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Gero Exam 3 > CH 21: Mobility > Flashcards

CH 21: Mobility Flashcards

1
Q

degenerative joint disease in which there is progressive deterioration and abrasion of joint cartilage, with the formation of new bone at the joint surfaces

A

osteoarthritis

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2
Q

bone condition characterized by low bone density and porous bones

A

osteoporosis

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3
Q

a decline in walking speed or grip strength associated with an age-related decrease in muscle mass and function

A

sarcopenia

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4
Q

Effects of Aging on Musculoskeletal Function**

A

Decline in number and size of muscle fibers and muscle mass _ decreased body strength
Grip strength endurance declines
Connective tissue changes reduce flexibility of joints/muscles
Sarcopenia can be caused by disease, immobility, decreased blood flow to muscle, and decreased caloric intake
Activity impacted by psychosocial factors (grief, retirement, relocation)

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5
Q

decline in __ leads to decrease body strength

A

number and size of muscle fibers and muscle mass

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6
Q

reduce flexibility of joints/muscles

A

connective tissue changes

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7
Q

can be caused by disease, immobility, decreased blood flow to muscle, and decreased caloric intake

A

sarcopenia - decline in muscles mass

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8
Q

psychosocial factors that impact activity

A

grief
retirement
relocation

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9
Q

musculoskeletal health promotion**

A

Maintain a physically active state
Exercise programs should address cardiovascular endurance, flexibility, and strength training
Exercise improves body tone, circulation, appetite, digestion, elimination, respiration, immunity, sleep, and self-concept
Enhance physical activity during daily routines
Exercise 30 min x 5 days/week
Pace exercise throughout the day
Adjust exercise as indicated
Prepare for longer rest periods
Seek advice from PCP about type of exercise best suited for their capacities and limitations
If unable to do aggressive exercise, promote activities that include ROM, joint mobility, and circulation
Well balanced diet with 1500 mg calcium
Weight reduction if obese

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10
Q

Guidelines for Exercise Programs for Older Adults

A

Physical examination FIRST
Assess current activity level, ROM, muscle strength and tone, and response to physical activity
Emphasize exercises that focus on good speed and rhythm
To determine age-adjusted training HR, subtract age from 220 and multiply by 70%; assesses maximum rate to provide vascular benefits and prevent complications, max range for safety
Monitor pulse during exercise and reduce activity if above 10 bpm of target HR
Consult PCP if resting HR > 100
Wear proper-fitting, shock absorbing shoes with traction
Encourage warm-up and cooling down
Begin with conservative exercise program and gradually increase activity
Stop for adverse s/s

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11
Q

4Ms Framework

A

-What matters
-Medication
-Mentation
-Mobility

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12
Q

mind body connection

A

Exercise can influence mood and behavior, and vice versa
Physical activity aids respiratory, circulatory, digestive, excretory, and musculoskeletal function
Used to engage in social activity
Find activities appropriate for their capabilities and needs
Use 4M model for age-friendly care
Use therapeutic recreation

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13
Q

prevention of inactivity

A

-Effects of inactivity(Decreased muscle strength, GI motility, metabolism, ventilation/chest expansion, and aerobic capacity)
-Don’t encourage dependence!!!!
-Activity can lower BP, maintain muscle strength, improve lymphatic circulation, sharpen mental
acuity, elevate mood, improve digestion and
elimination
-Enhance motivation by showing interest
-Local resources (senior centers, exercise classes, volunteer opportunities, recreational programs, clubs)
-Keep older adults active in the community

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14
Q

common causes of fractures in older adults

A

trauma (FALLS)
cancer
osteoporosis (brittle bones)
other skeletal diseases

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15
Q

when to suspect fx with older adults

A

with any fall or bone trauma

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16
Q

what does it mean for absence of typical symptoms

A

does not r/o fracture; can appear days after initial injury

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17
Q

s/s of fx

A

change in shape/length of limb
restriction of limb
edema
discoloration
bone protrusion
spasms

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18
Q

fx healing in older adults

A

Fractures heal slowly in older adults with higher risk of complications

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19
Q

interventions to prevent fx

A

Advise to avoid risky behaviors
Rise from a kneeling or sitting position
Safe, properly fitting shoes
Watch your step!
Use of nightlights or sunglasses to prevent glare

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20
Q

interventions for fx

A

Activity within the limits of provider
Joint exercise and proper positioning to prevent contractures
Correct body alignment
Measures to prevent immobility complications
Gradually mobilize ASAP

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21
Q

osteoarthritis affects what age

A

> 55 yo

22
Q

Leading cause of physical disability in older adults

A

osteoarthritis

23
Q

causes of osteoarthritis

A

excessive use of the joint
obesity
trauma
low Vit D and C
genetics

24
Q

what joints most affected by osteoarthritis

A

Weight-bearing joints
(knees, hips, vertebrae, and fingers)

