Mobility
decreased metabolic rate increased risk for electrolyte imbalance altered exchange of nutrients and gases
Immobility effects on the metabolic processes
pressure ulcers
Immobility effects on the skin
increased urinary stasis (uti) increased risk of renal calculi (kidney stones) Decreased bladder muscle tone
Immobility effects on the urinary system
Range of Motion in which the resident is unable to assist with movement
Passive ROM-
1. Atelectasis - Collapse of the alveoli, secretion block bronchiole or bronchus, distal lung tissue alveoli collapse as the existing air is absorbed, producing hypoventilation. 2. hypostatic pneumonia- inflammation of the lung due to the stasis or pooling of secretions. 3. Entire lung or a lung lobe collapse
respiratory system effects
lying on back, facing upward knees bent and soles of feet flat on the bed
supine position
works together
synergistic
mobility increases
the plan of care for a client with osteoporsis includes active and passive exercise, calcium supplements and daily vitamins. What desired effect would the nurse look for if the therapy is effective?
relief from pain prevention of further injury allowing patients to regain strength
therapeutic benefits
abnormal condition of a blood clot
thrombosis
isometric, isotonic, isokinetic
types of exercises
optimal musculoskeletal balance
what does body alignment permit
health physiologic functioning
what does body alignment promote
Body alignment balance coordinated body movements
what's the 3 importance for body mechanics
each movement is to be preformed a minimum of 3 times
which advice would a physical therapist give to a nurse caring for a client who is immobile
assessing the skin integrity
which assessment would be the priority action of the nurse who is caring for a client with a leg in traction
A 40-year-old client who has just had a total knee replacement
which client would benefit the most from a consult with PT A 74- year-old client admitted with pneumonia A 40-year-old client who has just had a total knee replacement A 90-year - old client admitted with urinary tract infection A 50 -year -old client with difficulty swallowing after a stroke
finger painting on blank sheets of paper
which play activity would the nurse provide for a 4yr old on bed rest
The ability to keep an upright posture while standing still or moving.
Balance
The inner ear and fluid built up
Balance is maintained by
Study of mechanics of muscular activity and how that activity leads to internal loading of joints, ligaments and soft tissue
Biomechanics definition
congenital or acquired postural abnormalities bone formation and muscles development joint mobility musculoskeletal system trauma CNS
5 factors affecting body alignment and mobility
Gliding, condyloid, hinge, saddle, pivot, and ball-and-socket
6 types of joints related to movement
examine the skin for evidence of pressure points
A child who wears leg braces has a slight sensory loss in the lower extremities. Which is the most essential information for the nurse to teach the child and parents?
occupational therapist
A client who was using a walking frame (walker) is instructed to use a tripod walking stick. Which member of the rehabilitation team would recommend this modification?
to prevent contractures
A nurse advises patients to assist their child with stretching exercises. The child has impaired physical mobility due to neuromuscular impairment. what is the meaning to perform stretching exercises
Movement away from the midline of the body
Abduction
range of motion in which the resident assist with the movement
Active ROM
an individual's ability to tolerate completing activities of daily living
Activity tolerance-
Movement toward the midline of the body
Adduction
Promoting frequent turning and deep breathing to mobilize secretions
After a subtotal gastrectomy a client is returned to the surgical unit. Which is the best nursing action to prevent pulmonary complications? 1.Ambulating the client to increase respiratory exchange 2.Promoting frequent turning and deep breathing to mobilize secretions 3.Maintaining a consistent oxygen flow rate to increase oxygen saturation 4.Keeping a plastic airway in place to ensure patency of the client's airway
The sum total of all processes in an organism which use energy and simple chemical building blocks to produce large chemicals and structures necessary for life.
Anabolism
COAL: Cane Opposite Affected Leg
CANE
kidney stones
Calculi
breaking down
Catabolism
circular movement of a limb at the far end
Circumduction
Affect the efficiency of the musculoskeletal system and body alignment, balance, and appearance
Congenital or acquired postural abnormalities
the permanent tightening of fascia, muscles, tendons, ligaments, or skin that occurs when normally elastic connective tissues are replaced with nonelastic fibrous tissues
Contracture
head control Rolling crawling may walk unassisted
Developmental factors of infants
lying on the back with knees up and feet flat on the table
Dorsal recumbent-
bending of the foot or the toes upward
Dorsiflexion
The study of workplace equipment design or how to arrange and design devices, machines, or workspace so that people and things interact safely and most efficiently.
