Disc 6
Butterfly003Chapter 23
Musculoskeletal Function
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Diseases of musculoskeletal system are usually not fatal but can lead to chronic pain and disability.
May cause impairments in ability to perform activities of daily living (ADLs) and instrumental activities of daily living (IADLs)
When dependence occurs, can result in loss of self-esteem, perception of decreased quality of life, and depression
Introduction
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Muscle mass, tone, and strength decrease
Elasticity of ligaments, tendons, and cartilage decreases
Bone mass decreases
Intervertebral disks lose water, narrowing the vertebral space.
Posture and gait change leading to shift in center of gravity.
Age-Related Changes in Structure and Function
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Musculoskeletal system affected in numerous ways by aging process
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All the changes may cause pain, impaired mobility, self-care deficits, and increased risk of falls for older adults.
One-third of people age 65 or older have falls each year.
Moderate to severe injuries included hip fractures, lacerations, and traumatic brain injury.
Falls are the most common cause of accidental death.
Fall experience causes a fear of falling.
Consequences of Changes in Structure and Function
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Common problems and often result in loss of functional ability
May occur because of trauma to bone or joint, or may be the result of pathologic processes
Falls are a common cause.
Most common fractures are hip, the proximal femur, Colles (wrist), vertebral, and clavicular.
Fractures
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Most disabling type of fracture for older adults
25% patients with hip fractures die within 1 year after injury.
Complications of hip fractures generally related to immobility.
Classified by location: intracapsular, extracapsular
Affected extremity is externally rotated and shortened with tenderness and severe pain.
Hip Fracture
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Assess hips and lower extremities for evidence of fracture such as shortening of the extremity, and abnormal rotation.
Assess for presence of tenderness, swelling, or ecchymosis and pain with movement.
Obtain VS and level of consciousness.
Can you name six nursing diagnoses for hip fracture?
Hip Fracture: Assessment and Diagnosis
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Pain, resulting from the discomfort from the muscle and bone trauma
Decreased mobility, resulting from immobilization of the fracture and the healing process
Potential for reduced skin integrity, resulting from immobilization required for healing
Potential for infection, resulting from inadequate wound healing, compromised nutrition, and effects of immobility
Inadequate bathing/dressing/feeding/toileting self-care, resulting from discomfort and decreased mobility
Inadequate home maintenance, resulting from decreased independence and recovery period needed for fracture healing
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The patient will do the following:
Report minimum discomfort and an adequate level of pain control
Remain free from postoperative complications, such as altered skin integrity and wound infection
Adhere to the prescribed physical therapy regimen
Participate in physical and occupational therapies
Safely demonstrate use of assistive devices for mobility and ADLs
Return to the preinjury level of independence with appropriate support and assistive devices
Hip Fracture: Planning and Expected Outcomes
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Assess and stabilize medical conditions and hip fracture.
If surgical intervention: keep patient comfortable and hydrated and prevent complications of immobility during pre-op period
Postoperative: monitoring of VS, I&O, and mental status (watch for delirium)
Turning, deep breathing, and coughing
Monitor for signs of infection and bleeding
Assess movement, circulation, and sensation
Provide safety, comfort, and maintain their sense of independence and identity.
Maintain proper hip alignment to prevent dislocation.
Prevent constipation.
Appropriate patent teaching.
Hip Fracture: Intervention
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Successful achievement of expected outcomes will allow patient to return to preinjury level of function.
Should be successful in meeting goals of therapy
Should report minimum pain at the fracture or surgical site and intact skin integrity
Muscle strength, joint movement, level of mobility, and degree of safety while performing ADLs should be continually evaluated.
Hip Fracture: Evaluation
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Fracture of distal radius as a result of reaching out with open hand to break fall.
Immediate pain, local edema, swelling, and visible deformity from displacement of distal bone fragment
Treatment: closed reduction and immobilization with forearm splint or cast.
Elevate extremity and perform neurovascular assessment to monitor for complications.
Instruct patient to actively move thumb and fingers to improve venous return and decrease edema.
Colles Fracture
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Occurs after fall on outstretched hand or on fall to shoulder
Point tenderness, local edema, and crepitus
Shoulder noticeably deformed, dropping downward, forward, and inward
Treatment: reduction of fracture and immobilization with a sling or cast
Monitor for neurovascular complications, elevate extremity, and instruct patient to actively move hand and fingers.
