module 2 funds objectives

Describe changes in body systems related to alterations in mobility, including integumentary, respiratory, cardiovascular, endocrine, elimination, musculoskeletal, and neurological/psychosocial. (CO1, CO5)

-Integumentary: pressure injuries, skin breakdown. -Respiratory: atelectasis, pneumonia. -Cardiovascular: orthostatic hypotension, venous stasis, DVT. -Endocrine/Metabolic: decreased metabolic rate, fluid/electrolyte imbalance. -Elimination: constipation, urinary stasis, infections. -Musculoskeletal: atrophy, weakness, contractures, osteoporosis. -Neurological/Psychosocial: depression, anxiety, sensory deprivation.

Demonstrate proper use of canes, crutches, walkers, and wheelchairs. (CO4)

Canes: hold on strong side, move cane and weak leg forward together. Crutches: proper height (2-3 finger widths under axilla), teach 2-, 3-, or 4-point gait. Walkers: move walker forward, then step with weak leg, then strong leg. Wheelchairs: lock brakes before transfer, use footrests properly.

Identify physiological methods of controlling heart rate/pulse. (CO4)

Control: Autonomic nervous system - sympathetic ↑ HR, parasympathetic ↓ HR.

Identify the physiological controls of respirations. (CO4)

Control: Respiratory center in medulla/pons; chemoreceptors respond to CO₂, O₂, and pH.

Differentiate between surface and core body temperature sites. (CO4)

Core: rectal, tympanic, temporal artery - most accurate reflection of body temperature. Surface: oral, axillary, skin - more affected by environment.

Demonstrate application and maintenance of anti-embolic stockings and sequential compression devices. (CO4, CO5)

Ensure correct size; smooth wrinkles. Remove stockings at least once per shift to assess skin. Apply SCD sleeves correctly and check circulation frequently. Assess skin integrity, perfusion, and patient comfort.

Identify expected ranges of temperature, respirations, heart rate, blood pressure, and oxygen saturation for adult patients. (CO4)

Expected Adult Ranges: Temperature: 96.8-100.4°F (oral) Pulse: 60-100 bpm Respirations: 12-20/min Blood Pressure: 90-119/60-79 mm Hg O₂ Saturation: 95-100%

Describe factors that increase or decrease temperature, pulse, respiration, blood pressure, and oxygen saturation. (CO4)

Factors Affecting VS: Temp: age, environment, hormones, exercise, illness. Pulse: activity, fever, stress, medications. Respirations: pain, anxiety, activity, disease. BP: age, stress, exercise, medications, volume status. O₂ Sat: oxygen therapy, circulation, airway status.

Describe what blood pressure is measuring. (CO4)

Force of blood against arterial walls during systole/diastole.

Identify nursing interventions to reduce the risk of injury related to mobility alterations. (CO3, CO5)

Frequent repositioning (q2h). Skin assessments and pressure-relieving devices. Incentive spirometry, coughing/deep breathing. Hydration, high-fiber diet, toileting assistance. Progressive mobility: dangling, standing, ambulation. ROM (active, passive). Safety devices: gait belt, nonslip socks, call light within reach.

Describe the relationship between blood clots and alterations in mobility. (CO4)

Immobility → decreased calf muscle pump + venous stasis → clot formation (DVT). Risk: pulmonary embolism if clot travels to lungs.

Demonstrate proper transfer technique to wheelchairs. (CO4)

Lock wheelchair brakes. Remove footrests. Position chair at 30-45° angle to bed. Use gait belt; pivot transfer with patient standing and turning toward chair. Ensure patient's hips are back in chair.

Demonstrate appropriate blood pressure measurement using a sphygmomanometer and automatic blood pressure device. (CO4, CO5)

Measurement: Manual: sphygmomanometer + stethoscope, inflate 20-30 mmHg above expected, deflate slowly. Automatic: follow device instructions.

Differentiate normal vs. abnormal rhythm and bradycardia vs. tachycardia. (CO4, CO5)

Normal vs. Abnormal: Normal: 60-100 bpm, regular rhythm. Bradycardia: <60 bpm. Tachycardia: >100 bpm.

Describe trending vital signs and identify changes. (CO4)

Nurses monitor trends to detect subtle changes. A single abnormal reading is less informative than patterns over time (e.g., rising BP or falling O₂ saturation).

