Activity and Mobility Flashcards
(243 cards)
1
Q
What is the significance of Mobility in relation to Activities of Daily Living (ADLs)?
A
Mobility is essential for performing Activities of Daily Living (ADLs) and is affected by various factors like musculoskeletal disorders, trauma, disease, surgery, and prolonged immobility.
Mobility encompasses the physiology of movement and interventions to promote fitness.
2
Q
What are the key factors assessed in Pain management related to musculoskeletal problems?
A
Pain assessment includes its quality, location, and factors that worsen or improve it.
Common symptoms include those from osteoarthritis and bone tumors.
3
Q
What does Perfusion refer to in the context of musculoskeletal problems?
A
Perfusion refers to the circulation of blood and can be impaired due to musculoskeletal issues or trauma, necessitating monitoring of neurovascular status.
Compromised perfusion can lead to complications like Acute Compartment Syndrome (ACS).
4
Q
What is the risk associated with Infection in musculoskeletal health?
A
The risk of infection is heightened by impaired tissue integrity due to open fractures, extensive soft tissue damage, or surgically implanted devices.
Infection prevention strategies are crucial, especially pre- and post-operatively.
5
Q
Define Tissue Integrity in the context of musculoskeletal trauma.
A
Tissue Integrity refers to the health of tissue, which can be compromised by musculoskeletal trauma and prolonged immobility, leading to skin breakdown and pressure injuries.
Amputations can also impair tissue integrity, requiring careful limb care.
6
Q
What is the role of Sensory Perception in neurovascular assessments?
A
Sensory Perception involves assessing sensation, which can be impaired due to nerve damage from trauma or disease, and is critical in neurovascular assessments.
It is important for evaluating the patient’s condition.
7
Q
What is Cellular Regulation and how is it exemplified by Osteoporosis?
A
Cellular Regulation relates to diseases affecting bone tissue, exemplified by Osteoporosis, which causes weak, porous bones leading to fractures.
Osteoporosis is a significant health concern in musculoskeletal health.
8
Q
How is Immunity related to musculoskeletal disorders?
A
Immunity is a priority concept illustrated by Rheumatoid Arthritis (RA), a systemic autoimmune inflammatory disorder affecting joints.
RA impacts mobility and pain management.
9
Q
What is included in a Comprehensive Assessment for musculoskeletal health?
A
A Comprehensive Assessment includes patient history, physical examination, neurovascular status, functional ability, risk factors, and psychosocial status.
This thorough approach ensures effective care planning.
10
Q
What does Safe Patient Handling and Mobility (SPHM) involve?
A
SPHM involves implementing no-lift policies, using equipment, ensuring adequate staffing, and employing safe techniques for transfers and repositioning.
This is crucial for patient and healthcare worker safety.
11
Q
Fill in the blank: Regular _______ schedules are vital interventions to promote mobility.
A
repositioning
12
Q
What are common complications of immobility that need to be prevented?
A
Complications include:
* Venous stasis
* Thrombophlebitis
* Venous thrombosis
* Contractures
* Muscle atrophy
Exercise programs and joint protection principles are important for prevention.
13
Q
What is critical in the Management of Complications associated with musculoskeletal conditions?
A
Recognizing, preventing, and managing complications such as neurovascular compromise, infection, VTE, pressure injuries, and falls are critical nursing responsibilities.
This ensures patient safety and optimal recovery.
14
Q
What aspects should be covered in Patient and Family Education?
A
Education should cover:
* Conditions
* Risk factors
* Safety measures
* Medication administration
* Recognizing complications
* Self-management strategies
* Post-discharge care
This promotes independence and continuity of care.
15
Q
True or False: Psychosocial Care is important for addressing the emotional impact of mobility limitations.
A
True
16
Q
What is the importance of Teamwork and Collaboration in musculoskeletal care?
A
Effective teamwork with physical and occupational therapists, case managers, and other healthcare members is essential for comprehensive assessment, planning, and delivery of care.
This is especially important for mobility and rehabilitation.
17
Q
What is the second largest body system essential for movement?
A
The musculoskeletal system
The musculoskeletal system comprises bones, joints, and skeletal muscles.
18
Q
Why is mobility considered a basic human need?
A
It is necessary for performing Activities of Daily Living (ADLs)
Impaired mobility can significantly impact other body systems.
19
Q
What can prolonged impaired mobility lead to?
A
- Skin breakdown
- Constipation
- Venous thromboembolism
These issues can arise from disease, surgery, or trauma affecting the musculoskeletal system.
20
Q
What are key components of assessing mobility status?