Clavicular Fracture
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Casting materials include plaster of Paris or synthetic materials such as fiberglass.
Instruct to keep casts dry; keep extremity elevated to level of heart to decrease edema; maintain movement of extremity to prevent muscle atrophy and joint stiffness.
Assess for potential areas of skin irritation or breakdown; neurovascular assessment; control pain with medication; prepare patient for self-care and prevent complications.
Casts and Cast Care
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Degenerative joint disease; noninflammatory disease of joints characterized by progressive articular cartilage deterioration and formation of new bone in joint space
When joint cartilage lost, two bone surfaces come into contact with each other, resulting in joint pain.
Most common type of arthritis
Causes: age, trauma, lifestyle, obesity, and genetics are predisposing factors.
Osteoarthritis (OA)
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Joints most commonly affected: distal interphalangeals, carpometacarpal joint, first metatarsophalangeal joint, proximal interphalangeals, knees, hips, and spine
Gradual onset aching joint pain; pain occurs with activity and relieved with rest; stiffness after periods of inactivity that resolves with activity
Crepitus may be heard and felt with range of motion in affected joints; affected joints have decreased range of motion.
Bony enlargements, Heberden nodes, may be seen on the distal interphalangeals, and Bouchard nodes may be seen on the proximal joints.
OA Presentation
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History of problem: the onset, location, quality, and duration of the joint pain and precipitating factors
Questions about drugs used to relieve pain, including prescription and OTC agents and nonpharmacologic interventions
Inspect affected joints for pain, tenderness, swelling, redness, crepitation, and range of motion
Can you name three nursing diagnoses for OA?
OA: Assessment and Diagnosis
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Pain resulting from inflammation and deterioration of the joint cartilage
Reduced mobility as a result of lower extremity joint stiffness
Inadequate self-care as a result of limitations in joint movement and strength
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The patient will do the following:
Verbalize an improved level of comfort with activities
Successfully use various adaptive devices in maintaining independence in ADLs and IADLs
Demonstrate safe use of assistive devices for ambulation
Demonstrate an understanding of the use of orthotics
OA: Planning and Expected Outcomes
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Instruct on joint protection and energy conservation.
Educate on heat and cold therapy, nonsteroidal antiinflammatory drugs, topical gels, and injected steroids.
For surgical patients (severe pain and increasing disability)
Preoperative period: educate about surgical procedure, its risks, potential complications, and postoperative course
After surgery: prevent complications, relieve surgical pain, and assist patient in achieving higher level of function and activity
OA: Conservative Intervention
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The main indications for surgery are severe pain and increasing disability.
Preoperative period: educate about surgical procedure, its risks, potential complications, and postoperative course
After surgery: prevent complications, relieve surgical pain, and assist patient in achieving higher level of function and activity, monitor for complications: DVT, joint or wound infection, blood loss, nerve injury, joint dislocation, and surgical pain
Rehabilitation begins within 24–48 hours and includes muscle strengthening and range-of-motion exercises.
Occupational therapy provides instructions for independence in daily activities.
OA: Surgical Intervention
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Successful achievement of expected outcomes for patient with osteoarthritis are to relieve pain and restore function.
Conservative measures will improve mobility and increase comfort.
The patient needs to understand the expected outcomes, as well as the risks associated with surgical procedures.
Understanding the disease process and treatment measures will assist an older adult in maintaining function and independence.
OA: Evaluation
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The most frequently encountered, clinically important degenerative spinal disorders in the aging population
Bony overgrowth of facet joints of vertebrae leads to narrowing of spinal canal and possible compression of nerve roots.
Most frequently seen in lumbar region at levels L3 and L4
Leads to progressive back pain and possible weakness of lower extremities
Spinal Stenosis
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Assessment focuses on patient’s symptoms
Identify exact location of pain or numbness, the duration of the symptoms, and successful pain relief measures.
Assess comfort levels during routine ADLs.
Can you name four nursing diagnoses for spinal stenosis?
Spinal Stenosis: Assessment and Diagnosis
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203656 (BB) - Please note that in other chapters, for question "Can you name ... nursing diagnose ...", the answer has been listed in the notes part. Please provide the same in this slide.
The patient will do the following:
Report a minimum or tolerable level of pain
Demonstrate improved mobility and tolerance of activity
Incorporate a plan for lifestyle modifications that includes activity and rest
Demonstrate safe use of assistive devices and make necessary environmental changes to promote safety
Spinal Stenosis: Planning and Expected Outcomes
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Nursing care depends on severity of spinal cord narrowing, patient’s state of health, and degree of pain and immobility.
