourages people with Alzheimer’s disease to remember and talk about the past
reminiscence therapy
type of group therapy that promotes self-esteem, self-awareness, and socialization for people with Alzheimer’s disease
motivation therapy
going through items that belong to other people
rummaging
a type of mental health disorder that may involve acute episodes; affects a person’s ability to think, communicate, make decisions, and understand reality
schizophrenia
a type of mental health disorder characterized by excessive anxiety about social situations; also called social phobia
social anxiety disorder
the part of the nervous system in side the vertebral canal that conducts messages between the brain and the body and controls spinal reflexes
spinal cord
the repeated use of legal or illegal substances in a way that is harmful to oneself or others
substance abuse
a condition in which a person becomes restless and agitated in the late afternoon, evening, or night
sundowning
a situation that leads to agitation
trigger
giving value to or approving
validating
a type of therapy that lets people with Alzheimer’s disease believe they are living in the past or in imaginary circumstances
validation therapy
forceful actions that include attacking, hitting, or threatening someone
violence
walking aimlessly around the facility or facility grounds
wandering
the inhalation of food, fluid, or foreign material into the lungs
aspiration
weakening or wasting away of muscles
atrophy
the way the parts of the body work together when a person moves
body mechanics
medications used to control a person’s mood or behavior
chemical restraint
the process of burning
combustion
the permanent and painful shortening of a muscle, tendon, or ligament that can restrict movement
contracture
blue or pale skin and/or mucous membranes due to decreased oxygen in the blood
cyanosis
difficulty swallowing
dysphagia
easily ignited and capable of burning quickly
flammable
collecting and putting things away in a guarded way
hoarding
the delivery of medication, nutrition, or fluids through a person’s vein
intravenous therapy
acronym for use of a fire extinguisher stands for
PASS-pull-aim-squeeze-sweep
any method, device, material, or equipment that restricts a person’s freedom of movement
physical restraint
acronym for steps taken during a fire; stands for
RACE-rescue-activate-contain-extinguish
a physical or chemical way to restrict voluntary movement or behavior
restraint
measures used in place of a restraint or that reduce the need for a restraint
restraint alternatives
an environment in which restraints are not kept or used for any reason
restraint-free care
sheet that provides information on the sage use and hazards of chemicals, as well as emergency steps to take in the event chemicals are splashed, sprayed, or ingested
Safety Data Sheet (SDS)
burns caused by hot liquids
scalds
the stoppage of breathing from a lack of oxygen or excess of carbon dioxide in the body; may result in unconsciousness or death
suffocation
the act of moving or walking, with or without an assistive device
ambulation
to sit up with the legs hanging over the side of the bed in order to regain balance
dangle
the science of designing equipment, areas, and tasks to make them safer and to suit the worker’s abilities
ergonomics
semi-sitting body position in which a person’s head and shoulders are elevated 45 to 60 degrees
fowler’s
body position in which a person is lying on either side
lateral
moving a person as a unit, without disturbing the alignment of the body
logrolling
special equipment used to lift and move or lift and weigh a person; also called hydraulic lift
mechanical lift
the act of helping people into positions that promote comfort and health
positioning
the way a person holds and positions his body
posture
body position in which a person is lying on his stomach, or front side of the body
prone
rubbing or friction resulting from the skin moving one way and the bone underneath it remaining fixed or moving in the opposite direction
shearing
moving a body part away from the midline of the body
abduction
body position in which a person is lying on his left side with the upper knee flexed and raised toward the chest
Sims
body position in which a person is lying flat on his back
surpine
a belt made of canvas or other heavy material used to help people who are weak, unsteady, or uncoordinated to stand, sit, or walk
transfer belt
Exercises to put a joint through its full arc of motion that are done by a resident with some assistance from a staff member
active assisted range of motion (AAROM)
Exercise to put a joint through its full arc of motion that are done by a resident himself, without help
active range of motion (AROM)
moving a body part toward the midline of the body
adduction
special equipment that helps a person who is ill or disabled perform activities of daily living
assistive devices
bending backward
dorsiflexion
straightening a body part
extension
bending a body part
flexion
weakness of muscles in the feet and ankles that interferes with the ability to flex the ankles and walk normally
foot drop
extending a joint beyond its normal range of motion
hyperextension
touching the thumb to any other finger
opposition
devices applied externally to limbs to support, protect, improve function, and prevent complication
orthotic devices
exercises to put a joint through its full arc of motion that are done by a staff member, without the resident’s help
passive range of motion (PROM)
doctors who specialize in rehabilitation
physiatrists
turning downward
pronation
exercises that put a joint through its full arc of motion
range of motion (ROM)
