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OA Test 2
Mobility and Safety
| Question | Answer |
|---|---|
| What age-related changes to the musculoskeletal system affect the mobility and safety of older adults? | Neurologic function; visual function; osteoporosis (most significant overall impact); arthritis |
| What is the function of Bones? | Function of bones = Facilitate movement, storage of calcium, production of blood cells, and support and protection of body organs and tissues |
| What are the age-related changes of bones? | resorption, lower ca+ absorption, increases serum PTH, impaired osteoblast activity regulation & bone formation (2ary to reduced osteroblastic production of bone matrix)& a lower # of functional marrow cells as a result of replacemnt of marrow w/fat cells |
| Women & men have increased bone loss d/t? | Women and men have increased bone loss d/t lower levels of estrogen and test. |
| What factors can affect bone remodeling? | hyperthyroidism, decreased activity levels, COPD, deficiencies of Vit D and calcium, medication |
| What results from loss of muscle mass? | There is a decrease in the size & number of muscle fibers |
| When muscle fibers deteriorate what are they replaced with? | Connective & fat tissue |
| When muscle cell membranes deteriorate there is a subsequent escape of ___ &___ which results in? | With the deterioration of muscle cell membranes there is a subsequent escape of fluid & potassium which results in a decline in motor function and a loss of muscle strength and endurance |
| In the joints of OAs there is a diminished viscosity of ____? | Synovial fluid |
| OAs joints can have degeneration of ____&____ cells? | collagen and elastin cells |
| T/F OAs joints can have fragmentation of fibrous structures in CT (Connective Tissue)? | True |
| OAs joints can have formation of ____ tissue and areas of ____ in the joint capsules and CT? | Scar tissue and areas of calcification in the joint capsules and connective tissue |
| Degenerative changes in the arterial cartilage results in? | Degenerative changes in the arterial cartilage resulting in extensive fraying, cracking, and shredding, in addition to a pitted and thinned surface |
| What happens in response to continuous wear and tear of OAs Joints? | Outgrowths of cartilaginous clusters |
| What nervous system changes occur in OAs? | Decline in the righting reflex; Impaired proprioception (particulary in women); Diminished vibratory sensation; joint position sense in the lower extremities; increase in body sway; decrease reaction time… |
| OAs have a slowed performance in walking and performing ADLs which puts them at risk for what? | FALLS |
| What are the age related changes that are risk factors for unsafe mobility & falls? (Hint display 18-2) | Age-related changes-osteoporosis, vision changes, slowed reaction time, nocturia…. |
| What are some pathologic conditions & functional impairments that are risk factors for unsafe mobility and falls? | Cardiovascular disease, respiratory disease, metabolic disturbances, cognitive impairments… |
| Name some types of medications that are risk factors for unsafe mobility and falls? | Alcohol, antidepressants, antihypertensives, diuretics, opoids…. |
| What are some environmental risk factors for unsafe mobility and falls? | Environmental (throw rugs, glare, lack of handrails, highly polished floors, high toilets, etc); More examples on page 387 |
| How do functional consequences associated with musculoskeletal changes affect healthy older adults? | Muscle strength; Endurance; and coordination |
| ____-declines around 40 y/o, decreases more in lower extremities than upper, attributed to loss of muscle mass? | Muscle strength |
| _____– happens b/c of age related changes in the muscles and CNS, shorter time before muscle fatigue? | Endurance |
| ____ leads to – decreased ROM, decreased lower back flexion, perform ADLs slower, gait changes? | Coordination |
| T/F OA Bones can be fractured by little or no trauma (falling on floor)? | True |
| What impacts the susceptibility to fracture and falls? | Osteoporosis can cause a fall and a fracture |
| The risk for fractures and falls ___ in direct relation to age? | Risk increases in direct relation to age |
| What age group is more likely to have hip fractures, affecting their independence and quality of life? | More likely in OA |
| Women sustain more fractures in ____ and men sustain more fractures at ____? | women sustain more fractures in 60s & Men sustain more fractures at 35 |
| What are the most frequent settings an OA falls and fractures something in? | Community settings, acute care settings, and nursing homes more frequent |
| What are the most costly injuries to an OA? | Falls are the most costly injury in OA-many OAs have trouble recovering from them |
| What are nursing ( and collaborative) interventions to promote healthy musculoskeletal function? | Exercise; Wt bearing exercise; resistance training; flexibility training; balance training; strength training and health education about lifestyle, nutrition and medical interventions. |
| What does wt bearing exercise prevent? | osteoporosis |
| What does resistance training do? | increases muscle size, strength, & power |
| What dose flexibility training improve? | ROM |
| What does balance training improve? | safe mobility |
| What does strength training improve? | Balance |
| As a nurse what do you want to address with your OA about fall prevention? | Address monitoring devices, prevention and fear of falling. |
| What are some devices you as a nurse can use to help prevent falls? | Devices = Pads in pt clothing, signal to transmit when fallen, auditory room-monitoring |
| What are some things you as a nurse can do to prevent falls? | Prevention = Assess environment – no loose rugs, remove heavy furniture; Adjust bed to low position; External hip pads; Soft pads around move; Personal Emergency Response System worn on clothing; Bedrails |
| T/F As a nurse you should encourage OAs to express the fear of falling? | True |
| One of the best ways for nurses to prevent a falls is to? | Provide education and reassurance about interventions that are being implemented as care plan |
| Who should be included in the teaching of preventing falls? | Family member and caregiver should be included on intervention |
Created by:
cgwayland
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