Instruct patient to allow sufficient periods of rest and to limit activities that produce pain.
Initiated pain relief measures and evaluate for their effectiveness using assessment scales
Offer other measures like heat or cold applications, massage therapy, relaxation techniques, and position changes while in bed.
Spinal Stenosis: Intervention
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Patient’s ability to perform ADLs independently with minimum discomfort should be evaluated by self-report and observation.
Effectiveness of pain relief measures should be discussed with patient and changes made when medications have lost effectiveness.
Reinforce instructions about precautions and activities for patients undergoing epidural injections or surgical procedures.
Spinal Stenosis: Evaluation
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Chronic, systemic, inflammatory, autoimmune disease that causes joint destruction and deformity and results in disability
Starts with the proximal interphalangeals, metacarpophalangeals, and wrists when the synovial membrane becomes inflamed and thickens, and production of synovial fluid is increased (pannus)
Pannus tissue result in decreased joint motion, deformity, and finally ankylosis, or joint immobilization.
Onset gradual, and course is one of remissions and exacerbations
Rheumatoid Arthritis (RA)
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Symptoms: painful, stiff joints, decreased range of motion in joints, joint swelling, and deformity
Morning joint stiffness which lasts from 30 minutes to 6 hours
Affected joints are warm and swollen.
Joint deformities include ulnar deviation of the wrists, boutonnière deformity caused by contractures of the distal and proximal interphalangeal joints, and swan-neck deformity caused by contractures of the distal interphalangeal joint.
RA Presentation
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Family history and constitutional symptoms, including fever, anorexia, weight loss, fatigue, and duration of the joint stiffness
Physical exam of affected joints
System assessment of the eye for scleritis and corneal ulcers, lungs for pneumonitis, and heart for pericarditis
Can you name six nursing diagnoses for RA?
RA: Assessment and Diagnosis
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203656 (BB) - Please note that in other chapters, for question "Can you name ... nursing diagnose ...", the answer has been listed in the notes part. Please provide the same in this slide.
The patient will do the following:
Maintain normal joint motion in affected joints, with minimum deformities
Experience adequate pain control of inflammation
Maintain optimal functional status
RA: Planning and Expected Outcomes
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Educate to cope effectively with chronic nature of disease.
Discuss pain management, maintenance of self-care activities, promotion of safe mobility, methods of joint protection and precautions, and management of overall health.
Provide information about resources that are available.
Teach about action, side effects, and special precautions related to the specific drugs.
RA: Intervention
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Older adult with rheumatoid arthritis should experience minimum discomfort and be able to maintain acceptable level of function and mobility.
Active participation by patient in activities to prevent joint deformities; patient should experience less deformity, increased comfort levels, and understanding of disease process.
RA: Evaluation
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Result of elevated levels of serum uric acid
Joint inflammation caused by sodium urate crystals in joint
Most commonly affected joint is the great toe.
Can be acute or chronic
Affected joint becomes hot, reddened, and tender; pain can be severe and interfere with mobility, self-care, and functional abilities; chills and fever may be present.
Gouty Arthritis (Gout)
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History of symptoms
Assess for of warmth, swelling, cutaneous erythema, and severe pain in the affected joint, fever, chills, and malaise and presence of tophi
Identify risk factors or conditions that may predispose patient to development of gout.
Can you name three nursing diagnoses for gout?
Gout: Assessment and Nursing Diagnosis
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203656 (BB) - Please note that in other chapters, for question "Can you name ... nursing diagnose ...", the answer has been listed in the notes part. Please provide the same in this slide.
The patient will do the following:
Verbalize increased comfort and pain relief with the use of appropriate analgesics and nonsteroidal antiinflammatory drug (NSAID)
Be able to verbalize understanding of the disease process
Incorporate appropriate diet modifications and lifestyle changes
Modify his or her activity and rest pattern based on limitations imposed by the pain
Incorporate health practices to minimize recurrent attacks
Gout: Planning and Expected Outcomes
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Provide pain relief measures and prevention of recurrent attacks of gout.
Educate about role of dietary habits should be provided.
Consult with dietician to educate on avoiding a diet with purines, alcohol, and weight reduction if obese.
Encourage fluids to prevent kidney stones.
