Week 2 - Mobility and Falls Flashcards
1
Q
What is mobility?
A
ability for a patient to change and control their body position.
2
Q
What is impaired mobility?
A
a state in which a person has a limitation in physical movement but is not immobile.
3
Q
what is the scope of mobility?
A
Full independent mobility
partial or impaired mobility
Immobility
4
Q
How would human anatomical abnormalities impact mobility?
A
Bone
Muscle
Brain
Nerve transmission
5
Q
What are some range of attributes that contribute to mobility?
A
strength
endurance
coordination
postural ability - (ability to sit or stand)
6
Q
What is reconditioning?
A
form of physical activity to restore your strength, stability, flexibility
7
Q
what is deconditioning?
A
A loss of physical fitness due to not maintaining physical activity
8
Q
What is disuse syndrome?
A
when you don’t use your body, describes the effects of the body and mind when they are sedentary
9
Q
What is geriatric syndrome?
A
include a number of conditions such as: dementia, delirium, falls, spontaneous bone fractures etc.
10
Q
What is dyskinesia?
A
involuntary, erratic, writhing movements of the face, arms, legs or trunk
11
Q
what are some causes fo partial/impaired mobility?
A
change in general health
medical procedures/diagnostic tests
musculoskeletal, neurologic and neuromuscular conditions
12
Q
True or false: Age-related changes and risk factors decrease the older adult’s susceptibility to impaired mobility
A
False; increase
13
Q
True or false: Impaired mobility is associated with poor health outcomes
A
True
14
Q
True or false: Age related changes are not life threatening but impair mobility
A
true
15
Q
what is sarcopenia?
A
loss of skeletal and function associated with frality (age related syndrome of physiological decline and increase vulnerability)
16
Q
What are some age related changes to gait?
A
- slower steps
-narrowing of standing base
-slower reaction time
-wider side to side swaying when walking (body sway)
-decrease in height step
-reduced proprioception (your body’s ability to sense movement, action, and location.)
-changes are more pronounced in people with sedentary lifestyles
17
Q
What is osteoarthritis?
A
when the normal soft and resilient lining becomes damaged, bones of the joint rub together causing joint destruction.
18
Q
True or false: Osteoarthitis can not be a chronic condition
A
False
19
Q
What are some of the risk of osteoarthritis?
A
age
obesity
repetitive use of joint
family history
trauma of the joint
20
Q
What symptoms are associated with impaired mobility
A
pain, unstable joints, stiffness, enlarged joints
21
Q
What are the most common joints associated with impaired mobility?
A
knees, hips, neck, lower back, fingers
22
Q
What is Parkinson’s disease?
A
- chronic condition
-symptoms: pain, mood, constipation, sexual dysfunction, excessive salivation and sweating, soft spoken voice, disordered sleep, reduced sense of smell etc.
progression can be over 20 years
23
Q
this restraint is a medication given for the specific and sole purpose of inhibiting a behaviour or movement ( ex: pacing, wandering, agitation, aggression or uncooperative behaviour) not required to treat the Resident’s medical or psychiatric symptoms
A
chemical restraint
24
Q
what is chemical restraint?
A
medication given for the specific and sole purpose of inhibiting a behaviour or movement.
25
environmental restraint
barriers to personal movement which serve to confine residents to specific areas.
26
Is an environmental restraint a restrictive practice that restricts a person's free access to all parts of their environment, including items and activities.
true
27
true or false.
isolation for protection purposes during a time of infectious outbreak is not considered a restraint
true
28
What is an intristic risk factor?
related to a person sensory, gait or cognition
29
this is the intentional use of physical force or power, threatened or actual, against oneself, another person, or a group or community that either results in or has high likelihood of resulting in injury, death, pyschological harm, deprivation.
interpersonal violence
30
what is interpersonal violence?
this is the intentional use of physical force or power, threatened or actual, against oneself, another person, has likelihood of resting in injury, death, pyschological harm, deprivation.
