Understand nurse aide’s range of function in rehabilitative/restorative and maintenance care Unit B Resident Care Skills Resident Care Skills Essential Standard NA4.00 Understand nurse aide skills related to the residents’ vital function and movement Understand nurse aide skills related to the residents’ vital function and movement Indicator 4.02 Understand nurse aide’s range of function in rehabilitative/restorative and maintenance care Understand nurse aide’s range of function in rehabilitative/restorative and maintenance care 14.02Nursing Fundamentals 7243

4.02Nursing Fundamentals Body Systems Related to Restorative/Rehabilitative Care

4.02Nursing Fundamentals SKELETAL SYSTEM

Nursing Fundamentals Comprises the bony framework of the bodyComprises the bony framework of the body Has 206 bonesHas 206 bones SKELETAL SYSTEM 4.02

5 FUNCTIONS: SupportSupport ProtectProtect MovementMovement Mineral storageMineral storage Blood cell productionBlood cell production Nursing Fundamentals

6 JOINTS - point where bones meet: Immovable – craniumImmovable – cranium Slightly movable - vertebral discsSlightly movable - vertebral discs Freely movable - shoulder, knee, wristFreely movable - shoulder, knee, wrist Nursing Fundamentals

7 COMPOSITION OF JOINTS: Ligament - connects bone to boneLigament - connects bone to bone Tendon - connects muscle to boneTendon - connects muscle to bone Nursing Fundamentals

8 COMPOSITION OF JOINTS: Bursa - fluid filled sac that allows bones to move easily over othersBursa - fluid filled sac that allows bones to move easily over others Cartilage – connective tissue that cushions the joint at end of bones and between bonesCartilage – connective tissue that cushions the joint at end of bones and between bones Nursing Fundamentals

9 Osteoporosis - porous bone that breaks easilyOsteoporosis - porous bone that breaks easily SKELETAL SYSTEM – COMMON DISORDERS Nursing Fundamentals

10 Fracture - break in bone –simple - bone broken, skin intact –compound - bone broken, penetrates skin –comminuted - bone broken, fragments in tissue –greenstick - incomplete break Nursing Fundamentals

11 Arthritis - inflammation of the joints –osteoarthritis due to stress on joints usually affects weight bearing joints: knees, hips, vertebrae and fingers aching, stiffness, limited motion Nursing Fundamentals

12 –rheumatoid arthritis - systemic disease causes inflammation, deformity and crippling joints painful, stiff, swollen, red and warm Arthritis - inflammation of the joints Nursing Fundamentals

13 Amputation – removal of all or part of limb Sprain - stretched or torn ligaments or tendons Bursitis - inflammation of bursa causing pain on movement Nursing Fundamentals

14 Bones more porous or brittle Joints less flexible Postural changes Awkward walking patterns Slowed recovery from position changes and sudden movements SKELETAL SYSTEM – EFFECTS OF AGING Nursing Fundamentals

15 Slow and unsteady body movement Difficulty holding objects Complaint of pain in joints Swelling, redness and warmth in joints Inability to move joints OBSERVATIONS TO REPORT Nursing Fundamentals

16 Complaint of pain with movement Complaint of neck or head pain Resident who has fallen (stay with resident, call for help, do not move resident or allow resident to move) Nursing Fundamentals

17 Resident with cast on arm or leg –complaint of pain in limb –swelling of fingers or toes –pale skin of fingers or toes –cyanosis and coolness of fingers or toes Nursing Fundamentals

18 Resident with cast on arm or leg –odor or drainage from cast –inability to move toes or fingers –complaint of numbness of fingers or toes –drainage from cast Nursing Fundamentals

Nursing Fundamentals MUSCULAR SYSTEM

20 Provides body with ability to move Over 650 different muscles that comprise nearly half the body weight MUSCULAR SYSTEM Nursing Fundamentals

21 Functions of muscles –Allow movement –Help body stay erect – posture –Produce most of body’s heat –Give body form –Provide movement of internal organs Nursing Fundamentals