Demonstrate the technique of assessing respirations. (CO4, CO5)

Observe chest rise/fall for 30-60 sec; do not inform patient to avoid altering rate.

Demonstrate the technique of temperature methods of the following routes oral, rectal, axillary, tympanic, and temporal. (CO4, CO5)

Oral: place probe under tongue, close lips.' Rectal: insert lubricated probe 1-1.5 in (adults). Axillary: place in dry axilla, hold arm down. Tympanic: gently pull ear back/up (adult), insert probe. Temporal: sweep probe across forehead over temporal artery.

Define orthostatic hypotension and safety measures to prevent injury. (CO2, CO5)

Orthostatic Hypotension: BP drop on standing; prevent by slow position changes, assistance with ambulation.

Assess pain using an appropriate pain scale for the patient's needs. (CO4, CO5)

Pain is often called the "fifth vital sign." Use validated scales (numeric, Wong-Baker Faces, FLACC, etc.) based on patient's age and cognitive ability.

Demonstrate pulse oximetry measurement using a digit and earlobe probe. (CO4, CO5)

Place probe on fingertip, toe, or earlobe; ensure site has good perfusion and is free from nail polish/poor circulation.

Identify methods of heat production and heat loss. (CO4)

Production: metabolism, muscle activity, shivering, hormones. Loss: radiation, conduction, convection, evaporation.

Describe the benefit of anti-embolic stockings and sequential compression devices when caring for patients with alterations in mobility. (CO4, CO5)

Promote venous blood return. Reduce venous stasis and edema. Prevent deep vein thrombosis (DVT) and pulmonary embolism.

Identify differing body positions, including prone, supine, lateral recumbent, Fowlers, and Trendelenburg. (CO4)

Prone: on abdomen. Supine: on back. Lateral recumbent: side-lying. Fowler's: HOB 45-60°. Trendelenburg: head lower than feet.

Describe pulse oximetry and what is being measured. (CO4)

Pulse Oximetry: Non-invasive measure of arterial oxygen saturation (SpO₂), percentage of hemoglobin bound with O₂.

Describe methods to promote venous return for patients with alterations in mobility, including range of motion exercises, positioning techniques, anti-embolic stockings, and sequential compression devices. (CO4, CO5)

Range of Motion (ROM) Exercises: prevent stiffness, enhance circulation. Positioning: elevate legs, avoid crossing legs. Anti-embolic Stockings: apply firm, even pressure to lower extremities to prevent venous pooling. Sequential Compression Devices (SCDs): intermittent inflation/deflation mimics muscle pumping action.

Describe the terms respiratory rate, depth, and rhythm. (CO4)

Rate: breaths per minute. Depth: shallow, normal, deep. Rhythm: regular vs. irregular.

Demonstrate the technique of assessing the pulse of adult patients, including the carotids, apical, radial, and dorsal pedis. (CO4, CO5)

Sites: carotid, apical (5th ICS, midclavicular), radial, dorsalis pedis.

Identify physiologic methods of controlling body temperature. (CO1, CO4)

The hypothalamus regulates balance between heat production (metabolism, shivering, exertion) and heat loss (skin, evaporation, respiration).

Identify proper equipment for vital signs measurement. (CO4, CO5)

Thermometers (oral, tympanic, temporal, axillary, rectal), sphygmomanometer, stethoscope, pulse oximeter.

Demonstrate patient care techniques using ergonomic principles (lifting/rolling patient, ambulation assistance) to prevent injury. (CO2, CO4)

Use body mechanics: -Wide base of support, bend at knees, tighten core. -Keep patient/object close to your body. -Avoid twisting; pivot instead. Techniques: -Lifting/rolling: use draw sheets, logroll with 2-3 staff if spinal precautions. -Ambulation: use gait belt, stand on patient's weak side, support with assistance devices as ordered.

Identify proper delegation related to vital sign measurement. (CO4)

Vital sign measurement can be delegated to assistive personnel only when the patient is stable. Nurses remain accountable for accuracy, interpretation, and reporting.

Describe the role of vital signs in patient care. (CO4)

Vital signs reflect a patient's health status and physiologic functioning. They are regulated by homeostatic mechanisms and deviations may indicate health changes.

Demonstrate proper cuff selection for blood pressure measurement. (CO4, CO5)

Width = 40% arm circumference; length = 80% circumference.