25
Q

sx of osteoarthritis

A

No systemic symptoms, localized disease
Excessive exercise may cause more pain

26
Q

tx of osteoarthritis

A

analgesics (acetaminophen)
rest
heat/ice
aquatherapy
t’ai chi
massage
acupuncture
splints
braces
canes
proper body alignment and mechanics
weight reduction
nutritional intake
PT/OT
avoid stress on the joints
ROM
allow independence
hip and knee replacements

27
Q

RA in older adults

A

Most older patients developed it earlier in life
Greater systemic involvement occurs in older adults
Joint pain is present during rest and activity

28
Q

interventions for RA

A

rest and support the limb
ROM
PT/OT
heat
massage
analgesics
NSAIDs/immunosuppressants/corticosteroids for inflammation
diet change

29
Q

gout is characterized by:

A

exacerbations and remissions

30
Q

interventions of gout

A

Encourage fluid intake,
low-purine diet (avoid many kinds of meat)
avoid alcohol
thiazide diuretics can exacerbate
colchicine for acute attack
long-term meds allopurinol
indomethacin
probenecid

31
Q

when does osteoporosis normally affect

A

Primarily affects adults in middle to later life

32
Q

potential causes of osteoporosis

A

Inactivity/immobility
Disease (Cushing’s, diverticulitis, hyperthyroidism)
Reduction in anabolic sex hormones
Insufficient diet or loss of calcium, Vit D/C, and protein
Meds (antacids, corticosteroids, thyroid supplements)

33
Q

osteoporosis can cause:

A

kyphosis
height reduction
fractures

34
Q

tx of osteoporosis

A

SERMs
calcium & Vit D supplements
bisphosphonates
diet rich in protein and calcium
braces
regular exercise

avoid heavy lifting, jumping, etc.
ROM, ambulation, PT

35
Q

caused by friction and irritation on the feet that create layers of thickened skin; usually appears on the heels and soles of feet

A

calluses

36
Q

cone-shaped layers of thick, dry skin that forms over a bony prominence

A

corns

37
Q

a bony prominence over the first metatarsal head

A

bunions

38
Q

hyperextension at the metatarsophalangeal joint with flexion and corn formation at the proximal interphalangeal joint

A

hammer toe

39
Q

inflammation of the ligamentous band at its heel attachment in the foot

A

plantar fasciitis

40
Q

Podiatric Considerations

A

Encourage no self-treatment of conditions
Proper foot care
Seek professional podiatric care
Foot massages (but not those with PVD, lesions, or nerve damage)
Shoe shops can modify shoes
Orthotics
Foot exercises, ice
Antimicrobials for infections

41
Q

how to manage pain

A

Can interfere with mobility, activity, ADLs, and social life
Avoid injury
Passive stretching to control muscle cramps
Avoid excessive exercise
Correct positioning
Gentle touch and movement
Diversional activities (Guided imagery)
Heat (cautious with neuropathy)

42
Q

preventing injury

A

Fall prevention
Do not straighten a contracture
Be careful with turning and transfers

43
Q

promoting independence

A

Minimize limitations and strengthen capacities
Appropriate use of mobility aids
PT/OT collaboration

44
Q

how to facilitate proper positioning

A

correct body alignment

45
Q

assisting with range of motion

A

Promotion of joint motion & muscle strength, stimulation of circulation, maintenance of functional capacity, and prevention of contractures
Active  independently by patients
Active assistive  with assistance to the patient
Passive  with no active involvement of the patient
Most significant concern is degree of ROM to complete ADLs
Put all joints through full ROM daily

46
Q

steps for assisting with range of motion

A

Offer support above and below joint
Move joint slowly and smoothly x3
Do not force past resistance
Document

47
Q

stop ROM if:

A

resting HR >100 bpm
exercise HR >35% above resting HR
increase/decrease in SBP by 20 mm Hg
angina
dyspnea
pallor
cyanosis
dizziness
poor circulation
diaphoresis
acute confusion
restlessness

48
Q

Assisting with mobility aids and assistive technology

A

Enable patients to independently fulfill needs and enhance function
Evaluate for true need
Individually fitted

49
Q

use of a cane

A

Provide wider base of support; not for weight bearing; used on unaffected side and advanced when affected limb advances

50
Q

use of walkers

A

Offer broad base and used for weight bearing and stability
Advance the walker then step forward

51
Q

use of wheelchairs

A

Promote mobility for persons unable to ambulate, disabilities, paralysis, or cardiac disease

52
Q

use of assistive technology

A

Promote independent function
Splints, utensil grips, Velcro attachments, computers, voice synthesizers, Braille reading, remote control devices, robotic arms

Gero Exam 3 (8 decks)

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