22 Paralysis - loss of voluntary movement due to neurological damage such as stroke or trauma Multiple sclerosis – weakness of muscles due to loss of covering on nerves that control them Atrophy – muscle mass decreases in size MUSCULAR SYTEM – COMMON DISORDERS Nursing Fundamentals

23 Contracture - permanent shortening of muscle; joints become ankylosed (frozen) Muscle strain – damage caused by trauma Myalgia - muscle pain Torn muscle - tear caused by trauma Nursing Fundamentals

24 Poorer response to stimuli Pain when moving, therefore muscles not used as often Less active Muscle strength and bulk loss Slower muscle - nerve interaction Nursing Fundamentals

25 Difficulty holding or lifting objects Inability to move a body part Difficulty walking Loss of muscle strength and tone MUSCULAR SYSTEM – EFFECTS OF AGING Nursing Fundamentals

26 Edema of tissue or joint Complaint of muscle pain Generalized weakness and fatigue Slow, unsteady body movement Nursing Fundamentals

Nursing Fundamentals NERVOUS SYSTEM

28 Controls and organizes all body activities Divided into two parts –Peripheral nervous system –Central nervous system brain spinal cord NERVOUS SYSTEM Nursing Fundamentals

29 Basic unit of structure - neuron or nerve cell –Most complex cell in body –Does not reproduce; if destroyed, it is not replaced Nursing Fundamentals

30 Nervous system enables you to –Speak –Hear –Taste –See –Smell –Think –Respond/move –Learn –Remember Nursing Fundamentals

31 Central nervous system –brain cerebrum –largest portion of brain –responsible for judgment, memory, association and discrimination –divided into left and right hemispheres Nursing Fundamentals

32 Central nervous system (continued) –brain cerebellum - responsible for coordination of muscles, balance and posture, and muscle tone thalamus - monitors sensory stimuli Nursing Fundamentals

33 Central nervous system (continued) –brain hypothalamus - controls the autonomic nervous system, the cardiovascular system, body temperature, appetite, water balance, the GI system, sleep, emotional state Nursing Fundamentals

34 Central nervous system (continued) –brain pons - responsible for reflex actions like chewing, and production of saliva medulla oblongata - regulates heartbeat, respirations, swallowing, coughing, blood pressure Nursing Fundamentals

35 Central nervous system –spinal cord 18 inches long extends from brain to small of back carries messages to and from brain relays messages to body through spinal nerves handles reflexes Nursing Fundamentals

36 Peripheral nervous system – nerves leaving the spinal cord and going throughout the body –digestion –secretion of glands –heart beat and breathing Nursing Fundamentals

37 CVA – Stroke or cerebrovascular accident - damage to part of brain due to blood clot or hemorrhage cutting off blood supply Head or spinal cord injuries NERVOUS SYSTEM – COMMON DISORDERS Nursing Fundamentals

38 Dementia from nutritional deficiencies, exposure to toxic substances, reduced blood flow to brain or unknown causes Alzheimer’s disease - common cause of organic disease Nursing Fundamentals

39 Parkinson’s disease – progressive nervous disease associated with destruction of brain cellsParkinson’s disease – progressive nervous disease associated with destruction of brain cells Multiple sclerosis - loss of covering around nerve fibers interfering with nerve impulses to and from brainMultiple sclerosis - loss of covering around nerve fibers interfering with nerve impulses to and from brain Nursing Fundamentals

40 Loss of nerve/brain cells Increase in reaction time Changes in memory Receptors become less sensitive, so require increased stimuli for response NERVOUS SYSTEM – EFFECTS OF AGING Nursing Fundamentals

41 Reduced sense of touch and sensitivity to pain Reduced blood flow to brain Forgetfulness Nursing Fundamentals

42 Jerking motions Speech changes Complaint of numbness Complaint of dizziness Complaint of nausea Nursing Fundamentals

43 Confusion Complaint of loss of feeling on one side Incontinence Deranged thought processes Tremors Nursing Fundamentals

44 Muscular rigidity Complaint of visual disturbances or changes Paralysis Seizures Nursing Fundamentals