Activity And Immobility Flashcards
1
Q
Body alignment
A
- Standing: head erect and midline, shoulders, and hips straight toes pointed forward etc.
- Sitting: head erect, weight evenly distributed, feet supported on floor
- Walking: posture, gait and mobility should be fluid & coordinated
- Greatest no. of falls occur from not picking up feet high enough
- Positioning patients: Maintain correct alignment
- Use supportive devices as needed: footboard, overhead trapeze, trochanter rolls, splints
2
Q
Body Mechanics
A
- Lifting Mechanics
- Use center of gravity
- keep weight close to lifter as possible
- Synchronize manner
- Avoid lifting person or object > 35% of your body weight. Ask for assistance when needed
- Avoid twisting & bending
- Slightly flex knees & hips; use thighs & lower torso, wide - base of support
3
Q
Body Mechanics
A
- Moving, repositioning &transferring
- Assess pt’s musculoskeletal alignment
- Mobility of joints
- Neuromuscular system
- Ask patient to assist when possible
- use center of gravity and correct body alignment
- Raise bed to a comfortable height
- Use assistive devices properly
4
Q
Positioning in Bed
A
- Prone: lying face
Down, palms - Supine: Flat
- Semi Fowler’s (30-45 degrees)
- Fowler’s Position >45 degrees
- Lateral (side-lying)
- Trendelenburg
- Sim’s (enema)
- Lithotomy
- Knee- Chest
5
Q
Assessing Muscle strength
A
- Test strength of prime mover muscle groups for each joint; repeat motions for active ROM
- Ask person to flex and hold as you apply opposing force
- Muscle strength should be equal bilaterally and should fully resist opposing force
- Graded on 0-5 scale
6
Q
Range of motion
A
Assess extremities for comprised circulation, physical impairment/ limitations and contraindications before performing exercises
- Encourage active and functional ROM exercises
- Perform passive ROM for any limitations to prevent contracture
- Discontinue excercises with c/o of pain
- Do not exercise painful or swollen joints
- Do not force joints pass point of resist
- Exercise one extremity at a time
7
Q
Range of Motion
A
- Pull all joints through ROM slowly and gently
- Provide support above and below the joint
- Follow sequence of exercises for upper and lower body
- Exercises with at least 5 full ROM to each joint at least twice daily
8
Q
Ambulation
A
- Assess activity tolerance, strength , coordination and balance
- Determine type of assistance needed
- Maintain safety precautions
9
Q
Factors affecting mobility
A
- Older adults
- Increased convexity in the thoracic spine(kyphosis) from disk shrinkage and decreased height
- Loss of muscle tone
- Subcutaneous fat loss
- Arthritic joint changes may be present
- Inflammation, regent, and trauma can all interfere with joint mobility
- Osteoporosis
10
Q
Effects of immobility
A
Muscle atrophy
- Contractures
- Ankylosis
- Atelectasis/ hypostatic pneumonia
- Pressure Ulcers
- Sleep disturbances
- Osteoporosis
- Venous STasis leading to potential DVT
- Orthostatic intolerance
- Constipation
- Urinary Stasis
- UTI & kidney stones
- depression, anxiety
11
Q
Implementation
A
- Health promotion- recommend exercise 150- 300 min/ wk
- Encourage attempts at behavior that promote self- care activities despite limitations
- Encourage functional ROM, AROM, PROM as needed
- Get patients out of bed as indicated
12
Q
Implementation
A
Types of exercises
- isometric (contraction without motion)
- Isotonic ( weight training)
- Isokinetic ( resistance at constant, pre-set speed
- Aerobic
- Anerobic ( rapid, intense exercise)
13
Q
Assistive devices and safety precautions
A
- Canes
- Place cane on stronger side advance cane then weaker leg, then stronger leg pass cane
- Two points of support are present at all times
- Walkers : Advance walker, the client to walk into walker
- Wheelchair Safety anc Etiquette
- Hoyer Lift/ Mechanical Lifts
- Casts, splints, braces, crutches
14
Q
Transferring Patients Safety
A
- Transfer patients from bed to chair
- Assess patients for dizziness, orthostatic hypotension
- Allow patients to dangle at bedside before standing
- Transferring patient from chair to bed
- Transferring patient from bed to stretcher
- Using Hoyer or mechanical lifters
- Preventing injury during a fall - lowering patient to be on the floor
15
Q
Summary
A
- Nurses must adhere to safe body mechanics to avoid injury to self and patients
- Back injury is a leading cause of disability and loss hours of work for nurses, precautions must be taken to prevent injury
- Assessing of the patient’s functional ability is paramount in maintaining safety
- Promoting safe mobility and transfer will help preserve patient’s functional ability and prevent the many complications of immobility