Ergonomics
turning the sole of the foot outward
Eversion
Straightening of a joint
Extension
bending a joint
Flexion
a semi-sitting position; the head of the bed is raised between 45 and 60 degrees
Fowler's position
a person's manner of walking
Gait
the extreme or overextension of a limb or body part beyond its normal limit
Hyperextension
Decreased respiratory movement Pooling of respiratory secretions Atelectasis Hypostatic pneumonia
Immobility effects on respiratory system
orthostatic hypotension, increased cardiac workload, thrombus formation
Immobility effects on the cardiovascular system
disturbance in appetite anorexia MOST COMMON altered protein metabolism altered digestion and utilization of nutrients constipation which can lead to a VASOVAGAL SYNCOPAL EPISODE
Immobility effects on the gastrointestinal system
Usually caused by a foreign object or improper diet
Intestinal impaction
turning inward
Inversion
involves muscle contraction without shortening
Isometric
Planks, wall sits pushing against the wall for 10 seconds
Isometric Exercise Examples
exercise in which muscle tension occurs without a significant change in muscle length
Isometric exercise
a surgical incision for the removal of a stone from the bladder
Lithotomy
abnormal anterior curvature of the lumbar spine (sway-back condition)
Lordosis
The body system that supports the body and enables it to MOVE Posture maintenance
Muscular System function
The question of what constitutes nursing knowledge is a vital one for nurses to consider for a number of reasons.
Nursing Knowledge Base
sitting up and leaning over a table to breathe at 90 degrees
Orthopneic position
bends the foot downward at the ankle
Plantar flexion-
turning the palm downward
Pronation
our sense of body position
Proprioception
the need to change positions frequently, at least every 2 hours
Protective Positioning
lies on abdomen with head turned to side, helps to prevent flexion contractures of hips and knees, not for spinal injuries
Protective Prone Position
rest, ice, compression, elevation
RICE
the movement of a joint to the extent possible without causing pain
Range of Motion (ROM)
The head of the bed is raised and the foot of the bed is lowered
Reverse Trendelenburg's position
CIRCULAR MOVEMENT AROUND AN AXIS
Rotation
abnormal lateral curvature of the spine
Scoliosis
lying on left side with right knee drawn up and with left arm drawn behind, parallel to the back
Sim's position
lying on left side with right knee drawn up and with left arm drawn behind, parallel to the back
Sims position
movement that turns the palm up
Supination
controls and coordinates functions throughout the body and responds to internal and external stimuli
The nervous system function
take the medication according to a specific schedule
The nurse is planning care for a client with myasthenia gravis who is experiencing diplopia , ptosis , and mild dysphagia . An anticholinergic medication is prescribed . Which instructions would the nurse give as a priority ?
fibrous, cartilaginous, synovial
The three types of joints are
encourage early mobility
To prevent thrombophlebitis in the immediate postoperative period , which action is most important for a nurse to include in the client's plan of care ?
lying on back with body tilted so that the head is lower than the feet
Trendelenburg position
Rolled towel support placed against the hips and upper leg to prevent external rotation of the legs.
Trochanter roll
1. Strict bed rest 2. Bed rest with commode privileges 3. Bed rest with bathroom privileges (also BRP)
Types of bed rest
inability to empty the bladder/ urinate
Urinary retention
Any forced expiratory effort against a closed airway such as when an individual holds his or her breath and tightens his or her muscles in a concerted, strenuous effort to move a heavy object or change positions in bed.
Valsalva maneuver
walker with affected leg
Walkers
prolonged immobility
What factor in the client's history increases the risk for osteoporosis
Blowing vigorously into the mouthpiece
Which action by the client using an incentive spirometer indicates the need for further instruction ? Blowing vigorously into the mouthpiece Getting into a chair to use the spirometer Coughing deeply after using the spirometer Using lips to form a seal around the mouthpiece
supporting the surgical incision with a pillow during coughing
Which action would the nurse perform to help a client cough and deep-breathe after surgical treatment of esophageal cancer to prevent pneumonia ?
Metabolic Respiratory Integumentary Gastrointestinal Musculoskeletal
Which complication is likely to occur in a client who is unable to perform range of motion exercises due to impaired mobility? Select all that apply. One, some, or all responses may be correct. Metabolic Respiratory Integumentary Gastrointestinal Musculoskeletal
pulmonary embolism
Which complication is the nurse attempting to prevent in a client who had bariatric surgery who is encouraged to be more mobile ?
Atelectasis
Which complication would the nurse understand the surgeon is trying to minimize when incentive spirometry has been prescribed for a client after surgery?
increase oral fluid intake to 2 to 3 L per day
Which discharge instruction would the nurse give the with limited mobility to prevent urinary stasis and formation of renal calculi ?
Pain relief Intact skin Good tissue perfusion Maintenance of mobility Independence with activities of daily living ( ADLs ) Prevention of complications
Which goal of treatment would the nurse expect to in the care plan of a client who experienced a fracture Select all that apply Pain relief Intact skin Good tissue perfusion Maintenance of mobility Independence with activities of daily living ( ADLs ) Prevention of complications
length of time this problem has existed
Which information is most important for the nurse to obtain from a client with limited mobility who recently experienced a cerebrovascular accident (CVA ) and reports constipation ?
