Activity and Exercise Exam 3
aerobic exercise
Activity during which the amount of oxygen taken in the body is greater than that used to perform the activity. Improve cardiovascular conditioning & physical fitness. ex: walking, biking, gardening, swimming, dancing
Anaerobic exercise
Activity in which the muscles cannot draw out enough oxygen from the bloodstream. weight lifting & sprinting are also isokinetic
Positioning Clients
Fowler's position= HOB raised 45-60; refers to a 45 angle of elevation, for tube feeding, shortness of breath Semi/Low-fowler's position= HOB 15-45 degrees; typically means 30 degrees of elevation high-fowler's position= HOB 60-90; clients sitting upright, for feeding clients in bed Orthopneic position= client sits either in bed or on the side of the bed with an overbid table across the lap. Facilitates respiration allowing maximum chest expansion, helpful to clients who have problems exhaling, COPD pts.
the nurse is working on a hospital committee focused on preventing back injury in nurses. What evidence based practice is most likely to result in a decrease in back injuries if followed?
If the weight to be lifted exceeds 35 pounds or other condition exist assistive devices should be used
exercises in which the person tenses against resistance, special machines or devices provide the resistance to the movement, used in physical conditioning, build up certain muscle groups, lifting weights
Isokinetic exercises
are exercises that involve pressure against a solid object and are useful for strengthening abdominal, gluteal, quadriceps muscles used in ambulation; for maintaining strength in immobilized muscles in casts or traction; endurance training
Isometric
squeezing a towel or pillow b/w the knees while at the same time tightening the muscles in the fronts of the thighs by pressing the knees backwards, and holding for several sec. often called "quad sets" is an example of?
Isometric bed exercises
effects of immobility: Respiratory system
decrease respiratory movement= difficult to expand the lungs fully pooling(accumulation) of respiration secretions= inactivity allows secretion to pool by gravity, dehydration(thickens secretions), crackles, infection in lungs causing Pneumonia. Poor oxygenation & accumulation of CO2 in the blood cause respiratory acidosis, lethal disorder atelectasis= when ventilation decrease & secretions accumulate & block bronchiole with mucus causing a collapse of a lobe or entire lung
effects of immobility: Metabolic System
decreased metabolic rate: negative nitrogen balance= decrease in the protein stores that are essential for building muscle and for wound healing. anorexia= lack of appetite, decrease protein, imbalance nitrogen levels & causing malnutrition negative calcium balance
the nurse is caring for a client diagnosed with early osteoporosis. which intervention is most applicable for this client? institute an exercise plan that includes weight bearing activities increase the amount of calcium in the client's diet protects the clients bones with strict bed rest provide the clients with assisted ROM exercising twice a day
institute an exercise plan that includes weight bearing activities
a muscle contraction or tension against resistance is a __________ exercise and are used in physical conditioning
isokinetic
strengthening abdominal, gluteal, and quadriceps muscles by using a rolled towels b/w the legs is a _________________ exercise
isometric
the muscle shortness to produce muscle contraction and active movement, this exercise is ________________, like ADL, active ROM, walking
isotonic
pushing or pulling against a stationary object, using a trapeze to lift the body off the bed, lifting the buttocks off the bed by pushing with the hands against the mattress, & pushing the body to a sitting position is an example of?
isotonic bed exercises
The bed bound client complains of pain and burning in the right calf area, what action should be taken by the nurse?
measure the calf and compare to the opposite calf
Isometric exercises produce....
mild increase is HR, cardiac output, no increase in blood flow to others part of the body
Isometric (static or setting) exercises
muscle contraction occur without moving the joint, only contract muscles
Isokinetic (resistive) exercise
muscle contraction or tension against resistance
isotonic exercises increase....
muscle tone, mass, strength, maintain joint flexibility & circulation, heart & cardiac output quicken to increase blood flow to all parts of the body
Nurses intervention for effects of immobility in urinary system
need our patients to move immediately after surgery catheter if needed
Risk factor for thrombus (blood clot)
oral contraceptives smoking prolonged bed rest sleeping during a long plane ride
the nurse is caring for a client experiencing dyspnea (difficult or labored breathing). In which position should the nurse place this client
orthopneic position across the overbid table
the client who is unconscious is developing foot drop. What nursing action is indicated?
