4 Body Systems and Related Conditions: Homeostasis

4 Body Systems and Related Conditions
Define the following terms:
Homeostasis
the condition in which all of the bodys systems are working their best.
Metabolism
physical and chemical processes by which substances are produced or broken down into energy or products for use by the body.
Dilate
to widen.
Constrict
to narrow.
Transparency 4-1: The Integumentary System

1. Describe the integumentary system Remember the following points about the integumentary system: Largest organ and system Natural protective covering Prevents excessive loss of water and injury to internal organs Skin made of tissue and glands Skin is a sense organ Regulates body temperature (Dilates if hot, which allows more blood to surface for sweat/evaporation. Constricts if cold to keep in body heat.)

1. Describe the integumentary system Normal changes of aging include the following: Skin gets thinner and more fragile. Skin is drier and less elastic. Protective fatty tissue gets thinner and person may feel colder. Hair thins and turns gray. Wrinkles and brown spots appear. Fingernails and toenails thicken and become more brittle. Reduced circulation can cause skin dryness, itching, and irritation.

1. Describe the integumentary system Observe and report the following regarding the integumentary system: Pale, white, reddened, or purple areas, blisters or bruises Dry or flaking skin Rashes or discoloration Cuts, boils, sores, wounds, abrasions Fluid or blood draining from skin Changes in moisture level Swelling

1. Describe the integumentary system Observe and report, integumentary system (contd.): Blisters Changes in wound or ulcer Redness or broken skin between toes or around toenails Scalp or hair changes Skin that appears different from normal In ebony complexions, also look for change in the feel of the tissue (e.g. orange peel look)

1. Describe the integumentary system Common disorders of this system include the following: Pressure sores (also called decubitus ulcers) occur where blood has poor circulation and bone is close to skin. Skin receives less oxygen and nutrients, cells die, and tissue breaks down. Sheets and incontinent pads under patients should always be wrinkle-free Patients who are unable to move due to injury should be repositioned every 2 hours to prevent Pressure sores More information on pressure sores is found in chapter 6.

Atrophy the wasting away, decreasing in size, and weakening of muscles from lack of use. Contractures the permanent and often painful stiffening of a joint and muscle.

2. Describe the musculoskeletal system and related conditions Remember the following points about the musculoskeletal system: Human body has 206 bones. Two bones meet at a joint (for movement). Joints make movement possible either in all directions or in one direction only. Muscles provide movement and produce body heat. Physical activity/exercise increases circulation, increasing blood flow to organs and tissues. Inactivity can cause depression, pneumonia, constipation, UTIs, loss of self- esteem, and blood clots. Muscles develop atrophy or contractures from inactivity. ROM exercises help prevent atrophy or contractures.

2. Describe the musculoskeletal system and related conditions Normal changes of aging to the musculoskeletal system include the following: Muscles weaken and lose tone. Body movement slows. Bones lose density and become more brittle. Joints can stiffen/become painful. Height is gradually lost.

2. Describe the musculoskeletal system and related conditions Observe and report the following regarding the musculoskeletal system: Changes in movement and activity Changes in ability to do ROMs Pain during movement New or increased swelling of joints White, shiny, red, or warm joints Bruising Aches and pains reported by resident

2. Describe the musculoskeletal system and related conditions Common disorders of this system include the following: Arthritis Osteoporosis Fractures Hip replacement Knee replacement

Inflammation swelling. Autoimmune illness an illness in which the bodys immune system attacks normal tissue in the body. Osteoarthritis a type of arthritis that usually affects hips and knees and joints of the fingers, thumbs, and spine. Rheumatoid arthritis a type of arthritis in which joints become red, swollen, and very painful, and movement is restricted.

2. Describe the musculoskeletal system and related conditions Remember these facts about arthritis: Arthritis is inflammation of the joints causing stiffness and pain, and decreased mobility. Arthritis may be caused by aging, injury, or autoimmune illness. Two types are osteoarthritis and rheumatoid arthritis. Pain and stiffness increase in cold or damp weather.

