chapter 4 body systems and related conditions

Homeostasis

The condition in which all of the body's systems are working at their best

Metabolism

Physical and chemical processes by which substances are broken down or transformed into energy or products for use by the body.

Dilate

To widen

Constrict

To narrow

Signs

What the NA actually sees, hears, feels, or smells.

Symptoms

Not directly seen by the NA, but are reported by the resident who experiences them.

Anterior or ventral

The front of the body or body part

Posterior or dorsal

The back of the body or body part

Superior

Toward the head

Inferior

Away from the head

Medial

Toward the midline of the body

Lateral

To the side, away from the midline of the body

Proximal

Closer to the torso

Distal

Farther away from the torso

Integumentary System

Largest organ and system, natural protective covering, prevents excessive loss of water and injury to internal organs.

Normal changes of aging to the integumentary system

Thinner, drier, more fragile skin; less elastic skin; thinning fatty tissue can cause person to feel colder; thinner, gray hair; wrinkles and brown spots; harder, more brittle nails; dry, itchy skin due to lack of oil from sebaceous glands.

Pressure injuries

Occur where blood has poor circulation and bone is close to skin, can be very dangerous to residents' health.

Scabies

A skin infection caused by a tiny mite called Sarcoptes Scabiei, causing itching and a rash that looks like thin burrow tracks.

Atrophy

The wasting away, decreasing in size, and weakening of muscles from lack of use.

Contracture

The permanent and often painful shortening of a muscle or tendon, usually due to lack of activity.

Musculoskeletal System

The human body has 206 bones; two bones meet at joint for movement; muscles provide movement and produce body heat.

Physical activity/exercise

Increases circulation, increasing blood flow to organs and tissues.

Inactivity

Can cause depression, pneumonia, constipation UTI's, loss of self-esteem, and blood clots.

Muscle Atrophy

Muscles develop atrophy or contractures from inactivity.

ROM Exercises

Help prevent atrophy or contractures.

Normal Aging Changes

Include weaker, less toned muscles, slower body movement, less dense and more brittle bones, stiffer, painful joints, and loss of height.

NAs Role in Fall Prevention

Includes answering call lights promptly, keeping pathways clear, placing walkers and canes within reach, ensuring non-skid shoes are worn, encouraging regular movement, and assisting with ROM exercises.

Observation for Changes

Includes changes in movement and activity, ability to do ROM exercises, pain during movement, new or increased swelling of joints, white, shiny, red, or warm areas over joints, bruising, and aches and pains reported by resident.

Inflammation

Swelling.

Autoimmune Illness

An illness in which the body's immune system attacks normal tissue in the body.

Rheumatoid Arthritis

A type of arthritis in which joints become inflamed, red, swollen, and very painful, resulting in restricted movement and possible deformities.

Osteoarthritis

Common type of arthritis that usually affects the hips, knees, fingers, thumbs, and spine; also called degenerative joint disease (DJD) or degenerative arthritis.

Arthritis

Inflammation of the joints, causing stiffness, pain, and decreased mobility; may be caused by aging, injury, or autoimmune illness.

Arthritis Pain Factors

Pain and stiffness increase in cold or damp weather.

Arthritis Treatment

Includes anti-inflammatory medications (aspirin or ibuprofen), local applications of heat, ROM exercises, exercise and activity, and diet.

Care Guidelines for Arthritis

Includes watching for stomach irritation or heartburn caused by anti-inflammatory medications, encouraging activity, adapting ADLs for independence, and treating each resident as an individual.

Osteoporosis

A disease that causes bones to become porous and brittle, causing them to break easily.

Menopause

The end of menstruation; occurs when a woman has not had a menstrual period for 12 months.

Osteoporosis Facts

Causes bones to become brittle; may be due to age, lack of hormones, lack of calcium, alcohol consumption, or lack of exercise; occurs more commonly in women after menopause.

Osteoporosis Symptoms

Include low back pain, stooped posture, loss of height, and fractures.

Osteoporosis Prevention

Includes encouraging residents to walk and do light exercise as ordered, moving residents with osteoporosis very carefully, and following care plans regarding medication and supplements.

Partial Weight-Bearing (PWB)

A doctor's order stating that a person is able to support some body weight on one or both legs.

Non-Weight-Bearing (NWB)

A doctor's order stating that a person is unable to touch the floor or support any body weight on one or both legs.

Full Weight-Bearing (FWB)

A doctor's order stating that a person has the ability to support full body weight (100%) on both legs.

Fall Prevention

Is the key to preventing fractures.

Cast Care Guidelines

A cast must be completely dry before a person can bear weight on it.

Elevate extremity in cast

To stop swelling.

