Activity & Exercise + Immobility Flashcards
what is SO IMPORTANT ABOUT PHYSICAL ACTIVITY & EXERCISE?
- contribute greatly to one’s own physical & emotional well-being
- allows one to keep fit & elevate one’s mood
- stress management
- better sleep quality
- improves confidence & self-image
- patients need the MOTIVATION to engage in regular exercise
definition of DECONDITIONING
- based upon INACTIVITY OF PHYSICAL ACTIVITY
- indication of physical, emotional decline due to inactivity
what are some ACTIVITIES SEEN IN HEALTH CARE SETTINGS?
- WALKING
- TURNING/POSITIONING
- LIFTING
- CARRYING
**often see nurse undergo injuries–such as on the BACK due to overexertion from lifting or moving patients
definition of MOVEMENT
complex process that requires COORDINATION between the musculoskeletal & nervous systems
defintiion of BODY MECHANICS
a term that describes the COORDINATED EFFORTS of the MUSCULOSKELETAL SYSTEM & NERVOUS SYSTEM
definition of BODY ALIGNMENT
- or aka POSTURE; allows for the positioning of the joints, tendons, ligaments, & muscles while in standing, sitting, or lying positions
- indicates a person’s center of gravity is STABLE
how does GRAVITY & FRICTION PLAY A PART?
if we have an UNSTEADY PATIENT; this means their CENTER OF GRAVITY IS UNBALANCED & WEAK
- friction is where we have a FORCE THAT IS OPPOSITE TO THE MOVEMENT
- the GREATER SURFACE AREA = GREATER FRICTION
- the LARGER THE OBJECT = GREATER RESISTANCE to MOVEMENT
what is the TYPICAL CORRECT BODY ALIGNMENT?
- RELAXED and FACE FORWARD POSITIONING
- minimization of HUNCHING
definition of SHEAR
- the force exerted against the skin while the skin remains stationary & bony structures move
- ex. moving HOB - patient pulled by gravity on underlying sheets
- causes damage to UNDERLYING TISSUE & impedes blood flow
what is the SKELETAL SYSTEM and what is it composed of?
- composed of ATTACHMENTS for MUSCLES & LIGAMENTS that forms the FRAMEWORK for the body
-contains our joints, ligaments, tendons, and cartilage
what about our SKElETAL MUSCLES?
muscules that are concerned with MOVEMENT OR POSTURE
- they can either EXTEND OR CONTRACT
definition of PROPRIOCEPTION
where we have the ACTUAL AWARENESS of the POSITION OF THE BODY and all its PARTS
what do we use to help ease pain within the MUSCLES?
can use HEAT THERAPY
- allows for VASODILATION & RELAXING OF THE MUSCLES
definition of PHYSICAL ACTIVITY
any movement produced by the SKELETAL MUSCLES that results in ENERGY EXPENDITURE
definition of PHYSICAL EXERCISE
type of SUBSET OF PA; more of a PLANNED, STRUCTURED, and REPETITIVE movements that has a more FINAL OR INTERMEDIATE OBJECTIVE OR GOAL
- goal; improvement or maintenance
definition of ISOTONIC/DYNAMIC CONTRACTION/EXERCISES
mobilizing; causes the body to move
- have CONTRACTION OF THE MUSCLE
definition of ISOMETRIC EXERCISES
- stabilizing; causes the body to hold a stable position
- has an INCREASE IN MUSCLE TENSION — has NO SHORTENING OR ACTIVE MOVEMENT OF MUSCLE
- still has ENERGY EXPENDITURE
- ex. having car in neutral
what are PATHOLOGICAL INFLUENCES that must be considered during ACTIVITY?
- CONGENITAL DEFECTS (scoliosis, OI - brittle bone disease)
- DISORDERS pertaining to the BONES, JOINTS, or MUSCLES (osteoporosis)
- CNS DAMAGE
- MSK TRAUMA (fractures etc..)
- OBESITY (increased SOB, risk of disorders, low back pain)
definition of SPHM
involves the SAFE PATIENT HANDLING & MOBILITY
- where we have TECHNIQUES and improved assessments of equipment and procedures to allow SAFE MOVING, HANDLING, and TRANSFERING OF PATIENTS
infants - developmental changes in MSK?
have more of a SPINE THAT IS FLEXED
- continued DEVELOPMENT OF MOVEMENT–just starting to lift their head, sit up, and stand
toddlers - MSK developmental changes?
- has more of a SWAYBACK SPINE and PROTRUDING ABDOMEN
adolescents - MSK developmental changes
greater amount of ACTIVITY - more sports and more sporadic growth
older adults - MSK changes?
