Exam (elaborations)
Gerontological Nursing, 4e (Tabloski) Chapter 18 The Musculoskeletal System
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Gerontological Nursing, 4e (Tabloski) Chapter 18 The Musculoskeletal System
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Gerontological Nursing, 4e (Tabloski)Chapter 18 The Musculoskeletal System
Afterrassessingranrolderrpatient,rwhichrmusculoskeletalrchangesrwillrthernurserattributerasrbeingrarn
ormalrpartrofrtheragingrprocess?rSelectrallrthatrapply.
1. Lossrinrheight
2. Lowerrlegrmuscleratrophy
3. Calcificationrofrtherfingerrjoints
4. Swanrneckrdeformityrofrtherhands
5. Decreasedrrangerofrmotionrinrthershouldersr
Answer:r 1,r2,r5
Explanation:r 1.rArchangerinrthermusculoskeletalrstatusrthatrisrarnormalrpartrofrtheragingrprocessrisrarl
ossrinrheight.
2. Archangerinrthermusculoskeletalrstatusrthatrisrarnormalrpartrofrtheragingrprocessrisrlowerrlegrmus
cleratrophy.
3. Calcificationrofrtherfingerrjointsrisrassociatedrwithrosteoarthritisrwhichrisrnotrarnormalrchangerinrt
hermusculoskeletalrstatusrwithraging.
4. Swanrneckrdeformityrofrtherhandsrisrassociatedrwithrrheumatoidrarthritisrwhichrisrnotrarnor
malrchangerinrthermusculoskeletalrstatusrwithraging.
5. Archangerinrthermusculoskeletalrstatusrthatrisrarnormalrpartrofrtheragingrprocessrisrarchangerinrrang
erofrmotionrofrthermajorrjointsrsuchrasrthershoulders.
PagerRef:r480
CognitiverLevel:r Analyzing
ClientrNeed:r HealthrPromotionrandrMaintenancerNurs/
IntegrConc.:r NursingrProcess:rAssessment
LearningrOutcome:r 1.rExplainrnormalrchangesrinrthermusculoskeletalrsystemrassociatedrwithraging.
1
Copyrightr©r2019rPearsonrEducation,rInc.
,1) Thernurserisrcaringrforranrolderrclientrdiagnosedrwithrosteoarthritis.rTherclientrasksrthernurse,r"W
hatrisrosteoarthritis?"rWhichrstatementrshouldrthernurserincluderinrtherteaching?
1. "Thisrisrarmetabolicrbonerdisease."
2. "Thercartilagerofrtherjointsrhaverbecomereroded."
3. "Therdiseaserisrcausedrbyrsynovialrinflammation."
4. "Thisrisrardiseaserofrthermusclesraroundrtherjoints."rA
nswer:r 2
Explanation:r 1.rOsteoarthritisrisrnotrarmetabolicrbonerdisease.rMetabolicrbonerdiseasesrincluderosteo
porosis,rosteomalacia,randrPaget'srdisease.
2. Osteoarthritisrisrcharacterizedrbyrprogressivererosionrofrthercartilagerwithinrjoints,rwhichrisrthe
nrreplacedrbyrnewrbonerinrtherjointrspaces.
3. Rheumatoidrarthritisrisrarjointrdiseaserthatrinvolvesrsynovialrinflammation.
4. Osteoarthritisrisrcharacterizedrbyrprogressivererosionrofrthercartilagerwithinrjoints,rwhichrisrthe
nrreplacedrbyrnewrbonerinrtherjointrspaces.
PagerRef:r466-
468rCognitiverLevel:r Applyi
ng
ClientrNeed:r PhysiologicalrIntegrity
ClientrNeedrSub:r PhysiologicalrAdaptationrNurs/Integr
Conc.:r NursingrProcess:rImplementation
LearningrOutcome:r 6.rImplementrthernursingrmanagementrprinciplesrrelatedrtorthernursingrcarerofr
olderrpatientsrwithrarthritis.