Gout: Intervention
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Patients should be able to maintain healthy lifestyle, incorporating changes suggested during treatment.
Pain management should allow patients to participate fully in ADLs and allow full mobility.
Gout: Evaluation
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Which of the following is associated with gout? (Select all that apply.)
Crepitation
Joint become severely deformed
High uric acid levels
Symptoms include fever and malaise.
Avoiding alcohol may help
Treatment may involve joint surgery.
Quick Quiz!
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ANS: C, E
Answer to Quick Quiz
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Common in postmenopausal women
Reduction in bone mass and loss of bone strength
Causes: renal or hepatic failure, hyperthyroidism, hyperparathyroidism, type I diabetes mellitus, rheumatoid arthritis, and chronic kidney disease
Risk factors: heredity and genetic predisposition, lifestyle factors, and age
Risk factors that can be modified with lifestyle changes involve calcium intake, exercise, cigarette smoking, and consumption of alcoholic beverages.
Osteoporosis (1 of 2)
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Frequently no clinical symptoms appear until fractures occur.
Initial complaint may be back pain or fatigue.
Bone densitometry commonly done with dual-energy x-ray absorptiometry (DEXA)
Labs: CBC, serum calcium, serum phosphorus, alkaline phosphatase, and urinary calcium obtained to differentiate osteoporosis from other diseases that may cause bone loss
Osteoporosis (2 of 2)
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Directed at minimizing bone loss and preserving current level of bone mass
Patient education is critical for prevention and risk reduction.
Changing lifestyle risk factors, nutritional counseling, and pharmacologic management are strategies used to prevent osteoporosis.
Adequate calcium intake or supplements
Weight-bearing and resistance exercises
Pharmacological treatments
Osteoporosis Management
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Family health history and determination of risk factors, level of exercise, alcohol and caffeine intake, and smoking
Assess age of onset of menopause, lifelong intake of calcium, history of fractures, presence of pain, and history of falls.
Physical examination for the presence of kyphosis, gait impairments, muscle weakness, and cognitive impairments
Can you name five nursing diagnoses for osteoporosis?
Osteoporosis: Assessment and Diagnosis
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203656 (BB) - Please note that in other chapters, for question "Can you name ... nursing diagnose ...", the answer has been listed in the notes part. Please provide the same in this slide.
The patient will do the following:
Demonstrate taking precautions at home and in the community to prevent falls and activities that may result in fractures
Report an adequate level of pain control in the presence of bone fractures
Consume nutritional supplements, food products, and medications recommended or prescribed for meeting dietary needs, as evidenced by a diet log
Verbalize acceptance of changes brought about by the disease and an understanding of the treatment and prevention of further deformities
Osteoporosis: Planning and Expected Outcomes
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Education about disease process, strategies to prevent further injury or deformity, and measures to promote decreased loss of bone
Emphasize identification and minimization of controllable risk factors.
Recommend exercise programs that will place some stress on bones.
Teach about pain management modalities.
Osteoporosis: Intervention
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Patient should describe measures to decrease potential for further bone loss, as well as measures to maintain a safe living environment.
Patient will be able to participate in regular exercise programs and to identify resources available for prevention of disease.
Osteoporosis: Evaluation
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Inflammatory disease of bone in which both osteoclasts and osteoblasts proliferate
Recent evidence supports theory that viral infection of osteoclasts causes disease.
Onset is insidious.
Involves pelvis, femur, skull, tibia, and spine
First symptom is bone pain not relieved with rest and movement.
Prognosis is not favorable because of complications that may develop: pathologic fractures and loss of hearing related to changes in the temporal bone, possible cord compression and paralysis related to overgrowth of the spinal vertebrae
Paget Disease
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Health history and family history of disease
Assess for warmth, deformity, pain, and erythema over long bones; assess range of motion in joints; and evaluate presence of any weakness, ataxia, or hearing loss
Can you name four nursing diagnoses for Paget's disease?