2. Describe the musculoskeletal system and related conditions Arthritis may be treated in these ways: Anti-inflammatory medications (aspirin or ibuprofen) Local applications of heat ROMs Exercise Diet

Osteoporosis
a condition in which the bones become brittle and weak; may be due to age, lack of hormones, not enough calcium in bones, alcohol, or lack of exercise.
Menopause
the stopping of menstrual periods. Remember these facts about osteoporosis: Causes bones to become brittle May be due to age, lack of hormones, lack of calcium, alcohol consumption, or lack of exercise Occurs more commonly in women after menopause

2. Describe the musculoskeletal system and related conditions Remember these signs and symptoms of osteoporosis: Low back pain Loss of height Stooped posture

2. Describe the musculoskeletal system and related conditions The following can be done to prevent or slow osteoporosis: Encourage residents to walk and do other light exercise as ordered. Move residents with osteoporosis very carefully. Follow care plan regarding medication, calcium, and fluoride supplements, which might be used to treat osteoporosis.

Partial weight bearing (PWB) able to support some weight on one or both legs. Non-weight bearing (NWB) unable to support any weight on one or both legs Full weight bearing (FWB) able to bear 100 percent of the body weight on one or both legs on a step. REMEMBER: Fall prevention is the key to avoiding fractures.

2. Describe the musculoskeletal system and related conditions Follow these guidelines when caring for a new cast: Do not cover until dry. Do not place on hard surface. Elevate extremity in cast. Observe for skin discoloration, tightness, swelling, sores, skin temperature, burning, numbness or tingling, drainage, bleeding, or odor. Protect residents skin from edges of cast. Keep cast dry. Do not insert anything into cast. Tell the nurse if pain medication is needed. Use bed cradles as needed.

2. Describe the musculoskeletal system and related conditions Remember these facts about hip fractures: Cause may be a fall or weakened bones Elderly bones heal slowly The following are common reasons for hip replacements: Fracture does not heal properly Weakened hip due to aging Painful and disabled hip

2. Describe the musculoskeletal system and related conditions Remember these facts about hip fractures: Cause may be a fall or weakened bones Elderly bones heal slowly The following are common reasons for hip replacements: Fracture does not heal properly Weakened hip due to aging Painful and disabled hip
Transparency 4-4: Care Guidelines for Hip Replacement Keep often-used items within reach. Dress affected side first. Never rush the resident. Use praise and encouragement. Ask for pain medication if needed. Have the resident sit to do tasks. Follow the care plan. Do not perform ROM exercises on a leg on hip replacement side. Hip cannot be bent of flexed more than 90 degree angle. It cannot be turned inward or outward. Transfer resident carefully, with stron side leading in standing, pivoting and sitting. With chair or toilet transfers, operative leg/knee should be straightened. Strong leg should stand first.

2. Describe the musculoskeletal system and related conditions Observe and report the following about hip replacement: Red, draining, bleeding, or warm incision Increase in pain Numbness or tingling Abnormal vital signs Inability to use equipment properly and safely Resident not following doctors orders for activity and exercise Problems with appetite Increasing strength and improving ability to walk

2. Describe the musculoskeletal system and related conditions The following are common reasons for knee replacement: Relieve severe pain Restore motion to damaged knee Help stabilize a knee that buckles or gives out REMEMBER: Recovery time for knee replacement is generally shorter than for a hip replacement.
Transparency 4-5: Care Guidelines for Knee Replacement Apply special stockings as ordered. Perform ankle pumps as ordered. Encourage fluids. Assist with deep breathing exercises. Ask for pain medication if needed. Report to nurse if you notice redness, swelling, heat or deep tenderness in one or both calves.
Transparency 4-6: The Nervous System

3. Describe the nervous system and related conditions Remember the following points about the nervous system: Control and message center of body Controls and coordinates all body functions Senses and Interprets information from outside the body Two main parts: central nervous system (brain) and peripheral nervous system

3. Describe the nervous system and related conditions Normal changes of aging to the nervous system include the following: Slower responses and reflexes Decrease in sensitivity of nerve endings in skin Some memory loss, more often with short-term memory