A
- Gait
- Alignment
- Range of motion (ROM)
- Muscle strength
- Endurance
Collaboration with physical and occupational therapists is often involved.
21
Q
What is identified as one of the most common reports from individuals with musculoskeletal problems?
A
Pain
Conditions like osteoarthritis and bone tumors frequently cause pain.
22
Q
What factors should be assessed in pain evaluation?
A
- Quality
- Location
- Factors that worsen or improve it
Pain and impaired sensory perception may limit physical mobility and function.
23
Q
What is an interrelated concept discussed in Chapter 44?
A
Sensory perception
Impaired sensory perception can occur if nerves are damaged due to trauma or disease affecting the musculoskeletal system.
24
Q
What are the two types of tissue described in the composition of bone?
A
- Cortical/compact
- Spongy/cancellous
Bone composition also involves calcium and phosphorus metabolism influenced by calcitonin and parathyroid hormone.
25
What are the three types of joints mentioned in the chapter?
* Fibrous
* Cartilaginous
* Synovial
## Footnote
Synovial joints are the most common and often affected by disease or injury.
26
What significant changes in the musculoskeletal system are associated with aging?
* Muscle atrophy
* Decreased coordination
* Loss of muscle strength
* Gait changes
## Footnote
These changes increase the risk for falls and injury.
27
What common age-related condition affecting joints is mentioned?
Osteoarthritis
## Footnote
Osteoarthritis is a frequent issue for older adults.
28
What are key components of a comprehensive musculoskeletal assessment?
* Patient history
* Physical examination
* Observing gait
* Assessing range of motion
* Muscle strength
* Identifying deformities or swelling
## Footnote
Collaborating with therapists for functional ability and mobility assessment is crucial.
29
What diagnostic tests are used to assess musculoskeletal health?
* Laboratory tests (serum calcium and phosphorus)
* Imaging techniques (MRI)
* Arthroscopy
## Footnote
MRI is expensive and not widely used for osteoporosis diagnosis compared to BMD.
30
What is the purpose of arthroscopy?
To diagnose pathologic changes in joints
## Footnote
It requires the patient to have mobility in the joint and monitoring for complications.
31
What are some complications to monitor for after an arthroscopy?
* Swelling
* Increased pain
* Thrombophlebitis
* Infection
## Footnote
These complications can arise post-procedure.
32
What three key concepts does Chapter 44 focus on regarding musculoskeletal health?
* Mobility
* Pain
* Sensory perception
## Footnote
The chapter emphasizes the importance of thorough assessment considering physiological basis, age-related changes, and the impact of disease or trauma.
33
What is the primary impact of musculoskeletal health problems on older adults?
Decreased mobility
## Footnote
Changes in mobility status contribute to functional decline in older adults.
34
What are the common musculoskeletal health problems that affect mobility?
Diseases of cellular regulation, bone tumors, bone infection, deformities
## Footnote
These conditions almost all result in decreased mobility.
35
How does impaired mobility affect Activities of Daily Living (ADLs)?
Significantly impacts ADLs and a patient's self-esteem
36
What is osteomyelitis?
A bone infection often resulting from impaired tissue integrity
## Footnote
It can arise from postoperative surgical site infections (SSIs) or infections from surgically implanted devices.
37
Which population is particularly susceptible to contiguous spread osteomyelitis?
Older adults with slow-healing foot ulcers
38
What is osteoporosis?
A chronic metabolic disorder leading to decreased bone density and increased fragility fractures
39
What are the primary causes of primary bone cancer?
Most often found in adolescents and young adults
40
What are metastatic bone tumors commonly associated with?
Cancers such as prostate, breast, kidney, thyroid, and lung
41
What is the most common symptom of bone tumors?
Pain
42
What are some pain management strategies for bone tumors?
Analgesics, chemotherapy, radiation
43
What is the significance of monitoring neurovascular status?
Crucial for assessing perfusion indicators and complications related to musculoskeletal problems
44
What are the risk factors for osteoporosis?
* Genetic factors
* Aging
* Other medical conditions
* Long-term drug therapy (e.g., corticosteroids)
* Prolonged decreased mobility
45
What are modifiable risk factors for osteoporosis?
* Smoking
* Excessive alcohol use
* Limited carbonated beverage intake
* Sedentary lifestyle
46
What is a key prevention strategy for osteoporosis?
Regular weight-bearing exercise (like walking)
47
What medications are commonly used to protect bones in osteoporosis?
Bisphosphonates
48
What are the specific administration instructions for bisphosphonates?
* Early morning
* With water
* Remain upright
49
What is the primary treatment for osteomyelitis?
