Using Case Study 2 described in Box 24.1 the following is observed as you walk Mary Jane back to the examining room: a. Mary Jane appears to be frail and has a very kyphotic posture, causing her to be...

Using Case Study 2 described in Box 24.1 the following is observed as you walk Mary Jane back to the examining room:

a. Mary Jane appears to be frail and has a very kyphotic posture, causing her to be bent and look down toward the floor. While ambulating toward the examination room, you note she has an effective gait speed but has two episodes where she demonstrates a deviation in her path. From this brief introduction, what critical questions should you ask this patient? What tests should you perform to further assess balance?

b. What measurements should be taken as a result of the observation of flexed posture? Are there any red flags that warrant safety precautions and possible referral for bone density testing? If so, what are they?

c. Mary Jane frequently has episodes of dizziness that may be caused by her cardiac medications. Also, her prescription for beta blockers may blunt her heart rate response to exercise. What precautions will be necessary while she exercises?

d. Based on Mary Jane’s vertical height loss, document the assessment and the need to rule out osteoporosis and propose appropriate recommendations.