2.1 Mobility Flashcards
Physical Assessment for Mobility
- Make sure of no musculoskeletal or neurological injuries that affect movement.
- General ease of movement and gait, body alignment, joint structure, muscle mass, tone, strength, endurance that can be assessed walking to the room.
Assessment before moving patient
- Check medical records for conditions or orders that limit mobility
- Preform pain assessment. If there is pain administer medication 30 minutes before moving. If medication causes dizziness, move with caution.
- Assess patients ability to assist with moving and need for any equipment or assistance.
- While moving your patient assess for any skin signs of irritation, redness, edema, or blanching.
Back Injuries in Health Care Workers
- Uncoordinated lifts
- Manual lifting
- Transferring patients without assistive equipment
- Lifting when tired or recovering from injury
- Repetitive movements
- Standing for long periods of time
Proper Body Mechanics When Lifting
- Feet apart to create sturdy foundation
- Bend Knees instead of waist
- Keep neck, back, hips, and feet aligned when moving
- Avoid twisting/bending at the waist
- Raise bed to prevent back injury
- When moving patient who can assist, keep center of gravity high
Patient bedding positions
Fowler - Head of bed is 45-60 degrees.
(Helps with cardiac and respiratory functioning. Used for eating, conversation, urination, and defecation.)
Supine - Lying flat on back
Protective Side-Lying (Lateral Position) - Lying on side with pillows for support. Top leg flexed at 30 degrees and knee at 35 degrees. Calf of upper leg slightly behind body midline. Pillows to support back and top leg.
Patient Bedding Positions (cont)
Protective Sims Position - Variation of Lateral Position, but lower arm is behind the patient, and upper arm is flexed at both shoulder and elbow.
Protective Prone Position - Lies down on abdomen with head turned to side. This is not a good position for people with spinal problems. Pillow on head, abdomen and legs.
Protective Patient Techniques (Bedding)
- Special mattresses/adjustable beds help patients alleviate pressure. Pillows and rolls are used to keep patients in correct position. Patients position should be changed every 2 hours and massaging pressure points to restore blood flow.
Tools for bed positioning
Food Board - Prevents foot drop and used to keep foot in flexed position. Boots/High-top Sneakers can be used.
Trochanter Roll - Prevents external rotation of hips. Folded sheet with top edge by hips and lower edge 1/3 down thigh. Rolled up on each side so hips and thighs are in place.
Hand Roll - Wrist splints/hand rolls made of wash cloth can keep thumb in correct position.
Graduated Compression Stocking (TED Hose)
Require physician order for patients at risk of deep-vein thrombosis, pulmonary embolism, and to prevent phlebitis (clots and inflammation of leg)
- Increases velocity of blood in veins and improves venous valve function in legs, promoting blood flow back to the heart.
- Applied in the morning before patient gets out of bed in Supine position.
- If patient has been up/sitting patient should lie down with feet elevated for 15 minutes before applying.
- Also applied after surgery
How to apply TED
- Make sure size is correct
- Flip the hose inside out
- Start with toes and fit the heel
- Continue to roll up leg and make sure it is wrinkle free
Pneumatic Compression Devices (PCD)
- Fabric sleeves with air bladders that fit around leg and apply brief pressure. Intermittent compressions push blood from smaller vessels into deeper vessels and veins. Enhances blood flow.
- Can be used with anti-embolism stockings and anticoagulant therapy to prevent thrombosis formation.
How to apply Pneumatic Compression Devices (PCD)
How to apply Sequential Compression Devices (SCD)
SCD - Apply with Velcro and check arrows for proper application. Then attach to footboard and turn on.
Moving Patients
- Assess patient before moving
- Review medical record and nursing plan for contradictions in moving.
- Assess tubes/IV’s, incisions, or equipment that alter transfer.
- Assess patient weight and your strength to determine if more assistance is needed.
- Assess patient comfort level and provide medication if needed.
Assistive devices for moving patients in bed.
Siderails - Assist patient in pulling themselves up bed or rotating side to side.
Trapeze Bar - Assists patients in lifting themselves up or moving side to side
Lateral Assist Device - Friction reducing boards or board with rollers to push and pull patients to bed. Use legs instead of back to move patients to avoid injury.
Powered Full Body Sling Lift - Used when patient cannot bear weight. Moves patient in and out of bed/chair. If nurse must lift more than 35 pounds of patients weight, use assistive device. Sling is placed under body and lifts patient slowly.
Moving Patient from Bed to Chair
- Ensure bed and chair are both locked
- Place patient hands on your shoulder and not neck
- Grab patients waist
- Wide stance put leg closes to chair behind the other leg.
- Use legs to lift to avoid injuring back, stand same time patient stands, swivel, then squat down as patient sits.