IV antibiotic therapy
50
What is plantar fasciitis?
Inflammation in the arch of the foot causing severe pain
51
What is crucial in the assessment of patients with bone tumors?
Pain assessment
52
What should be included in patient education for osteoporosis?
Risk reduction strategies, safe use and side effects of medications, recognizing complications
53
What is the focus of interprofessional collaboration in musculoskeletal care?
Ensuring home safety and hazard reduction
54
What psychosocial impacts can musculoskeletal problems have on patients?
Fear, decreased self-esteem, altered body image
55
True or False: Musculoskeletal problems primarily impact Mobility.
True
56
What is a key focus of care for patients with Osteoarthritis (OA)?
Mobility
## Footnote
OA serves as the concept exemplar for mobility, which is crucial for patient movement and self-care.
57
What is Rheumatoid Arthritis (RA) characterized as?
A systemic, autoimmune inflammatory disorder
## Footnote
RA management often involves drugs that suppress the immune response.
58
What is a major symptom of both Osteoarthritis (OA) and Rheumatoid Arthritis (RA)?
Pain
## Footnote
Pain is due to joint swelling, cartilage deterioration, inflammation, or nerve compression.
59
How is inflammation defined in the context of arthritis?
Inflammation of one or more joints
## Footnote
Inflammation is a key component in both OA and RA.
60
What is a major complication after Total Joint Arthroplasty (TJA)?
Venous thromboembolism (VTE)
## Footnote
Patients may be on anticoagulant therapy affecting clotting.
61
What is a serious potential complication after TJA?
Infection
## Footnote
Surgical site infection is a major concern, especially for patients on immunosuppressive drugs.
62
What does Osteoarthritis (OA) involve?
Progressive deterioration and loss of articular cartilage and bone
## Footnote
OA commonly affects weight-bearing joints, hands, and the spine.
63
What are common pharmacologic interventions for Rheumatoid Arthritis (RA)?
* Disease-Modifying Antirheumatic Drugs (DMARDs)
* Methotrexate
* Leflunomide
* Hydroxychloroquine
* Biological Response Modifiers (BRMs)
## Footnote
Self-management education is vital for RA patients.
64
What is Total Joint Arthroplasty (TJA)?
Surgical creation of a functional synovial joint using implants
## Footnote
TJA is often performed for severe arthritis, including Total Hip and Knee Arthroplasty.
65
What is included in perioperative care for TJA?
* Preoperative teaching
* Identifying a 'joint coach'
* Pre-habilitation (prehab)
* Infection prevention protocols
## Footnote
This includes screening, nasal mupirocin, CHG baths, and IV antibiotics.
66
What is a key focus of postoperative care after TJA?
Preventing complications
## Footnote
This includes hip dislocation, VTE, infection, and monitoring neurovascular status.
67
Who do nurses collaborate with in the care of patients undergoing TJA?
Interprofessional teams
## Footnote
This includes physical/occupational therapists and case managers for various aspects of care.
68
Fill in the blank: Arthritis is defined as _______.
inflammation of one or more joints
69
True or False: Pain management is not a critical intervention goal for arthritis.
False
70
What is the role of patient education in the management of arthritis and TJA?
Emphasized throughout the care process
## Footnote
It includes self-management teaching.
71
What is a key focus and Priority Concept in musculoskeletal trauma care?
Mobility
## Footnote
Mobility is crucial as musculoskeletal trauma significantly impairs a patient's ability to move.
72
What are the potential complications of prolonged immobility?
* Contracted joints
* Osteoarthritis
* Osteoporosis
* Muscle atrophy
73
What nursing interventions are aimed at promoting mobility?
Using devices like walkers, canes, and crutches
74
What Priority Concept is associated with perfusion in musculoskeletal trauma?
Perfusion
## Footnote
Impaired perfusion can occur due to hemorrhage and affects major organs.
75
What is a significant issue related to pain in musculoskeletal trauma?
Phantom limb pain (PLP)
## Footnote
PLP is a common concern after amputation.
76
What does impaired tissue integrity refer to in the context of musculoskeletal trauma?
Damage to soft tissue and structures due to trauma
77
What is a common risk associated with open fractures?
Infection
## Footnote
Open fractures alter tissue integrity, making infections a serious concern.
78
What is defined as a break or disruption in the continuity of a bone?
Fractures
79
What are the management techniques for fractures?
* Traction
* External fixation
* Open reduction internal fixation (ORIF)
80
What serious complication can arise from Acute Compartment Syndrome (ACS)?
Reduced circulation leading to limb-threatening conditions
81
What is Fat Embolism Syndrome (FES)?