Observe for swelling

Look for skin discoloration, tightness, sores, skin temperature, burning, numbness or tingling, drainage, bleeding, or odor.

Protect resident's skin

Keep skin safe from edges of cast.

Keep the cast dry

Do not allow moisture to enter the cast.

Do not insert anything into cast

Avoid putting objects inside the cast.

Tell the nurse if pain medication is needed

Inform nursing staff when pain relief is required.

Use bed cradles as needed

Utilize bed cradles to keep the cast elevated.

Cause of hip fractures

May be a fall or weakness in bones.

Elderly bones heal slowly

Older adults experience slower recovery from fractures.

Reasons for hip replacement surgery

Fractured hip that does not heal properly, weakened hip due to aging, painful and stiff hip.

Keep often-used items within reach

Ensure accessibility to frequently needed objects.

Dress affected side first

Start dressing with the side that had surgery.

Do not rush the resident

Provide praise and encouragement instead of pressure.

Ask for pain medication prior to moving

Request pain relief before assisting with movement.

Hip cannot be bent or flexed more than 90 degrees

Maintain hip positioning to avoid excessive bending.

Abduction pillow usage

May be used for 6-12 weeks after surgery during sleep.

Transfer resident carefully

Lead with the strong side when standing, pivoting, and sitting.

Observe for and report after hip replacement surgery

Look for red, draining, warm, or bleeding incision, increase in pain, numbness or tingling, tenderness or swelling in calf, shortening and/or external rotation of affected leg, abnormal vital signs, inability to use equipment properly, unwillingness to follow doctor's orders, problems with appetite, improvements in strength and walking ability.

Reasons for knee replacement surgery

Relieves severe pain, restores motion of damaged knee, helps stabilize a knee that buckles or gives out.

Apply special stockings and/or compression devices

Use as ordered for post-operative care.

Perform ankle pumps

Execute as ordered to promote circulation.

Encourage fluids high in vitamin C

Promote hydration with vitamin C-rich beverages.

Assist with deep breathing exercises

Help residents perform breathing techniques for recovery.

Report to nurse if redness, swelling, heat, or deep tenderness is noticed

Inform nursing staff of any concerning symptoms in calves.

Nervous system functions

Control and message center of body, coordinates all body functions, senses information from outside the body.

Normal changes of aging to the nervous system

Includes slower responses and reflexes, decrease in sensitivity of nerve endings, and some memory loss, particularly short-term memory.

Hemiplegia

Paralysis on one side of the body

Hemiparesis

Weakness on one side of the body

Expressive Aphasia

Trouble communicating thoughts through speech or writing

Receptive Aphasia

Difficulty understanding spoken or written words.

Emotional lability

Inappropriate or unprovoked emotional responses, including laughing, crying, and anger.

Dysphagia

Difficulty swallowing.

CVA

Occurs when blood supply to a part of the brain is blocked or a blood vessel leaks or ruptures within the brain.

CVA Effects

Results in lack of oxygen to tissues, causing cells to die.

CVA Complications

Swelling, leaking blood, and clots affect surrounding healthy brain tissue.

CVA Weakness

Weakness occurs opposite affected side of the brain.

Mild Stroke

May result in few, if any, complications.

Gait

Manner of walking

Parkinson's Disease

A progressive, degenerative disease causing stiff muscles, stooped posture, shuffling gait, pill-rolling, tremors, and mask-like facial expression.

Parkinson's Tremors

Can make ADLs difficult.

Multiple Sclerosis (MS)

A progressive disease affecting the central nervous system.

MS Nerve Function

Protective sheath breaks down over time and nerves cannot send messages properly.

MS Abilities

Residents will have varying abilities.

ADLs

Activities of Daily Living

Transfer Belt

Always use a transfer belt for transfers.

Dressing Assistance

Dress weaker side first. Undress stronger side first.

Eating Assistance

Place food in the resident's field of vision and use assistive devices.

Signs of Choking

Watch for signs of choking when assisting with eating.

Soft Foods

Serve soft foods if swallowing is difficult.

Speech Pathologist

Call in a speech pathologist if a patient is having trouble with food and swallowing.

Multiple Sclerosis (MS) Symptoms

Symptoms can include blurred vision, fatigue, tremors, poor balance, trouble walking, weakness, numbness, tingling, incontinence, and behavior changes.

Consequences of MS

MS can cause blindness, contractures, and loss of function in arms and legs.

Care Guidelines for MS

Assist for ADLs, be patient with self-care and movement, allow time for tasks, offer rest periods, give resident time to communicate, prevent falls, help avoid stressful situations, listen to residents, adapt care to symptoms reported, encourage a healthy diet with plenty of fluids, give regular skin care, assist with ROM exercises.

Paraplegia

Loss of function of lower body and legs.