care that is managed by professionals to restore a person to the highest possible level of functioning after an illness or injury
rehabilitation
care given after rehabilitation to maintain a person’s function and increase independence
restorative care
turning the joint
rotation
turning upward
supination
AFO
Ankle Foot Orthotic
Osteoporosis
a condition in which bones loose density, cause them to be brittle and easily broken. caused by one or a combination of lack of calcium in diet, loss of estrogen, lack of exercise, reduced mobility, or agee. More common in women after menopause. signs and symptoms are low back pain, loss of height, fractures, and stooped posture
Osteoarthritis
also called degenerative arthritis or degenerative joint disease, is a condition in which the cushiony cartilage that rests btwn the bones and pads the ends of the bones begins to slowly erode. cartilage also loses elasticity. without the padding of the cartilage, the bones bein to rub together causing pain, redness, swelling, stiffness, and limited motion
Cartilage
ends of movable bones are covered with a flexible protective substance called cartilage that allows free joint movement. also found in the nose
Rolled bath blankets or towels that prevent the hip and leg from turning outward
Trochanter rolls
Something used to keep bed covers from resting on the resident’s legs and feet
Bed cradles or foot cradles
Keeps hips in proper position after hip surgery
Abduction pillows/wedges/splint/pads
Cloth-covered or rubber grips that keep the hand and/or fingers in a normal, natural position. Help prevent finger, hand, or wrist contractures
Handrolls
Stuffed devices made of terry cloth or a similar material that keep the fingers separated. They help prevent contractures of the thumb or fingers
Finger cushions
Padded protectors wrapped around elbows to help prevent rubbing, irritation, and pressure injuries
Elbow protectors
Devices applied externally to a limb for support and protection. They keep the joints in the correct position and are used to improve function and prevent complication, such as contractures.
Orthotic devices
What are the goals of range of motion exercises?
To decrease or prevent contractures and atrophy, increase circulation, and improve strength and movement
What do backrests, regular pillows or wedge shaped foam pillows do?
Provide support and comfort and maintain proper body alignment
Padded boards or pillow like devices placed against the residents feet to keep them properly aligned.
Footboards
Rehabilitation
Care used to restore a person to her highest level of functioning possible after an accident, illness, or injury. Revolves around person-centered care, holistic care.
Physiatrists
doctors who specialize i rehabilitation
Device used to help with balance. Must be able to bear some weight on both legs, even if one leg is weaker
Cane, cane held on stronger side
Type of device that is applied externally to a limb for support and protection
Orthotic device
When a resident used a cane, walker, or crutches, on which side should the NA stay?
Weaker side
Which type of cane has four rubber tipped feet
quad cane
A type of cane that is straight with a curced handle at the top and rubber tipped bottom to prevent slipping
C Cane
Residents who have paralysis are at a higher risk of injury from
Heat and Cold
Weakness on one side of the body
Hemiparesis
Inappropriate or unprovoked emotional responses
Emotional Lability
Warning sign of a cerebrovascular accident
Transient ischemic attack (TIA)
Tendency to ignore a weak or paralyzed side of the body
One-sided neglect
Difficulty communicating through speech or writing
Expressive aphasia
Caused by a blockage of the blood supply to the brain or a leaking or ruptured blood vessel with the brain
CVA Cerebrovascular accident
Difficulty understanding spoken or written words
Receptive aphasia
What controls and coordinates all body functions. Also senses and interprets information from outside the body
nervous system
two main parts of the nervous system are the
central nervous system and peripheral nervous system
the peripheral nervous system consists of
the cranial and spinal nerves
What makes up the central nervous system
the brain and spinal cord
What does the ear provide
balance and hearing
The nervous system provides
nerve message centers for heartbeat and respiration
What are the sense organs that are part of the nervous system
skin, tongue, nose, eyes, and body sense organs
Elastic bandages should be wrapped in what direction
Far to Near
what side to you start with when dressing with someone with an affected side
weaker side first
Disorder that causes pain, fatigue, sleep problems ,problems with thinking and memory, and depression
fibromyalgia syndrome
Method of treating fractures that keeps bones in the proper position by using weight and pulleys
Traction
5 parts of the musculoskeletal system
muscles, bones, joints, tendons, ligaments
an extra sheet placed on top of the bottom sheet to help prevent skin damage caused by shearing
draw sheet
when transferring a resident who has a stronger side and a weaker side the NA should
Move stronger side first
When assisting with eating of a resident recovering for CVA always place food in the
unaffected, stronger side of the mouth
how many bones in the body
206
fracture that is still in the body
closed fracture
how do you hold cast
with the palm of hand
leading cause of disability
stroke
3rd leading cause of death
stroke
what do you keep track of when someone is having a seizure
check time started and how long it continues
when do you need a person in SIM’s position
enima and rectal temp
how to reposition someone?
