Activity, Exercise, and Musculoskeletal Assessment

Question 1

Elevates mood and attitude.
Enables physical fitness.
Helps one to quit smoking and stay tobacco-free.
Boosts energy levels.
Helps in the management of stress.
Promotes a better quality of sleep.
Improves self-image and self-confidence.

Answer 1

physical activity

Question 2

is the physiological changes that occur from periods of inactivity and patients who are hospitalized are at increased risk for this because they are less active.

Answer 2

deconditioning

Question 3

describes the coordinated efforts of the musculoskeletal and nervous systems.

Answer 3

body mechanics

Question 4

similar to posture, refers to the positioning of joints, tendons, ligaments, and muscles. If a patient has good body alignment, their center of gravity is stable. This reduces strain on musculoskeletal structures, promotes comfort, and contributes to balance and energy conservation.

Answer 4

body alignment

Question 5

is required for maintaining position and for movement. Diseases, injury, pain, physical development, life changes, and many medications can compromise balance. Poor balance can compromise mobility, physical safety, and can create a fear of falling that reduces activity.

Answer 5

balance

Question 6

Patients can fall if their center of gravity is unbalanced, because of the gravitational pull on their weight. To lift safely, you must overcome the weight of the object and know its center of gravity. People’s center of gravity is not directly center of their body. It is usually midline at 55% to 57% of their standing height.

Answer 6

gravity

Question 7

is a force that occurs in a direction to oppose movement. The greater the surface area of an object being moved, the greater the ______

Answer 7

friction

Question 8

. When friction is exerted against the skin, while the skin remains stationary and the bony structures move, it is called _____

Answer 8

shear

Question 9

This can damage underlying blood vessels and tissue, causing decreased blood flow and pressure injuries

Answer 9

shear

Question 10

Using full body slings and mechanical lifts can prevent ______ ______, as well as protect healthcare workers from injury.

Answer 10

friction and shear

Question 11

are a region where two bones connect.

Answer 11

joints

Question 12

are elastic, they bind joints and connect bones and cartilage.

Answer 12

ligament

Question 13

connect muscle to bone and are strong, flexible, and inelastic.

Answer 13

tendons

Question 14

is nonvascular supporting connective tissue that sustains weight and serves as a shock absorber between articulating bones.

Answer 14

cartilage

Question 15

isometric

Answer 15

maximum HR formula

Question 16

maximum HR formula

Answer 16

220-age

Question 17

makes us aware of our body’s position

Answer 17

proprioception

Answer 18

physical activity

Question 19

is a subset of PA that is planned, structured, and repetitive and has a final or an intermediate objective, such as the improvement or maintenance of physical fitness.

Answer 19

physical excercise

Question 20

cause muscle contraction and change the muscle length

Answer 20

isotonic

Question 21

Increase muscle mass, tone, and strength; promotes osteoblastic activity to strengthen bones; enhance circulatory and respiratory function.

Answer 21

isotonic exercise

Question 22

tightening or tensing of the muscles without moving the body parts

Answer 22

isometric excercise

Question 23

Not ideal for patients who do not tolerate increased activity

Answer 23

isometric exercise

Question 24

Increase muscle mass, tone, and strength; increase circulation to that body part and osteoblastic activity.

Answer 24

isometric exercise

Question 25

contracting a muscle while pushing against a stationary object or resisting the movement of an object. (push-ups). Promote muscle strength and osteoblastic activity.

Answer 25

resistive isometric exercise

Question 26

t/f: face direction of movement

Answer 26

true

Question 27

t/f: Leverage, rolling, turning, or pivoting require less work than lifting.

Answer 27

true

Question 28

what does SPHM stand for?

Answer 28

safe patient handling and mobility

Question 29

Evidence-based research has shown that__________ interventions significantly reduce overexertion injuries by replacing manual patient handling with safer methods guided by ergonomics

Answer 29

SPHM

Question 30

is the design of work tasks to best suite the capabilities of the workers.

Answer 30

ergonomics

Question 31

includes: standardized assessment tools to identify a patient’s mobility level; an ergonomics assessment of patient rooms and health care environments; Assessment algorithms to select the right equipment and number of staff for each patient handling/mobility task; Unit peer leaders who act as patient handling experts and staff trainers; Safety huddles to share safety information with staff and a minimal lift policy.

Answer 31

SPHM

Question 32

They also improve patient outcomes with fewer falls, skin tears, and pressure injuries occurring.

Answer 32

SPHM techniques

Question 33

____________ lack the coordination, strength, and stability to sit or stand

Answer 33

newborns

Question 34

they grow and develop their bones and muscles, and can support their weight, sit, stand, then walk.

