Activity & Immobility: Week 6 Flashcards
Gait
The manner or style of walking, including rhythm, cadence, length of stride, and speed
Spinal Malformations
Kyphosis: overexaggerated thoracic spine
Lordosis: overexaggerated lumbar spine
Scoliosis: exaggerated lateral curvature of the spine
Atrophy vs. Hypertrophy
atrophy- related to decreased use, causes decreased muscle size
hypertrophy- increased or enlargement of muscle. strengthening
Ergonomics
Science that focuses on factors or qualities in an object’s design/use that contribute to comfort, safety, efficiency, and ease of use
Body Mechanics
Center of gravity: lower the better
Lifting: use assistive devices when appropriate
Pushing or pulling: wide base of support
Fowler’s Bed Position
Head of bed at 45-60 degrees
Promotes lung expanision, useful for proceudres (NG insertion, suctioning), helps promote drainage post abdominal surgery
High Fowler’s Bed Position
Head of bed between 60-90 degrees
Promotes lung expansion the most, good position to put people in acute respiratory distress, good for patients experiencing regurgitation, (lowers the diaphragm to allow for FULL lung expansion) best for patients eating in bed
Semi-Fowler’s Bed Position
Head of bed between 15-45 degrees (usually 30 degrees)
Prevents regurgitation from eating/enteral feedings, helps promote lung expansion (minimally compared to flat) , most common position for patients in bed, we try never to lay patient flat because of aspiration risks for pneumonia risk, most hospitals want patients at least 30 degrees, however, for patients who have just had their groin accessed or have had some procedure or line in the groin, may be restricted to 30 degrees or lower
Trendelenburg
Entire bed tilted with head of bed lower than foot of bed
Used to facilitate postural drainage and promote venous return, can be used if patient hypotensive and to shunt blood to heart/brain and out of the extremities, used more commonly in emergency situations
Reverse Trendelenburg
Entire bed tilted with foot of the bed low to ground and head of bead high
Promotes gastric emptying, and prevents reflux, we use sometimes when patients have lines in their groins and cannot bend their legs so they are sitting up.
Modified Trendelenburg
Patient remains flat but legs elevated above the heart
Helps with hypovolemia a bit as well, helps with venous return (fluid getting stuck in legs)
Trapeze Bar, Mechanical Lift, Log Roll
Trapeze bar– allows patient to pull with upper extremities to raise trunk off the bed
Mechanical Lift- for immobilized/weak patients, make sure you know hospital policy
Log roll- for patients in spinal and cervical precautions [know procedures]
Venous Thrombus Embolism [VTE] and/or deep vein thrombosis [DVT]
VTE- clot that has detached from the wall [blocking blood flow in some way]
DVT- clot within the vein obstructing blood flow
Virchow’s Triad
Damage to the vessel wall
Alteration in blood flow (immobility/ bed rest)
Alterations in blood constituents (changed clotting factors, increased platelet activity)
Pulmonary Embolism
Deadly complication related to VTE/DVT that has lodged in pulmonary circulation blocking gas exchanged
Pulmonary Toilet
Turn, Cough, Deep Breathe
Includes positioning patient in bed
Helps prevent respiratory complications associated with immobility
Gait Belt
Assistive device which helps nurses mobilize patients
Reduce chances of patient falling and decreases injury of nurses hurting themselves
Make sure you read the website related to gait belt
Single legged versus quad cane
Single legged- provides support and balance for patients with MILD balance or strength impairment
Quad cane- best for unilateral weakness
Review nursing teaching points for all types of canes
Rollator Walker
Walker which has either 2 or 4 wheels- commonly used short-term
Follows same rules as other walkers
Crutch gaits
2-point: partial weight-bearing on both feet
3-point: all weight bearing on one-leg, affected leg not on the ground
4-point: weight-bearing on both legs, each leg moves alternately, 3 points of contact/support at all times
Swing-through: for patients with paraplegia, weight placed on supported legs then crutches step
Lofstrand crutch
Forearm crutch
Usually used for longer periods of time, usually related to some type of long-term paralysis/serious weakness
Pseudodiarrhea
Impacted feces become hardened and clog and then liquid stool tries to pass around it; can lead to bowel obstruction
Consequence of immobility
Peristalsis
Can become decreased with immobility causing multiple other gastointestinal consequences
Renal Calculi
Urinary Stasis
Another word for kidney stones
Caused by abnormal gravity associated with a person being in bed long-term, urine becomes lodged in kidneys, causing higher risks of renal calculi, UTIs, etc.
Contractures, Foot Drop
Contracture: possibly permanent, abnormal fixation of the joint, caused by disuse, atrophy and shortening muscle fibers [causes decreased ROM]
Foot drop: type of foot contracture, foot permanently flexed in plantar flexion; unable to lift toes off the ground, increases risk for falls
CVA
Cerebral vascular accident–> more commonly known as a stroke
Common cause of long-term immobility
SCDs
Anti-embolic stockings
SCD= sequential compression device; inflates and deflates at cyclical pace, use whenever patient is not ambulating
Anti-embolic stockings- maintains external pressure on muscles of lower extremities, promotes venous return, remove at least once per shift. Appropriate use is critical.
