Mobility

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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


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