A complication of fractures where fat globules clog small blood vessels
82
What is Venous Thromboembolism (VTE)?
A common and potentially fatal complication of lower-extremity surgery or trauma
83
What condition involves median nerve compression and is a common repetitive stress injury?
Carpal Tunnel Syndrome (CTS)
84
What should be included in nursing assessments for musculoskeletal trauma?
* Mechanism of injury
* Pain level
* Neurovascular status (color, temperature, pulses, capillary refill, movement, sensation)
85
What are essential interventions in nursing care for musculoskeletal trauma?
* Promoting mobility
* Pain management
* Infection prevention
* Preventing complications like VTE, ACS, and FES
86
What is a critical safety priority after musculoskeletal trauma or surgery?
Neurovascular Assessment
87
What is the importance of patient education in musculoskeletal trauma care?
Teaching about risks for complications, safe use of mobility aids, and proper exercises
88
Fill in the blank: Surgical removal of a limb is called _______.
Amputation
89
What is a significant aspect of care involving collaboration with therapists in musculoskeletal trauma?
Rehabilitation
90
What should be assessed in the residual limb after an amputation?
Neurovascular status
91
True or False: Pain management is not necessary for patients with musculoskeletal trauma.
False
92
What is considered a fundamental human need related to mobility?
Mobility is essential for performing Activities of Daily Living (ADLs)
## Footnote
Impaired mobility can diminish self-esteem and quality of life
93
What common musculoskeletal issues can impair mobility?
Musculoskeletal issues include:
* Arthritis
* Osteoporosis
* Trauma
## Footnote
These issues often lead to pain and reduced quality of life.
94
How are Osteoarthritis (OA) and Rheumatoid Arthritis (RA) differentiated?
OA is noninflammatory and localized, while RA is inflammatory and systemic
## Footnote
OA involves degeneration of cartilage, whereas RA involves autoimmune processes.
95
What is the etiology of Osteoarthritis (OA)?
Primary OA is caused by aging and genetic factors
## Footnote
It leads to cartilage deterioration and loss of joint function.
96
What are the systemic effects of Rheumatoid Arthritis (RA)?
RA can affect:
* Joint inflammation
* Pain
* Stiffness
* Other body systems (e.g., vasculitis, respiratory, cardiac complications)
## Footnote
RA is an autoimmune disorder that can lead to joint deformities.
97
What is Gout and what causes it?
Gout is a systemic disease caused by errors in purine metabolism, resulting in urate crystal deposits in joints
## Footnote
It causes severe joint inflammation, typically affecting the great toe.
98
What characterizes Osteoporosis?
Osteoporosis is characterized by decreased bone density and porous bones that fracture easily
## Footnote
It is linked to genetic factors, lack of calcium, and hormonal changes.
99
What age-related changes increase the risk of falls in older adults?
Age-related changes include:
* Muscle tissue atrophy
* Decreased coordination
* Loss of muscle strength
* Gait changes
## Footnote
These changes increase the risk for falls and injury.
100
What assessments are critical for Osteoarthritis (OA)?
Assessments for OA include:
* Joint pain
* Stiffness
* Mobility
* Ability to perform ADLs
* History of arthritis
## Footnote
Observing for joint deformities is also important.
101
What are the key components of a neurovascular assessment?
Key components include:
* Color
* Temperature
* Distal pulses
* Capillary refill
* Movement
* Sensation
## Footnote
This assessment is crucial after musculoskeletal injury or surgery.
102
What are signs of infection in a post-surgical patient?
Signs of infection include:
* Redness
* Warmth
* Swelling
* Pain
* Fever
## Footnote
Patients with open fractures or surgical repairs are at high risk.
103
What is the significance of assessing for Acute Compartment Syndrome (ACS)?
Increased pain, impaired mobility, and decreased sensation indicate potential neurovascular compromise and ACS
## Footnote
ACS is a limb-threatening condition requiring immediate intervention.
104
What nursing care is essential for managing pain after trauma or surgery?
Essential nursing care includes:
* Frequent pain assessment
* Timely administration of analgesics
* Non-pharmacologic methods like rest and heat/cold
## Footnote
Aggressive pain management promotes early mobility.
105
What is the role of interdisciplinary collaboration in patient care for fractures?
Interdisciplinary collaboration includes:
* Physicians
* Nurses
* Physical therapists
* Occupational therapists
* Case managers
## Footnote
This teamwork supports comprehensive patient care and recovery.
106
Fill in the blank: Osteoporosis is linked to _______ and _______ factors.
[genetic] and [immune] factors.
107
True or False: Osteoarthritis is primarily a systemic disease.
