mobility

Joints 1. Changes to the structure and function of tendons, ligaments, and cartilage begin to occur after as few as...... bc 2. immobility leads to changes in 3. Prolonged immobilization causes the 4. As the connective tissue that forms ligaments and tendons continues to soften, weaken, and thicken, the 5. Joint contractures 6. The flexor muscles are naturally stronger than 7. In clients with continued muscle disuse, atrophy occurs and leads to an imbalance between the 8. Contractures ca

1. 4 days of bed rest. Most of these changes are due to alterations in the collagen fibers that make up these structures 2. tissue tension, elasticity, and shape, leading to joint stiffness and decreased range of motion, especially in the extremities 3. ormation of abnormal tissue both within and between the joint spaces, which restricts nourishment to the joints. 4. cartilage around the joints begins to deteriorate. 5. abnormal fixations of the joints that occur as a result of changes to muscles and connective tissue. 6. extensor muscles. 7. opposing muscles The stronger flexor muscles pull and place a joint in a bent, nonfunctional position. After several weeks, the collagen fibers in connective tissue will become denser and less flexible, further restricting movement. 8. severely limit range of motion, partially or permanently, and may require surgical correction to restore the joint's mobility.

Place the steps for moving a client up in bed in the correct order. (Drag the following options to match with their correct order.) 1 2 3 4 5 6 7 - Raise the clients bed - Lower the clients bed to the lowest position - Lock the wheels of the bed - Use the draw sheet to move client - Position the clients arms across their chest - Assess the clients level of mobility - Get lift assistance

1. Assess the client's level of mobility . 2. Get lift assistance. 3. Lock the wheels of the bed. 4. Raise the client's bed. 5. Position the client's arms across their chest. 6. Use the draw sheet to move client. 7. Lower the client's bed to the lowest position.

Interventions for Psychological Complications of Immobility 1. Depression-- asessessment and intervention 2. social isolation

1. Assessment- Monitor the client's emotional status during every shift. Intervention A. Encourage the client to express feelings. B. Communicate support and empathy. C. Report mental health concerns to the provider. Intervention 2. Encourage interactions with family, friends, staff, volunteers, and even other clients.

1. muscle 2. bones 3. synovial joints 4. ligaments and tendons 5. nerves 6. cartilage A. reduces friction btwn the bones B. maintain posture and generate heat C. allow for flexibility and mvmt. of bones. D. Provide a solid and stable framework; produce red blood cells. E. Provide for connections of muscles and bones F. control contraction and relaxation of muscles; coordinate balance and movement.

1. B 2. D 3. c 4. E 5. F 6. A

1. what are the 3 key principles of body alignment? 2. what body injury is the most common?

1. Combined effort from the musculoskeletal and nervous systems to maintain posture, alignment, and balance. 2. lower back

gross motor skills

1. Developed through childhood, The use of large muscle groups to perform whole body movements. The skills needed to sit, stand, and then ambulate are usually attained early in life. Motor skill development continues in a loosely predictable order, reaching a peak in late childhood. Over the life course, significant changes leading to a decline often occur in the older adult population.

1. kyphosis 2. occurs most commonly in who

1. Excessive outward curvature of the upper area of the spine. 2. older adult females due to weakening and breakage of the vertebra. This posture change can impact a client's ability to ambulate and rise from a seated position.

Types of Movement 1. Flexion: 2. Extension: 3. Abduction: 4. Adduction: 5. Pronation: 6. Supination: 7. Circumduction: 8. Rotation: 9. Inversion: 10. Eversion:

1. Flexion: bend; reduce the angle between the bones 2. Extension: straighten the limb 3. Abduction: move away from baseline 4. Adduction: bring closer to baseline 5. Pronation: turning to face backward 6. Supination: turning to face forward 7. Circumduction: circular motion 8. Rotation: side-to-side 9. Inversion: turn inward 10. Eversion: turn outward

1. What helps helps trigger the urge to defecate by causing stool in the rectum to press on the anal sphincter. 2. Clients who are frequently supine may have a 3. constipation occurs 16 times more often in clients who are prescribed than..... And this condition... 4. If the constipation becomes chronic, the client may develop a 5. how to treat it

1. Gravity, when a person is in an upright position 2. decreased sensation of the need to move their bowels. 3. bed rest than in those who are active . This condition results from the combination of the hardened stool and the decreased urge to defecate 4. fecal impaction, in which a hardened mass of feces creates a blockage. 5. The client cannot pass an impaction and requires medical intervention to resolve the issue.

1. ambulation 2. what should be performed prior to ambulating a client 3. Clients who have been immobile may experience manifestations 4. what should the clientwear to decrease falls

1. Improves muscle and joint strength, prevents complications of immobility, and decreases a client's length of stay in the hospital. This is especially true for older adult clients, who are more prone to quickly losing mobility and function. Ambulation also increases a client's sense of well-being and independence. 2. mobility assessment- to determine the need for additional personnel or assistive devices to ensure client and staff safety. 3. orthostatic hypotension with a change of position. Therefore, the client should be instructed to sit for a few minutes on the side of the bed prior to standing—a position termed dangling 4. non-skid footwear and that the pathway is clear to decrease the risk of falls. Confirm that all drainage tubes and intravenous lines are positioned to prevent accidental removal before ambulating the client.

