Nursing 102: Mobility Flashcards by Melissa Balkovec

What are the potential complications of Immobility?

Atelectasis
Hypostatic Pneumonia
DVT
VTE
Pressure Sores (decubitis ulcers)
Foot Drop
Joint Stiffness/Restrictive Movement
Weakness
Muscle Atrophy
Osteoporosis
Increased Risk of Fracture
Increased level of Ca in blood in urine
Overflow Incontinence
Urinary Calculi (bladder or kidney stone)
Indigestion
Heartburn
Constipation
Fecal Impaction
Depression
Insomnia
Bone Loss

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_____ and _____ are in the same category

Beds and Graves

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Results from fluid collection in the dorsal region of the lungs in bedridden or elderly confined to a supine position for extended periods

Hypostatic Pneumonia

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Collapse of lung tissue with loss of volume

Atelectasis

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Consists of muscles, ligaments, tendons and cartilage

Muscular System

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Consists of bones and joints

Skeletal System

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Work together to support body weight, control movements, and provide stability, allows gross and fine motor movement, works collectively with the circulatory and nervous systems

Muscular and Skeleton systems

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Store nutrients, produce blood cells

Bones

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Provides Oxygen, calcium and other nutrients to strengthen bones; transports electrolytes needed for muscle movements

Blood

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Innervate muscles to provide the electrical stimulus needed to initiate contraction

Nerves

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Can have a detrimental effect on an individual’s ability to perform ADLs, communicate and participate in recreational activities

Alterations in musculoskeletal integrity

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Common source of frustration and pain for individuals with musculoskeletal dysfunction or injury

Impaired Mobility

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How many bones are in the adult human skeleton?

206

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Consists of ribs, sternum, vertebral column, skull

Axial Skeleton

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Consists of pectoral girdle, upper limbs, pelvic girdle, lower limbs

Appendicular Skeleton

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Forms body structure, supports soft tissues, protects vital organ, provides point of attachment for muscles, stores minerals, forms blood cells

Skeleton

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Three types of muscle

Skeletal
Smooth
Cardiac

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How many skeleton muscles are there?

640

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Under voluntary control by the nervous system, critical for physical mobility, attach to bone via tendons

Skeletal Muscles

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Causes movement of skeletal bones

Skeletal muscle contraction

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Formed where two bones meet, hold skeleton together and provide mobility

Joints

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composed of differing amounts of collagen fibers, proteoglycan matrix, fibroblasts, chondroblasts and other structural components

Connective Tissues

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Connect bones to other bones, strengthen and stabilize joints, may limit the mobility of some joints

Ligaments

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Connect bones to muscles, carry contractile forces from the muscle to the bone to cause movement

Tendons

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Flexible connective tissue found throughout the body, connects structures; does not contain blood vessels

Cartilage

Systems that can be affected by mobility issues

``` Musculoskeletal Nervous Digestive Integumentary Cardiovascular Respiratory Urinary ```

Common conditions that cause alterations in mobility

``` Back problems Fractures Multiple Sclerosis Osteoarthritis Parkinson Disease Spinal Cord Injuries Joint Disorders Trauma ```

Causes of back problems

``` Persistent straining Bad posture Improper lifting Poor physical fitness Obesity Trauma Degenerative disorders Muscle irritation Pregnancy ```

Break in the continuity of bone

Fractures

Factors that affect the severity of a fracture

Nature of the event | Strength of the bone

Common causes of fractures

``` Falls Blunt trauma MVA Child Abuse Repetitive Forces (running) ```

Screenings to detect musculoskeletal disorders

Bone density scans - to detect osteoporosis in older adults Spinal screenings -identify scoliosis in school-aged children Genetic Testing - family history of genetic disorders

Stretching or tearing of LIGAMENTS

Sprain

Stretching or tearing of a MUSCLE or TENDON

Strain

Sprains and strains are usually treated with ______

``` R.I.C.E Rest Ice Compression Elevation Mild pain relievers ```

Severe sprains and strains may meed to be treated with _____.

Surgery | Physical Therapy

Autoimmune disorder that destroys the myelin sheath around nerves, disrupts transmission of nerve impulses, impairs brain's ability to communicate with the rest of the body

Multiple Sclerosis

Symptoms of Multiple Sclerosis

