Gerontological Nursing, 4e (Tabloski) Chapter 18 The Musculoskeletal System

Gerontological Nursing, 4e (Tabloski) Chapter 18 The Musculoskeletal System 1) After assessing an older patient, which musculoskeletal changes will the nurse attribute as being a normal part of the aging process? Select all that apply. 1. Loss in height 2. Lower leg muscle atrophy 3. Calcification of the finger joints 4. Swan neck deformity of the hands 5. Decreased range of motion in the shoulders Answer: 1, 2, 5 Explanation: 1. A change in the musculoskeletal status that is a normal part of the aging process is a loss in height. 2. A change in the musculoskeletal status that is a normal part of the aging process is lower leg muscle atrophy. 3. Calcification of the finger joints is associated with osteoarthritis which is not a normal change in the musculoskeletal status with aging. 4. Swan neck deformity of the hands is associated with rheumatoid arthritis which is not a normal change in the musculoskeletal status with aging. 5. A change in the musculoskeletal status that is a normal part of the aging process is a change in range of motion of the major joints such as the shoulders. Page Ref: 480 Cognitive Level: Analyzing Client Need: Health Promotion and Maintenance Nurs/Integ Conc.: Nursing Process: Assessment Learning Outcome: 1. Explain normal changes in the musculoskeletal system associated with aging. 1 Copyright © 2019 Pearson Education, Inc. 2) The nurse is caring for an older client diagnosed with osteoarthritis. The client asks the nurse, "What is osteoarthritis?" Which statement should the nurse include in the teaching? 1. "This is a metabolic bone disease." 2. "The cartilage of the joints have become eroded." 3. "The disease is caused by synovial inflammation." 4. "This is a disease of the muscles around the joints." Answer: 2 Explanation: 1. Osteoarthritis is not a metabolic bone disease. Metabolic bone diseases include osteoporosis, osteomalacia, and Paget's disease. 2. Osteoarthritis is characterized by progressive erosion of the cartilage within joints, which is then replaced by new bone in the joint spaces. 3. Rheumatoid arthritis is a joint disease that involves synovial inflammation. 4. Osteoarthritis is characterized by progressive erosion of the cartilage within joints, which is then replaced by new bone in the joint spaces. Page Ref: 466-468 Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Physiological Adaptation Nurs/Integ Conc.: Nursing Process: Implementation Learning Outcome: 6. Implement the nursing management principles related to the nursing care of older patients with arthritis. 3) The nurse screens an older adult woman for risk factors for osteoporosis. Which does the nurse identify as a contributing factor? 1. Breastfeeding five children during reproductive years 2. Using hormone replacement therapy for menopause 3. Bone density of 2.5 standard deviations below the mean 4. A body mass index of 35 Answer: 1 Explanation: 1. Osteoporosis is the loss of bone mass. Women are at increased risk. Pregnancy and prolonged lactation are risk factors for decreased bone mass due to the transfer of nutrients to the fetus and infant. 2. Menopause results from lack of estrogen causing rapid bone loss. Hormone replacement therapy might slow bone loss. 3. This is the definition of osteoporosis and is a risk factor for broken bones and falls. 4. A thin body habitus, not an obese one, is a risk factor for osteoporosis. Page Ref: 463-477 Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Physiological Adaptation Nurs/Integ Conc.: Nursing Process: Implementation Learning Outcome: 2. Identify risk factors for the older person related to common musculoskeletal problems.