Examples of Ergonomic Practices and Equipment in Health Care

1. Modifiable workstations and chairs 2. Keyboards with wrist supports 3. Adjustable IV stands and poles 4. Height-adjustable beds 5. Two-person lifts/transfers 6. Client transfer devices 7. Shower chairs 8. Toilet seat risers 9. Side-opening garbage and linen containers 10.Elimination of uneven floor surfaces

functions of skeletal muscle

1. Movement (main function): The skeletal muscles work with the skeleton to create body movements such as texting, sitting, standing, walking, running, and dancing. 2. Posture and positioning: The skeletal muscles maintain posture and body positioning without a person's conscious control. They cause motion through a series of contractions and relaxations, or contract to hold the body in a certain position such as sitting or standing. 3. Generate body heat: Contracting muscles generate heat that assists in maintaining body temperature. Shivering is an example of the muscles working to produce heat.

1. mobility 2. what routine was initially a curative properties for all types of illnesses and injuries, but began to be questioned in the 1940s, when it was noted that soldiers recovered from infections and injuries more quickly when they were instructed to increase their activity levels sooner. 3. Later, scientific research conducted in preparation for space exploration confirmed that prolonged immobility has 4. ______, ________, _________ require motion to stay healthy

1. Moving from one position to another. 2. prologned bed rest. Bed rest for as little as one week can have an effect on a client's ability to move and perform the activities of daily living (ADLs). 3. physiological, psychological, and cognitive effects. 4. Bones, muscles, and joints

Body movement 1. what can increase the risk of muscle strain and injury 2. The nurse should ensure that the client or object being handled is 3. Awkward positions, such as 4. The nurse should be sure to ______ the client face to face when transferring. 5. If picking up an object from a lower level, make certain to 6. __________ longest and strongest muscles in the body and should be used for lifting.

1. Reaching, bending, and twisting motions 2. as close to the nurse's body as possible—for example, by raising the bed when administering care or moving a client. 3. extended arms, inhibit the muscles' ability to perform efficiently and fatigue the muscles and tendons more quickly. 4. face the client face to face when transferring. Pivot the feet in the direction of the move, rather than twisting the spine. 5. bend the knees (not the back) and use the legs to move the load. 6. quadriceps leg muscles

using proper body mehcanics

1. Stand or move as close to the object as possible. 2. Keep the abdominal muscles contracted and the lower back in its normal position. 3. Maintain the head upright with shoulders raised up. 4. Bow the hips slightly and squat. 5. Do not twist the torso. Always pivot or side-step. 6. Push up from the knees and use that momentum to lift the object.

1. ergonomics 2. In the workplace, poor ergonomics results in frustration, stress, workarounds, and exposure to dangerous or hazardous situations. To improve ergonomics, products, tools, tasks, and the general environment should be adapted and used to fit the needs of the worker. Risk factors in the workplace can be divided into three areas. 3. The use of ergonomics can

1. Study of body mechanics in relation to the demand and design of the work environment and the equipment used. It focuses on designing, adjusting, and arranging items so that people can work safely and efficiently. Ergonomics can be found everywhere—for example, in the design of appliances, shoes, furniture, pillows, keyboards, cell phones, remote controls, and motor vehicles. 2. Practice controls: lighting, noise, transfer lifts, carts, furniture, whole-body vibrations, exposure to heat/cold. Physical characteristics: posture, duration, force, velocity, heavy exertion, repetition, time, lunch/rest breaks, recovery time. Environmental hazards: mental stress, physical stress, workload hours (shift, overtime), falls, slips, exposure to hazards. 3. increase work satisfaction, maximize productivity, and decrease the risk of injury and fatigue. When employees are able to work safely, comfortably, and efficiently, they can perform at a higher level, which is beneficial to the emplo

Functions of the Skeletal System

1. Support: Provide a solid and stable framework. 2. Protect: Provide mechanical protection for the internal organs such as the brain, spinal cord, heart, and lungs. 3. Produce: Red bone marrow in the center of the bones produces red blood cells, white blood cells, platelets, and macrophages. 4. Storage: Provide storage for calcium, phosphorus, magnesium, iron, and lipids. 5. Movement: Bones work with the muscular attachments to create motion.

1. besides MAT what is another sandardized tool to evaluate mobility and the risk for falls in older adults 2. an older adult who who takes longer than --- seconds to complete the test is at an increased risk of falling. 3. what should be performed prior to initially mobilizing a client and repeated every 24 hours

1. Timed Up & Go (TUG) assessment. With the TUG, the client is instructed to stand up from a seated position, ambulate 10 feet, turn and ambulate back to the chair, and become seated. The client is to perform these actions at a comfortable pace while the health care team member monitors how long it takes the client to accomplish this task. During the assessment, the nurse should observe the client's balance, stride, posture, and gait. An older adult client who takes longer than 12 seconds to complete the test is at an increased risk of falling. 2. 12 3. A mobility assessment should be performed prior to initially mobilizing a client and repeated every 24 hours. Additionally, it should be conducted following procedures that may alter a client's mobility and need for assistance. The results of the assessment should be recorded in the medical record and verbally communicated with the health care team members to ensure the safety of both the client and the staff.

