Nursing Assessment of the Musculoskeletal System Flashcards
What are gerontologic changes in muscles?
Decreased number and diameter of muscle cells; replacement of muscle cells by fibrous connective tissue
Loss of elasticity in ligaments and cartilage
reduced ability to store glycogen; decreased ability to release glycogen as quick energy during stress
What are gerontologic changes in joints?
Increased risk for cartilage erosion that contributes to direct contact between bone ends and overgrowth of bone around joint margins
Loss of water from disks between vertebrae; narrowing of intervertebral spaces
What are gerontologic changes in bones?
Decrease in bone density
What are gerontologic differences in assessment findings for muscles?
Decreased muscle strength and bulk; abdominal protrusion; flabby muscle
Increased rigidity in neck, shoulders, hips, and knees
Decreased fine motor dexterity, decreased agility
Slowed reaction times and reflexes as a result of slowing of impulse conduction along motor units; earlier fatigue with activity
What are gerontologic differences in assessment findings for joints?
Joint stiffness, decreased mobility, limited ROM, possible crepitation on movement; pain with motion and/or weight bearing
Loss of height from disk compression; posture change
What are gerontologic differences in assessment findings for bones?
Loss of height from vertebral compression, back pain; deformity such as dowager’s hump (kyphosis) caused by vertebral compression
What subjective data would you collect when performing a musculoskeletal assessment?
Past medical history Medications (how do the medications work and how are they doing for you) Surgery or other treatments Functional health patterns health perception-healthmanagement pattern nutritional-metabolic pattern elimination pattern activity-exercise pattern, sleep-rest pattern cognitive-perceptual pattern self-perception-self-concept pattern role-relationship pattern sexuality-reproductive pattern coping-stress tolerance pattern value-belief pattern
What objective data would you collect when performing a musculoskeletal assessment?
Physical examination
Inspection, Palpation, Motion, Muscle-strengh testing, Observe HT and WT, Measurement, Observing of movements, gaits and assess for abnormalities
When getting a health history while performing a musculoskeletal assessment what questions would you ask pertaining to health perception-health management pattern?
Describe your usual daily activities
Do you experience any difficulties performing these activities
Describe what you do if you experience difficulty in dressing, preparing meals and feeding yourself, performing basic hygiene, or maintaining your home
Do you have to lift heavy objects? Describe any specialized equipment you use or wear when you work or exercise that helps protect you from injury
Do you take any drugs or herbal products to manage your musculoskeletal problems? If so, what are their names and what are the expected effects
When getting a health history while performing a musculoskeletal assessment what questions would you ask pertaining to nutritional-metabolic pattern?
Obtain a 24-hour diet recall
What dietary supplements do you take? (Ask specifically about calcium, vitamin D supplements, and herbal products)
What is your weight? Describe any recent weight loss or gain
When getting a health history while performing a musculoskeletal assessment what questions would you ask pertaining to elimination pattern?
Does your musculoskeletal problem make it difficult for you to reach the toilet in time?
Do you need any assistive devices or equipment to achieve satisfactory toileting?
Do you experience constipation related to decreased mobility or to drugs taken for your musculoskeletal problem?
When getting a health history while performing a musculoskeletal assessment what questions would you ask pertaining to activity-exercise pattern?
Do you require assistance in completing you usual daily activities because of a musculoskeletal problem?
Describe your usual exercise pattern. Do you experience musculoskeletal symptoms before, during, or after exercising?
Are you able to move all your joints comfortably through full range of motion?
Do you use any prosthetic or orthotic devices?
When getting a health history while performing a musculoskeletal assessment what questions would you ask pertaining to sleep-rest pattern?
Do you experience any difficulty sleeping because of a musculoskeletal problem?
Do you require frequent position changes at night?
Do you wake up at night because of musculoskeletal pain?
When getting a health history while performing a musculoskeletal assessment what questions would you ask pertaining to cognitive-perceptual pattern?
Describe any musculoskeletal pain you experience. How do you manage your pain? (Ask specifically about adjunctive therapies such as heat and cold or alternative therapies such as acupuncture)
When getting a health history while performing a musculoskeletal assessment what questions would you ask pertaining to self-perception-self-concept pattern?
Describe how changes in you musculoskeletal system (posture, walking, muscle strength) and decreased ability to do certain things have affected how you feel about yourself. How have these changes affected your lifestyle?