Paget’s Disease: Assessment and Diagnosis
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Pain, resulting from bone deformity and possible joint involvement
Reduced mobility, resulting from bone deformity, fracture, or pain
Potential for injury, resulting from limitations of mobility and altered bone metabolism
Distorted body image, resulting from deformities and disturbance in function
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The patient will do the following:
Achieve a satisfactory comfort level with pain management techniques and medications
Modify the home environment and take precautions in the community to prevent injuries
Verbalize an understanding of the chronic nature of the disease and appropriate therapies
Make positive coping statements related to a potential altered body image
Paget’s Disease: Planning and Expected Outcomes
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Educate regarding the disease and treatment
Manage pain strategies
Assess safety and mobility issues
Consult with physical or occupational therapists
Paget’s Disease: Intervention
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Documentation of patient’s ability to perform ADLs and understanding of importance of therapy for prevention of pain, deformity, and loss of function
Evaluate need for adaptive equipment.
Paget’s Disease: Evaluation
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Infection of bone that can be either acute or chronic
Symptoms of osteomyelitis associated with a bone injury are localized pain, tenderness on palpation, erythema, warmth to the touch, and edema.
Symptoms of osteomyelitis associated with infected pressure ulcers are subtle changes in mental status, low-grade fever, and increased purulent wound drainage which may go unnoticed until sepsis occurs.
Has as good prognosis if treated early; if first sign is sepsis then poor prognosis
Osteomyelitis
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Focus assessment on identifying risk factors predisposing patient to osteomyelitis.
Examine preexisting wounds or infections carefully.
Monitor vital signs and diagnostic test results.
Assess oral cavity.
Can you name three nursing diagnoses for osteomyelitis?
Osteomyelitis: Assessment and Diagnosis
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203656 (BB) - Please note that in other chapters, for question "Can you name ... nursing diagnose ...", the answer has been listed in the notes part. Please provide the same in this slide.
The patient will do the following:
Report minimum discomfort and adequate pain control
Verbalize an understanding of the need for long-term therapy to eliminate infection
Demonstrate safe and independent mobility
Exhibit intact skin surfaces and no evidence of further infection
Osteomyelitis: Planning and Expected Outcomes
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Use sterile technique during dressing changes and following strict wound precautions.
Teach importance of completing course of oral antibiotics, methods of preventing infection, and specific techniques of wound management.
Allow patient to make informed decisions about care and consult with therapeutic recreation specialists.
Consulted with physical and occupational therapists to provide individualized exercise programs that promote optimal function and prevent disability
Osteomyelitis: Intervention
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Patients should participate fully in all aspects of care.
Any wounds or other potential sources of infection should show progressive healing.
Patient should verbalize understanding of chronic nature of treatment, and documentation should include patient’s involvement in wound care or antibiotic therapy.
Osteomyelitis: Evaluation
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PVD, infections, neoplasms, and traumatic injury may lead to lower extremity amputation.
Atherosclerosis and diabetes predisposing factors in development of foot or extremity ulcers
Osteomyelitis with bone destruction results in amputation of extremity.
Amputation
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Before surgical procedure, assess to determine presence of other diseases and their effect on function
Focus on mobility and self-care ability
Assess affected limb determining peripheral pulses, temperature, sensation, and movement
Note characteristics of ulcer or gangrenous area
Ascertain feelings about impending surgical procedure and how amputation will affect health and lifestyle
Can you name six nursing diagnoses for amputation?
Amputation: Assessment and Diagnosis
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203656 (BB) - Please note that in other chapters, for question "Can you name ... nursing diagnose ...", the answer has been listed in the notes part. Please provide the same in this slide.
The patient will do the following:
Report pain relief with the administration of analgesics
Demonstrate acceptance of body image changes
Have an incisional area that remains clean and without evidence of infection
Safely perform self-care activities within his or her activity and energy expenditure limitations
Amputation: Planning and Expected Outcomes
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Education is important in preventing amputation.
Teach about promptly notifying health care provider for changes in temperature, sensation, and color; if sore develops, prompt treatment must be sought.
Teach methods to protect lower extremity from injury.
Amputation: Intervention
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Preoperative: provide extensive information about surgical procedure, including the purpose of amputation, potential use of a prosthesis, and rehabilitation program
Postoperative: provide routine postoperative care and monitor carefully for complications that may be the result of preoperative health problems; provide pain relief measures and monitor for side effects; manage stump dressings
Amputation: Surgical Intervention
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Rehabilitative care starts immediately after surgery with application of dressing, when patient’s condition is stable, physical therapy begins.
Assist patient with accepting body image changes.
Prosthetic fitting and adaptation
Not all older adults are candidates for prostheses.
Delayed prosthetic fitting takes place when stump is healed and well shaped.
The physical therapist and prosthetist instruct the older patient in the use of the prosthesis.