place high-topped shoes on the client while in bed
food drop
plantar flexion
effects of immobility: Cardiovascular system
pt may experience tachycardia with minimal movement. increase use of the Valsalva maneuver= putting pressure, can cause cardiac arrhythmias, is related to GI causing constipation Orthostatic (postural) hypotension= during prolonged immobility person attempts to sit or stand, blood accumulate in the lower extremities & central blood pressure drops. Pt feels dizzy, light-headed, may faint, increase HR Venous vasodilation & stasis= valves in the veins can no longer work effectively to prevent backward flow of blood thrombus formation= blood clots are thrombosis formation when blood is not moving like it should stasis form the venous vasodilation will cause blood clot
The nurse is providing range of motion exercising to the clients elbow when the client complains of pain. What action should the nurse take?
reduce the movement of the joint just until the point of slight resistance
effects of immobility: Integumentary system
reduced skin turgor= loss in skin elasticity skin breakdown = immbility impedes circulation, formation of pressure ulcers
the activity like weight lifting and ________________ where the muscle cannot draw out enough oxygen from the bloodstream is _____________ exercises.
sprinting , anaerobic
When planning care the nurse should identify which client as needing logrolling for position changes?
the client who fell from a house, sustaining a fractured tibia logrolling are for clients with: neck surgery, back surgeries, spinal injury, injuries such as fractures
the postoperative client is ambulating for the first time since surgery. The client has been able to tolerate sitting up on the side of the bed and has stood at the bedside without difficulty on two occasions. Which staff member should ambulate this client?
the registered nurse
effects of immobility: Urinary system
urinary stasis= pt in supine position, gravity impedes the emptying of urine from the kidneys & the urinary bladder renal calculi= immobile pt, calcium move out of the bone, is in urine make it more alkaline causing calculi(stones), extreme pain & bleeding urinary retention= bladder distention, decrease muscle tone & inhibit ability to empty completely urinary infection= static urine, bacterial growth, hypercalcuria in urine supports bacterial growth
running, walking, swimming, cycling, ADL's, active ROM exercises are what type of exercises?
Isotonic
What are some types of exercises?
Isotonic (dynamic) exercise Isometric (static or setting) Isokinetic (resistive) exercise aerobic exercise anaerobic exercise
effects of immobility: musculoskeletal system
Osteoporosis= low calcium, spongy bones, deform, fracture easily Atrophy= decrease in size, loss strength & funtion Contractures= permanent shortening of the muscles forms, limit joint mobility, foot drop, wrist drop stiffness and pain in the joints= excess calcium deposit in joint causing pain & stiffness. without movement, the collagen the connective tissue that's in the joint becomes ankylosed(permanently immobile)
the newly admitted client has contractors of both lower extremities. what nursing intervention should be included in this client's plan of care?
ROM exercises to prevent worsening of contractures
Isotonic (dynamic) exercise
Those in which the muscle shortens to produce contractions and active movement.
effects of immobility: GI system
constipation= decrease of peristalsis & colon motility, stool becomes hard, more strength is requires, patient lack of strength, can lead tp impaction
the nurse has document that the client has orthostatic hypotension. Which assessment finding would support this assessment?
decrease in blood pressure when moving from supine to standing
an activity that causes the amount of oxygen taken into the body part to be greater than that used to perform the activity is ______________ exercises and it improves _________________ conditioning and physical fitness
aerobic, cardiovascular
body mechanics
*Using body mechanics= is the efficient, coordinated, and safe use of body to move objects & carry out the ADLs *Lifting= nurses should NOT lift > 35 pounds without assistance from equipment or individuals. Types of assistive equipment: mobile-powered, mechanical lifts, ceiling-mounted lifts, sit-to-stand powered lifts, friction-reducing devices, transfer chairs. Pulling and pushing= a person maintains balance with least effort when the base of support is increased in the direction in which the movement is to be produced. pivoting= technique in which the body is turned in a way that avoids twisting of the spine preventing back injury= change position, movements to avoid are: twisting(rotation) of the thoracolumbar spine, acute flexion of the back with hips & knees straight. when moving an object, read feet apart to provide a wide base of support.