False
108
What are common assessment findings for Osteomyelitis?
Common findings include:
* Bone pain
* Fever (may be absent in older adults)
## Footnote
Assessing for localized, pulsating pain is critical.
109
What diagnostic tests are used to assess bone density for osteoporosis diagnosis?
Diagnostic tests include:
* DXA (Dual-energy X-ray Absorptiometry)
* Radiography
## Footnote
These tests help confirm osteoporosis.
110
What complications can immobility lead to?
Complications of immobility include:
* Contracted joints
* Osteoarthritis
* Osteoporosis
* Muscle atrophy
* Skin breakdown (pressure injuries)
* Constipation
* VTE
## Footnote
VTE stands for venous thromboembolism, a condition where blood clots form in veins.
111
What nursing interventions are essential to prevent complications of immobility?
Nursing interventions include:
* Frequent repositioning
* Skin care
* Bowel protocols
* Exercises to maintain muscle mass, tone, and strength
## Footnote
These interventions are crucial to mitigate the effects of immobility.
112
What is the ultimate goal of promoting Activities of Daily Living (ADLs)?
The ultimate goal is to restore the patient's ability to perform ADLs and function independently.
113
How do nurses assess a patient's ability to perform ADLs?
Nurses assess the patient's ability to perform ADLs by collaborating with PT/OT to evaluate functional status and the need for assistive devices or modifications.
114
What can nurses provide to assist with self-care?
Nurses can provide:
* Suggestions for self-care
* Devices for self-care
* Teaching safe techniques
* Ensuring the home environment supports independent functioning
## Footnote
Home care assistance may also be part of this support.
115
Why is care coordination and transition management important?
Care coordination and transition management are vital for determining appropriate discharge placement and arranging necessary home care services and structural modifications.
116
What role do case managers and rehabilitation therapists play in patient care?
Case managers and rehabilitation therapists collaborate to determine appropriate discharge placement (home, rehab unit, skilled nursing facility) and needed home care services.
117
What is essential for continuity of care during patient transitions?
Written instructions and hand-off communication with new care providers are essential for continuity of care.
118
What community resource is mentioned for ongoing support and education?
The Arthritis Foundation is mentioned as an important community resource for ongoing support and education.
119
What demographic is increasingly at risk for falls due to functional decline?
Older adults
## Footnote
Older adults experience difficulties with activities of daily living (ADLs) and instrumental activities of daily living (IADLs) due to mobility status changes.
120
What is the most common injury in older adults resulting from falls?
Hip fractures
## Footnote
Hip fractures have a high mortality rate due to complications.
121
Name two physiologic aging changes that increase fall risk in older adults.
* Decreased bone density (osteopenia/osteoporosis)
* Joint cartilage degeneration leading to osteoarthritis (OA)
122
What disease processes contribute to increased fall risk in older adults?
* Osteoporosis
* Foot disorders
* Cardiac function changes
* Chronic obstructive pulmonary disease (COPD)
123
Which types of medications are known to increase fall risks in older adults?
* Diuretics
* Antihypertensives
* Antidepressants
* Sedatives
* Opioids
124
Fill in the blank: Environmental hazards such as _______ and inadequate lighting can increase the risk of falls.
floor clutter
125
What assessment tool is used to measure an older adult’s capacity for self-care?
Katz Index of Independence in Activities of Daily Living
## Footnote
This tool assists in detecting subtle health changes and preventing functional decline.
126
What role does collaboration with physical and occupational therapists play in mobility assessments?
Assessing functional status and determining the need for assistive devices
127
True or False: Using assistive devices like walkers and canes can help maintain functional capacity and independence in ADLs.
True
128
What is a crucial aspect of effective communication in patient-centered care?
Planning care carefully and communicating the plan with staff and the patient
129
Name a key aspect of interprofessional teamwork in patient care.
Determining motor capacities and planning appropriate interventions
130
Fill in the blank: Providing education in a way that is accessible and understandable is vital for _______.
effective patient and family care
131
What psychosocial impact can mobility limitations have on patients?
Diminished self-esteem and body image
132
How can chronic pain affect a patient's emotional responses?
It can lead to anxiety and depression.
133
What is the purpose of Safe Patient Handling and Mobility (SPHM) programs?
Improve quality of care and reduce harm for both patients and healthcare workers
134
What is an essential practice for infection prevention in surgical patients?
Administering IV antibiotics before incision
135
What is a key factor in preventing venous thromboembolism (VTE) in older adults?
Implementing evidence-based VTE prevention protocols
136
Name one method to prevent hip dislocation after total hip arthroplasty (THA).
