MED-SURG NURSING EXAM 1 PREP — Mobility, Immobility & Musculoskeletal Exemplars

A comprehensive vocabulary review of mobility terminology, complications of immobility, assistive device rules, and musculoskeletal conditions including osteoporosis, fractures, and osteomyelitis.

Mobility

The ability to move freely, purposefully, and safely in one's environment.

Immobility

A state of inability to move independently, which may be complete or partial.

Ambulation

The act of walking.

Gait

The manner or pattern of walking.

Activity Tolerance

The maximum amount of physical activity a person can perform without adverse effects.

Disuse Syndrome

The cluster of complications that result from prolonged immobility across ALL body systems.

Isometric Exercise

Muscle contraction WITHOUT joint movement where muscles tighten against resistance; used for patients in casts or traction.

Isotonic Exercise

Muscle contraction WITH joint movement that moves through a range of motion to build strength and endurance.

Isokinetic Exercise

Muscle contraction at a constant speed against variable resistance, typically used in later rehab stages.

ROM

Range of Motion — the extent of movement possible in a joint.

Contracture

Permanent shortening of a muscle or tendon causing a fixed joint deformity.

Atrophy

The wasting or shrinking of muscle from disuse, potentially losing up to $3\%$ strength per day.

Orthostatic Hypotension

A drop in BP $\ge 20\,mmHg$ systolic or $\ge 10\,mmHg$ diastolic when moving from lying to standing.

Atelectasis

The collapse of alveoli, identified as the most common early postoperative respiratory complication.

DVT

Deep Vein Thrombosis; a blood clot forming in a deep vein (usually the legs) resulting from blood stasis.

Virchow's Triad

The three factors contributing to DVT: blood stasis, hypercoagulability, and vessel wall injury.

Pulmonary Embolism (PE)

A life-threatening condition where a DVT clot dislodges and travels to pulmonary circulation, causing sudden chest pain and tachycardia.

Hypostatic Pneumonia

Bacterial growth in pooled secretions resulting from impaired cough and clearance during immobility.

Foot Drop

A plantar flexion contracture where the foot remains unsupported in bed and cannot dorsiflex, leading to an unsafe gait.

Braden Scale

An assessment tool used on admission and regularly to evaluate a patient's risk for pressure injuries.

Maceration

Pale, soggy, and vulnerable skin caused by prolonged moisture from sweat or incontinence.

Paralytic Ileus

A gastrointestinal complication of immobility characterized by a lack of bowel sounds and abdominal distension.

Active ROM

Exercises where the patient moves their own joints independently; maintains both mobility and muscle strength.

Passive ROM

Exercises where the nurse moves the patient's joints; prevents contractures ONLY and does NOT build muscle strength.

Crutch Palsy

Brachial plexus nerve damage caused by bearing weight through the axilla instead of the hands/wrists while using crutches.

Osteoporosis

A metabolic bone disease where osteoclast activity exceeds osteoblast activity, leading to decreased bone density.

DEXA Scan

The gold standard diagnostic test used to measure bone mineral density (BMD).

T-score

A value comparing BMD to a healthy young adult norm where a score $\le -2.5$ indicates Osteoporosis and $-1.0 \text{ to } -2.5$ indicates Osteopenia.

Bisphosphonates

First-line medications for osteoporosis (e.g., Alendronate) that inhibit osteoclast activity to slow bone resorption.

Teriparatide (Forteo)

A PTH analog and the only osteoporosis medication that stimulates bone formation (anabolic).

Compartment Syndrome

A surgical emergency where increased pressure in a closed muscle compartment causes ischemia; marked by unrelenting pain and pain with passive stretch.

Fat Embolism Syndrome

A complication occurring $24-72$ hours after long-bone fractures, characterized by respiratory distress, confusion, and petechiae.

Petechiae

Small pinpoint red spots on the chest, axilla, and neck; a hallmark sign of Fat Embolism Syndrome.

Buck's Traction

A type of skin traction used for temporary hip fracture management, typically using $5-10\,lbs$ of weight.

Sequestrum

Dead bone tissue that forms within an infected area during osteomyelitis.

Involucrum

New bone that forms around dead bone (sequestrum) during the pathophysiology of osteomyelitis.

Phantom Limb Pain

A neurologically real phenomenon where a patient feels burning, shooting, or aching pain in an amputated limb.