how we control postural hypotension
*rest with HOB elevated 8-12 inches *avoid sudden changes in position *never bend down all the way to the floor or stand up too quickly after stooping *postpone activities such as shaving and hair grooming for at least 1 hour after rising *be aware of symptoms of hypotension most severe at: -30-60 Mts after a heavy meal -1-2 hrs after taking an anti hypertension medication *hot baths (high temp) can lead to venous pooling *wear elastic stocking at night to inhibit venous pooling in the legs *rocking chair can improve circulation in lower extremities *don't hold breath or bear down, valsalva maneuver slow HR, decreasing BP
Practice guidelines for Providing Passive ROM exercises
-ensure client understands the reason of doing ROM exercises -Remove rings if hand swelling -clothe client in a loose gown, cover body with bath blanket -Use correct body mechanics when providing ROM exercises to avoid injury to the client & yourself -position bed in appropriate height -expose only the limbs being exercised to avoid embarrassment -support client's limbs above & below the joints. Cupping joints in the palm of your hand or Cradling limbs along your forearm -use a firm, comfortable grip when handling the limb -move body parts slowly, smoothly -avoid moving or forcing body part beyond the existing range of motion -if muscle spasticity occurs during movement, STOP movement temporarily, but continue to apply slow, gently pressure unit muscle relaxes -if contracture is present, apply slow firm pressure, without causing pain, to stretch the muscle fibers -if rigidity occurs, apply pressure against rigidity, continue to exercise slowly -teach client's caregiver the purposes and techniques of performing passive ROM at home -avoid hypertension of joint in older adult is joints are arthritic -asses skin condition during exercises
which pt is at higher risk to develop a DVT? 25 years old female on birth control 50 years old secretary who smokes and works 12 hours daily 75 years old male who walks 3 miles a day 7 years old post op. appendectomy
50 years old secretary who smokes and works 12 hours daily
Nurses intervention for effects of immobility in Cardiovascular system
encourage activity, regular movement, stretching, legs uncrossed, dorsal flexion exercise to prevent DVT (deep vein thrombosis), massage to prevent blood clot, if pt has DVT massage can actually move a blood clot & cause harm or dead periods of immobility is also a risk for secretaries, teacher & students during zoom for prolonged time, pmts that take oral contraceptive even in healthy young women, prolonged inactivity like bed rest, sleeping during a long plane rise can cause thrombus, pressure ulcer, constipation
Nurses intervention for effects of immobility in musculoskeletal system
for osteoporosis pt can swim, weight bearing exercises, actually standing on their own two feet that weight bearing exercise like walking, healthy diet, calcium, vit D, phosphorus. for atrophy: ROM exercises, if are immobile, perform isometric exercises for contracture= passive ROM exercise, put the body in its correct alignment in bed like if their were standing, toes will be up and we can use splint or foot board
which is the position of choice for people who have difficulty breathing & for some people with heart problems?
fowler's position
Factors affecting body alignment and activity (pg. 1012)
growth and development nutrition= over/under(less than 18.5), obesity, vit D & calcium personal values and attitudes= motivation external factors= high temp, high humidity, lack of money, safe neighborhood prescribed limitations= bedrest, SOB-shortness of breath, pregnant women may need bedrest
While assessing the client with a bath the nurse encourages full range of motion in all client's joint.which activity would best support ROM in the hand and arm?
have the client to brush hair and teeth
Nurses intervention for effects of immobility in GI system
high fiber diet, increase in fluid intake, privacy
Nurses intervention for effects of immobility in Metabolic system
high protein diet weight bearing exercises to help metabolic system.