2) Thernurserscreensranrolderradultrwomanrforrriskrfactorsrforrosteoporosis.rWhichrdoesrthernur
seridentifyrasrarcontributingrfactor?
1. Breastfeedingrfiverchildrenrduringrreproductiveryears
2. Usingrhormonerreplacementrtherapyrforrmenopause
3. Bonerdensityrofr2.5rstandardrdeviationsrbelowrthermean
4. Arbodyrmassrindexrofr35r
Answer:r 1
Explanation:r 1.rOsteoporosisrisrtherlossrofrbonermass.rWomenrareratrincreasedrrisk.rPregnancyrandr
prolongedrlactationrarerriskrfactorsrforrdecreasedrbonermassrduertorthertransferrofrnutrientsrtortherfe
tusrandrinfant.
2. Menopauserresultsrfromrlackrofrestrogenrcausingrrapidrbonerloss.rHormonerreplacementrthe
rapyrmightrslowrbonerloss.
3. Thisrisrtherdefinitionrofrosteoporosisrandrisrarriskrfactorrforrbrokenrbonesrandrfalls.
4. Arthinrbodyrhabitus,rnotranrobeserone,risrarriskrfactorrforrosteoporosis.rPa
gerRef:r463-477
CognitiverLevel:r Applying
ClientrNeed:r PhysiologicalrIntegrity
ClientrNeedrSub:r PhysiologicalrAdaptationrNurs/Integr
Conc.:r NursingrProcess:rImplementation
LearningrOutcome:r 2.rIdentifyrriskrfactorsrforrtherolderrpersonrrelatedrtorcommonrmusculoskeletalr
problems.
2
Copyrightr©r2019rPearsonrEducation,rInc.
, 3) Anrolderrclientrisrsurprisedrtorlearnrofrardiagnosisrofrrheumatoidrarthritis.rWhatrshouldrthernurs
erexplainrtortherpatientraboutrthisrhealthrproblem?rSelectrallrthatrapply.
1. Itrleadsrtordeformitiesrofrtherhands.
2. ItrisrcausedrbyrarvitaminrDrdeficiency.
3. Itrisrdiagnosedrbyrarpositiverpannusrbloodrtest.
4. Itrisrcharacterizedrbyrlowrbonermassrandrcompromisedrbonerstrength.
5. Itrcausesrsystemicrproblemsrthatrcanraffectrtherheart,rlungs,randrkidneys.rAn
swer:r 1,r5
Explanation:r 1.rRheumatoidrarthritisrisranrinflammatoryrconditionrthatrleadsrtordeformitiesrofrtherha
nds.
2. Osteomalacia,rdemineralizationrofrtherbone,risrcausedrbyrardeficiencyrofrvitaminrD.
3. Pannus,rarproliferationrofrtissuerinrthersynovialrspace,rcanrberobservedronrx-
raysrafterrtherdiseaserhasrprogressed.
4. Osteoporosisrisrcharacterizedrbyrarlossrinrbonermassrleadingrtorcompromisedrbonerstrength.
5. Inradditionrtorjointrsymptoms,rpatientsrwithrsevererandradvancedrRArhaversystemicrandrnon-
rjointrmanifestationsrofrtherdiseaserwhichrincluderpleurisyrwithreffusion,rpericarditisrandrmyocardi
tis,randrrenalrinvolvement.
PagerRef:r487
CognitiverLevel:r Applying
ClientrNeed:r PhysiologicalrIntegrity
ClientrNeedrSub:r PhysiologicalrAdaptationrNurs/Integr
Conc.:r NursingrProcess:rImplementation
LearningrOutcome:r 4.rComparertherpharmacologicalrmanagementrandrnursingrresponsibilitiesrrela
tedrtortherolderrpersonrwithrcommonrmusculoskeletalrproblems,rincludingrosteoporosis,rosteomala
cia,rPaget'srdisease,rosteoarthritis,rrheumatoidrarthritis,rgout,rpseudogout,randrhiprfractures.
3
Copyrightr©r2019rPearsonrEducation,rInc.
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