NURS 2750 EXAM 3 QUESTIONS WITH VERIFIED
SOLUTIONS
Functions of the musculoskeletal system
•Protection of vital organs
•Mobility and movement
•Facilitate return of blood to the heart
•Production of blood cells (hematopoiesis)
•Reservoir for immature blood cells
•Reservoir for vital minerals
Coordinated efforts of the musculoskeletal and nervous systems
body mechanics
force that occurs in a direction to oppose movement
friction
regulating factors of bone formation and maintenance
-Stress and weight bearing
-Vitamin D
-Parathyroid hormone and calcitonin
-Blood supply
normal calcium level
9-10.5 mg/dL
developmental changes in infants, toddlers, and preschoolers
•Prolonged immobility delays gross motor skills, intellectual development, or musculoskeletal
development
very bow-legged and top heavy - unsteady gait so increased risk for injury
developmental changes in adolescents
•Delayed in gaining independence and in accomplishing skills
•Social isolation can occur if there is trauma, illness, surgery, etc
"risk-takers"
developmental changes in adults
•Physiological systems are at risk
•Changes in family and social structures
,^^ with prolonged immobility because they tend to have sedentary lifestyles
developmental changes in older adults
•Decreased physical activity
•Hormonal changes
Bone reabsorption
more comorbidities; bones more brittle and weak
spinal changes (kyphosis), side to side gait ... encourage them to look up
ability to move about freely
mobility
inability to move about freely
immobility
an intervention that restricts patients for therapeutic reasons
bed rest
metabolic effects due to impaired mobility
endocrine, calcium absorption, and GI function
kidneys unable to secrete calcium = hypercalcemia = fractures possible
CV effects due to impaired mobility
orthostatic hypotension, thrombus
also dizziness, n/v, tachycardia, pallor, fainting
muscle effects due to impaired mobility
loss of muscle mass, atrophy
urinary elimination effects due to impaired mobility
urinary stasis
renal calculi (bc hypercalcemia_
respiratory effects due to impaired mobility
atelectasis (collapse of alveoli) and hypostatic pneumonia (inflammation of lungs from stasis of
secretions)
musculoskeletal effects due to impaired mobility
,loss of endurance and muscle mass and decreased stability and balance
skeletal effects due to impaired mobility
impaired calcium absorption, joint abnormalities
ex: disuse osteoporosis = pathological fx possible
integumentary effects due to impaired mobility
pressure ulcer, ischemia
describe the change of metabolic changes due to immobility
immobility --> muscle atrophy --> negative nitrogen balance --> further loss of mass -->
increased weakness
* nutritional intake due to anorexia and/or restrictions can affect negative nitrogen balance
and increase weakness even more *
what kind of muscle/skeletal effects can immobility cause?
dorsal and plantar flexion
if muscles break down and shorten the foot cannot extend once pressed down (causes unsteady
gait... dragging foot b/c cannot lift it)
You notice a respiratory change in your immobilized postoperative patient. The change
you note is most consistent with:
A. Atelectasis.
B. Hypertension.
C. Orthostatic hypotension.
D. Coagulation of blood.
A. atelectasis
what is considered orthostatic hypotension?
when the systolic drops at least 20 mmHg when changing from sitting to standing, etc
signs of infection of the urinary system due to immobility
watch urine output, fluid intake, lab work, possible renal calculi, constipation
psychosocial effects of immobility
hostility, giddiness, fear, anxiety; sleep-wake alterations; depression, sadness, dejection
how to assess mobility...
, •Describe any changes you've noticed in your ability to walk and take care of yourself on a daily
basis.
•Have you experienced any stiffness, swelling, pain, or difficulty with moving? If so, describe
how you felt.
•Have you noticed any shortness of breath? (incr. secretion stasis)
how to assess immobility...
•Describe your normal daily activity. Has this changed recently?
•How have your appetite and diet changed since you've had problems moving around? (incr. fat
and decr. protein = weak muscle)
•Describe what you eat in a normal day.
•Does your day seem very long?
•Are you sleeping well at night?
•Have you noticed any places on your skin that are reddened or have any open sores? (possible
pressure injuries)
•Describe any changes you've noticed in urinating and/or in having bowel movements.