in a straight line
support weak body parts, prevent or correct deformities or prevent joint movement. Ankle, knee or back braces are common
Braces
carry messages to and from the brain from the rest of the body
Nerves
helps with conscious movement of the skeletal system
somatic nervous system (SNS)
What are the two parts of the autonomic nervous system (ANS)
conserve body’s energy and provide for relaxation of the body and activate the body’s fight-or-flight response.
Right hemisphere in the cerebrum controls
Movement and activities of left side
what controls reasoning, memory, consciousness, speech, vision, hearing, sensation.
Cerebral cortex
what controls Long term memory
Planning
Attention
Reward
Reaches maturity at age 25
Frontal lobe
What controls hearing, speech, auditory processing
Temporal lobe
What controls vision and visual processing
occipital lobe
What controls Spatial processing
Knowledge of numbers
Manipulation of objects
Integration of sensory information
Parietal lobe
what controls Planning, controlling and executing voluntary motor functions
Motor Cortex
what controls Perception
Body position
Temperature
Touch
Somatosensory cortex
What Controls and coordinates body movements
cerebellum
How many pairs of cranial nerves
12 pairs
How many spinal nerves
31 pairs
Disease affecting the blood vessels that supply blood to the brain.
Leading cause of disability in adults
Third leading cause of death
Can occur suddenly
Causes- Ruptured blood vessel, embolus
Stroke
Most common stroke
Blood supply is blocked
Ischemic stroke
Symptoms of Stroke
Sudden weakness/numbness on face, arm, leg on one side of body
Sudden confusion, trouble speaking or understanding, slurred speech, dysphagia
Sudden trouble seeing, severe headaches
Trouble walking, dizziness, loss of balance, facial drooping
Aphasia
inability to speak
Temporary lack of oxygen in the brain
Tingling, weakness or some loss of movement an arm or leg
Warning sign of stroke
Transient ischemic attack (TIA)
Cause: Neurons in the brain that produce dopamine begin to break down and die
Treatment: drug therapy, surgery
Parkinson’s Disease
Signs of Parkinson’s Disease
Tremors
Muscle rigidity
Propulsive gait/shuffling gait
Stooped posture
Pill rolling
Slurred speech
patient does not lose consciousness, one part of body jerk, only a part of brain is involved.
Partial seizure
whole brain is involved, tonic phase- lose consciousness, if standing or sitting, person falls to the floor. All muscles contract at the same time, body is rigid. In clonic phase, muscle groups contract and relax causes jerking and twitching movements. Confusion and headache may occur when awakened.
generalized seizure
lasts few seconds, loss of consciousness, twitching of eyelids and staring
petit mal
Progressive disease
Impulse transmission disruption
Loss of myelin
Multiple Sclerosis
Symptoms of…. are Numbness, tingling
Muscle weakness
Fatigue
Tremors
Blurred or double vision
Poor balance
Difficulty walking
Multiple sclerosis
Care of MS person
Prevent falls
Be patient with self-care and movement, offer support and encouragement as symptoms change
Offer rest periods
ROM
Report s/s of pressure ulcer, depression, UTI, and contracture, try to provide a stress-free environment.
CNA’s role of patient with spinal injury
Turn resident every 2 hours
ROM
Bowel and bladder retraining
Encourage deep breathing and coughing
Listen to the resident
Allow independence
Assist with ambulation to prevent falls.
*For one-sided neglect, remind residents about weaker side of body.
*Always place food in the unaffected side of the mouth.
