Alterations in mobility

Question 1

sprain

Answer 1

Tears that occur in ligaments.

Question 2

strain

Answer 2

Tears in the muscles.

Question 3

Sarcopenia

Answer 3

Loss of muscle mass, usually due to aging.

Question 4

venous thromboembolism

Answer 4

Blood clot formation in a vein that can migrate to become lodged in the pulmonary vessels.

Question 5

what are some nervous system effects of immobility

Answer 5

Confusion
Depression
Loss of confidence
Loss of cognitive function

Question 6

what are some cardiovascular system effects of immobility

Answer 6

Decreased cardiac output
Venous stasis
Orthostatic hypotension
Deep vein thrombosis (DVT)

Question 7

what are some pulmonary system affects from immobility

Answer 7

Pneumonia
Decreased cough reflex
Pulmonary secretion pooling
Hypoventilation
Atelectasis
Decreased lung expansion

Question 8

what are some effects of on the GI from immobility

Answer 8

Swallowing difficulties
Incontinence
Constipation
Fecal impaction
Bowel dysfunction
Anorexia
Increased intestinal gas
Heartburn
Aspiration
Malnutrition

Question 9

what are some genitourinary affects from immobility

Answer 9

Incontinence
Urinary tract infections (UTIs)
Urinary retention

Question 10

what are some integumentary system affects from immobility

Answer 10

Skin breakdown
Pressure injuries
Infections
Abrasions
Tissue damage
Inflammation over bony prominences
Friction and shear

Question 11

venous stasis

Answer 11

Pooling of blood in the veins due to immobility. This reduces venous blood returning to the heart.

Question 12

_____ may be caused by a contusion or sprain, repetitive motion, or disease processes such as rheumatologic diseases or infection.

Answer 12

Synovitis

Question 12

______ is an inflammatory condition of the joints.

Answer 12

Arthritis

Question 13

Articular cartilage

Answer 13

Thin layer of hyalin cartilage covering the articular facets of a joint.

Question 14

Joint effusion

Answer 14

Fluid accumulation in the intra-articular space.

Question 15

gout

Answer 15

Presence of uric acid crystals in a joint, usually in the toe. A form of arthritis.

Question 16

Lab test and diagnostic for arthritis

Answer 16

x-ray, U/S (arthrocentesis)

Question 17

arthrocentesis

Answer 17

A procedure to remove synovial fluid for testing.

Question 18

A _______ device can be used by a physical therapist to cause involuntary muscle contractions.

Answer 18

neuromuscular electrical stimulation (NMES)

Question 19

_____ is a softening of the bones often associated with aging, specifically with post-menopausal clients.

Answer 19

Osteoporosis

Question 20

what are primary causes of osteoporosis

Answer 20

Primary causes include aging, gonadal insufficiency, decreased calcium intake, and low Vitamin D levels. During bone remodeling there is an increase in bone resorption resulting in a decreased bone mass.

Question 21

What are secondary causes of osteoporosis

Answer 21

Secondary osteoporosis may be caused by different disease processes such as chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), multiple myeloma, endocrine disorders, rheumatoid arthritis, and malabsorption syndromes.

Question 21

When osteoporosis causes thoracic compression, it can lead to _____ , cervical lordosis, and shortness of breath and compression on the abdominal cavity.

Answer 21

kyphosis

Question 22

kyphosis

Answer 22

A rounding of the upper back due to weak spinal bones. Sometimes referred to as hunchback.

Question 23

cervical lordosis

Answer 23

A rounding of the upper back at the cervical area due to compression or weakening of spinal bones. Also referred to as a dowager’s hump

Question 24

lab test and diagnostic for osteoporosis

Answer 24

dual energy x-ray absorptiometry,serum levels of calcium, magnesium, phosphorous, liver enzymes, PTH levels, thyroid levels, and tests to rule out cancer.

Question 25

what is dual entry x-ray absorptiometry

Answer 25

measures bone density can look for osteopenia and osteoporosis

Question 26

Erosive osteoarthritis

Answer 26

primarily affects the distal interphalangeal and proximal interphalangeal joints.

Question 27

Atelectasis

Answer 27

Collapse of alveoli in the lungs often caused by effects of anesthesia or as a complication of immobility.

Question 28

Prolonged immobility may result in alterations in the nervous system, including a reduction in production of

Answer 28

serotonin.