Using abduction pillows or splints
137
What should be monitored frequently to prevent complications after orthopedic surgery?
Neurovascular status (circulation, movement, sensation - CMS)
138
True or False: Enhanced Recovery After Surgery (ERAS) programs aim to improve patient outcomes and reduce hospital stay length.
True
139
What is an important quality measure for care transitions?
Providing patient self-management health teaching before discharge
140
What are the two classifications of joints based on their degree of movement?
Amparosis and thyrosis
## Footnote
Amparosis refers to slightly movable joints, while thyrosis refers to freely movable synovial joints.
141
What type of joint is characterized by limited movement, such as between vertebrae?
Amparosis
142
Which joints are known for their extensive range of motion, like flexing and extending?
Thyrosis or synovial joints
143
What is an example of a hinge joint?
Knees or elbows
144
What is the term for immobile joints, such as those found in the skull?
Synothrosis
145
What is the function of hyaline cartilage in joints?
Provides lubrication and allows bones to move without sliding against each other
146
What is synovium?
The inner lining of the joint capsule that produces synovial fluid
147
What is the role of synovial fluid in joints?
Acts like grease to allow joints to move
148
What type of arthritis is characterized as inflammatory or autoimmune?
Rheumatoid arthritis
149
What is the main characteristic of degenerative arthritis?
Chronic disease, such as osteoarthritis
150
What is another name for gouty arthritis?
Gouty arthritis is also known as inflammatory or metabolic arthritis
151
What is a key symptom of rheumatoid arthritis?
Morning stiffness
152
How long does morning stiffness last with rheumatoid arthritis compared to osteoarthritis?
Rheumatoid arthritis stiffness lasts for several hours; osteoarthritis stiffness lasts for an hour or less
153
What is a common systemic effect of rheumatoid arthritis due to its autoimmune nature?
Fatigue or flu-like symptoms
154
What are rheumatoid nodules?
Small lumps of tissue that develop under the skin
155
What laboratory test can help determine if a patient has rheumatoid arthritis?
Rheumatoid factor blood test
156
What does an increased ESR indicate?
Chronic inflammation
157
What medication is often the first line for reducing inflammation in rheumatoid arthritis?
Aspirin
158
What are DMARDs?
Disease-modifying antirheumatic drugs used for more aggressive forms of rheumatoid arthritis
159
What is a potential complication of long-term prednisone use?
Increased risk of osteoporosis
160
What is a common non-pharmacological method for managing rheumatoid arthritis pain?
Physical therapy
161
Fill in the blank: The main goal of rheumatoid arthritis treatment is to relieve _______.
Pain
162
What dietary recommendations are made for patients with rheumatoid arthritis?
Increase protein and calcium intake
163
What is the significance of weight-bearing exercises for rheumatoid arthritis patients?
Strengthens muscles around the joint
164
What is a sinovectomy?
A surgery to remove synovium from the joints
165
True or False: There is a cure for rheumatoid arthritis.
False
166
What is a common complaint related to rheumatoid arthritis that affects daily activities?
Fatigue
167
What is the relationship between rheumatoid arthritis and joint damage?
Joint damage limits range of motion and may require surgery
168
What is osteoarthritis?
A degenerative joint disease characterized by depletion of cartilage in the joints
## Footnote
Osteoarthritis is the most common type of arthritis, leading to joint pain, stiffness, and limited mobility.
169
Which joints are most commonly affected by osteoarthritis?
Weight-bearing joints such as hips and knees
## Footnote
These joints are subjected to more stress over time.
170
What are the main characteristics of osteoarthritis?
Progressive deterioration and loss of articular cartilage and bone in one or more joints
## Footnote
It is a non-inflammatory, localized disorder.
171
What are some risk factors for developing osteoarthritis?
* Age
* Obesity
* Joint injury
* Chronic joint disease
* Metabolic disorders
## Footnote
Conditions like rheumatoid arthritis can also increase the risk.
172
What are common signs and symptoms of osteoarthritis?
* Joint pain
* Stiffness
* Swelling
* Reduced range of motion
* Crepitus
## Footnote
Symptoms may worsen after movement or prolonged inactivity.
173
How is osteoarthritis diagnosed?
Based on history, physical examination, radiologic changes, and possibly lab results
## Footnote
X-rays are used to determine structural changes but do not assess pain level.
174
What is the primary drug of choice for treating osteoarthritis pain?
Acetaminophen
## Footnote
Recommended not to exceed 4000 mg per day due to hepatotoxicity risks.
175
What are some examples of non-steroidal anti-inflammatory drugs (NSAIDs) used for osteoarthritis?