The challenges associated with repositioning, lifting, and transferring clients are based on the following considerations.

1. Variations and differences in body size and shape: height and weight 2. Level of cooperation: willing versus combative 3. Mental function: oriented versus confused 4. Physical disabilities 5. Health-related conditions and equipment

1. Before attempting any type of transfer, the nurse must determine 2. The ____ is a beneficial tool for evaluating the level of assistance necessary and the client's weight-bearing capabilities. 3. There are four assistance levels

1. amount of assistance a client will require, which also reflects the client's ability to follow directions and level of cooperation. 2. MAT 3. 1. Maximum assistance: The client cannot bear weight, assist, or maintain a seated position. Use a total mechanical lift or sling. 2. Moderate assistance: The client can maintain a seated position and has some upper extremity strength but lacks enough lower extremity strength to transfer safely. Use sit-to-stand powered lifts and assistive devices. 3. Minimum assistance: The client can rise from a seated position and sustain a steady stand. Use a gait belt and ambulation assistive devices as indicated. 4. No assistance: The client can stand, march or step in place, and walk without any help.

1. ADL 2. who will help you perfom ADL 3. Examples of assistive devices for clients who have mobility challenges that affect their ADLs

1. basic essential skills that a person does independently every day and that are usually related to personal care. ADLs include activities that one learns as a child and can be completed unsupervised, such as dressing, bathing, toileting, and feeding oneself. Providing support to enable performance of ADLs is an important aspect for clients to achieve a high quality of life and independence. 2. occupational therapist- achieve the best outcome for independence and reduce the physical strain caused by providing care for caregivers. 3. commode chairs, toilet seat risers, and shower chairs.

1. deep vein thrombosis 2. who are at greater risk for developing a DVT 3. These factors diminish the body's ability to effectively circulate blood, leading to 4. Blood that is not moving freely is more likely to --- 5. The most serious complication of DVT is a 6. Alternatively, the clot could travel to the brain or heart resulting in a

1. blood clot inside a deep vein, usually within the extremities. typically in the arms, pelvis, thighs, or lower legs 2. immobile-- increased blood viscosity and the atrophy of muscles that normally assist the body in pumping the blood 3. venous stasis 4. clot 5. pulmonary embolism- obstruction of blood flow in a pulmonary artery due to the movement of blood clot from an extremity to the lungs. 6. stroke (cerebrovascular accident), (Death of brain cells due to a blood clot or the rupture of a blood level within the brain.) or the heart, causing a heart attack (myocardial infarction). (arterial blood flow to the heart muscle is blocked resulting in death of cardiac muscle cells.)

1. Indications that a client has developed an activity intolerance can include 2. One helpful tool for evaluating activity tolerance from the client's perspective is the..... Target zone. The lowest and highest level and what do they indicate.

1. both physical manifestations and functional inabilities. Deconditioning may have occurred if the client experiences weakness, fatigue, lightheadedness, chest pain, diaphoresis, or significant changes in vital signs with an increased activity level. The nurse should monitor for these manifestations as the client increases movement and performs ADLs. 2. Borg Rating of Perceived Exertion (RPE) scale. The RPE scale is a subjective scale, enabling clients to gauge their level of exertion during activity. The lowest level is 6, indicating a state of resting or sitting that is effortless. The highest level is 20, signifying that maximal effort is required to perform the action. The target zone is for the client to rate activities between 12 and 14, representing a somewhat hard to strong effort.

Balance 1. The center of gravity is the 2. While standing, the imaginary line for the center of gravity runs 3. Improved stability and balance occur when the center of gravity is

1. central point of weight for an object or the body. 2. horizontally just below the umbilicus, intersecting with the line of gravity. The center of gravity shifts as a person changes position. When a person bends their legs or leans over, the center of gravity lowers to balance and keep the body from falling over 3. lower and closest to the base. Creating a wide base by spreading the feet shoulder-width apart and flexing the knees improves stability and balance.

1. mobility assessment 2. what items should be included

1. evaluates how well a client can move, including which specialized equipment or aids are needed to maximize their mobility potential. A mobility assessment demonstrates the client's ability to participate in meaningful activities, determines their level of independence, and identifies any activity intolerances or influential factors. 2. --Normal mobility status --Ability to sit, Ability to stand, Ability to walk --Use or need for assistance --Degree of mobility and immobility --Condition of the skin --Presence of any manifestations during activity

gastrointestinal system 1. The gastrointestinal tract uses ________to optimize the movement of food from the mouth to the rectum. 2. Clients who are prescribed bed rest tend to have a 3. As muscle activity slows, the 4. These factors, in combination, can lead to an increased risk of 5. Having less food in the gastrointestinal tract slows 6. what medication furtehr slows it down. 7. Prolonged transit time in the intestinal tract increases the absorption of water from

1. gravity 2. decreased appetite and overall food intake compared to more active clients. 3. absorption of protein from the gastrointestinal tract decreases, leading to a lower level of protein in the blood 4. malnutrition in clients who are on bed rest. Imbalance in a client's intake that can include deficiencies or excesses in nutrients, vitamins, or calories 5. peristalsis and reduces the thickness of the mucosal lining. 6. opioid medications for pain further slows this motility 7. the feces and results in a drier, harder stool.

