Activity Flashcards

1
Q

what is the primary cause of musculoskeletal disorders among nurses?

A

patient handling
-over half of nurses have chronic back pain

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2
Q

who is most at risk for musculoskeletal disorders due to patient handling?

A

CNA’s
RN’s rank 8th for occupations at risk for injury

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3
Q

what percentage of nursing back injuries were preventable?

A

89%

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4
Q

what variables lead to back injuries?

A

-manual lifting
-uncoordinated lifts
-exceeding recommended lift weight limits
-using outdated techniques
-transferring or repositioning uncooperative or confused patients

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5
Q

what are the proper body mechanics of lifting?

A

-close to object
-face direction of movement
-slide, roll, push, pull instead of lift
-broad support base
-flex knees, straight back
-strong core
-low center of gravity
-longest and strongest bones for power
-use weight of your body by rocking

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6
Q

safe patient transfer?

A

-assess pt capabilities to assist in moving
-ensure enough staff available
-remove clutter (clear path)
-decide on equipment
-plan transfer
do not put the patient in Trendelenburg (puts all organs in to thoracic cavity)
Ask questions:
ROM, arm/leg strength, walking ability

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7
Q

lifting guidelines?

A

35 lbs MAX per person
if over 35 lbs, use assistive devices
*need more ppl if pt confused, combative, on the floor, etc

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8
Q

assist devices example?

A

-sling lift
-stand scale (good for knee replacement)

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9
Q

effects of immobility: increases what?

A

cardiac workload
venous thrombosis risk
urinary stasis
contractures risk
skin breakdown risk
bone loss
work of breathing
sense of powerlessness

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10
Q

effects of immobility: decreases what?

A

respiration depth
respiration rate
bladder muscle tone
muscle size, tone, strength
endurance, stability, coordination
sensory stimulation

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11
Q

immobility effects specifically in elderly?

A

rapidly deteriorates muscle mass in older/frail pt with little muscle mass to begin with
*~2wks for young healthy pt

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12
Q

low mobility in hospitalized patients conclusion?

A

low mobility and bed rest are common in hospitalized pts and are important predictors of adverse outcomes

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13
Q

activity assessments?

A

-activity orders
-muscle mass, tone, strength
-joint structure and function
-strength and endurance
-mobility probs (fractures/breaks, strokes, amputations, resp probs, heart probs)
-physical health probs
-mental health probs
-fall risk assessment
-meds (sedatives, antihypertensives, opioids)
-nutrition deficiences

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14
Q

AMPAC 6 CLICKS

A

how much difficulty…
1. turning over in bed
2. sitting down on and standing up from chair w/ arms
3. moving from lying on back to sitting on side of bed
1: unable, 2: a lot, 3: a little, 4: none
how much help from someone else…
4. moving to and from bed to a chair (including wheelchair)
5. to walk in hospital room?
6. climb 3-5 steps w/o railing
1: total, 2: a lot, 3: a little, 4: none

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15
Q

what is AMPAC used with? what are the values?

A

JH-HLM
AMPAC 6-7 = JH 2
AMPAC 8-9 = JH 3
AMPAC 10-15 = JH 4
AMPAC 16-17 = JH 5
AMPAC 18-21 = JH 6
AMPAC 22-23 = JH 7
AMPAC 24 = JH 8

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16
Q

what is JH-HLM?

A

daily mobility score
1. lying in bed
2. bed activities/dependent transfer
3. sit at bed edge
4. move to chair/commode
5. standing (1+ mins)
6. walk 10+ steps
7. walk 25+ feet
8. walk 250+ feet

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17
Q

who does not have to move?

A

physiologically unstable
EKG changes/cardiac enzymes
INR >5, PTT >100
unresponsive to verbal stimuli
spinal trauma/unable fractures
femoral sheath
thrombolytic admin

18
Q

safety and activity interventions?

A
  • ambulating
  • PROM/AROM: passive and active range of motion
  • position changes (necessary to reduce pressure on capillary beds (tissue death) causes skin breakdown)
  • trapeze bars/side rails
    -physical therapy consults
    -turning systems
    -avoiding knee gatching (end of bed pushed up- pressure causing DVT and PE)
    -log rolling
    -specialty beds
19
Q

what is Fowler’s?

A

head of bed elevated 45-60 degrees

20
Q

what is low Fowler’s?

A

HOB elevated 15-30 degrees

21
Q

what is semi Fowler’s?

A

HOB elevated to 30-45 degrees

22
Q

what is high Fowler’s?

A

HOB elevated 90+ degrees

23
Q

what is Fowler’s important for?

A

reducing aspiration risk, slipping in bed, tube feedings

24
Q

what is orthopneic?

A

sit up 90 degrees and on pillows (tripod position)
*for COPD- expands lungs for better ventilation

25
Q

what is prone position?

A

lying face down
*increases blood flow to anterior surfaces which increases oxygenation perfusion

26
Q

what is lateral position?

A

lying on side
*place pillows everywhere there is a bony prominence

27
Q

what is SIM’s position?

A

on side, arm back, one leg slightly elevated on pillow
*frequently used in OB and maternity

28
Q

what is lithotomy position?

A

stirrups/legs up
*for pelvic procedures

29
Q

trendelenburg?

A

feet elevated, bed straight

30
Q

reverse trendelenburg?

A

head elevated, bed straight

31
Q

protective positioning?

A

-pillows
-pressure reducing mattress
-support boots
-hand rolls
-trochanter rolls
*maintain body parts in normal anatomical position

32
Q

what is Bloom’s taxonomy?

A

remember
understand
apply
analyze
evaluate
create

33
Q

what is a trochanter roll for?

A

add support to avoid hips externally rotating

34
Q

what is log rolling?

A

maintaining spinal alignment while turning/moving pt

35
Q

what should you offload to prevent pressure injuries? (most common site due to constant pressure)

A

sacrum
other common sites?
heels, back of head, elbows, etc

36
Q

what are support boots for?

A

to maintain plantar flexion
prevents foot drop by keeping foot in anatomical alignment
*foot board also prevents foot drop

37
Q

which side should you stand on when assisting with ambulating?

A

stand on WEAK side

38
Q

walkers adjusted to?

A

height/level of patient’s hip

39
Q

cane use?

A

hold cane on strong side
1. advance cane
2. advance weak leg
3. advance strong leg
*creates tripod strength

40
Q

axillary crutches duration?

A

long term

41
Q

forearm crutches duration?

A

short term