Musculoskeletal Considerations in the Older Adult

The nurse is planning an educational session for a group of older adults at a senior center about osteoarthritis prevention. What is the rationale for the nurse providing this information to this group of people? Joint replacement surgery Pain management techniques Educate about mobility devices Osteoarthritis being a leading cause of disability

Osteoarthritis being a leading cause of disability Osteoarthritis is a degenerative joint disease that is the leading cause of disability in the United States. It is the most common type of arthritis seen in older adults.

The nurse is addressing pain in the patient who sustained a hip fracture and is awaiting surgery. Prior to administering the narcotic analgesic, what should the nurse assess? Select all that apply. Pain level Respirations Homan's sign Body temperature Level of consciousness

Pain level The nurse would always assess the patient's pain level prior to the administration of a narcotic analgesic. The nurse would assess the level again 30-60 minutes after administration to determine effectiveness of pain medication. Respirations Narcotic analgesics can cause respiratory depression, including bradypnea. Therefore, the nurse should assess the rate and depth of respirations. Level of consciousness Sedation and confusion can occur from narcotic analgesics, especially in older adults. As a result, the nurse should assess the patient's level of consciousness.

A female patient in rehabilitation for a joint replacement secondary to osteoarthritis informs the nurse she cannot keep up the pace of all the therapies. The patient reports increased fatigue. Which interventions would the nurse include in the plan of care? Select all that apply. Provide rest periods. Space out therapy sessions. Administer pain medication. Assess for signs of depression. Practice relaxation techniques.

Provide rest periods. The nurse should provide rest periods between activities. This allows the patient time to recharge before the next activity. Space out therapy sessions. Collaborate with the different therapy modalities to space out sessions to decrease fatigue in the patient. This will allow the patient to participate more. Practice relaxation techniques. Relaxation techniques will help the patient unwind in-between therapy sessions.

In which time frame should the nurse tell the patient that the symptoms of gouty arthritis will dissipate? 3 days 7 days 10 days 14 days

7 days Most cases of gouty arthritis usually subside in about 7 days regardless of treatment.

What information should the nurse include when educating a group of postmenopausal women about osteoporosis treatment? Select all that apply. Bisphosphonate therapy Weight-bearing exercises Calcium supplementation Nonsteroidal anti-inflammatory drugs (NSAIDs) Disease modifying anti-rheumatic drugs (DMARDs)

Bisphosphonate therapy Bisphosphonates are used to prevent further bone loss in patients with osteoporosis. Weight-bearing exercises Weight-bearing exercises should be a part of maintaining bone strength in patients with osteoporosis. Calcium supplementation Calcium supplements may be prescribed and work well to increase oral calcium intake in patients with osteoporosis.

Which changes would the nurse expect to find as a result of muscle cell loss and increased fibrous tissue in an older adult patient? Select all that apply. Decreased strength Increased muscle tone Decreased muscle mass Lordotic or concave back Erosion of articular cartilage

Decreased strength Strength will decrease in older adults due to increased fibrous tissue and muscle cell loss. Decreased muscle mass Age-related changes that happen in the musculoskeletal system cause decreased muscle mass.

Which information should the home health nurse provide a patient with osteoporosis to prevent complications of the disease? Select all that apply. Treat depression. Ensure good lighting. Use assistive devices. Include calcium in diet. Administer pain medications.

Ensure good lighting. The nurse should instruct the patient to have good lighting in areas to prevent trips, falls, and fractures. Use assistive devices. Assistive devices should be used by the patient for ambulation. This will help in fall prevention. Include calcium in diet. The nurse would instruct the patient to include calcium-rich foods in the diet such as dairy products.

The nurse caring for a patient with severe rheumatoid arthritis enters the day room and notices the patient is quiet, withdrawn, and crying. Based on these observations, what is the best nursing intervention? Administer a narcotic analgesic. Bring the patient to his or her room. Get the patient involved in a group game. Evaluate the patient for signs of depression.

Evaluate the patient for signs of depression. Patients with chronic pain of rheumatoid arthritis frequently have accompanying depression. The nurse should assess for signs of depression.

Which assessment finding made by the nurse supports the patient's diagnosis of spinal stenosis? Muscle spasms Heberden's nodes Bouchard's nodes Lower extremity burning and numbness

Lower extremity burning and numbness Burning and numbness in the lower extremities is a clinical manifestation found in patients with spinal stenosis.

The nurse is planning care for a patient who was brought to the emergency room after a hip fracture. For which treatment modalities should the nurse prepare the patient? Select all that apply. Reduction Surgical repair Physical therapy Walking with a cast Anti-rheumatic drugs

Reduction Many hip fractures are treated by using reduction. This can be done with or without a surgical procedure. Surgical repair It is common for a patient to undergo surgery for the treatment of a hip fracture. This can be done by inserting hardware or by internal fixation. Physical therapy Physical and occupational therapy are used to assist the individual back to the best level of health with exercises and gait training with assistive devices.

The nurse is developing a plan of care for an older adult who sustained a hip fracture a week ago. The nurse includes ambulation in the plan of care to avoid which complications? Select all that apply. Urosepsis Pneumonia Malnutrition Osteoporosis Pressure ulcers

Urosepsis Urosepsis is a common complication after older adults sustain a hip fracture. It occurs from a urinary tract infection causing systemic infection, or sepsis, which may result from immobility. Pneumonia A common complication from hip fractures is pneumonia as a result of immobility. Pressure ulcers Pressure ulcers can happen after a hip fracture due to decreased mobility.

The nurse reviews the medical record of a new patient and notes the presence of rheumatoid arthritis in the medical history. Which clinical manifestations would the nurse expect to find in the patient? Select all that apply. High uric acid levels Warm, swollen joints Morning joint stiffness Boutonnière deformity Rapid onset of symptoms

Warm, swollen joints Joints in the patient with rheumatoid arthritis are generally warm and swollen. Morning joint stiffness It is common for patients to have joint stiffness in the morning that lasts from 30 minutes to 6 hours. Boutonnière deformity Boutonnière deformities are noted in patients with rheumatoid arthritis and are caused by contractures of the distal and proximal interphalangeal joints.