1. physical exercise has been shown to 2. all adults should engage in 3. Aerobic activities are those that 4. Older adults can benefit greatly from

1. improve health outcomes and reduce risk of chronic disease. Strengthens bones and muscles and reduce risk of cardiovascular disease, diabetes, and some cancer. Exercise also improves overall quality of life and reduces the risk of falls. 2. moderate-intensity aerobic activities for at least 150 min per week (30 min per day, 5 days per week). 3. increase both HR and RR. Ex- ballroom dancing, water aerobics, swimming laps, brisk walking (2.5 miles), hiking, and slow bike riding at 10 miles per hour. 4. multicomponent exercise programs that incorporate aerobics and muscle-strengthening and balance-training activities. Adapted yoga and resistance bands can build muscle and bone and improve balance.

1. Decreased mobility can lead to an 2, These changes can negatively impact the client's

1. increased dependence on others, a loss of privacy, and an inability to participate in work and hobbies previously enjoyed. 2. self-concept and self-esteem and can lead to feelings of frustration, anxiety, and depression. Social isolation due to decreased mobility further impacts the client's emotional health. slef concept- The beliefs one holds regarding their qualities and attributes formed through experiences.

1. Bones 2. Prolonged immobility reduces the 3. Disuse osteoporosis 4. The resulting injuries are termed 5. Rebuilding bone mass takes considerably longer than

1. living tissues that are constantly remodeling (bone breakdown and replacement that occurs throughout a lifespan.) and changing. Normally, the rate of bone growth matches the rate of bone destruction. Normally, the rate of bone growth matches the rate of bone destruction. The action of supporting body weight in an upright position maintains the equilibrium between the development and breakdown of skeletal tissue. 2. mechanical load and stress on bones, contributing to a loss of mass, density, and strength. 3. Loss of skeletal mass, density, and strength caused by immobility. This demineralization results in fragile bones, which are prone to breaking even under minor stress 4. Fractures that occur following stress on a bone that would not typically result in a break. 5. rebuilding lost muscle mass and strength.

1. A pressure injury is 2. Such an injury results from 3. who is more susceptible 4. pressure injury can range from 5. tissue damage can occur due to

1. localized damage or necrosis of the skin and/or underlying tissue. 2. extended direct pressure, sometimes in combination with shear (sliding) or friction (rubbing) trauma 3. The skin of older adults is thin, fragile, and more vulnerable to this type of injury. 4. intact skin with nonblanchable redness to deep wounds with exposed bone and necrotic tissue. 5. prolonged pressure or trauma.

1. Range of motion- what are the benefits 2 ROM exercises can be either

1. manipulation of a joint within its range of flexion and extension. The benefits of ROM are increased joint function and flexibility, improved posture, reduced stiffness, and lower risk of injury. 2. Passive range of motion mvmt. of a joint by another individual without the client's assistance. Muscles and joints are completely relaxed while external motion and forces move the body part. Passive ROM preserves the flexibility of the joint, but it does not prevent loss of muscle mass or bone demineralization because the muscle is not voluntarily contracting, and the bones are not undergoing any type of weight-bearing stress. Active range of motion voluntary movement of a joint by the client without any type of assistance. During passive and active ROM exercises, flexion of the joints is achieved through the movements of flexion and extension; abduction and adduction; pronation and supination; circumduction; rotation; and inversion and eversion

1. Musculoskeletal 2. musculoskeletal system is a detailed 3. These tissues include 4. Muscles are....... Bones are 5. what connects muscles and bones 6. what enables motion and felxibility btwn bones

1. muscles and the skeleton 2. grouping of tissues that are important for stability and proper body functioning. 3. muscles, bones, joints, tendons, cartilage, and ligaments 4. soft tissues that provide the motor power or force for movement; bones are hard connective tissues that create the rigid structure and shape of the human body. 5. tendons and ligaments Tendons- Nonflexible fibrous connective tissue that attaches muscle to bone. Ligaments- Flexible fibrous connective tissue that attaches bone to bone. 6. synovial joints

muscles 1. The maintenance of muscle mass requires a significant supply of 2. When muscles are not used, they 3. The more well-developed a muscle is, the faster 4. This sort of deterioration, which occurs with 5. Sarcopenia 6. muscles in which extremity experience this first.

1. oxygen and glucose. 2. atrophy—that is, they become smaller and weaker. 3. it will atrophy 4. both prolonged bed rest and immobilization of a limb, results in poor muscle coordination and reduced ability to perform activities of daily living. Because older adult clients have a lower baseline muscle mass, the effects can be more noticeable in this population. 5. loss of lean muscle mass. It is caused by a deterioration of the twitch fibers in voluntary muscles; these fibers are responsible for the speed of contraction and the ability to resist fatigue. 6. The muscles in the lower extremities bc they are used constantly working to hold the body in an upright standing position. This phenomenon explains why clients will often report feelings of weakness in their legs after just a few days of bed rest.