* Ibuprofen
* Naproxen
* Celecoxib
* Diclofenac
## Footnote
Use of NSAIDs carries risks of GI bleeds and renal failure.
176
What is the goal of osteoarthritis treatment?
To decrease tenderness, pain, stiffness, and improve range of motion
## Footnote
A multidisciplinary approach is often used.
177
What are non-pharmacological therapies for osteoarthritis?
* Patient education
* Dietary information
* Physical therapy
* Occupational therapy
## Footnote
These interventions are essential for managing symptoms and improving quality of life.
178
What type of exercises are recommended to maintain joint mobility in osteoarthritis patients?
Low-impact exercises such as walking, swimming, or cycling
## Footnote
These activities help maintain joint strength and flexibility.
179
What surgical options are available for severe osteoarthritis?
* Arthroscopic surgery
* Joint irrigation
* Debridement
* Total joint replacement
## Footnote
These procedures are considered when non-surgical interventions fail.
180
What is gout?
A systemic metabolic disease characterized by increased uric acid levels, leading to urate crystal deposits in joints
## Footnote
Gout is considered the only curable form of arthritis.
181
What is the difference between primary and secondary gout?
Primary gout is genetically predisposed; secondary gout is due to elevated uric acid from other diseases or medications
## Footnote
Examples include renal insufficiency or diuretic use.
182
Fill in the blank: Osteoarthritis is characterized by the breakdown of _______.
cartilage
183
What are the signs and symptoms of gout?
Pain and inflammation in the affected joint, acute attacks often in the great toe, chronic gout with repeated attacks.
## Footnote
Chronic gout includes remission and exacerbation episodes.
184
How is gout diagnosed?
History taking, physical examination, blood draw for serum uric acid levels, renal function lab evaluation, joint aspiration for uric acid crystals.
## Footnote
Aspiration tests for the presence of uric acid crystals in the joint.
185
What medications are commonly used to manage gout?
Colchicine, Allopurinol to increase uric acid excretion.
## Footnote
Colchicine and Allopurinol help reduce inflammation and manage uric acid levels.
186
What medications should be avoided in gout management?
Aspirin, diuretics, alcohol.
## Footnote
These can increase uric acid levels in the body.
187
What dietary changes are recommended for patients with gout?
Low purine diet, increased fluid intake.
188
What is osteoporosis?
A chronic disease of cellular regulation causing significant bone density loss and potential fractures.
189
What causes osteoporosis?
Combination of genetic, lifestyle, and environmental factors.
190
What are the common risk factors for osteoporosis?
* Postmenopausal women
* Older age (over 50)
* Family history of osteoporosis
* Eating disorders
* Rheumatoid arthritis
* History of low trauma fractures
## Footnote
High incidence in Euro Caucasian or Asian ethnicities.
191
What are some modifiable risk factors for osteoporosis?
* Estrogen or androgen deficiency
* Inactivity or prolonged immobility
* Low body weight
* Poor nutrition (low calcium and/or vitamin D)
* Smoking
* High alcohol and caffeine intake
* Chronic steroid therapy.
192
What are the signs and symptoms of osteoporosis?
* Increased fractures (especially wrist, hip, spine)
* Decreased height
* Postural changes (kyphosis)
* Chronic back pain
* General weakness.
193
What is the recommended calcium intake for postmenopausal women?
About 1500 milligrams per day.
194
What type of exercise is particularly effective for bone health?
Weight-bearing exercise, such as walking.
195
What are common types of fractures associated with osteoporosis?
* Hip fractures
* Wrist fractures (Colles' fracture)
* Spinal fractures (vertebral compression fractures).
196
What is a common complication of hip fractures in older adults?
High mortality rate due to complications related to surgery, such as pneumonia.
197
What is balloon kyphoplasty?
A procedure to treat spinal compression fractures by inflating a balloon in the vertebra and injecting bone cement.
198
What is the purpose of closed reduction in fracture treatment?
To realign bone fragments without surgical incision.
199
What are the signs and symptoms of fractures?
* Deformity of the affected area
* Changes in circulation, sensation, and motion
* Swelling
* Bruising
* Pain.
200
What is the purpose of neurovascular assessments in fracture care?
To monitor circulation, sensation, and movement to prevent complications.
201
What are the two types of fracture treatments?
* Closed or manual reduction
* Open reduction internal fixation (ORIF).
202
What are common complications following fracture surgical repairs?
* Immobility
* Infection (pneumonia)
* Fat embolisms
* Deep vein thrombosis (DVT)
* Pressure ulcers
* Joint contractures.
