Question

A 67-year-old, moderately obese woman examined today for increasing back and left shoulder pain. Limited circumduction of left arm noted in comparison with right arm. Strength of left arm is less than right, with less muscle definition in the left arm. Examination of back indicates significant kyphosis, and the patient states that she is ‘shrinking.’ Bone density testing of the hip is ordered.”

1. How does the nurse interpret “limited circumduction”
2. When the patient arrives, the nurse correlates the “kyphosis” with what physical finding? What causes kyphosis in the older adult?
3. How should the nurse explain the patient’s decreasing height?
4. What is the rationale for ordering bone density testing of the hip in this patient?

Answer 1

1. 1.limited circumduction interpret by the nurse is Patient is unable to fully move the arm in a circle around the shoulder 2answer - .kyphosis is an exaggerated, and forward rounding of the back it can occur at any age but it's most common in older women. Causes- osteoporosis is most common cause in older adults, lonterm use of corticosteroid leads to osteoporosis, weakness in the spinal bones that causes them to compress or crack, fractures- broken or crush vertebrae, cancer and cancer treatments leads cancer in the spine can weak the vertebrae that leads more prone to compression fracture. Physical findings - on physical examination nurse find the back curvature of the spine 3. Answer . Height loss related to aging changes in the bones muscles and joints, people typically lose almost 1 cm every 10 yrs after age 40.height loss is more rapid after age 70 . You may lose total of 1 to 3 inches in height as you age. 4. Answer bone density test is the only test that can diagnose the osteoporosis, osteoporosis is the main common cause for kyphosis in older adults. Rational- early diagnose of osteoporosis is helpful to prevent the fracfractures in older adults.