1. body alignment 2. Optimal posture supports the 3. Good body alignment is determined based on an 4. When handling clients or lifting objects,

1. positioning of the various parts of the body while performing activities 2. spine, muscles, and joints, which increases strength, reduces fatigue, and uses less energy 3. Imaginary line that passes vertically through the body and divides it into two equal halves. This vertical line should run from the top of the head and straight down through the ear lobe, shoulder, trunk, hip, femur, knee, and ankle. 4. keep the back straight, the chin level, and tighten abdominal muscles to maintain alignment throughout the task.

1. A client's level of mobility can be influenced by 2. Proper body alignment enhances

1. posture, body alignment, and ability to balance 2. posture and creates a stable center of gravity. This improves the client's balance, decreasing the risk of falls and injuries. Good posture and alignment also minimize the risk of musculoskeletal strain. Assisting clients to practice the principles of good posture and body alignment can enhance their efforts toward increased and independent mobility.

Cardiovascular System Effects Prolonged immobility can cause alterations in the cardiovascular system. 1. After only 24 hours of bed rest, body fluids normally present in the lower extremities will be 2. A lower circulating blood volume 3. This lowered demand results in atrophy of the heart muscle, known as

1. redistributed to the head, abdomen, and chest areas due to the change in gravitational force. This change temporarily increases the blood volume returning to the heart, which in turn signals the body to release hormones to regulate fluid balance. The resulting diuresis and potential dehydration decrease the circulating blood volume and increase the viscosity, or thickness, of the blood. 2. decreases the amount of blood that is ejected when the heart contracts 3. cardiac deconditioning.- Atrophy of the heart muscle that results in a decreased amount of blood being ejected from the heart during contraction

1. Immobility, especially with_______ positioning, reduces the amount of air exchanged and increases the risk of infection. 2. Prolonged bed rest can result in a structural change in the lungs evidenced by narrowed airways, particularly the 3. Clients who are immobile also experience

1. supine- impairs the ability of the ribcage to freely expand due to the physical restriction caused by the bed. Additionally, it causes the abdominal organs to shift toward the diaphragm, which decreases the depth of breaths and the effectiveness of coughing 2. bronchioles 3. dehydration, which thickens the mucus secretions in the lungs, making it difficult for the client to expel the mucus when coughing.

1. Immobility places a large portion of the client's skin in constant contact with the 2. Prolonged pressure 3. The areas most susceptible to the effects of pressure are bony prominences 4. Skin that is exposed to

1. surfaces of the bed and at risk for altered skin integrity. 2. compresses the skin and tissue between the bone and the firm surface, restricting the flow of blood and lymph to those areas. 3. which have thinner skin—for example, the back of the head, shoulder blades, elbows, sacrum, ischium, and heels. 4. moisture from perspiration, wound drainage, or incontinence is at an even greater risk for skin breakdown.

1. What has important effects on the genitourinary system bc.... 2. Supine positioning interferes with these mechanisms and increases the risk of incomplete emptying of the bladder, known as 3. Incomplete drainage of the kidneys and urinary retention can lead to the formation of 4. what can it promote

1. upright positioning bc Gravity enhances the drainage of urine from the kidneys and its collection in the lower portion of the bladder. Gravity also causes the abdominal organs to exert pressure on the bladder, which enhances the sensation of the urge to void. 2. urinary retention- bladder does not completely empty with urination. 3. renal calculi- Stones that develop in the kidney and usually related to dehydration or an increase of stone-forming substances. 4. development of a urinary tract infection. Urinary retention can lead to overdistention of the bladder that damages the lining of the bladder and also increases the risk for infection.

A nurse is caring for a client who can move self from a semi-reclining position to sit on the edge of the bed but is unable to hold the position. The nurse should assign the client which of the following activity levels? A. Maximum assist B. Moderate assist C. Minimal assist D. No assist

A The nurse should assign the activity level of maximum assist to a client who can move self from a semi-reclining position to sit set on the edge of the bed but cannot hold the position. The nurse should assign the activity level of moderate assist to a client who can sit on the side of the bed with their feet on the floor and hold that position. The nurse should assign the activity level of minimal assist to a client who can rise up from a seated position with an assistive device. The nurse should assign the activity level of no assist to a client who can march in place.

A nurse is caring for a client who will require a mechanical lift to transfer from the bed to a reclining chair. The nurse should follow the recommendation of asking how many personnel to assist with this task? A. 2 or more B. 1 to 2 C. 0 to 1

A The recommendation for 2 or more personnel for assistance is for clients who are identified as activity level 2 or moderate assist. The recommendation for 1 to 2 personnel for assistance is for clients who are identified as activity level 3 or minimal assist. The recommendation of 0 to 1 personnel for assistance is for clients who are identified as activity level 4 or no assist.

Which of the following actions demonstrates the proper use of body mechanics? (Select all that apply.) A. Bend the knees to improve balance. B. Turn the torso when assisting the client to pivot. C. Maintain good posture at all times. D. Bend at the waist to move heavy objects. E. Position objects to be lifted 12 inches away. F. Place the feet in line with the shoulders.