203
What should be done if a patient experiences severe pain after hip surgery?
Assess for potential dislocation and do not attempt to put the hip back in place.
204
What are the JCO measures related to?
Preoperative care
205
What baseline assessments should be obtained before surgery?
EBCs and level of consciousness
206
Why is it important to monitor patients' level of consciousness before surgery?
Elderly patients can be disoriented due to trauma, shock, and medications
207
What should be monitored in terms of fluid management before and after surgery?
Intake and output of fluids
208
What is important to assess every two hours post-surgery?
CSSM (circulation, sensation, motion)
209
What precautions should be taken regarding pain management before surgery?
Assess pain level and determine effective medications
210
What dietary considerations should be taken into account before surgery?
Last meal and normal diet at home
211
What does NPO mean in the context of preoperative care?
Nothing by mouth, indicating fasting before surgery
212
What is the purpose of an abduction pillow after hip replacement surgery?
To prevent the legs from coming together and causing injury
213
What are the traditional hip precautions after posterior approach surgery?
No flexing more than 60 to 90 degrees or internal rotation
214
What is a common piece of equipment needed upon discharge after surgery?
Front wheel walker
215
What can be used to help patients put on socks without bending?
Sock applicator
216
What complications can arise due to immobility post-surgery?
Atelectasis and constipation
217
What is the role of incentive spirometry post-surgery?
To help expand the lungs and prevent atelectasis
218
What should be monitored regarding patients' intakes and outputs?
What is going in and out, especially if they have fluid restrictions
219
What is the purpose of sequential compression devices (SCDs)?
To help with circulation and prevent DVTs
220
What should patients be educated about regarding cane use?
Use the cane on the unaffected side
221
What is a common drain used post-surgery for pain management?
JP drain
222
What should be monitored regularly after surgery in terms of circulation?
CSM (circulation, sensation, motion)
223
What is a common complication of narcotic medication use post-surgery?
Constipation
224
What types of therapy are important for mobility post-surgery?
Physical therapy and occupational therapy
225
What is the goal for patients post knee or hip replacement?
Get them up and out of bed within 24 hours
226
Fill in the blank: Patients may require _______ for mobility training post-surgery.
Physical therapy
227
True or False: Patients can perform weight-bearing activities immediately after hip surgery.
False
228
What should be done regarding dressing changes after surgery?
Initial changes should be done by the surgeon
229
What type of chairs may be ordered for patients upon discharge?
High seat chairs or elevated toilet seats
230
What is the importance of teaching patients what to expect after surgery?
It helps them mentally prepare and reduces anxiety
231
What is the second leading cause of accidental deaths?
Falls
## Footnote
Falls are highly preventable accidents, particularly among the elderly.
232
What percentage of falls involve elderly individuals?
75%
## Footnote
Falls among the elderly are often caused by simple factors.
233
What are common causes of falls in elderly individuals?
Getting up too fast and not using assistive devices
## Footnote
Many falls occur at night due to poor lighting and the need to use the bathroom.
234
When do many falls occur in the elderly?
At night and during change of shift
## Footnote
Poor lighting and sleepiness contribute to nighttime falls.
235
What are some risk factors for falls?
* Sensory perception issues
* Altered mental status
* General weakness
## Footnote
Sensory issues may include hearing or vision problems, while altered mental status can be due to conditions like delirium.
236
How does altered mental status increase fall risk?
It causes confusion and impulsivity
## Footnote
Particularly prevalent in elderly patients in acute care settings.
237
What is the primary nursing concern regarding falls?
Preventing falls
## Footnote
Nurses assess environments for hazards that could cause falls.
238
What environmental modifications can help prevent falls?
* Night lights
* Appropriate lighting
* Non-slip flooring
## Footnote
Ensuring a safe environment is crucial in both home and hospital settings.
239
Why is it important to assess an individual's previous level of functioning?
To identify goals for recovery
## Footnote
Understanding prior functioning helps in planning rehabilitation.
240
What should be the goal for patients recovering from hip fractures?
To return to their previous level of functioning
## Footnote
This is especially important to avoid long-term effects of immobility.
241
What is a key aspect of maintaining independence in older adults?
Encouraging self-care activities
## Footnote
Activities like dressing and personal hygiene should be promoted to maintain confidence and mobility.
242
Fill in the blank: If elderly individuals do not use it, they _______.
lose it
## Footnote
This emphasizes the importance of maintaining independence and physical activity.
243
What is the relationship between independence and self-confidence in older adults?
Maintaining independence helps increase self-confidence
## Footnote
Encouragement in self-care activities contributes to overall well-being.