``` Sensory and Motor disturbances alterations in bladder/bowel control Can last days/weeks/months No specific test available Diagnosed when other conditions are ruled out. ```

Degeneration of cartilage an bone in a joint/normal process of aging due to wear and tear on a joint

Osteoarthritis

Central nervous system (CNS) disorder caused by degeneration of neurons that produce the neurotransmitter dopamine

Parkinson Disease

Medical emergencies that may result in permanent disability or paralysis

Spinal Cord Injuries

May affect arms, legs and trunk, may also affect breathing muscles

Cervical spinal injury

Usually affect the legs; may cause loss of bladder/bowel control

Thoracic and lumbar sacral injury

Joint disorder that affects chewing and talking

Temporomandibular joint syndrome (TMJ)

Inflammation of the tendon

Tendonitis

Inflammation of the synovial membrane

Synovitis

Inflammation of the bursa

Bursitis

Types of joint disorders that may affect the hands and wrist

Effusion (presence of excess fluid) Rheumatoid Arthritis Dupuytren's contracture (thickening and contracture of tissue beneath the skin of the palm and fingers) Carpal Tunnel syndrome

Types of joint disorders of the foot

Gout (buildup of uric acid) Bunions (lateral deviation of the great toe) Club Foot Hammertoe

Risk Factors for alterations in mobility

Increasing Age | Genetic Mutations

Essential for preventing many bone, muscle and joint problems

Healthy lifestyle habits

Helps maintain strong bones and provide necessary ions for muscle contraction and nerve transmission

Good nutrition and adequate calcium intake

Stimulates the body to build muscle strength and deposit minerals in bones, maintain flexibility in joints and prevent the development or worsening of some joint disorders

Regular exercise

Certain conditions that can limit mobility or cause immobility

Chronic back pain Osteoarthritis trauma

Conditions that can be caused by limited mobility or immobility

Constipation Pressure ulcers depression

Concepts related to mobility include _____

``` Collaboration Comfort Health, Wellness, Illness and Injury Mood and Affect Safety Stress and Coping ```

Gather information to determine whether or not the patient is experiencing dysfunction

Mobility Nursing Assessment

Primary manifestations of musculoskeletal disroders

Pain and limited mobility

How does a patient move or ambulate? note balance, posture, indication(s) of weakness, characteristics of gait, fluidity of movement, weight-bearing status, current use (or lack of use) of assistive devices, visible signs or voiced complaints of pain (grimacing, moaning, guarding, wincing)

Observation

Activity level, physical capabilities/limitations, use of assistive devices, past medical /surgical history, current medications, occupation, recreational activities, presence of pain, location, onset, severity, description, aggrevating/alleviating factors, degree of physical limitation, pharm, non-pharm treatments, complimentary therapies

What nurse should address during patient interview

Inspection and palpation of bones, joints, muscles to note deformities, edema, tenderness, pain, ROM using a goniometer

Focused assessment for mobility

Pain Pulse Pallor (color of skin, redness, pale, etc) Parathesia (numbness, tingling) Paralysis(loss of feeling)/paresis (muscle weakness)

The 5 P's of Neurovascular Assessment

No tenderness, pain or musculoskeletal deformities No swelling, warmth, inflammation, crepitis, clicking or popping noises in joints No evidence of lost cartilage Full range of motion against resistance, symmetrically, bilaterally Upright body posture Symmetrical use of extremities No numbness or tingling Smooth steady gait Cervical and Lumbar spine should be concave, thoracic spine should be convex

Normal finding on Mobility Assessment

Diagnostic tests that can support diagnosis of musculoskeletal and neurologic problems that can cause altered mobility as well as determine effectiveness of treatment

``` Blood tests (alk phos, Ca, Growth Hormone) Imaging ( bone density, dexa scan, X-ray, CT, MRI) Electrical test (electromyography, nerve conduction) Joint Aspiration ```

Can view soft tissues such as muscles, tendons, ligament and articular cartilage, no radiation

MRI

series of Xrays that can provide a very detailed image of calcified tissues, radiation