A C F

1. Gastroesophageal reflux 2. As gastric fluids accumulate in the upper portion of the stomach,

A backflow of gastric fluids into the esophagus that can result in irritation of the tissue. Can occur due to supine positioning. 2. they put pressure on the lower esophageal sphincter. These gastric fluids can backflow through the sphincter and cause damage to the lining of the esophagus.

pivot disc-- who needs it

A sit-to-stand lift can be used to assist the client in rising from a seated to a standing position. Surgical pain or trauma can impede a client's ability to lift the body upright. This type of lift would be appropriate for a client who possesses the lower extremity strength and balance required to maintain an upright position, once that position is achieved.

slide or transfer board - what is it - who requires it - how many staff - what to always ensure

A slide board allows the lateral transfer of a client without imposing the physical exertion of lifting on the staff member. The board's rigid, slippery surface makes it easier to slide the client from one surface to another, such as from the gurney to the bed. Clients who require a slide board transfer are usually immobile or acutely ill and unable to assist. A minimum of three to four staff members should be used when performing this type of transfer. Always ensure that all drainage tubes and intravenous lines are secure prior to transfer to prevent accidental dislodgement.

foot drop

A type of joint contracture that results in the foot and toes permanently pointing downward

A. Deep vein thrombosis B. Skin breakdown 1. help client ambulate 2.sequential compression devices 3. high protein meals 4. high protein shakes

A. Deep vein thrombosis 1. help client ambulate 2.sequential compression devices B. Skin breakdown 3. high protein meals 4. high protein shakes

Sort the following actions into those that indicate correct body mechanics or incorrect body mechanics. (Drag each description to the desired category.) A. correct body mechanics B. incorrect body mechanics 1. Pivot or sidestep when moving client 2. Bend slightly at the waist 3. Place feet close together 4. Raise the clients bed when positioning 5. Lift from the large back muscles 6. Stand close to the client when lifting

A. correct body mechanics 1. Pivot or sidestep when moving client 4. Raise the clients bed when positioning 6. Stand close to the client when lifting B. incorrect body mechanics 2. Bend slightly at the waist 3. Place feet close together 5. Lift from the large back muscles

Interventions for Integumentary Complications of Immobility Complication- Pressure injury-- Assessment and intervention

Assessment Assess the client's skin for manifestations of damage daily. Inspect identified areas of breakdown daily for changes. Intervention 1. Ensure the client is repositioned at least every 2 hours to promote adequate blood flow to bony prominences. 2. Use pillows and cushions to support the client in different positions. 3. Use assistive devices and proper technique when repositioning to minimize additional skin trauma. 4. Use pressure redistribution devices on mattresses and chairs to decrease prolonged pressure on areas susceptible to breakdown. 5. Moisturize dry skin to decrease the risk of skin breakdown. 6. Ensure intake of adequate calories, protein, and micronutrients to promote healing of damaged areas. 7. Keep skin free from moisture due to incontinence, wound drainage, or perspiration, all of which increase the risk of skin breakdown.

A nurse is assessing the competency of a new assistive personnel (AP) as they assist in moving a client up in bed. Which of the following actions by the AP demonstrates competence? A. Lifts with arms fully extended B. Places feet shoulder width apart C. Maintains client's bed in a low position during move D. Twists at the waist during the mo

B

Based on the mobility level assigned to this client, how should the nurse plan to address the client's mobility needs? A. Client can move without assistance to increase activity levels B. Client requires the assistance of one or two team members to increase activity levels C. Client requires the assistance of more than two team members to increase activity levels D. Client should remain on bed rest and be repositioned every 2 hours

B

A nurse is caring for a client who can rise to a standing position from a chair with the use of a cane. The nurse should assist the client with ambulation using which of the following equipment? A. No equipment necessary B. Gait belt C. Mechanical sit to stand D. Mechanical lift

B The nurse should obtain and use a gait belt for a client who is able to use a cane to rise up from their chair. The nurse would not need to use any equipment for a client who is able to march in place or step forwards and backwards. The nurse would use a mechanical sit to stand lift for a client who is able to sit on the edge of the bed with their feet on the floor but is unable to stand with the use of an assistive device. The nurse would use a mechanical lift for a client who is unable to stand on their own. This client would not be able to ambulate.

Which assistive devices should the nurse plan to use when increasing the client's level of mobility? (Select all that apply.) A. Crutches B- Slide board C- Gait belt D- Pivot disc E-Walker F- Mechanical sit-to-stand lift

C, E This client requires an assistive device to mobilize due to the left leg weakness. A walker is an appropriate choice for an older client who demonstrates lower extremity weakness. A gait belt should always be used when ambulating a client with any deficits to protect both the client and the staff from injuries related to falls. Crutches require a substantial amount of upper arm strength and are best used by younger clients. A slide board is indicated for an immobile client who requires a lateral transfer. A pivot disc is used for clients who can stand but demonstrate difficulty with moving their feet to negotiate a transfer to a chair or wheelchair. A mechanical sit-to-stand lift is used for clients who demonstrate difficulty rising from a seated to standing position.

cane - types of cane - what do canes do . - The broader base of a quad cane will offer... - the top of the cane should be leveled with what - the elbow should bent at what angle

Canes increase stability and improve gait mechanics. They can be single-point or four-point models; the latter are often referred to as quad canes. The broader base of a quad cane will offer more support and may prevent falls in clients who have greater mobility issues. The height of the cane should be assessed to ensure ease of use and optimal balance. When the client is standing with the arms relaxed at their side, the top of the cane should be level with the inside of the wrist. When the client is gripping the cane, the elbow should be bent at approximately a 15- to 30-degree angle

childhood- gait is achieved at what age

During childhood, continued practice and development of gross motor skills lead to changes in gait and stance. The fine-tuning of the gait is typically achieved between ages 5 and 7, as the child learns to narrow the base and lengthen the stride. Continued development of all locomotion skills leads to the ability to run, jump, and dance. Strength and endurance continue to improve with practice and activity, usually peaking during late adolescence.

adulthood

During early adulthood, muscle mass and strength reach their maximum, but there is a slight decline in mobility when performing challenging tasks. While muscle mass and strength slowly decline, overall mobility performance typically remains stable until late adulthood. An early decline during this stage is usually the result of illness or trauma.