3. Describe the nervous system and related conditions Observe and report the following regarding the nervous system: Fatigue or pain with movement Shaking or trembling Inability to speak clearly Inability to move one side of body Disturbance in vision or hearing Changes in eating or fluid intake

3. Describe the nervous system and related conditions Observe and report the following (contd.): Difficulty swallowing Bowel or bladder changes Depression or mood changes Memory loss or confusion Violent behavior Unusual change in behavior Decreased ability to perform ADLs

3. Describe the nervous system and related conditions Common disorders of this system include the following: Dementia (covered in detail in Chapter 5) Alzheimers disease (covered in detail in Chapter5) CVA/Stroke Parkinsons disease Multiple Sclerosis Head and spinal cord injuries

Hemiplegia paralysis on one side of the body. Hemiparesis weakness on one side of the body. Expressive aphasia inability to speak or speak clearly. Receptive aphasia inability to understand spoken or written words.

Emotional lability laughing or crying without any reason, or when it is inappropriate. Dysphagia difficulty swallowing.

3. Describe the nervous system and related conditions Remember these facts about CVA/Stroke: Caused when blood supply to brain is cut off by a clot or ruptured vessel. Results in lack of oxygen to tissue, causing cells to die. Swelling, leaking blood, and clots affect surrounding healthy brain tissue. Weakness occurs opposite affected side of brain. Mild stroke may result in few, if any, complications.
Transparency 4-7: Care Guidelines for Stroke Assist with exercises as ordered, keeping safety in mind. Use terms weaker or involved, not bad. Assist with speech therapy as needed. Use verbal and nonverbal communication to express positive attitude. Residents may experience confusion, memory loss, and emotions. Be patient and understanding. Encourage independence and self-esteem. Always check on residents body alignment. Pay special attention to skin care. If residents have lost sense of touch or sensation, be aware of potentially harmful situations such as closeness to heat and sharp objects. Conduct procedures supporting affected side when caring for residents with one-sided paralysis or weakness.
Transparency 4-7: Care Guidelines for Stroke (contd.) For transfers: Always use gait belt. Stand on and support weaker side. Lead with stronger side. For assisting with dressing: Dress weaker side first. Undress stronger side first. Use assistive equipment to help resident dress himself.
Transparency 4-7: Care Guidelines for Stroke (contd.) For assisting with communication: Keep questions and directions simple. Phrase questions so they can be answered with a yes or no. Agree on signals, such as shaking or nodding the head or raising a hand or finger for yes or no. Give residents time to respond. Listen attentively. Use a pencil and paper if the resident can write. Use verbal and nonverbal communication to express your positive attitude. Use pictures, gestures, or pointing. Use communication boards or special cards to aid communication. Keep the call signal within reach of residents.

Gait manner of walking. Paraplegia loss of function of lower body and legs.
Quadriplegia loss of function of legs, trunk, and arms.
Transparency 4-9: Care Guidelines for Multiple Sclerosis Help with ADLs. Be patient with self-care and movement. Allow time for tasks. Offer rest periods. Give resident time to communicate. Prevent falls. Help avoid stressful situations. Listen to residents. Encourage proper diet. Give regular skin care. Assist with ROM exercises.

3. Describe the nervous system and related conditions Remember these facts about head and spinal cord injuries: May result from diving, sports injuries, falls, car and motorcycle accidents, industrial accidents, war, and criminal violence. Can cause permanent brain damage, mental retardation, personality changes, trouble breathing, seizures, coma, memory loss, loss of consciousness, paresis, paralysis. Effects of spinal cord injuries depend on force of impact and where spine is injured. May cause paraplegia or quadriplegia. Rehabilitation is needed. Emotional support is important.
Transparency 4-10: Care Guidelines for Head and Spinal Cord Injuries Give emotional, as well as physical, support. Be patient. Prevent falls and burns. Be patient with self-care. Give good skin care. Assist with position changes at least every two hours. Perform passive range of motion exercises. Encourage fluids and proper diet to prevent constipation. Give extra catheter care as needed. Offer rest periods as needed. Use special stockings as ordered. Encourage deep breathing exercises as ordered. Provide for privacy if involuntary erections occur. Assist with bowel and bladder training.