Answer 34

infants

Question 35

still have an awkward posture with a swayback and larger abdomen

Answer 35

Toddlers

Question 36

the musculoskeletal system continues to grow and develop, allowing better coordination for fine motor skills.

Answer 36

third year to adolescence

Question 37

growth is sporadic, which can make them appear awkward and uncoordinated.

Answer 37

adolescents

Question 38

should have full musculoskeletal function and the ability to carry out ADLs and physical exercise.

Answer 38

middle aged adults

Question 39

may experience bone loss, walk more slowly and incorrectly, and appear less coordinated. Many are afraid of falling.

Answer 39

older adults

Question 40

t/f: consider the pt's knowledge of exercisea and activity, their values and beliefs about exercise and health, barriers to activity and exercise andcurrent exercise behaviros or habits

Answer 40

true

Question 41

with work, people often don’t have the time to exercise. Some employers will provide exercise opportunities by doing things like installing on-site walking tracks.

Answer 41

environmental factors

Question 42

t/f: Children today are less active, but many schools have been good with providing fitness opportunities and encouraging exercise. Communities may have fewer or more facilities and programs for access to fitness and exercise

Answer 42

true

Question 43

t/f: Patients are more likely to incorporate an exercise program if those around them are supportive. Having a friend or significant other to exercise with. Parents supporting their children’s physical activities by encouraging them, providing transportation to sporting events, and participating in family outings.

Answer 43

true

Question 44

what are the five stages of change int he TTM model?

Answer 44

Precontemplation - Aware of the problem but do not intend to change their behavior in the next 6 months. Contemplation - Aware of the need for change and intend to take action within 6 months but lack commitment. Preparation - Have decided to take action in the immediate future (within the next month). Often have a plan. Action - Have made specific changes in their life-styles within the past 6 months. Maintenance - Have shown the desired behavior over 6 months and are working to prevent relapse.

Question 45

Aware of the problem but do not intend to change their behavior in the next 6 months.

Answer 45

Precontemplation

Question 46

Aware of the need for change and intend to take action within 6 months but lack commitment.

Answer 46

contemplation

Question 47

Have decided to take action in the immediate future (within the next month). Often have a plan.

Answer 47

preparation

Question 48

Have made specific changes in their life-styles within the past 6 months.

Answer 48

action

Question 49

Have shown the desired behavior over 6 months and are working to prevent relapse.

Answer 49

maintenance

Question 50

Access to facilities or a public park and walking area? How much time do they believe they have to exercise during the day? Do they have social support?

Answer 50

assess socioeconmonic factors

Question 51

This will include aspects of the musculoskeletal assessment that we will be talking about today. Review the medical record for any conditions that may affect their ability to be mobile and active, or that affects their body alignment.

Answer 51

physical health assessment

Question 52

 Try to help the patient be at ease so that they will display their normal body positioning.

Answer 52

assess body alignment

Question 53

 Note whether they can sit upright in bed or in a chair. Allow them to use the siderails of the bed, if present. Don’t just take their word for it that they can stand. Let them use their assistive devices if they are typically used. They should be able to raise their buttocks off the bed and hold for a count of five.

Answer 53

assess their ability to sit and stand

Question 54

t/f: determine the patient preferred form of exercise level of intensity and frequency

Answer 54

true

Question 55

should be = 2 hours and 30 minutes of moderate intensity _______per week, such as brisk walking

Answer 55

aerobic exercise

Question 56

they should have ______ or more days/week of muscle strengthening exercises for all muscle groups.

Answer 56

2

Question 57

is the type and amount of exercise or work a person can do without undue exertion or injury. Observe patients after they perform ADLs, ambulate, or sit up in a chair for several hours. Look for difficulty breathing, assess heart rate and blood pressure. Compare to baseline rates at rest.

Answer 57

activity tolerance

Question 58

what is the target H formula?

Answer 58

(max HR)(0.6) and (max HR)(0.9)

Question 59

how much time do you warm up and cool down for?

Answer 59

5, 10 minutes

Question 60

prevent deconditioning?

Answer 60

stretching excercises,

Question 61

how soon to you admin pain med before exercise?

Answer 61

30 minutes

Question 62

what do you want to do with your feet while helpin them fall?

Answer 62

feet apart to provide a broad base of support

Question 63

The ______is the only one who knows if exercise has been beneficial and effective for them.

Answer 63

patient

Question 64

When the expected outcomes are not met, explore the reason why so that you can adjust the plan with them accordingly.