*Observe for swallowing problems.
*Encourage fluids and proper nutrition.
different positions
Fowlers- HOB is 45-90 degree angle
Support head and arms with pillows
Prone- Lying on stomach
Side lying( Lateral)- need 4 pillows
Bed should be flat
Head and shoulders are supported on a pillow
Arms and hands are supported on a pillow
supine position
It helps the body to balance without causing muscle or joint strain.
*The lungs are able to expand and contract.
*Blood circulation is more efficient.
*Digestion is easier.
When body is in alignment
For men- upper body.
Women- Thigh, use upper arms, hips, thighs, shoulder for moving and lifting heavy objects.
Good body posture- let the body move and function with strength and efficiency
Base of support
Lifting by 1 person
Raise the person’s head by locking arms with person
The person’s near arm is under the nursing assistant’s near arm and behind the shoulder
The nursing assistant’s far arm is under the person’s shoulder.
The person is raised to a semi sitting position
Lifting by 2 people
Two nursing assistants lock arm with the person
The nursing assistant have their far arm under person’s head and shoulder.
The nursing assistant raise the person to a sitting up position
Moving by 1 person
Ask person to flex the knees
Explain that you will move on the count of 3
Nursing assistant’s body weight is shifted from rear leg to front leg as person is moved up in bed
Moving with lift sheet
Place lift sheet under the person from head to above the knees. Se this for unconscious , paralyzed, or recovering from spinal cord injuries.
Roll the sides of the lift sheet close to the person
Grasp the rolled-up sheet firmly near the shoulders and buttocks.
Slide the person on the count of 3.
Moving by 2 people
Ask person to flex knees and move up on count of 3
Stand on the opposite side of the bed from your helper. Each of you should be turned slightly toward the head of the bed. For each of you, the foot that is closest to the head of the bed should be pointed in that direction.
Stand with your feet about shoulder-width apart. Bend your knees. Keep your back straight.
Roll the assist device up to the resident’s side. Have your helper do the same on her side of the bed. Grasp the device with your palms up at the resident’s shoulders and hips. Have your helper do the same
Return bed to its lowest position. Remove privacy measures. Leave call light within the resident’s reach.
Moving person in segments
Cross the person’s arm over the chest
Place your arm under persons shoulder and other arm under mid back and move the upper part toward you
Place your arms under the waist and thighs and move the midsection
Place your arms under thighs and calves and move the legs
Moving person away from you
Move the person to the side near you
Cross the arms over the chest and cross the leg near you over the far leg
Place one hand on the persons shoulder and the other on the buttock near you
Push the person gently toward the other side
Moving person toward you
Place one hand on person’s far shoulder and the other on the far hip
Roll the person toward you gently
Place pillows under head and neck
Position upper leg in front of lower leg
Support upper leg and thigh with pillows
Place pillow under upper hand, arm (small) and against back
the upper body is sitting nearly straight up (between 60 and 90 degrees).
High fowlers position
the upper body is not raised as high (30 to 45 degrees).
Semi-Fowler’s position:
The Trendelenburg and Reverse Trendelenburg are positions that always require a doctor’s order.
Trendelenburg may be used for a resident who has gone into shock and has low BP
Make sure the bed is flat
Move the person as a unit to one side- use turning sheet
Place pillows between knees
Both nursing assistants stay on the same side and roll the person as one unit.
Place a pillow under the resident’s head to support the neck during the move.
Place the resident’s arms across his chest. Place a pillow between the knees.
Stand with feet shoulder-width apart. Bend your knees.
Grasp the assist device on the far side
Gently roll the resident toward you. Turn the resident as a unit.
Reposition resident comfortably in proper alignment. Unroll the draw sheet and leave it in place for the next repositioning.
log rolling
what are the Guidelines for ROM
Exercise in an organized manner
*Support the joint being exercised
*Move joint smoothly and gently
*Do not force a joint beyond its present ROM
*Do ROM 3 times on each joint
why do people use walking aids
To support the body
*For safety of patient
device Used for weakness on one side of body.
*Provide balance and support
*Hold cane at strong side of body
cane
how do you use cane
move cane forward 6-10 inches, weak leg is moved forward with the cane, the strong leg is moved forward in front of the cane and the
4 point walking aid
*Give more support than cane
*Walker is moved 6 inches in front of person
*The person moves weak leg and foot and then strong side and foot to the walker
walker
what moves first with walker
move weak first so that they can stand on strong
how to use wheel chairs
Go backwards down ramps. Turn chair around before entering elevators.
