NUR104 Assessment Task 2: Workbook 45% - Musculoskeletal and Psychosocial Changes in Ageing, Social Justice Principles, and Care Planning for Mrs. James

NUR104 Assessment Task 2: Workbook 45%
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Rubric Criteria:
Use of evidence to analyse the biophysical, and psycho-social processes associated with
ageing.
Question:
1. Explain the musculoskeletal changes that occur in ageing that could have
predisposed Mrs. James to the fracture.
2. Describe two possible psychosocial challenges associated with Mrs. James
fracture.
Response:
1. Muscles in the elderly lose tone and become rigid with age. The bones are more
susceptible to break because of their brittle nature. The overall height of bones
decreases due to shortening of trunk and spine. Breakdown of joints causes
severe inflammation, stiffness, deformity and pain in older people. Aging of
musculoskeletal system affects the quality of life in elderly. Loss of bone and
narrowing of inter-vertebral discs causes loss of locomotive strength and ability.
The amount of synovial fluid between joints decreases along with thinning of
cartilage. This causes the joints to become stiff and ligaments to shorten. There
is loss of lose mass in the elderly which will lead to brittle bones. Brittle nature of
bones increases the likelihood of occurrence of fractures (Effects of Aging on the
Musculoskeletal System, 2022). There are three major sources of physical pain in
bones that occurs in the elderly, i. e., joint pain, muscle strains and broken
bones. Muscles fibers loose their tensile strength due to inability of the body to
produce proteins required for muscles to grow. This results in small size of
individual muscle cells. Hormonal changes due to age related factors are also
responsible for decreased muscle mass. There is a high chance of fractures and
injuries in old age due to less flexibility of leg muscles. Poor flexibility also causes
excessive stress on joints leading to increased risk of pain in lower back. The
connective tissues in ligaments and tendons tend to become more rigid and
brittle as joints get stiffer with age. According to the case study, Mrs James
suffered a fracture after having a fall which occurred due to weakening of her
joints and ligaments. The patient is 89 years old which is an indication that the
density of bones is very less, as the loss of bones density is higher and rapid in
women. The cartilage joint gets thinner due to which there is a higher possibility
of fracture. Mrs. James has lost muscle strength in her legs due to which that fall
caused increased stress in her joints, ultimately leading to fracture.
2. Psycho-social challenges faced by Mrs. James after fractures include post
traumatic stress disorder, depression and chronic anxiety. Occurrence of
symptoms of depression impact the clinical outcomes of patient. Psychological
distress in elderly leads to chronic anxiety and persistent fear of falling along
with acute stress disorders. The severity of fracture in Mrs. James will impact a
wide of psychological conditions in her mind such as persistent stress and

nightmares from fear of falling again (The physical, psychological and social
impact of long bone fractures on adults: A review, 2019). Orthopedic trauma
from fracture will lead to development of post traumatic stress disorder in Mrs.
James. There are many long and short term mental health problems associated
with onset of an injury. It may take time for a patient to recover from the trauma
of that injury and return to their independent activities of daily lives. Mrs. James
might becomes conscious of her appearance due to fractured limb.
Rubric Criteria:
Appraisal of the principles of social justice
Question:
Consider the social justice principles of access and participation.
1. Explain the principle of access and illustrate your explanation with one example
of a potential barrier that exists for Mrs. James regarding access to healthcare.
2. Explain the principle of participation and illustrate your explanation with one
example of an action that could be taken to ensure that Mrs. James is able to
participate in decisions relating to her healthcare
Response:
1. The principle of access to resources is an important principle of social justice,
which refers to equal access to all the available resources to various
socioeconomic groups. Different levels of injustices in society leads to variations
in accessing public resources. This principle of social justice ensures that patients
from different backgrounds have equal access to healthcare resources. This
policy ensures that patients do not have to face any potential barrier in receiving
healthcare services. Mrs James lives in a housing commission unit and she is
suffering from fracture. There is a possibility that she might be suffering from
lack of financial resources along with her vision problems due to which she has to
wear glasses. Mrs. James has issues related to vision along with a fracture that
she recently suffered from (Pal & et. al., 2019). A potential barrier for her might
include restriction of movement, psychological distress and sedentary lifestyle.
Due to lack of movement, she might not be able to pay a visit to a physician's
clinic and get herself checked. Restriction of activity and a substantially increased
risk of new fractures might prevent her from approaching healthcare institutions.
2. The principle of Participation ensures that involvement of patient and their
family members in decisions related to their health (Pallesen, Honore, Aadal &
Kjeldsen, 2022). The principle of participation is integral in achieving better
health outcomes for Mrs James. Active participation from patient and their
associated family can help individuals have appropriate knowledge about their
health problems. The healthcare workers offer information to patients about
their condition along with their solutions to help them recover. This collaboration
enhances the problem solving skills along with ensuring that needs of both, the
patient and healthcare professional is fulfilled. Possibility of a patient getting
involved in their treatment leads to enhanced care as the patient can discuss