You will need to apply them in the morning before you lower your legs from the bed to the floor
Which instruction would be appropriate for the nurse to include when teaching a client about thigh -high antiembolism elastic stockings ?
Administer stool softeners and laxatives as ordered . Reposition the client off of side after 30 minutes . Inspect the skin for pressure -related redness or edema Assist the client to change position at least every 2 hours . Apply graduated compression stockings or sequential compression devices as ordered .
Which intervention would the nurse use in a client with paralysis after a cerebrovascular accident? Select all that apply . Administer stool softeners and laxatives as ordered . Reposition the client off of side after 30 minutes . Inspect the skin for pressure -related redness or edema . Assist the client to change position at least every 2 hours . Apply graduated compression stockings or sequential compression devices as ordered .
coloring books and crayons
Which is the most appropriate toy for the nurse to give a 6-year- old child on complete bed rest ?
Promoting frequent turning and deep breathing to mobilize secretions
Which nursing action would best prevent pulmonary complications in a client immediately after subtotal gastrectomy
Every client response to immobility in the same way
Which statement would indicate a need for further learning regarding the psychosocial effects on clients with immobility ?
collapsed lung; incomplete expansion of alveoli
atelectasis
the wasting away of a body organ or tissue; any progressive decline or failure; to waste away
atrophy
weakness on one side of the body
hemiparesis
paralysis of one side of the body
hemiplegia
Joint between bones (as at the elbow or knee) that permits motion in only one plane
hinge joint
rehabilitative exercises and lifting weights
isokenetic exercise examples
exercise involving muscle contractions with resistance varying at a constant rate
isokinetic exercise
involves muscle shortening and active movement
isotonic exercise
The ability to keep an upright posture while standing still or moving.
balance
the proper relationship of body parts to one another
body alignment or posture
Keep objects close to body, do not bend at the waist. avoid constant repetition of lifting. Pull, push or roll rather than lift. Rock back and forth in feet and with body as a force for pulling or pushing Widen base up support, tighten stomach muscles lift with leg muscles keep back straight
body mechanics techniques
collaborate care patient education positioning lifting and transfers
bone formation and muscles development nursing responsibilities
swimming, walking, jogging, bicycling bed pull ups
isotonic exercise examples
joint range of motion ex arthritis
joint mobility
hunchback
kyphosis
lying on back with legs raised and feet in stirrups
lithotomy position
increased energy, vitality, well-being improved sleep improved appearance improved self concept increased positive health behaviors
mobility pros on psychological
increased appetite increased intestinal tone
mobility pros on the Gastrointestinal system
increased efficiency of the heart decreased resting heart rate and blood pressure increased flow of oxygenation of all body parts
mobility pros on the cardiovascular system
increased efficiency of metabolic system increased body temperature regulation
mobility pros on the metabolic body processes
increased muscle efficiency strength increased coordination increased efficiency of nerve impulse transmission
mobility pros on the musculoskeletal system
increased depth of respiration increased respiration rate increased gas exchange at the alveolar level increased rate of carbon dioxide excretion
mobility pros on the respiratory system
improved skin tone, skin color, skin turgor from improved circulation
mobility pros on the skin
Cardiovascular, Neurological, Musculoskeletal, Pulmonary, Surgery
conditions that require bed rest
early detection education counseling careful positioning and transfers
congenital or acquired postural abnormalities nurses responsibilities
a crackling sound made in breathing by a person with an inflamed lung, detected using a stethoscope.
crepitation
increased blood flow to the kidneys increased efficiency in maintaining fluid acid base increased efficiency excreting body waste
mobility pros on the urinary system
Radiographic position in which the body or part is rotated at an angle that is neither frontal nor lateral.
oblique position
low blood pressure that occurs upon standing up
orthostatic hypotension
every 2 hours
positioning schedule
growth spurt screen for scoliosis
developmental factors adolescence
assess balance between rest and activity activity levels very greatly
developmental factors adult
increased balance encourage physical activity
developmental factors childern
assess ease of movement gait alignment muscle mass tone and strength Arthritic joint changes and loss of muscle tone
developmental factors older adults
assess walking running jumping most can walk most can run provide safe environment
developmental factors toddlers
metacarpophalangeal joint (wrist)
ellipsoid joint
A clot that breaks lose and travels through the bloodstream.
embolus
shoulder and hip
example of ball and socket joint
atlas and axis C1 and C2
example of pivot joint
carpometacarpal joint of the thumb
example of saddle joint
carpals and tarsals
gliding (plane) joint