31
true or false: cues associated with imparied mobility (parkinson's)
- stooped posture
- goes off balance easily
- wide step
- uncontrolled quick movements
- tremors worse with movement
- levodopa cures parkinson's
- true
- true
- false
- true
- false
- false
32
true or false:
impaired mobility becomes more likely when people are not active or do not participate in their normal roles
true
33
true or false: bed rest does not causes deconditioning
false; it does cause
34
Decreases calcium absorption in the bone leads to decreased bone mass (increases risk of fractures) - is this true
yes
35
What are the consequences of immobility within the cardiovascular system?
reduced cardiac capacity
orthostatic hypotension
blood clots
36
What are the consequences of immobility within the respiratory system?
reduced lung expansion
37
What are the consequences of immobility within the gastrointestinal?
constipation
38
What are the consequences of immobility within the psychological aspect?
depression, anxiety
39
decreased immobility can cause a risk for skin breakdown (integrumentary)
true
40
what does a healthy 24 hours include for the older adult?
Physical Activity:
Aerobic activity
Muscle strengthening
Balance
Optimizing light activities
Discuss intensity
Sleep
Sedentary Activity
41
should an older adult with a history of inactivity start with high physical activity?
no! they should start with smaller amounts of physical activity and slowly increase duration, frequency and intensity
42
True or false. A person with congnitive impairment are more likely to experience elder abuse?
true
43
Types of Elder Abuse :
For each description name what type of abuse it falls under:
nonconsensual sexual contact of any kind
inflicting or threatening physical pain/injury
inflicting mental pain, anguish, or distress
illegal taking/theft =,misuse or concealment of funds/assets
refusal or failure to provide basic needs
desertion of vulnerable older adult
behaviour of an older adult that threatens her/his own health/safety
sexual abuse
physical abuse
emotional/pyschological abuse
financial abuse
neglect
abandoment
self-neglect
44
what can we do as nurses if we suspect elder abuse/neglect?
prevention, community services, and criminal code & reporting
45
as nurses is it our job to explain rights to older adults, listen to older adults, and offer suggestions in how to keep their assets safe, support them in being active and engaged with social networks?
yes it our job to do so, this fall under the category of prevention when we suspect elder abuse or neglect.
46
true or false. As nurses it is not our job to educate older adults who may not be familiar with social services available to them.
false, it is our job. This falls under the category of community services when we suspect elder abuse.
47
This is a law in Manitoba that protects adults from abuse and neglect while receiving care in personal care homes, hospitals, or any other designated health facility.
Protection for Persons in Care Act.
48
Mobility causes....
Pain
Nutrition
Intracranial regulation
tissue integrity
elimination
perfusion
and gas exchange
49
Mobility includes....
gross simple movements
coordination
complex movements
50
What are the categories leading to a change in mobility?
Change in general health
muscoskeletal neurologic
neuromuscular conditions
51
What are the consequences if mobility is not maintained? (name the system affected)
system affected could be cardiovascular, respiratory, musculoskeletal, integumentary, gastrointestinal, and urinary system
52
Name the physiological effect and potential complications when Cardiovascular system is affected by the consequences of immobility
reduced cardiac capacity, decreased cardiac output, orthostatic hypotension, venous stasis, and deep vein thrombosis
53
name the physiological effect and potential complications when respiratory system is affected by the consequences of immobility
recued lung expansion, atelectasis, and pooling of respiratory secretions
54
reduction in muscle mass and atrophy, contracture of joints, and bone demineralization are physiological effects and potential complications of what system ?
musculoskeletal system
55
name the physiological effect and potential complications when integumentary system is affected by the consequences
skin breakdown
56
reduced peristaltic motility and constipation are physiological effect and potential complications of what system in terms of consequences of immobility?
gastrointestinal system
57
Name the physiological effect and potential complications of urinary system is affected by the consequences of immobility?
renal calculi, urinary stasis, and infection
58
Name the three age related changes
in the second column what does BMD mean?
spinal column changes
bone density changes
BMD= bone mineral changes ( can also be referred by this)
cartilage/muscle changes
59
In the following description name what kind of age related changes it is describing:
demineralization leads brittle/fragile bones and susceptibility to fracture (even without fall) i.e spontaneous fracture
thinning of vertebral disks shorten the spinal column and can lead to onset kyphosis (curvature of upper spine, or hunching back)
With age soft tissues lose elasticity. This becomes more rigid and muscle mass is lost.
bone density changes
spinal column changes
cartilage/muscle changes
60
True or false. for women, fastest overall BMD loss 5 to 7 years post menopase related to decreased estrogen?