3. Describe the nervous system and related conditions Normal changes of aging to the sense organs include the following: Reduced vision and hearing (sense of balance may be affected) Decreased senses of taste, touch and smell Decreased sensitivity to heat and cold

3. Describe the nervous system and related conditions Observe and report the following regarding the sense organs: Changes in vision or hearing Signs of infection Dizziness Complaints of pain in eyes or ears

3. Describe the nervous system and related conditions Remember these facts about vision impairment: Vision impairment can affect people of all ages. Some residents may wear eyeglasses or contacts. People over 40 are at risk for developing cataracts, glaucoma, and blindness. Cataracts may be corrected surgically. Glaucoma can occur suddenly or gradually, and is treated with medication and sometimes surgery. Residents who are visually impaired may enjoy books on tape, large-print books, or Braille books (if they are trained to read Braille).
The Circulatory System
Remember these facts about the Circulatory System:
Made up of heart, blood vessels, and blood Blood carries food, oxygen, and essential substances Major functions are to: Supply food, Oxygen and hormones to cells Produce and supply antibodies Remove waste products from cells Control body temperature
Normal Changes in Aging to the Circulatory System include the Following:
Heart pumps less efciently Decreased blood ow Narrowed blood vessels
Observe and Report the following regarding the Circulatory System:
Changes in pulse rate Weakness or fatigue Loss of ability to perform ADLs Swelling of hands and feet Pale, blue hands, feet or lips Chest pain Weight gain Shortness of breath Severe headaches
Common disorders of the circulatory system:
Hypertension (HTN) Coronary artery disease Myocardial infarction (MI) Congestive heart failure (CHF) Peripheral vascular disease (PVD)
Hypertension: High blood pressure (measurement of over 140/90) Diuretics: Medications that reduce uid volume in the body
Remember these facts about Hypertension:
Causes: Hardening & narrowing of blood vessels Kidney Disease Adrenal Tumors Pregnancy Common symptoms: Headache Blurred Vision Dizziness Sometimes there are no noticeable symptoms
Remember these facts about Coronary Artery disease: to heart
Caused by vessels in coronary arteries narrow, reducing blood Common symptoms: Angina Pectoris
Angina Pectoris: The medical term for chest pain, pressure, or discomfort due to coronary artery disease
Remember these Facts about Myocardial Infarction (MI) or heart attack:
Causes
Complete block of blood ow to heart muscle

which results in tissue death Area of dead tissue may be large or small Can result in serious heart damage or death
Guidelines for Heart Attack:
pressure Quitting smoking is encouraged Stress management program may be started Residents may need to avoid cold temperatures
Residents may be placed on exercise program Residents may be on low fat/low-sodium diet Medications may be used to regulate heart rate and blood
Causes
Remember these Facts about Congestive Heart Failure:
Failure of heart muscle to pump effectively due to

damage
Symptoms:
Trouble breathing Coughing or gurgling with breathing Dizziness Confusion Fainting Pale or blue skin Low Blood Pressure Swelling of feet and ankles Bulging neck veins Weight gain
Guidelines for care of Congestive Heart Failure:
Medication can help control CHF Low-sodium diet or uid restriction may be Rx. Limited activity or bed rest may be Rx. I&O may ned to be measured Residents may need to be weighed daily Extra Pillows may help breathing Help with personal care and ADLs as needed High-Potassium foods can help with muscle cramps Report all Symptoms to the nurse
Remember these Facts about Peripheral Vascular Disease:
Causes Symptoms:
Fatty deposits in the blood vessels that harden Cool arms and legs Swelling in hands and feet Pale or bluish hands or feet Bluish nail beds Ulcers of legs and feet Pain may be severe when walking but can decrease
with rest Anti-embolic stockings can help prevent swelling and blood clots and aid circulation
The Respiratory System

4 Body Systems and Related Conditions: Homeostasis

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4 Body Systems and Related Conditions

Define the following terms: