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NURS2518 : The Older Client > Week 2 - Mobility and Falls > Flashcards

Week 2 - Mobility and Falls Flashcards

1
Q

What is mobility?

A

ability for a patient to change and control their body position.

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2
Q

What is impaired mobility?

A

a state in which a person has a limitation in physical movement but is not immobile.

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3
Q

what is the scope of mobility?

A

Full independent mobility
partial or impaired mobility
Immobility

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4
Q

How would human anatomical abnormalities impact mobility?

A

Bone
Muscle
Brain
Nerve transmission

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5
Q

What are some range of attributes that contribute to mobility?

A

strength
endurance
coordination
postural ability - (ability to sit or stand)

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6
Q

What is reconditioning?

A

form of physical activity to restore your strength, stability, flexibility

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7
Q

what is deconditioning?

A

A loss of physical fitness due to not maintaining physical activity

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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

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9
Q

What is geriatric syndrome?

A

include a number of conditions such as: dementia, delirium, falls, spontaneous bone fractures etc.

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10
Q

What is dyskinesia?

A

involuntary, erratic, writhing movements of the face, arms, legs or trunk

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11
Q

what are some causes fo partial/impaired mobility?

A

change in general health
medical procedures/diagnostic tests
musculoskeletal, neurologic and neuromuscular conditions

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12
Q

True or false: Age-related changes and risk factors decrease the older adult’s susceptibility to impaired mobility

A

False; increase

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13
Q

True or false: Impaired mobility is associated with poor health outcomes

A

True

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14
Q

True or false: Age related changes are not life threatening but impair mobility

A

true

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15
Q

what is sarcopenia?

A

loss of skeletal and function associated with frality (age related syndrome of physiological decline and increase vulnerability)

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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
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17
Q

What is osteoarthritis?

A

when the normal soft and resilient lining becomes damaged, bones of the joint rub together causing joint destruction.

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18
Q

True or false: Osteoarthitis can not be a chronic condition

A

False

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19
Q

What are some of the risk of osteoarthritis?

A

age
obesity
repetitive use of joint
family history
trauma of the joint

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20
Q

What symptoms are associated with impaired mobility

A

pain, unstable joints, stiffness, enlarged joints

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21
Q

What are the most common joints associated with impaired mobility?

A

knees, hips, neck, lower back, fingers

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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

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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

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24
Q

what is chemical restraint?

A

medication given for the specific and sole purpose of inhibiting a behaviour or movement.

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25
Q

environmental restraint

A

barriers to personal movement which serve to confine residents to specific areas.

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26
Q

Is an environmental restraint a restrictive practice that restricts a person’s free access to all parts of their environment, including items and activities.

A

true

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27
Q

true or false.
isolation for protection purposes during a time of infectious outbreak is not considered a restraint

A

true

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28
Q

What is an intristic risk factor?

A

related to a person sensory, gait or cognition

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29
Q

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.

A

interpersonal violence

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30
Q

what is interpersonal violence?

A

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.

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31
Q

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

A
  • true
  • true
  • false
  • true
  • false
  • false
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32
Q

true or false:
impaired mobility becomes more likely when people are not active or do not participate in their normal roles

A

true

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33
Q

true or false: bed rest does not causes deconditioning

A

false; it does cause

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34
Q

Decreases calcium absorption in the bone leads to decreased bone mass (increases risk of fractures) - is this true

A

yes

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35
Q

What are the consequences of immobility within the cardiovascular system?

A

reduced cardiac capacity
orthostatic hypotension
blood clots

36
Q

What are the consequences of immobility within the respiratory system?

A

reduced lung expansion

37
Q

What are the consequences of immobility within the gastrointestinal?

A

constipation

38
Q

What are the consequences of immobility within the psychological aspect?

A

depression, anxiety

39
Q

decreased immobility can cause a risk for skin breakdown (integrumentary)

A

true

40
Q

what does a healthy 24 hours include for the older adult?

A

Physical Activity:
Aerobic activity
Muscle strengthening
Balance
Optimizing light activities
Discuss intensity

Sleep
Sedentary Activity

41
Q

should an older adult with a history of inactivity start with high physical activity?

A

no! they should start with smaller amounts of physical activity and slowly increase duration, frequency and intensity

42
Q

True or false. A person with congnitive impairment are more likely to experience elder abuse?

A

true

43
Q

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

A

sexual abuse

physical abuse

emotional/pyschological abuse

financial abuse

neglect

abandoment

self-neglect

44
Q

what can we do as nurses if we suspect elder abuse/neglect?

A

prevention, community services, and criminal code & reporting

45
Q

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?

A

yes it our job to do so, this fall under the category of prevention when we suspect elder abuse or neglect.

46
Q

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.

A

false, it is our job. This falls under the category of community services when we suspect elder abuse.

47
Q

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.

A

Protection for Persons in Care Act.

48
Q

Mobility causes….