Amputation: Rehabilitation Intervention
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Based on achievement of expected outcomes: exhibiting positive outlook about body changes, performing self-care and other activities safely and adequately, and experiencing pain relief over time
Documentation of activities critical for multidisciplinary evaluation of the older patient’s progress
Amputation: Evaluation
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The nurse is caring for a patient with an amputation. Give three or more important nursing interventions necessary for proper recovery and adjustment postoperatively.
Quick Quiz!
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ANS: Answers may vary but should include pain medication, preventing complication, stump dressings and education, and rehabilitation.
Answer to Quick Quiz
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Chronic inflammatory condition—sudden onset of muscle stiffness and aching in neck, shoulders, and hip girdle
Cause unknown
Symptoms: muscle stiffness present in morning and lasts more than 1 hour
Constitutional symptoms such as fever, malaise, anorexia, and weight loss may be present.
Treated with NSAIDs and steroids
Polymyalgia Rheumatica (PMR)
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History of patient’s symptoms, physical examination, and functional assessment are important in determining the effect of disease on functional abilities.
Can you name five nursing diagnoses for PMR?
PMR: Assessment and Diagnoses
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203656 (BB) - Please note that in other chapters, for question "Can you name ... nursing diagnose ...", the answer has been listed in the notes part. Please provide the same in this slide.
The patient will do the following:
Report pain relief with initiation of treatment
Correctly describe pharmacologic therapy—purpose, action, and side effects of drugs
Establish an activity and rest pattern based on limitations imposed by the disease
Incorporate effective coping strategies in disease management
Correctly state the treatment rationale and prognosis
PMR: Planning and Expected Outcomes
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Provide patient with information about disease and treatment plan
Monitor for development of side effects
PMR: Intervention
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Pain management is necessary for the older patient to perform ADLs, evaluate the patient’s understanding of the drugs and their side effects.
Providing appropriate education about the disease and symptom management
Documentation of education, pain assessment, and functional abilities is important for ongoing planning and care of patient.
PMR: Evaluation
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Often overlooked in assessment and care
Foot problems, especially pain, are common.
Foot problems may cause an unsteady gait and may result in falls.
Painful feet can be result of congenital deformities, weak structure, injuries, and diseases.
Foot Problems
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Thickened and hardened dead or hyperkeratotic tissue that develops over bony protuberances
Cause localized pain
Caused by ill-fitting or loose shoes that constantly place pressure on bony prominences
Treatment: warm water soaks used to soften corns before gentle rubbing with pumice stone or callus file; gentle debridement by a podiatrist, moleskin or cotton pads are placed over areas of rubbing and pressure
Corns
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Dead tissue found on plantar surfaces of the feet
Form under metatarsal heads
Aging changes of decreased toe function and decreased fat padding contribute to development.
Treatment same as for corns
Calluses
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Arthritis and other age-related changes such as ligament and tendon atrophy predispose older adults to bunions.
Bony protuberances on side of great toe
Great toe rubs against shoe, bursa becomes inflamed, resulting in bursitis and pain.
Treatment: soft leather shoes that are flat and wide and lace up; NSAIDs may be prescribed to reduce inflammation and pain; surgical interventions used after conservative treatment has failed
Bunions
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Deformity of the second toe—clawlike position
Causes: improperly fitted shoes, muscle weakness, and arthritis
Symptoms: pain and burning on bottom of foot and problems walking in shoes
Treatment: metatarsal arch support, orthotics, splints, and passive manual stretching of proximal interphalangeal joint; surgical correction is done if conservative treatment is ineffective
Hammertoe
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Onychauxis; hypertrophic nails; can cause nail bed ulcers, infection, and pain
Onychomycosis: fungal infection of toenail; white, yellow, or brown nails with simple scaling or totally destroyed
Predisposing factors: moisture, poor footwear, recurrent trauma, and diabetes
Treatment: topical antifungals generally used for several months
Nail Disorders
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Educate about predisposing factors, prevention, and treatment of onychomycosis and need for ongoing foot care, including inspection of feet for signs of infection and application of medication.
Foot Problems Patient Education
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Idiopathic muscle cramps without muscle weakness are common.
Affect the calf or foot muscles, producing plantar flexion of the foot or toes
Occur most frequently at night during sleep.
May be prevented by stretching the affected muscles for several minutes at bedtime.
Stretching will generally relieve the discomfort.
Muscle Cramps
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