H&I Exam 1 (Mobility, Functional Ability, Pain, and Elimination)

active range of motion

full movement of each joint

aerobic exercise

requires oxygen metabolism to produce energy. Patients may engage in rigorous walking or repeated stair climbing to achieve the positive effects of aerobic exercise

anaerobic exercise

builds power and body mass. Without oxygen to produce energy for activity, anaerobic exercise takes place. Heavy weight lifting is an example of anaerobic exercise

atrophy

wasting

contracture

permant fixarion of a joint

dangling

the patient sits on the side of the bed before standing, is important to prevent injury to previously nonambulatory patients.

disuse osteoporosis

loss of bone mass due to lack of activity

equilibrium

balance

flaccidity

lack of muscle tone

footdrop

one of the more common contractures, results in permanent plantar flexion

friction

rubbing

gait

manner of walking

hemiparesis

weakness on one side of the body

hemiplegia

paralysis of one side of the body

hypertonicity

increased muscle tone

hypotonicity

lack of muscle tone

ischemia

reduced blood flow

isometric exercise

builds power and body mass. Without oxygen to produce energy for activity, anaerobic exercise takes place. Heavy weight lifting is an example of anaerobic exercise

isotonic exercise

involves active movement with constant muscle contraction. Examples include walking, turning in bed, and self-feeding

logrolling

moving the whole body as a unit

necrosis

death of cells, tissues, or organs

paraplegia

lower body paralysis

passive range of motion

moving each joint to the point of resistance

pathologic bone fractures

spontaneous breaks without trauma

pressure injuries

pressure sores, pressure ulcers, bedsores, or decubitus ulcers

proprioception

awareness of posture and movement

quadriplegia

inability to move all four extremities

range of motion

degrees of movement

spacity

increased muscle tone

trapeze

a triangular device suspended above the bed to facilitate repositioning and transfers.

What are the S/S of osteoarthritis

joints stiffness, swelling, pain, gout, crepitus hypertrophy, joint effusions, muscle atrophy, decreased mobility, depression, decreased sexual interest, anxiety, poor body image, irregular sleep wake cycle

What are the S/S of osteoporosis

increased risk for fractures, back pain, decreased mobility, spinal deformities, constipation, abdominal distension, reflux esophagus syndrome, respiratory compromise, cardiovascular problems, and kyphosis

What are the S/S of scoliosis

abnormal spine curvature, gait problems, limp, leg asymmetry, balance problems, and swelling

What are the S/S of cognitive impairment

impaired memory, speech, judgment, calculation, reasoning, and confusion,

What are the S/S of physical impairment

Pain (in the affected area), limited ROM, use of an assistive device, difficulty completing ADLs, and unsteady gait

What are the S/S of sensory impairment

Loss of taste, smell, touch, hearing, or sight

Cathartics

are strong laxatives that stimulate evacuation of the bowel by causing a change in GI transit time.

Chyme

is a thick fluid mass of partially digested food and gastric secretions that is passed from the stomach to the small intestine

Peristalsis

the mechanism of progressive contraction and relaxation of the walls of the intestine, forces chyme into the large intestine through the ileocecal valve, which prevents regurgitation (backflow) of chyme

Hemorrhoids

are swollen and inflamed veins in the anus or lower rectum

stoma

is a body opening but usually refers to the actual exit point for a GI surgical ostomy which forms a slight protuberance of mucosa (gut lining tissue) through the skin

colostomy

is surgically created when a portion of the colon (large intestine) or the rectum is removed and the remaining colon is brought through the abdominal wall at skin level to allow passage of stool waste

ileostomy

is a surgically created opening in the small intestine, usually at the end of the ileum

Laxatives

ease defecation, often by stimulating bowel activity

Cathartics

are strong laxatives that stimulate evacuation of the bowel by causing a change in GI transit time

polyps

cancerous growths

suppository

is a drug delivery system that is inserted into the rectum, where it dissolves for medication absorption through the rectal mucosa

Nociceptors

are the free endings of afferent nerve fibers, which are sensory neurons sensitive to noxious thermal, mechanical, or chemical stimuli

neurotransmitters

chemicals that transmit signals across synapses from one neuron to another.

A-delta fibers

which are large-diameter, myelinated fibers with rapid conduction of signals that are translated as sharp, acute pain

C fibers

which are smaller, unmyelinated fibers with slow conduction of signals that are translated as diffuse, dull, and longer-lasting pain.

pain threshold

is the lowest intensity at which the brain recognizes the stimulus as pain. This threshold varies from person to person

Pain tolerance

is the intensity or duration of pain that a patient is able or willing to endure.

Acute pain

most often is defined as pain lasting less than 3 to 6 months, depending on specific circumstances.

Chronic pain

is identified as postoperative pain that persists more than 3 months and pain (not following surgery) lasting longer than 6 months

Nociceptive pain

is the most common type of pain. It originates from visceral and somatic locations in the body. This type of physiologic (physical) pain occurs when nociceptors are stimulated in response to trauma, inflammation, or tissue damage from surgery

Visceral pain

arises from the organs of the body and occurs in conditions such as appendicitis, pancreatitis, inflammatory bowel disease, bladder distention, and cancer.

Somatic pain

results from injury to skin, muscles, bones, and joints. Somatic pain occurs in conditions such as sunburn, lacerations, fractures, sprains, arthritis, and bone cancer.

Referred pain

originates in one area but hurts in another area, such as pain from a myocardial infarction. The pain is caused by lack of oxygen to the heart muscle, but the pain may be felt in the jaw or down the left arm.