A

Pain
Nutrition
Intracranial regulation
tissue integrity
elimination
perfusion
and gas exchange

49
Q

Mobility includes….

A

gross simple movements
coordination
complex movements

50
Q

What are the categories leading to a change in mobility?

A

Change in general health
muscoskeletal neurologic
neuromuscular conditions

51
Q

What are the consequences if mobility is not maintained? (name the system affected)

A

system affected could be cardiovascular, respiratory, musculoskeletal, integumentary, gastrointestinal, and urinary system

52
Q

Name the physiological effect and potential complications when Cardiovascular system is affected by the consequences of immobility

A

reduced cardiac capacity, decreased cardiac output, orthostatic hypotension, venous stasis, and deep vein thrombosis

53
Q

name the physiological effect and potential complications when respiratory system is affected by the consequences of immobility

A

recued lung expansion, atelectasis, and pooling of respiratory secretions

54
Q

reduction in muscle mass and atrophy, contracture of joints, and bone demineralization are physiological effects and potential complications of what system ?

A

musculoskeletal system

55
Q

name the physiological effect and potential complications when integumentary system is affected by the consequences

A

skin breakdown

56
Q

reduced peristaltic motility and constipation are physiological effect and potential complications of what system in terms of consequences of immobility?

A

gastrointestinal system

57
Q

Name the physiological effect and potential complications of urinary system is affected by the consequences of immobility?

A

renal calculi, urinary stasis, and infection

58
Q

Name the three age related changes

in the second column what does BMD mean?

A

spinal column changes
bone density changes
BMD= bone mineral changes ( can also be referred by this)
cartilage/muscle changes

59
Q

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.

A

bone density changes
spinal column changes
cartilage/muscle changes

60
Q

True or false. for women, fastest overall BMD loss 5 to 7 years post menopase related to decreased estrogen?

A

true

61
Q

what do we diagnose when a patient has a very low bone mineral density, what do we refer ?

A

osteoporosis is diagnosed, and a patient may lose 2 to 3 inches in heights

62
Q

Cumulatively, age related changes such as ____, ____, and _____ reduced range of motion, painful joints, reduced strengths, nd risk for falls and fractures.

A

spinal column
bone density
cartilage/muscle changes

63
Q

Name the 6 most common risk factor in older adult in terms of immoblity

A

acute and chronic conditions
chronic pain
injury/trauma
side and adverse effects of medications
side and adverse effects of treatments
neurologic conditions

64
Q

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

A

chronic pain

acute/chronic conditions

injury/trauma

neurologic conditions

side and adverse effects of medications

side and adverse effects of treatments

65
Q

What is crepitus?

A

the sound or feel of bone rubbing on bone

66
Q

this is also known as a degenerative joint disease

A

osteoarthritis

67
Q

Osteoarthritis: Assessment ( Name the 3)

A

Examine the joints/muscles
Range of motion
Pain assessment

68
Q

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

A

Examine the joints/muscles
Range of motion
Pain assessment

69
Q

What are some interventions when dealing with a osteoarthritis patient?

A

stiffness with inactivity is relieved by activity
pain with activity is relieved with rest
the goal is control pain and minimize disability

70
Q

What are some non pharmacological interventions when dealing with a osteoarthritis patient?

A

weight reduction
exercise
surgery
heat and cold
assistive devices

71
Q

true or false.
When caring for an older adult with osteoarthritis, assess for pain prior to, during, and after physical acitivtiy

A

true

72
Q

true or false. Based on your assessment when dealing with a patient with osteoarthritis, consider pharmacological and non-pharmacological based interventions to relive pain.

A

true

73
Q

This is a ‘silent disorder’ and the loss of bone mineral density and structure to a large degree.

A

Osteoporosis

74
Q

How is osteoporosis associated with fractures?

A

high risk of fracture when a fall occurs

75
Q

modifiable risk factor for osteoprosis

A

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
Q

non-modifiable risk factors for osteoporosis

A

female gender
Northern european ancestry
advanced age
family history of osteoporosis

77
Q

true or false. Estrogen can increase bone mineral density however increased risk of cancer and heart disease?

A

true

78
Q

Name some pharmacological interventions when dealing osteoporosis

A

calcium and vitamin d
estrogen
bisphosphonates
SERMs ( selective estrogen receptor modulators)
parathyroid hormone

79
Q

Long term impaired mobility can lead to

A

osteoporosis

80
Q

what are the multi systemic complications

A

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
Q

True or false. Decreased on bone density which is typically with osteoporosis which can lead into decreased in function ability

A

true

82
Q

True or false. If your patient is in a psychotic stage, you can do a constraint with no consent.

A

true

83
Q

how to treat pain from experienced from osteoarthritis

A

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
Q

What are falls a symptom for?

A
  • 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
Q

What are some contributions to falls?

A
  • Iatrogenic factors
    -medications

NURS2518 : The Older Client (13 decks)

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