Age devlelopmental changes 1. infancy

During the first year of life, the infant must at first develop the muscles and coordination necessary to hold an erect posture. This is first noted when the infant achieves the ability to lift the chest and then sit independently. Advances in strength, coordination, and balance lead to the development of basic ambulation skills near the end of the first year. Although the infant or toddler initially employs a wide stance and short strides when walking, this technique changes with practice. Continued exploration of the environment leads to the development of depth perception and the implementation of gross motor strategies to navigate uneven surfaces and obstacles.

A. Joint contractures B. Malnutrition C. Atelectasis D. Constipation E. Pressure injury -Inspect client's position for proper body alignment every 2 hr --Assist client with meals -Use of incentive spirometer -Range-of-motion exercises every shift -Weigh daily -Elevate HOB 30 --45 degrees -High-fiber foods + fluids -Reposition every 2 hours -Evaluate client if nausea, vomiting, or abdominal pain -Keep skin free from moisture due to incontinence, perspiration, or wound drainage

Joint contractures Ensure range-of-motion exercises are performed every shift Inspect the client's position for proper body alignment every 2 hours Malnutrition Assist the client with meals if needed Weigh the client daily Atelectasis Encourage the frequent use of an incentive spirometer Elevate the head of the bed at least 30 to 45 degrees Constipation Evaluate the client for the presence of nausea, vomiting, or abdominal pain Encourage the consumption of high-fiber foods and fluids Pressure injury Reposition the client every 2 hours Keep the client's skin free from moisture due to incontinence, perspiration, or wound drainage

1. activity intolerance

Physical inactivity that leads to a loss of the ability to perform tasks is termed a functional decline or activity intolerance. This decline can be due to many factors, including prolonged bed rest, decrease in mobility, balance difficulties, or weakness due to an illness or hospitalization. Older adult clients are especially susceptible to the effects of generalized deconditioning and functional decline. Such changes can adversely affect a client's quality of life and independence and increase the occurrence of falls and fractures. Activity intolerance can delay a client's return home and increase the likelihood of readmission to an acute care facility

Positioning - Proper positioning involves - What does it involve

Positioning is the process of intentionally placing the body or a body part in a specific way. Proper positioning involves aligning the body in a neutral position, supporting the natural curves, and eliminating pressure points, hyperextension, or lateral rotation. Goals for client positioning and alignment consist of the two Ps: promotion and prevention. Promotion: comfort, safety, dignity, privacy, participation, frequent position changes Prevention: strain, injury, and skin breakdown

What level of mobility should the nurse assign to this client? A- Level 1: maximum assist B-Level 2: moderate assist C- Level 3: minimal assist D- Level 4: no assist

This client could perform most activities independently but would require an assistive device to ambulate due to the left leg weakness. The client would be classified as a Level 3: minimal assist. Level 1: maximal assist. The client has decreased upper body and trunk strength and is unable to shake hands or sit on the edge of the bed. Level 2: moderate assist. The client is able to sit on the edge of the bed but cannot point and flex the feet or extend the legs. A client must be able to perform these actions to bear weight on the legs. Level 4: no assist. The client can move about independently. The does not require any assistive devices and successfully performed all the activities in the MAT.

complications of bed rest? A. TRUE B. FALSE -Reports of heartburn - Manifestations of a blood clot in an extremity --Rapid, shallow breathing --Loose, frequent stools --ncreased muscle mass --Elevated blood pressure when sitting --Reddened areas of skin --Inability to flex the foot downward --Resistance to extension of an extremity

True Reports of heartburn Rapid, shallow breathing Reddened areas of skin Manifestations of a blood clot in an extremity Resistance to extension of an extremity False Increased muscle mass Elevated blood pressure when sitting Loose, frequent stools Inability to flex the foot downward

older adulthood-- adult reaches the

When an adult reaches the seventh decade of life, changes to body systems can result in a significant decline in the ability to ambulate and move. Age-related changes that affect mobility include alterations in muscle mass, posture, joint mobility, reflexes, and vision. Preexisting decreased muscle mass and significant obesity may exacerbate the impact of these changes. A client who is less affected by age-related changes in one body system can better compensate for other losses to maintain mobility. For example, exercising to build muscle strength will assist an older adult client to preserve mobility.