*To move resident to back of chair, stand in front of the wheelchair. Bracing your knees against the resident’s knees, the resident grasps armrests and pushes with feet into the floor.
Stretcher transfer
Bed height should be equal to or slightly above the height of the stretcher. Move the stretcher safety belts out of the way.
Two workers should be on one side of the bed opposite the stretcher. Two more workers should be on the other side of the stretcher.
Each worker should roll up the sides of the assist device and prepare to move the resident. Protect the resident’s arms and legs during the transfer.
Nursing assistant with special training in restorative nursing skills and rehab
Restorative aide
What are functions of skeletal system
Protection( Skull, ribcage)
Support( Framework)
Leverage
Storage of minerals
Production of blood cells
What to long bones do
bare weight - leg
what do short bones do
allows movement (wrists, fingers, ankle)
what do flat bones do
protect organs
irregular bones
vertebrae in spinal column
what are the types of joints
Ball and socket joint- Movement in all directions
Hinge joint-Movement in one direction
Pivot joint-Allows turning from one side to another
What are the functions of muscles
Movement of body parts
Maintenance of posture
Production of body heat
what are voluntary muscles
controlled by individual
what are involuntary muscles
work by themselves without any thought or action
Human body has over 300 muscles
Tendons connect muscles to bones
40% of your body weight is in muscle
30 muscles in the face
Eye muscles –movement occurs more than 100,000 times per day
facts
Human body has over 300 muscles
Tendons connect muscles to bones
40% of your body weight is in muscle
30 muscles in the face
Eye muscles –movement occurs more than 100,000 times per day
Effects of aging
Loss of muscle strength and tone
Paralysis-Loss of voluntary movement
Atrophy-Wasting of muscle tissue
Contractures- Lack of joint mobility,permanent shortening of muscles from disuse, causing deformities
Why does Paralysis happen
due to damage to brain or spinal cord. Flexor extensor activity, prevention with ROM exercises.
what are the Effects of aging
Bones lose calcium, causing them to become porous and brittle.
*Height is gradually lost due to shrinkage of space between the vertebrae in the spine.
*Loss of muscle mass in the body causes weight loss. Joints are less flexible and stiffer, which slows normal body movements and decreases range of motion.
what are Age -related disorders
Scoliosis- S curve to spine
Kyphosis-Hunchback
Osteoarthritis-Degeneration of joints
Osteoporosis
Fractures
Scoliosis and kyphosis are abnormal curvatures of spine
Osteoarthritis- deterioration of joint cartilage. Signs are aching, stiffness, limited motion, treatments are pain meds, heat, cortisone injections and joint replacement.(hip. Knee) Arthritis- inflammation of joints. RA and DJD.RA- affects the joimt tissue and lining. It can happen at any age. Autoimmune si the cause.have exacerbations and remissions, joints hot to touch.
Ostoearthritis-
affects the cartilage covering the end of bones that from the joint. Cartilage break down and bones rub together causes pain and deformity.
Gouty arthritis-
metabolic disease that can be severly disabling. Increased uric acid which deposits in the joints. It affects mostly feet and legs. Signs are constant pain, tenderness, swelling in the joints.
Osteoporosis
loss of calcium in bones, leading porous, brittle bones and fractures. Fractures commonly occurs at hip. Wrist, vertebrae in elderly due to falls and osteoporosis.most common in elderly females. Fracture can occur when they are walking, moving of lifting them
Muscular dystrophy
Hereditary, progressive disease in which muscle tissue is destroyed and muscles atrophy
*Symptoms: muscle weakness, stiffness, twitching of the hands and arms
*Cause: specific gene in the body
*Generally appears at birth or during childhood
*There is currently no cure.