true
61
what do we diagnose when a patient has a very low bone mineral density, what do we refer ?
osteoporosis is diagnosed, and a patient may lose 2 to 3 inches in heights
62
Cumulatively, age related changes such as ____, ____, and _____ reduced range of motion, painful joints, reduced strengths, nd risk for falls and fractures.
spinal column
bone density
cartilage/muscle changes
63
Name the 6 most common risk factor in older adult in terms of immoblity
acute and chronic conditions
chronic pain
injury/trauma
side and adverse effects of medications
side and adverse effects of treatments
neurologic conditions
64
With these following descriptions put them in the right following category of risk factors in immobility.
end-stage cancer, etc
individuals with orthopaedic injury, congenital deformities, cardiopulmonary conditions, nutritional deficiencies
spinal injury/deformities, head trauma
strokes, parkinson disease, etc
use of corticosteroids, chemotherapy
casts, splints, abductor pillows, RESTRAINTS ( need consent, consider the benefits vs risks, and ethical issues) braces, and traction
chronic pain
acute/chronic conditions
injury/trauma
neurologic conditions
side and adverse effects of medications
side and adverse effects of treatments
65
What is crepitus?
the sound or feel of bone rubbing on bone
66
this is also known as a degenerative joint disease
osteoarthritis
67
Osteoarthritis: Assessment ( Name the 3)
Examine the joints/muscles
Range of motion
Pain assessment
68
following the description, match the CORRECT assessment method when dealing with patient who has osteoarthritis
-tenderness, swelling, warmth, and redness
-crepitus in affected joints
Interprofessional Collaboration- Referral to Physiotherapist may be required
PQRST-U, Wong- Baker Faces scale
Examine the joints/muscles
Range of motion
Pain assessment
69
What are some interventions when dealing with a osteoarthritis patient?
stiffness with inactivity is relieved by activity
pain with activity is relieved with rest
the goal is control pain and minimize disability
70
What are some non pharmacological interventions when dealing with a osteoarthritis patient?
weight reduction
exercise
surgery
heat and cold
assistive devices
71
true or false.
When caring for an older adult with osteoarthritis, assess for pain prior to, during, and after physical acitivtiy
true
72
true or false. Based on your assessment when dealing with a patient with osteoarthritis, consider pharmacological and non-pharmacological based interventions to relive pain.
true
73
This is a 'silent disorder' and the loss of bone mineral density and structure to a large degree.
Osteoporosis
74
How is osteoporosis associated with fractures?
high risk of fracture when a fall occurs
75
modifiable risk factor for osteoprosis
low body weight
low calcium intake
estrogen deficiency
low testerone
lack of exercise or activity
use of steroids
excess coffee or alcohol intake
current cigarette smoking
76
non-modifiable risk factors for osteoporosis
female gender
Northern european ancestry
advanced age
family history of osteoporosis
77
true or false. Estrogen can increase bone mineral density however increased risk of cancer and heart disease?
true
78
Name some pharmacological interventions when dealing osteoporosis
calcium and vitamin d
estrogen
bisphosphonates
SERMs ( selective estrogen receptor modulators)
parathyroid hormone
79
Long term impaired mobility can lead to
osteoporosis
80
what are the multi systemic complications
reduced cardiac vascular
function
reduced gas exchange
reduced perfusion leads to increased risk skin breakdown
reduced ability to void (urine and feces)
increased fear of falling
81
True or false. Decreased on bone density which is typically with osteoporosis which can lead into decreased in function ability
true
82
True or false. If your patient is in a psychotic stage, you can do a constraint with no consent.
true
83
how to treat pain from experienced from osteoarthritis
nonpharmalogical and pharmacological
moist heat to relieve pain, spasms and stiffness
Use of orthotic devices such as braces and splints to support joints
Acetaminophen or Tylenol is the first line
NSAIDS (Nonsteroidal anti-inflammatory drugs) pose a risk for older adults
84
What are falls a symptom for?
- this could be due to an underlying neurological problem, sensory, cognitive, medication-related, osteoporosisrotic, musculo-skeletal they may indicate an impending physical illness
interaction be tween intrinsic and extrinsic factor
85
What are some contributions to falls?
- Iatrogenic factors
-medications