Crutches bodyweight should be supported by the hands on the grips, not in the -------. Bearing weight on the top of the crutches can lead to -------------------- Consulting with a ----------- can ensure the selection of the optimal crutch gait pattern for the client.

axilla nerve damage that causes numbness and tingling in the arms. physical therapist

1. what coordinates the action of muscle movement. 2. what is proprioceptor or kinesthesia

brain coordinates the action. Nerve cells in the spinal cord connect to the muscles throughout the body and fire signals that cause those muscles to contract. As the muscles shorten, they pull against the bone to which they are attached, generating movement. In essence, the bones are the levers, with the muscles generating the force needed to move the bones. As the muscles move, information from sensory receptors is sent back and forth to the brain to create a sense of self-awareness and body position Feedback from sensory receptors to coordinate, balance, and fine-tune body positioning and movement.

walker - which walker has the greatest support but requires the most strength and coordination - which walker is for minnor support when ambulaitng - Walkers with three or four wheels mainly assist with the client's ...... - A walker should not be used on - the top of the walker should be.... teh elbows should be bent at

can assist with ambulation of clients who experience balance or weakness difficulties. These devices provide a wide, stable base and are available in several varieties. The standard walker has no wheels, so the client must pick it up to move it. This type provides the greatest amount of support, but also requires more strength and coordination. A two-wheeled walker has wheels in place of the front legs and is best used by clients who require only minor support when ambulating. Walkers with three or four wheels mainly assist with the client's balance. A walker should not be used on stairs or an escalator. The top of the walker should be at the level of the wrist. When the client grips the walker, the elbows should be bent at approximately a 15-degree angle.

1. nervous system consists of two subsystems

central nervous system and the peripheral nervous system. The central nervous system includes the brain and the spinal cord. The peripheral nervous system is made up of thousands of nerves that interface with the spinal cord. These nerves are composed of fibers that are encased in c.t., which protects them. They communicate with muscles and sensory receptors through a series of chemical signals, known as neurotransmitter

Assistive devices

clients who have an alteration in gait or impaired ability to ambulate may require the use of assistive devices. Such equipment is designed to increase the efficiency of the gait, reduce pain, and increase function of the lower extremities. Assistive devices can also improve clients' balance, provide sensory cues, improve posture, and facilitate movement.

orthostatic hypotension

decrease in blood pressure and a sensation of dizziness that occurs when a client sits or stands up. This sensation occurs because gravity pulls body fluids to the lower extremities. Reduced blood volume and cardiac deconditioning increase this effect, especially in older adult clients and those who have had long periods of immobility. Orthostatic hypotension increases the risk of client falls, which can then lead to additional complications. A decrease in systolic blood pressure of 20 mm Hg or more. OR A decrease in diastolic blood pressure of 10 mm Hg or more within 3 minutes of changing to a sitting or standing position.

what plays an important role in the prevention of injury among nurses.

ergonomics This health care professional is subject to frequent physical demands as part of performing the required tasks, such as pushing and pulling carts, carrying supplies or equipment, and assisting clients in turning, ambulation, or transfers. Nurses who work in organizations that implement ergonomic practices and safety equipment, however, tend to have fewer work-related injuries. Some health care facilities have "minimal lift" or "never lift alone" policies in place to assist in injury prevention. Implementation of these practices requires education and training on use of team lifts, assistive devices, and equipment.

gait belt

gait belt or walking belt is a wide, strong belt that allows the caregiver to assist the client with stability. It is placed over the top of the client's clothing, generally at the waistline. The position may need to be altered slightly if the client has abdominal incisions or drains in place. The gait belt should be fastened snugly, but with enough space for the health care team member to slip their fingers under the belt to provide support. A gait belt can be used alone or in conjunction with another assistive device such as a cane, walker, or pivot disc.

pneumonia

infection in the lung tissue. that often occurs in clients with limited mobility as a result of shallow breathing, thickened mucus, and decreased ability to cough. As the thick secretions collect in the lower airways, the client experiences a reduced ability to remove pathogens and irritants from the lungs, which can result in an infection.

atelectasis- what does this collapse decrease

partial or complete collapse of the lung, including airways and small sections of lung tissue. bc of shallow breathing. This collapse decreases the number of alveoli that are available to exchange oxygen and carbon dioxide. during expansion

Mechanical lift-- what do you insoect the sling for

required for clients who are unable to support their own weight. These devices are used to lift and move a client from one place to another, such as from the bed to the chair. Staff members need to be educated on the operation of the mechanical lift, if one is used in their facility, to prevent injuries. Inspect the sling for manifestations of wear and ensure the base of the lift is placed in the maximum open position before use.

Clients who have been inactive or compromised due to illness will need to

slowly increase their activity to regain muscle strength, endurance, and coordination. It may be necessary, to begin with only a few minutes of exercise and slowly increase the duration over time. Even small amounts of moderate-intensity exercises can provide physical and mental benefits. Clients should seek health provider guidance regarding physical activity goals following illness.

crutches and what are the different kinds - typically used by who - Axilla crutches should be adjusted so that the crutch pads rest and elbows should bend at... And hand grips should rest at...

typically used by younger clients who possess the upper extremity strength needed to use them. They come in a variety of options, such as axillary, platform, and forearm, and can be used individually or in pairs. Walking with crutches effectively can take practice. Axilla crutches should be adjusted so that the crutch pads rest 1 to 2 inches below the axilla. The hand grips should be at the level of the client's hips. The elbows should have a 15- to 30-degree bend when holding the hand grips.