Activities of daily living

RISK FOR INJURY Some patients with a viral infection are acutely ill. Others may experience fatigue, lethargy, dizziness, or weakness as an adverse reaction to the antiviral agent. The nurse monitors these patients carefully. Call lights are placed in a convenient place for the patient and are answered promptly by the nurse. If fatigue, dizziness, or weakness is present, the patient may require assistance with ambulation or activities of daily living. The nurse plans activities so as to provide adequate rest periods. 

Before giving a nonnarcotic analgesic to a patient, the nurse assesses the type, onset, and location of the pain. It is important to determine if this problem is different in any way from previous episodes of pain or discomfort. If the patient is receiving a nonnarcotic analgesic for an arthritic or musculoskeletal disorder or soft tissue inflammation, the nurse should examine the joints or areas involved. The appearance of the skin over the joint or affected area or any limitation of motion is documented. The nurse evaluates the patient s ability to carry out activities of daily living. This important information is used to develop a care plan, as well as to evaluate the response to drug therapy. 

The nurse obtains the patient s history, that is, a summary of the disorder, including onset, symptoms, and current treatment or therapy, hi some instances, it may be necessary to question patients regarding their ability to carry out activities of daily living, including employment when applicable. 

Promoting an Optimal Response to Therapy The patient with a musculoskeletal disorder may be in acute pain or have longstanding mild to moderate pain, which can be just as difficult to tolerate as severe pain. Along with pain, there may be skeletal deformities, such as the joint deformities seen with advanced rheumatoid arthritis. For many musculoskeletal conditions, drug therapy is a major treatment modality. Therapy with these drugs may keep the disorder under control (eg, therapy for gout), improve the patient s ability to carry out the activities of daily living, or make the pain and discomfort tolerable. 

Ability of the patient to carry out any or all of the activities of daily living (eg, bathing, ambulating, dressing)... 

The nurse takes die vital signs to provide a baseline during dierapy. Odier physical assessments may include die patient s general appearance and, in the severely anemic patient, an evaluation of the patient s ability to carry out die activities of daily living. General symptoms of anemia include fatigue, shortness of breath, sore tongue, headache, and pallor. 

When these drugs are given to the female patient with inoperable breast carcinoma, tire nurse evaluates the patient s current status (physical, emotional, and nutritional) carefully and records tire finding in tire patient s chart. Problem areas, such as pain, any limitation of motion, and the ability to participate in tire activities of daily living, are carefully evaluated and recorded in tiie patient s record. The nurse takes and records vital signs and weight. Baseline laboratory tests may include a complete blood count, hepatic function tests, serum electrolytes, and serum and urinary calcium levels. The nurse reviews these tests and notes any abnormalities. 

The primary health care provider examines the eye and external structures surrounding the eye and prescribes the drug indicated to treat the disorder. The nurse examines the eye for irritation, redness, and the presence of any exudate and carefully documents the findings in the patient s record. A purulent discharge is often found with infection of the eye. Pruritus (itching) is often present with allergic conditions of the eye. It is also important to determine if any visual impairment is present because this would indicate the need for assistance with ambulation and possibly activities of daily living. 

As COPD progresses, dyspnea at rest develops and the ability to perform activities of daily living declines. 

The goals of treatment are to maintain patient independence, activities of daily living (ADL), and quality of life (QOL) by alleviating the patient s symptoms, minimizing the development of response fluctuations, and limiting medication-related adverse effects. 

AD, Alzheimer s disease ADLs, activities of daily living. 

Occupational and physical therapy may help patients to preserve joint function, extend joint range of motion, and strengthen joints and muscles through strengthening exercises. Patients with joint deformities may benefit from the use of mobility or assistive devices that help to minimize disability and allow continued activities of daily living. In situations where the disease has progressed to a severe form with extensive... 

Surgery generally is reserved for patients who fail to respond to medical therapy and have progressive limitations in activities of daily living (ADL). These patients should be referred to an orthopedic surgeon for evaluation. Most patients achieve... 

At baseline, quantify the patient s pain using a visual analogue scale, assess range of motion of affected joints, and identify activities of daily living that are impaired. 

Incorporate other measures to track disease progress. Use radiography to assess severity of joint destruction, determine 50-ft walking time and grip strength, and administer the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and the Stanford Health Assessment Questionnaire, where appropriate, to assess activities of daily living. 

Assess symptoms to determine if pain warrants additional attention. Does the pain affect quality of life or interfere with activities of daily living ... 

The musculoskeletal system consists of the muscles, bones, joints, tendons, and ligaments. Disorders related to the musculoskeletal system often are classified by etiology. Acute soft-tissue injuries include strains and sprains of muscles and ligaments. Repeated movements in sports, exercise, work, or activities of daily living may lead to repetitive strain injury, where cumulative damage occurs to the muscles, ligaments, or tendons.1-3 While tendonitis and bursitis can arise from acute injury, more commonly these conditions occur as a result of chronic stress.3,4 Other forms of chronic musculoskeletal pain, such as pain from rheumatoid arthritis (see Chap. 54) or osteoarthritis (see Chap. 55), are discussed elsewhere in this text. 

ADL Activities of daily living AU Each ear (auris uterque)... 

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