- have a GREATER LOSS OF BONE MASS
- slower walk and coordination
- increased risk of falls
- can have underlying conditions or weakness in the muscles
- greater MEDS and POLYPHARMACY
how do BEHAVIORAL ASPECTS PLAY A ROLE?
the more SUPPORTIVE EFFORTS ARE AROUND PATIENTS–the more they will incorporate themselves into an exercise program
- allows to hold yourself accountable!
what are FACTORS THAT CAN INFLEUNCE ACTIVITY & EXERCISE?
- CULTURAL BACKGROUND
- different ENVIRONMENTAL ISSUES/ACCESS TO ACTIVITIES
- FAMILY & SOCIAL SUPPORT
important questions to ask during nursing assessment?
- any major surgeries?
- any medications or symptoms?
- how much does the patient exercise each day?
- are they bedbound, in need of PT/OT, or necessity of assistive devices?
- do they have access to locations to exercise?
- how ready are they to develop this lifestyle change?
what are the APPRORIATE NANDAS?
Activity intolerance
Risk for injury
Impaired mobility in bed
Impaired mobility
Acute or chronic pain
what is our GOAL AND OUTCOME?
want to be able to IMPROVE AND MAINTAIN THE PATIENTS MOTOR FUNCTION AND INDEPENDENCE
- taking into account the PRIORITY NEEDS
- being able to COLLABORATE WITH OTHERS
what are the TYPES OF RANGE OF MOTION EXERCISES?
- ACTIVE, PASSIVE, or ASSISTEd
- FAROM; full active range of motion
- PAROM; partial active range of motion
- PROM; passive ROM
what are some things to remember while helping a PATIENT WALK?
- always ASSESS FIRST IF THE PATIENT CAN WALK SAFELT
- dangle legs first around 1 - 2 min before starting
- use gait belt and extra support
what are SOME OF OUR ASSISTIVE DEVICES TO WALK?
- walkers
- canes
- crutches
what can occur with DECREASE OF EXERCISE?
- CAD
- HT
- COPD
-DM
definition of MOBILITY
refers to a person’s ABILITY to MOVE FREELY
definition of IMMOBILITY
refers to the inability to move freely
what are SOME EFFECTS OF MUSCULAR DECONDITIONING?
- DISUSE ATROPHY - decreasing of muscle mass/shrinking of the muscle
- PHYSIOLOGICAL/PSYCHOLOGICAL EFFECTS
- SOCIAL EFFECTS (ex. bed rest- decreased socialization)
what are some METABOLIC CHANGES that occur with IMMOBILITY?
- decrease of ENDOCRINE METABOLISM
- decreased CALCIUM RESORPTION
- decreased GI SYSTEM FUNCTIONS
- DECREASED PERISTALSIS
what are some RESPIRATORY CHANGES that can occur with IMMOBILITY?
- ATELECTASIS (collasped lung)
- HYPOSTATIC PNEUMONIA
what are other CHANGES THAT CAN OCCUR?
- cardiovascular; ex. orthostatic hypertension
changes in BP and HR - msk changes; ex. increase of blood clots/atrophy
- urinary changes; ex. decrease in output = increase in UTI/stasis
- integumentary changes; risk of pressure ulcers
what can occur during DEVELOPMENTAL CHANGES?
INFANTS:
- can have delayed development
- want to develop their weight-support skills *tummy time
TODDLERS:
- have a MORE WIDE STANCE; with their head and trunk more forward
- if immobilized; can delay gross motor skills
ADOLESCENTS;
- growth increases
ADULTS:
- have more increased risk of immobility
OLDER ADULTS
- greater risk for falls and bone loss
what to observe during NURSING ASSESSMENT?
- can the patient perform ROM?
- how does the patient walk?
- how much do they exercise?
- how do they stand/sit/lay down?
what are some aspects of HEALTH PROMOTION FOR IMMOBILITY?
- prevent any work related msk injuries
- importance of exercise
- patient teaching of proper bone health
what are some METABOLIC INTERVENTIONS?
making sure patient has a HIGH PROTEIN HIGH CALORIE DIET with VITAMIN B AND C SUPPLEMENTS
what are some RESPIRATORY INTERVENTIONS
allow patient to cough and deep breathe every 1 - 2 hours
- use of chest physiotherapy
what are OUR POSITIONING TECHNIQUES?
- SUPPORTED FOWLER’s POSITION
- SUPINE POSITION
- PRONE POSITION
- SIDE-LYING POSITION
- SIMS POSITION
definition of INSTRUMENTAL ACTIVITIES OF DAILY LIVING
specific INTENSIVE SPECIALIZED THERAPY such as OT or PT
- ex. dressing yourself, grocery shopping etc…