Loss of calcium in bones leads to porous brittle bones and eventually to fracture
Most common in elderly females
Be careful with lifting/ moving
Need to do weight bearing exercises
Osteoporosis
when the membrane goes completely the joint become fixed and don’t move. Stiffness, swelling, pain etc. autoimmune inflammatory disease. Virus or bacteria can be the source of problem.
rheumatoid arthritis
CNA’s responsibility for arthritis
Perform ROM
Be gentle
Avoid moving joints past the point of resistance
types of fractures
Closed –The skin is closed, bone is in proper position and has not dislocated
Hairline –The skin is closed, fine line crack on X-ray, and has not dislocated
Open-The skin is open, bone may come through opening
signs of fracture
Limited movement
Unable to move
Edema
Bruising
Pain
Bleeding
to reduce pain, swelling, and further injury until emergency help arrives
RICE
Rest – Putting any weight on the injury could cause more harm.
*Ice – Ice can help prevent or reduce swelling. The skin should always be protected when using ice.
*Compression – Elastic bandages can be used to compress the injured area, hold the extremity in place, and reduce discomfort.
*Elevation – This can also help prevent or reduce swelling.
What is cast care
Support cast with pillows, slings
Check for pressure on nerves
Check circulation
Check stains, odor, or itching
Always support the cast when turning or repositioning, use trapeze to assist with moving, odor or drainage shows infection, if cast edges are rough, cover with tape. Wheel chair with elevated legs are used, cover cast with plastic during bathing, keep small objects from getting inside the cast, compartment syndrome occurs when pressure within muscles builds up , prevents blood and oxygen reaching muscles and nerves.
what is traction care
Keep the person in good body alignment
Keep weights off the floor
Do not add or remove weights
Position the person as directed
Provide ROM
what is nursing care after hip fracture
After surgery
1.Correct positioning, exercise, good nutrition 2. Observation of circulation, incision, pressure sores 3. Do not adjust traction
after hip surgery what is the care
Abductor pillows, wedges to keep hips apart, very important when they are turned on the side., don’t change the weight on traction
Avoid moving patient, avoid excessive movement-worsen injury, . Surgery are open reduction, internal rotation
The patient should not flex hip more than 90 degree, don not cross legs- dislocation of hip occurs., do not internally rotate hip on the affected side. Don’t’ do PROM, have limited weight bearing on that leg.
Follow care plan exactly.
*Follow orders regarding positioning and elevation of head of bed.
*Never perform ROM exercises on side of hip replacement without orders from nurse.
*Assist with dressing, starting with weaker side.
*Apply anti-embolic stockings as ordered.
Use adaptive devices.
*Ask resident to use handrails in shower.
*Ask nurse for pain medication prior to moving and positioning.
*Assist with coughing and deep breathing exercises.
*Encourage fluids.
Never rush resident.
*Keep often-used items in easy reach.
*Report incisions that are red, draining, bleeding or warm; increase in pain; fever or other change in vital signs; numbness or tingling; edema (swelling) of the legs.
what is knee replacement care
Apply special stockings to prevent blood clots.
*Do not perform special exercises unless trained and ordered.
*Assist with coughing and deep breathing exercises, as ordered.
*Assist with coughing and deep breathing exercises as ordered.
Encourage fluids.
*Ask nurse for pain medication prior to moving and positioning.
*Report incisions that are red, draining, bleeding or warm; an increase in pain or a burning sensation, especially on the operated side or in the calves; fever or other change in vital signs.
Report numbness or tingling; edema (swelling) of the legs; cyanosis or pale skin; problems with appetite; constipation; resident not following the doctor’s orders for exercise and activity; or reduced mobility in the extremity.
CNA’s role after amputation
Pillows cannot be used under the limb.
Apply stump stockings
Place the seam of the socks outside to prevent abrasion
Prosthesis need to be removed before going to bed
Use warm water and soap to clean the stump area
Physical, psychological and economic aspects.fecal impaction, constipation, fecal incontinence are pprevented.self care is the amin goal. Bathing, oral hygiene, elimination, eating, dressing, moving about are ADL’s. sometimes hands, wrists and arms are affected. Eating devices like, glass holders, silverware with curved handles, electric toothbrush, longer handle attached to combs, brush, sponges etc. page 650-651.Some people need wheel cahirs, cane, walker, they need to know how to transfer themselves from bed to w/c and from w/c to bed, toilet, bathtub by themselves with a sliding board. Person may use prosthesis, exercise are taught to stroke patients of how to swallow food. Speech therapy recommended for aphasia patient.
CNA Roles
Principles of rehab
Early treatment (E)
Activity strengthens (A)
Stress abilities not disabilities (S)
Treat the whole person (T)
