Musculoskeletal System
Key Points
- The musculoskeletal system enables movement, posture, organ protection, and mineral storage.
- Connective tissues (ligaments, tendons, cartilage) coordinate force transfer and joint stability.
- Activity, range-of-motion work, and nutrition support are central to preserving function and preventing decline.
Pathophysiology
The musculoskeletal system integrates bones, joints, muscles, and connective tissues to generate movement and maintain structural integrity. Skeletal muscle contracts and transfers force through tendons to bones, while ligaments and cartilage maintain alignment and reduce friction stress across joints.
Functional decline occurs with inactivity, aging, pain-avoidance behavior, and chronic inflammatory or degenerative disease. Reduced mobility accelerates weakness, stiffness, fall risk, and loss of independence in activities of daily living.
Classification
- Skeletal framework: Bones and joints for support, protection, and leverage.
- Muscle components: Voluntary skeletal muscle and involuntary smooth/cardiac muscle roles.
- Connective-tissue roles: Ligament stability, tendon force transfer, and cartilage cushioning.
- Common chronic condition context: Osteoarthritis-related pain and movement limitation.
Nursing Assessment
NCLEX Focus
Priority questions emphasize identifying mobility decline early and selecting interventions that preserve independence safely.
- Assess gait stability, transfer ability, endurance, and pain-limited movement.
- Observe joint stiffness, swelling, and reduced range of motion affecting ADLs.
- Identify fall-risk cues linked to weakness, balance deficits, or delayed reaction time.
- Report new pain patterns, acute function decline, or inability to perform baseline tasks.
Nursing Interventions
- Encourage ambulation and weight-bearing activity as tolerated to preserve bone/muscle health.
- Support scheduled range-of-motion activities and safe positioning routines.
- Apply comfort measures for chronic joint pain (heat/ice, massage, repositioning per plan).
- Reinforce nutrition patterns supporting tissue repair and bone health (protein and calcium intake).
Deconditioning Spiral
Avoidable inactivity rapidly worsens weakness and fall risk; early mobility support is a high-value safety intervention.
Pharmacology
| Drug Class | Examples | Key Nursing Considerations |
|---|---|---|
| nsaids | Osteoarthritis symptom-control context | Monitor comfort response and report persistent functional pain limits. |
| topical-analgesics | Local pain-relief context | Useful adjuncts to improve participation in mobility activities. |
Clinical Judgment Application
Clinical Scenario
A resident with osteoarthritis reports worsening knee pain and begins refusing ambulation over several days.
Recognize Cues: Increasing pain, reduced activity, and early functional withdrawal. Analyze Cues: Reduced mobility is likely to accelerate weakness and dependence. Prioritize Hypotheses: Immediate priority is preserving safe movement while controlling discomfort. Generate Solutions: Use comfort measures, paced ambulation, and assisted ROM schedule. Take Action: Implement support plan and communicate trend changes to nurse. Evaluate Outcomes: Mobility participation improves and fall-risk behaviors decrease.
Related Concepts
- complications-of-immobility - Inactivity drives multisystem decline and functional loss.
- fall-prevention - Mobility deficits and pain increase transfer/ambulation injury risk.
- range-of-motion-exercises - Core intervention for maintaining flexibility and joint function.
- safe-patient-transfer - Proper mechanics protect both client and caregiver.
- nutrition-support - Protein and micronutrient intake support tissue repair and strength.
Self-Check
- Which findings suggest musculoskeletal decline is becoming a fall-risk emergency?
- How does joint pain contribute to the deconditioning cycle?
- Which daily interventions best preserve mobility and ADL independence?