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NSE13 - Winter Semester - Week 1

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Ryerson University
Mary Santilli

Yasmin Groisman Winter Semester Week 1 Outline subjective questions. Include the effects of abnormal findings during the assessment that may result in an increase number of falls in the older population (arthritis, mental status, vital signs, cardiac and peripheral system, urology system) 1. Joints (pain, stiffness, swelling/heat/redness, limitation of movement) Question to ask:  Any problems with your joints? Any pain?  Location: Which joints? On one side or both sides?  Quality: What does the pain feel like: aching, stiff, sharp or dull, shooting?  Severity: How strong is the pain?  Onset: When did this pain start?  Timing: What time of day does the pain occur? How long does it last? How often does it occur?  Is the pain aggravated by movement, rest, position, weather? Is the pain relieved by rest, medications, applications of heat or ice?  Is the pain associated with chills, fever, recent sore throat, trauma, repetitive activity?  Any stiffness in your joints?  Any swelling, heat, redness in the joints?  Any limitation of movement in any joint? Which joint?  Which activities give you problems? 2. Muscles (pain/cramps, weakness) Question to ask:  Any problems in the muscles, such as any pain or cramping? Which muscles?  If in calf muscles: Does the pain occur with walking? Does it go away with rest?  Are your muscle aches associated with fever, chills, the “flu”?  Any weakness in muscles?  Location: Where is the weakness? How long have you noticed weakness?  Do the muscles look smaller there? 3. Bones (pain, deformity, trauma) Question to ask:  Any bone pain? Is the pain affected by movement?  Any deformity of any bone or joint? Is the deformity due to injury or trauma? Does the deformity affect ROM?  Any accidents or trauma ever affected the bones or joints: fractures, joint strain, sprain, dislocation? Which ones? Yasmin Groisman  When did this occur? What treatment was given? Any problems or limitations now as a result?  Any back pain? In which part of your back? Is the pain felt anywhere else, like shooting down leg?  Any numbness and tingling? Any limping? 4. Functional Assessment (ADL’s) Questions to ask:  Bathing – any problems getting in and out of tub, turning faucets?  Toileting – any problems urinating, defacating, are you able to get self on and off toilet, wipe self?  Dressing – any problems doing buttons, zipper, fasten open behind neck, pulling dress or sweater over head, pulling up pants, tying shoes, getting shoes that fit?  Grooming – any trouble shaving, brushing teeth, brushing or fixing hair, applying makeup?  Eating – any trouble preparing meals, pouring liquids, cutting up foods, bringing food to mouth, drinking?  Mobility – any trouble walking, walking up or down stairs, getting in and out of bed, getting out of house?  Communicating – any trouble talking, using phone, writing? 5. Self-Care Behaviors Questions to ask:  Tell me about your exercise program. Describe the type of exercise, frequency, warm-up program.  Any pain during exercise? How do you treat it?  Have you had any recent weight gain? Please describe your usual daily diet.  Are you taking any medications for musculoskeletal system: aspirin, anti- inflammatory, muscle relaxant, pain reliever?  [If person has chronic disability or crippling illness] How has your illness affected: - Interaction with family - Interaction with friends - Way you view yourself ABNORMAL FINDINGS – pg. 641-651 Describe the components of a synovial joint Synovial joints are freely movable because they have bones that are separated from each other and are enclosed in a joint cavity (filled with synovial fluid). Synovial fluid allows sliding of opposing surfaces, which permits movement. Yasmin Groisman - Resilient cartilage covers the surface of opposing bones. Cartilage is avascular (receives nourishment from synovial fluid). It is a stable connective tissue with a slow cell turnover. It is tough, yet flexible. It cushions the bones and gives a smooth surface to facilitate movement. - The joint is surrounded a fibrous capsule and is supported by ligaments. Ligaments are fibrous bands ru
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