Question 30

Up to _____ of muscle mass can be lost after just 10 days of immobility.

Answer 30

10%

Question 32

bedside assessment mobility tool (BMAT)

Answer 32

evaluates the client’s control of muscles in the core and the back as well as their ability to sit, shake the nurse’s hand, stretch, stand safely and with stability, and to take steps.

Question 33

6 p's of circulation

Answer 33

pain, pallor, pulselessness, paresthesia, poikilothermia, and paralysis.

Question 34

pallor

Answer 34

Pale color to the skin below the level of the injury, indicating insufficient arterial supply.

Question 36

paresthesia

Answer 36

A feeling of numbness or pins and needles in an extremity.

Question 37

Poikilothermia

Answer 37

Coolness of extremity despite room temperature

Question 38

OPQRST

Answer 38

O: Onset P: Provoking or palliating factors Q: Quality R: Region and radiation S: Severity T: Time and treatment

Question 39

Medications to treat osteoporosis

Answer 39

antiresorpitive bisphosphonates, antiresorpitive hormones, monoclonal antibodies, analog agent, calcium, calcitonin

Question 40

oral antiresorptive bisphosphonates

Answer 40

Alendronate,Risedronate, Ibandronate

Question 41

IV antiresorptive bisphosphonates

Answer 41

Pamidronate Ibandronate Zoledronic acid

Question 42

Action of antiresorptive bisphosphonates

Answer 42

Used for clients with low bone density. This category of medications strengthens bones and prevents further bone fractures.

Question 43

Nursing considerations ofantiresorptive bisphosphonates

Answer 43

Used along with calcium and vitamin D supplements. Good dental exams are needed before beginning these medications as there is a rare risk of osteonecrosis of the jaw.

Question 44

Antiresorptive: hormone, estrogens, and selective estrogen receptor modulators

Answer 44

HRT: Estrogens Estradiol SERMs: Raloxifene Bazedoxifene Lasofoxifene

Question 45

Action of Antiresorptive: hormone, estrogens, and selective estrogen receptor modulators

Answer 45

Inhibit bone resorption and inhibit bone remodeling.

Question 46

Nursing consideration ofAction of Antiresorptive: hormone, estrogens, and selective estrogen receptor modulators

Answer 46

Increased risk for DVT. SERMs may be a first-line therapy for younger post-menopausal clients​​​​​​​.

Question 47

Monoclonal Antibody Against RANKL

Answer 47

Subcutaneous Denosumab (Prolia) Romosozumab

Question 48

Action of Monoclonal Antibody Against RANKL

Answer 48

Denosumab: Blocks the differentiation of osteoclasts resulting in bone resorption. Romosozumab: Increases bone formation while decreasing bone resorption.

Question 49

Nursing considerations of Action of Monoclonal Antibody Against RANKL

Answer 49

Notify the provider if there is pain in hips, groin, or thighs as this is an indication the client is at risk for breaking the thigh bone. Do not get pregnant or breastfeed while on this medication. Use a reliable form of birth control. Must be used cautiously in clients with a history of cardiovascular disease due to an increased risk of MI or stroke. Risk for osteonecrosis of the jaw.

Question 50

arthroscopy

Answer 50

Allows for direct visualization of the affected joint.

Question 51

Surgery to replace an arthritic joint with a prosthetic joint, most often for knees and hips.

Answer 51

Total joint replacement

Question 52

Nursing considerations of total joint replacement

Answer 52

Use after non-surgical management is not successful. Postoperative care includes monitoring dressings and drainage devices, and underneath the buttocks for pooling of blood. Monitor neurovascular status. Maintain appropriate supportive equipment during repositioning. Hip replacement care includes avoiding crossing ankles or leg across body, which may lead to dislocation of the hip joint. The client may require raised toilet seats and handrails. Early ambulation is recommended when able.

Question 53

Inhibit the production of the prostaglandin COX-2

Answer 53

Oral: Celecoxib

Question 54

Nursing considerations of clelcoxib

Answer 54

Use with caution for those with cardiovascular disease. Risk for bleeding, ulcers with possible perforation of the stomach or intestines.

Question 55

Contusion

Answer 55

A bruise caused by a direct blow.

Question 56

A first-degree injury is

Answer 56

stretching of the fibers

Question 57

a second-degree injury is a

Answer 57

tearing of some to most of the fibers

Question 58

a third-degree injury is a

Answer 58

complete tearing of the injured fibers.