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Alterations In Mobility and Coordination

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Gout. Osteoporosis. Osteoarthritis. Degenerative Joint Disease. Risk Factors. Increased age ... Gout. Defect in Purine Metabilism. Oversecretion of Uric Acid ... – PowerPoint PPT presentation

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Title: Alterations In Mobility and Coordination


1
Alterations In Mobility and Coordination
  • NursingII
  • Mary Ellen Santucci DNSc, RN

2
Assessment of the Client
  • Subjective Data
  • Objective Data
  • Diagnostic Evaluations

3
Subjective Data
  • Pain
  • Altered Sensations

4
Objective Data
  • Posture
  • Gait
  • Bone Integrity
  • Joint Function
  • Muscle Strength and Weakness
  • Skin
  • Neurovascular status

5
Diagnostic Evaluations
  • Radiographic Studies
  • Computerized Tomography
  • Magnetic Resonance
  • Arthrography
  • Bone Densitometry

6
Diagnostics
  • Bone Scan
  • Arthroscopy
  • Arthrocentesis
  • EMG
  • Biopsy

7
Planning and Interventions
  • Biological disabilities
  • Psychosociocultural and spiritual problems
  • Specific interventions

8
Biological Disabilities
  • pain and stiffness
  • decrease muscle strength
  • loss of dexterity and locomotion

9
Psychosociocultural and spiritual problems
  • reaction to disability and chronicity
  • dependence, independence and interdependence
  • assistive, supportive and corrective devices
  • socioeconomic impact
  • family relationships

10
Specific Interventions
  • physical therapy and activity
  • heat and cold
  • traction casts
  • diet
  • psychological and social support
  • surgical intervention

11
Physical therapy
  • ROM
  • Exercise
  • Walker
  • Cane
  • Wheelchair
  • Heat and Cold

12
Traction and Cast
  • Cast Care
  • Applying a Cast
  • Bivalving a Cast
  • Compartment Syndrome
  • Home Care
  • Removing a Cast

13
Traction
  • Types of Traction
  • Skin
  • Bucks Traction
  • Skeletal Traction
  • PIN CARE
  • Pressure Ulcers
  • Pneumonia
  • Constipation
  • Urinart Stasis and Venous Stasis

14
Surgical Intervention
  • Joint Replacement (See Plan of Care 61-1)
  • Arthroscopy
  • Open Reduction Internal Fixation

15
Specific Alterations
  • Degenerative and Inflammatory Joint Disorders
  • Trauma
  • Infections

16
Degenerative and Inflammatory Joint Disorders
  • Osteoarthritis
  • Gout
  • Osteoporosis

17
Osteoarthritis
  • Degenerative Joint Disease
  • Risk Factors
  • Increased age
  • Genetic Predisposition
  • Gender and hormonal Factors
  • Obesity
  • mechanical Factors
  • Prior Inflammatory Disease

18
Osteoartritis
  • Management
  • Pharmacologic
  • Medical
  • Surgical

19
Gout
  • Defect in Purine Metabilism
  • Oversecretion of Uric Acid
  • Uric Acid Crystals in the Synovial Fluid
  • Prescence of Tophi
  • Pharmacology
  • colchine
  • probenecid
  • allopurinal

20
Osteoporosis
  • Reduction in total bone mass and a change in bone
    structure
  • Loss of Height
  • Kyphosis (Dowager Hump)
  • Risk for Fracture
  • Calcium Supplement, HRT, Vitamin D
  • Decreased ETOH, decreased Caffiene
  • Decreased Carbonated Beverages, No Smoking

21
Trauma
  • Sprains
  • Contusions
  • Soft Tissue Injury
  • Dislocations
  • Fractures
  • Amputations

22
Sprains, Contusions, Soft Tissue Injury
  • Cold
  • Heat
  • Support
  • Antiinflammatories

23
Dislocations
  • Replace Location
  • Support

24
Fractures
  • See Chart 63-1 Types of Fractures
  • Align
  • Immoblize
  • Complications
  • Shock
  • Fat Embolism
  • Compartment Syndrome
  • Reflex Sympatheitic Dystrophy
  • Infection

25
Amputations
  • See Figure 63-15 for types of amputations
  • Closed Rigid Cast Dressing
  • Soft Dressing
  • Pain
  • Wound Healing
  • Stump Wrapping
  • Stump Care
  • Prosthesis

26
Pharmacotherapeutics
  • Antiinflammatories
  • Pain Medications
  • Antibiotics
  • Vitamins
  • Calcium
  • Antigout
  • Vascular Drugs (Trental)

27
Discharge Planning
  • Role Changes
  • Americans with Disabilities Act
  • Office of Vocational rehabilitation
  • Assistive Devices
  • Home Care
  • Support Groups
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