Question

The nurse is caring for an older adult in a long-term care setting. The nurse reviews the medical record to find that the patient has progressive loss of total bone mass. The patient's history and tendency to take smaller steps with feet kept closer together will most likely result in which of the following? a. Increase the patient's risk for falls and injuries b. Result in less stress on the patient's joints c. Decrease the amount of work required for patient movement d. Allow for mobility in spite of the aging effects on the patient's joints

Short answer

The patient's progressive loss of total bone mass combined with a tendency to take smaller steps with feet kept closer together will most likely increase the patient's risk for falls and injuries (option a).

Step-by-step solution

Review Patient History

Examine the patient's medical records, noting the progressive loss of bone mass, which indicates a condition such as osteoporosis. Also, note the patient's altered gait, with smaller steps and feet kept closer together.

Understand the Clinical Implications

Relate the patient's progressive bone loss and gait changes to their clinical implications. Reduced bone mass can increase fragility, and a modified gait may be a compensatory mechanism to maintain balance.

Analyze Potential Outcomes

Analyze how these clinical findings could affect the patient's risk of falls and injuries. Consider how changes in bone mass and gait influence stability and the ability to recover from stumbles or slips.

Key concepts

Understanding Bone Mass Loss

Bone mass loss, particularly witnessed in conditions like osteoporosis, represents a significant health concern, especially for older adults. This condition, characterized by porous and fragile bones, results from imbalances in bone remodeling – when bone resorption outpaces bone formation. As bone density diminishes, the skeletal structure weakens, making fractures more likely even with minor stress or falls.

In the context of nursing care, it's crucial to recognize the signs of bone mass loss, such as a history of fractures, changes in posture, or reports of bone pain. Nurses play a vital role by facilitating diagnostic measures, promoting calcium and vitamin D intake, and encouraging weight-bearing exercises, which can all help slow the progression of bone mass loss and maintain skeletal health.

Elderly Mobility Issues

Decreased mobility is a common issue faced by the elderly, often due to a combination of factors such as muscular weakening, joint degeneration, or neurological conditions. Mobility difficulties can significantly impact an older adult's independence and quality of life, leading to additional health problems stemming from a sedentary lifestyle.

To address mobility issues, nurses should assess each patient's capabilities and limitations. Interventions might include physical therapy to improve strength and balance, occupational therapy to adapt activities of daily living to the patient's ability level, and the use of assistive devices to ensure safe movement. Communication with the interdisciplinary team is essential to create a comprehensive care plan tailored to individual needs, enhancing mobility and reducing complications.

Falls Prevention in Nursing Care

Falls in the elderly are a major concern and a leading cause of injury. Nursing care for fall prevention involves a multifaceted approach. Step one is to assess the risk factors such as environment hazards, medication side effects, and visual impairments. After the assessment, nurses create individualized care plans that might include strategies like:

• Installing grab bars and handrails in strategic locations.
• Ensuring proper lighting and removing potential tripping hazards.
• Prescribing appropriate footwear to aid in stability.
• Implementing exercise programs tailored to improve balance and strength.

Educating patients and caregivers about ways to minimize risks and maintain a safe living space is also critical. Such interventions are not only preventive but also empower patients, providing them with knowledge and resources to avoid falls and maintain their independence as much as possible.