Chapter 39 nursing care of the adult
Sings the patient has circulation impairment
-Pale, cyanotic, or mottled color -cool temp of extremity -more than 3-second capillary refill
Which is a circulatory indicator of peripheral neurovascular dysfunction
Cool skin
Endosteum
Covers the marrow cavity of long bones
Kyphosis
Curve in thoracic spine
Skull sutures are an example of which type of joint?
Synarthrosis
paresthesia
abnormal sensation
contracture
abnormal shortening of muscle
What factors would the nurse need to keep in mind about the focus of the initial history when assessing a new client with a musculoskeletal problem?
any chronic disorder or recent injury
Which nursing action is most important in caring for the client following an arthrogram?
apply ice
osteogenesis
bone formation
osteoblast:
bone forming cell
Bone densitometry:
bone mass density, dual energy x-ray most common
osteoclast
bone resorption cell
lordosis
curvature of the lumbar spine
Lordosis
curve in lumbar spine
atrophy
decrease in muscle size
bone scan -nursing interventions
detect bone tumors -assess for allergies, injection of radioisotope and performed 2-3 hours after. encourage fluids to distribute isotope
joint history and physical findings
diminished range of motion, stiffness, loss of height
arthroscopy -nursing interventions
direct visualization of joint -wrap joint to control swelling, monitor neuro status, educate family to monitor for signs and symptoms of complications
electromyography
electrical potential of the muscles -assess for use of anticoagulants, may cause bleeding, active skin infection
joint capsule
encloses bone ends
epiphysis
end of long bone
FRAX assessment tool
predicts patient's 10 year risk of fracturing a bone
What assessments indicate client has a normal gait
smoothness, knee flexion
What to anticipate finding when inspecting rheumatoid arthritis fingers
soft, subcutaneous nodules along the tendons
periosteum
tissue covering bone
fasicculation
twitch of muscle
MRI nursing interventions
use radio waves for high quality imaging -may hear knocking sound, assess for contradictions, assess for allergies
endosteum
vascular membrane covering the marrow cavity of long bones
Ligament structural changes
weakness
Bone -structural changes -functional changes -history and physical findings
-loss of bone mass after 30 years of age -fragile -loss of height, flexibility, flexion of hips and knees, osteoporosis
Gradual loss of bone after a peak of bone mass at age
30
When assessing the reflexes in the ankle, the nurse observes rhythmic contractions of the muscle when dorsiflexing the foot. What would the nurse document this finding as?
Clonus
Fibrous sheath that surrounds the articulating bones
Joint capsule
What laboratory study indicates the rate of bone turnover
Serum osteocalcin
Reason for older adult's risk for skeletal fractures
bone resorption is more rapid than bone formation
Osteoclasts
born resorption
trabeculae
cancellous bone
example of a gliding joint
carpal bones in the wrist
what is an example of gliding joint
carpal bones in the wrist
Joint structural changes
cartilage deterioration, thinning of intervertebral discs
ligament
collagen fibrils connecting bones
cortical bone
compact bone
tendon
connects muscle to bone
kyphosis
convex curvature of the thoracic spine
fascia
covers, supports, and separates muscles
crepitus
cracking sound
hypertrophy
enlargement of muscle
remodeling
ensures bone maintenance
effusion
excess fluid in joint
osteon
functional bone unit
spastic
having greater-than-normal muscle tone
Muscle structural changes
increase of collagen results in diminished size
Muscle tension being unchanged with muscle shortening and joint motion
isotonic contraction
history and physical findings with ligaments:
joint pain with motion, resolves with rest, osteoarthritis, swelling
Diminished range of motion, loss of flexibility, stiffness, and loss of height is related to
joints
Example of a hinge joint
knee
flaccid
limp
muscle history and physical findings
loss of strength, decreased endurance, longed response time, no tone
Muscle function changes
loss of strength, flexibility, weakness, fatigue, falls
osteocyte
mature bone cell
isotonic contraction
muscle being shortened without a change in its tension
isometric contraction
muscle tension increased without changing its length
Why are older adults at risk for falls
muscles atrophy with aging
tone
normal tension
arthrocentesis
obtain synovia fluid -remove hair from cite, administer analgesics, apply ice
Responsible for the process of ossification
osteoblasts
ossification
process calcium is deposited in bone matrix
osteopenic
reduction in bone mass
Osteoclasts are involved in the destruction and
remodeling of bone
resorption
removal/ destruction of tissue
lamellae
rings of bone matrix
synovium
secretes lubricating fluid
diaphysis
shaft of long bone
functional changes
stiffness, reduced flexibility, pain with daily activities
Best way to maintain strong bones
weight-bearing exercises
joint
where bone ends meet
Atonic
without tone