Question 65

which side do you stand on ?

Answer 65

the unaffected side

Question 66

know patient level of mobility assess patient risks for activiy intolerance mentally review transfer steps before beginning stand on unafffected side determine transfer equipment needed raise eds side rail on opposite side arrange equipment valuate for correct body allignment understand equipment before starting

Answer 66

safety guidelines for nusing skills

Question 67

You will be assessing the patient’s range of motion, muscle strength and tone, and joint and muscle condition.

Answer 67

muskuloskeletal assessment

Question 68

musko skeletal assessment is Especially important when the patient _____________________

Answer 68

reports pain or a loss of joint or muscle function.

Question 69

t/f:Ask the patient if they have had any history of bone, joint, or muscle problems, what their normal activity pattern is, and about their ability to perform their activities of daily living.

Answer 69

true

Question 70

You want to do this discretely, so that they a patient is unaware, or it will change the natural way they ____

Answer 70

walk. assess their gait

Question 71

arms swinging freely at the sides, with the head leading the body

Answer 71

normal

Question 72

often walk with smaller steps and a wider base of support

Answer 72

older adults

Question 73

 Observe while they are standing, from their side, behind, and while facing them.

Answer 73

posture

Question 74

upright with the hips and shoulders aligned. An even contour of the shoulders, level of scapulae, and iliac crests. The head should upright and aligned center. The extremities should be symmetrical

Answer 74

normal standing posture

Question 75

tend to have a stooped posture with hips/knees slightly flexed and arms bent at the elbows.

Answer 75

older adults

Question 76

 increase in lumbar spine curvature.

Answer 76

lordosis (swayback)

Question 77

exaggerated posterior curve of the thoracic spine.

Answer 77

kyphosis (hunchback)

Question 78

lateral curve of the spine

Answer 78

scoliosis

Question 79

loss of bone mass and bone tissue decrease in heigh bone fractures associated consider risk factors

Answer 79

osteoporosis

Question 80

Systemic skeletal condition, where the bone mass decreases, and the bone tissue deteriorates. This makes the bones fragile, leading to fractures.

Answer 80

osteoporosis

Question 81

A loss in height is usually the first clinical sign of this disease

Answer 81

osteoporosis

Question 82

 women, over the age of 50, have not had children, enter menopause before age 45. Having a family hx of osteoporosis, being smaller, or thinner.

Answer 82

uncontrollable osteoporosis

Question 83

Poor diet (low calcium, vitamin D, fruits/vegetables; high protein, caffeine, and sodium), inactive lifestyle, smoking, drinking too much alcohol, losing weight, long-term use of some medications (antiseizure, chemotherapy).

Answer 83

controllable osteoporosis

Question 84

feels soft and boggy when palpated.

Answer 84

atrophied muscle (reduced size

Question 85

where the patient independently moves their joints, passive, where you move the joint for them, or active assistive, where the patient moves their joint with some assistance.

Answer 85

range of motion (includes active range of motion)

Question 86

ask the patient to relax and you passively move the extremities

Answer 86

passive ROM

Question 87

during this exercise, you do not force the joint into a painful position

Answer 87

passive ROM

Question 88

extremities through their ROM. Do not force the joint into a painful position. Be familiar with the normal range of each joint. T

Question 89

Noted as the slight muscular resistance felt as you move a relaxed extremity passively through the Range of Motion.

Answer 89

muscle tone

Question 90

there should be just a slight resistance to movement.

Answer 90

normal muscle tone

Question 91

there will be considerable resistance with any sudden passive movement of a joint.

Answer 91

hypertonicity muscle tone

Question 92

the muscle feels flabby, and the extremity hangs loosely to gravity.

Answer 92

hypotonicity

Question 93

Have the patient perform maneuvers to demonstrate strength in major muscle groups. See Table 30.33 in your books (page 580). You will gradually be increasing resistance against their muscle flexion. ***Volunteer***Elbow  pull down on forearm as pt attempts to flex. Then as the forearm is flexed, apply pressure against the forearm as they try to straighten it. Hip  With pt sitting, apply downward pressure to thigh and ask them to raise their leg up. Then, with their leg flexed, hold their shin and ask the patient to straighten their leg. Hands  Have the patient squeeze your fingers with their hands, bilaterally. Feet  Place your hand against the bottom of the patient’s foot and ask them to press down, like they are pressing on the gas in their car.

Answer 93

muscle strength

Question 94

loss of bone mass and bone tissue decrease in heigh bone fractures associated consider risk factors

Answer 94

osteoporosis