Radiating pain

extends from the source to an adjacent area of the body. For example, in gastroesophageal reflux, pain in the stomach radiates up the esophagus.

Neuropathic pain

results from nerve injury, and the pain continues even after the painful stimuli are gone. Sometimes referred to as pathologic pain, neuropathic pain may stem from injury to nerves in the central or peripheral nervous system. It is usually chronic pain that may be continuous or episodic. Characteristically, neuropathic pain may be burning, aching, crushing, stabbing, shooting, tingling, or numbing.

Phantom pain

occurs when the brain continues to receive messages from the area of an amputation. Over time, the brain adapts to the loss of the limb and the pain stops.

psychogenic pain

Pain that is perceived by an individual but has no physical cause

Multimodal analgesia

is the use of more than one means for controlling pain. When more than one type of agent is used, analgesia is more effective, requires lower doses of each agent, and produces fewer side effects

Preemptive analgesia

is the administration of medications before a painful event to minimize pain

Nonopioid analgesics

include acetaminophen and nonsteroidal antiinflammatory drugs (NSAIDs) such as ibuprofen and aspirin. These drugs are used in the treatment of many types of mild to moderate pain.

Opioid analgesics

are the most effective agents for relief of moderate to severe pain. These narcotic medications work by binding to the opioid receptors in the nervous system, which are sites of endorphin action. There are many types of opioid analgesics, including agonist analgesics and agonist-antagonist analgesics.

Patient-controlled analgesia (PCA)

is a system in which an electronically controlled infusion pump immediately delivers a prescribed amount of analgesic to the patient when the patient activates a button, without the need for a nurse to administer it

Drug tolerance

is an adaptation to the medication, which eventually leads to less effective pain relief. It is better to change to another medication than continue increasing the dose of the same medication.

Physical dependence

builds as the body becomes unable to function normally without the medication, reaching the point of withdrawal symptoms on abrupt cessation of the medication.

Addiction

is a psychological or emotional dependence on a prescribed medication or illicit drug. The addicted individual craves the drug and engages in compulsive use, or abuse, regardless of the consequences.

Substance use disorder

occurs when a person’s repeated use of alcohol and/or drugs causes significant impairment, such as disability; inability to fulfill work, home, or school responsibilities; or health problems

adjuvant medications, or coanalgesic medications

work synergistically with standard pain medications to enhance pain relief and to treat side effects of the medication. For example, tricyclic antidepressants and anticonvulsants may be used together to treat neuropathic pain.

nephrons

which are the functional units of the kidney.

urge

The innervation of the bladder signals when it is time to urinate and empty the bladder

micturition

when all signals need for urination occur in the correct order

incontinence

the inability to control urination, is prevalent, particularly in women, and can greatly affect quality of life

Anuria

is the failure of the kidneys to produce or excrete urine

Dialysis

is a technique by which fluids and molecules pass through an artificial semipermeable membrane and are filtered by means of osmosis.

hemodialysis

the patient’s blood flows continually from the body through vascular catheters to the dialysis machine.

Peritoneal dialysis

is performed by instilling dialysis solution into the patient’s abdominal cavity through an external catheter. After the solution rests within the peritoneal cavity for a prescribed period, the solution is removed from the body through the catheter. In peritoneal dialysis, the abdominal cavity functions as the dialyzing membrane through which fluid and molecules are exchanged and toxic substances are removed from the body.

Oliguria

is defined as reduced urine volume: less than 1 mL/kg/hr in an infant, less than 0.5 mL/kg/hr in children or adults, or less than 500 mL/day in adults

Polyuria

is an excessive volume of urine formed and excreted each day.

Nocturia

is excessive urination at night.

Hematuria

is the abnormal presence of red blood cells in the urine.

Urinary incontinence

is the inability to control the passage of urine.

Stress incontinence

is loss of urine control during activities that increase intraabdominal pressure, such as coughing, sneezing, laughing, or exercise.

Urge incontinence

involves a sudden strong urge to void, followed by rapid bladder contraction. The affected person does not have enough time for toileting between recognition of the urge to urinate and the onset of voiding.

Mixed incontinence

is a combination of both stress and urge incontinence.

Functional incontinence

refers to lack of urine control in the absence of any abnormalities of the urinary tract. It occurs when some physical limitation in functioning, such as difficulty with clothing fasteners or impaired mobility, hinders reaching the toilet before voiding occurs.

Overflow incontinence

is seen in patients who are unable to empty the bladder completely, resulting in a constant dribbling of urine or increased frequency of urination.

Overflow incontinence

results from weakened muscles of the bladder, which may be a consequence of certain pathologic conditions.

Temporary incontinence

can occur in association with factors such as severe constipation, infections in the urinary tract or vagina, or medication usage.

Urinary retention

is the inability of the bladder to empty.

Urinary tract infections (UTIs)

are the result of bacteria in the urine. Infection occurs when bacteria from the digestive tract, usually Escherichia coli, invade the urethra and multiply. UTI is one of the most common health care–associated infections

urinary diversion

is a surgical procedure performed when bladder function is impaired owing to trauma or disease involving the bladder, the distal ureters, or, rarely, the urethra.

irrigation

flushing

Kegel exercises

which help strengthen and maintain pelvic floor muscles, thus aiding in the prevention of some types of incontinence.

what is the etiology of osteoarthritis

age, gender, race, heredity, bone mass, obesity,

what is the etiology of fractures

sudden injury, fatigue/ stress fractures, and pathologic fractures