specific assessments regarding immobility/mobility
•Pain and altered sensations
•Activity
•Gait
•Alignment
•Symmetry (bones, muscle mass
•Muscle tone
•Range of motion
•Any involuntary muscle movements
•Indications of inflammation
•Gross deformities
general inspection of the body to assess for mobility/immobility
-Gait
-Postural abnormalities
-Age-related changes
-Alignment
-Decorticate rigidity- flexion and internal rotation of upper extremities joints and legs
-Decerebrate rigidity- neck and elbow extension with the wrists and fingers flexed
-Hemiplegia (paralyzed on one side)
-Hemiparesis (weakness on one side)
describe decorticate rigity
plantar flexed
internally rotated legs
flexed elbows
SOLUTIONS
Functions of the musculoskeletal system
•Protection of vital organs
•Mobility and movement
•Facilitate return of blood to the heart
•Production of blood cells (hematopoiesis)
•Reservoir for immature blood cells
•Reservoir for vital minerals
Coordinated efforts of the musculoskeletal and nervous systems
body mechanics
force that occurs in a direction to oppose movement
friction
regulating factors of bone formation and maintenance
-Stress and weight bearing
-Vitamin D
-Parathyroid hormone and calcitonin
-Blood supply
normal calcium level
9-10.5 mg/dL
developmental changes in infants, toddlers, and preschoolers
•Prolonged immobility delays gross motor skills, intellectual development, or musculoskeletal
development
very bow-legged and top heavy - unsteady gait so increased risk for injury
developmental changes in adolescents
•Delayed in gaining independence and in accomplishing skills
•Social isolation can occur if there is trauma, illness, surgery, etc
"risk-takers"
developmental changes in adults
•Physiological systems are at risk
•Changes in family and social structures
,^^ with prolonged immobility because they tend to have sedentary lifestyles
developmental changes in older adults
•Decreased physical activity
•Hormonal changes
Bone reabsorption
more comorbidities; bones more brittle and weak
spinal changes (kyphosis), side to side gait ... encourage them to look up
ability to move about freely
mobility
inability to move about freely
immobility
an intervention that restricts patients for therapeutic reasons
bed rest
metabolic effects due to impaired mobility
endocrine, calcium absorption, and GI function
kidneys unable to secrete calcium = hypercalcemia = fractures possible
CV effects due to impaired mobility
orthostatic hypotension, thrombus
also dizziness, n/v, tachycardia, pallor, fainting
muscle effects due to impaired mobility
loss of muscle mass, atrophy
urinary elimination effects due to impaired mobility
urinary stasis
renal calculi (bc hypercalcemia_
respiratory effects due to impaired mobility
atelectasis (collapse of alveoli) and hypostatic pneumonia (inflammation of lungs from stasis of
secretions)
musculoskeletal effects due to impaired mobility
,loss of endurance and muscle mass and decreased stability and balance
skeletal effects due to impaired mobility
impaired calcium absorption, joint abnormalities
ex: disuse osteoporosis = pathological fx possible
integumentary effects due to impaired mobility
pressure ulcer, ischemia
describe the change of metabolic changes due to immobility
immobility --> muscle atrophy --> negative nitrogen balance --> further loss of mass -->
increased weakness
* nutritional intake due to anorexia and/or restrictions can affect negative nitrogen balance
and increase weakness even more *
what kind of muscle/skeletal effects can immobility cause?
dorsal and plantar flexion
if muscles break down and shorten the foot cannot extend once pressed down (causes unsteady
gait... dragging foot b/c cannot lift it)
You notice a respiratory change in your immobilized postoperative patient. The change
you note is most consistent with:
A. Atelectasis.
B. Hypertension.
C. Orthostatic hypotension.
D. Coagulation of blood.
A. atelectasis
what is considered orthostatic hypotension?
when the systolic drops at least 20 mmHg when changing from sitting to standing, etc
signs of infection of the urinary system due to immobility
watch urine output, fluid intake, lab work, possible renal calculi, constipation
psychosocial effects of immobility
hostility, giddiness, fear, anxiety; sleep-wake alterations; depression, sadness, dejection
how to assess mobility...
, •Describe any changes you've noticed in your ability to walk and take care of yourself on a daily
basis.
•Have you experienced any stiffness, swelling, pain, or difficulty with moving? If so, describe
how you felt.
•Have you noticed any shortness of breath? (incr. secretion stasis)
how to assess immobility...
•Describe your normal daily activity. Has this changed recently?
•How have your appetite and diet changed since you've had problems moving around? (incr. fat
and decr. protein = weak muscle)
•Describe what you eat in a normal day.
•Does your day seem very long?
•Are you sleeping well at night?
•Have you noticed any places on your skin that are reddened or have any open sores? (possible
pressure injuries)
•Describe any changes you've noticed in urinating and/or in having bowel movements.
specific assessments regarding immobility/mobility
•Pain and altered sensations
•Activity
•Gait
•Alignment
•Symmetry (bones, muscle mass
•Muscle tone
•Range of motion
•Any involuntary muscle movements
•Indications of inflammation
•Gross deformities
general inspection of the body to assess for mobility/immobility
-Gait
-Postural abnormalities
-Age-related changes
-Alignment
-Decorticate rigidity- flexion and internal rotation of upper extremities joints and legs
-Decerebrate rigidity- neck and elbow extension with the wrists and fingers flexed
-Hemiplegia (paralyzed on one side)
-Hemiparesis (weakness on one side)
describe decorticate rigity
plantar flexed
internally rotated legs
flexed elbows
