Activity/Mobility Notes Flashcards
Atrophy
decreased muscle size
hypertrophy
increased muscle mass resulting from exercise/training
muscle tone
residual tension that remains in a resting normal muscle with an intact nerve supply
flaccidity
decreased tone caused by disuse or neurological impairment
- describe as weakness
spasticity
increased tone that interferes with movement caused by neurological impairment
- described as stiffness, tightness or pulling of the muscle
- paresis
- hemiparesis
- paresis: impaired muscle strength/weakness
- hemiparesis: weakness 1/2 body
Paralysis
- Hemiplegia
- Paraplegia
- Quadriplegia
Paralysis: absence of strength long secondary to nervous impairment
- Hemiplegia: paralysis of 1/2 body
- Paraplegia: paralysis of legs
- Quadriplegia: paralysis of arms and legs
Ligamentss
- bone to bone (or cartilage)
- stability and joint support
Cartilage
found in joints that act as shock absorber and reduces friction
Tendons
- Muscle to bone
- Facilitates movement
Tonus
Slight contraction
Contractures
permanent contraction of muscle (caused by prolonged bed rest)
Roughage
foods high in fiber
Basal Ganglia
in the cerebrum that help move muscles via nerve impulses (walking, swimming, laughing)
Parkinson’s Disease
degeneration of basal ganglia, affecting walking/coordination
Cerebellum
allows for smooth body movements and coordination (assists motor complex and basal ganglia)
Atelectasis
incomplete expansion/collapse of lung tissue (b/c decreased use of lung tissue)
Footdrop
inability to raise foot due to weakened/paralyzed dorsiflexors
Fibrinolysin
breaks down blood clots
active exercise
- pt independently moves joint through full ROM
only active exercise increases muscle mass, tone, strength and improves cardiovascular and respiratory function
passive exercise
pt cannot move independently and nurse move joints through its ROM
What is the role of the skeletal system?
- Support
-> soft tissues - Maintains body form adn posture
- Protection
-> ex: Brain, heart, lugs and spinal cord - Fixated strucutre for movement
- Stores minerals
-> calcium and fat - Blood cell production
-> RBC + WBC
Joints
classified based on amount of movement permitted AND basis of material between adjoining bones
Describe the following joint type:
Fibrous
(Movement, Examples)
Movement:
- Immovable (synathrosis)
Material Between Bones:
- X
Examples:
- Sutures between bones and skull
Describe the following joint type:
Cartilaginous
(Movement, Examples)
Movement:
- Slightly movable (amphiarthrosis)
Material Between Bones:
- X
Examples:
- Pubic symphisis
- joints between bodies of vertebrae
Describe the following joint type:
Synovial
(Movement)
Movement:
- Freely Movable (diarthrosis)
Material Between Bones:
- X
Examples:
- X
Describe the following joint type:
Ball & socket
(Movement, Material Bewteen Bones, Examples)
Movement:
- Freely Movable (diarthrosis)
Material Between Bones:
- Synovial Fluid
Examples:
- Shoulder/Hip joints
Describe the following joint type:
Condyoid
(Movement, Material Bewteen Bones, Examples)
Movement:
- Freely Movable (diarthrosis)
Material Between Bones:
- Synovial Fluid
Examples:
- Wrists joint and joints connecting fingers to palms
Describe the following joint type:
Gliding
(Movement, Material Bewteen Bones, Examples)
Movement:
- Freely Movable (diarthrosis)
Material Between Bones:
- Synovial Fluid
Examples:
- Carpal bones of wrist adn tarsal bones of feet
Describe the following joint type:
Hinge
(Movement, Material Bewteen Bones, Examples)
Movement:
- Freely Movable (diarthrosis)
Material Between Bones:
- Synovial Fluid
Examples:
- Elbow, knee and ankle joints
Describe the following joint type:
Pivot
(Movement, Material Bewteen Bones, Examples)
Movement:
- Freely Movable (diarthrosis)
Material Between Bones:
- Synovial Fluid
Examples:
- Joints between the atlas and axis of the neck
- between the proximal ends of the radius and the ulna at the wrist
Describe the following joint type:
Saddle
(Movement, Material Bewteen Bones, Examples)
Movement:
- Freely Movable (diarthrosis)
Material Between Bones:
- Synovial Fluid
Examples:
- Joints between trapezium and metacarpal of the thumb
What are the roles of the Muscular System? What three muscle tyes make up the Muscular System?
Movement
Maintain Posture
Heat Production
3 Types of Muslce:
- Skeletal
- Cardiac
- Smooth
What are the roles of the Nervous System?
Nerve impulses stimualte muscles to contract
Neurons conduct impulses from one part of the body to another
- Afferent neurons convey information from receptors to the central nervous system (CNS).
- Efferent neurons convey the response from the CNS to skeletal muscles via the somatic nervous system.
Describe the elements of correct alignment/balance
Stability enhanced with a wide base and lower center of gravity
Body balance enhanced with feet spread apart and flex at hip/knee
- Abdominal muscles help upward, with abdomen tucked in and buttocks downward
- Knees are slightly flexed
- Weight distributed through soles/heels
Describe the following problem:
Problems with Bone formation/Muscle development
(Abnormalities Affecting Activity/Alignment)
Abnormalities Affecting Activity/Alignment:
- Congenital problems (achondroplasia -> dwarfism)
- Vit D deficiency (-> deformities in skeletal sys/rickets)
- Osteoporosis
MISC:
- X
Describe the following problem:
Problems Affecting Joint Mobility
(Abnormalities Affecting Activity/Alignment)
Abnormalities Affecting Activity/Alignment:
- Arthritis (-> bone spurs)
MISC:
- X
Describe the following problem:
Trauma to Muscoloskeletal Systems
(Abnormalities Affecting Activity/Alignment, MISC)
Abnormalities Affecting Activity/Alignment:
- Break in bone/cartilage (fracture)
- Soft tissue injuries (sprains, strains, dislocation)
MISC:
- Sprain = least serious injury
Describe the following problem:
Problems Affecting the Nervous System
(Abnormalities Affecting Activity/Alignment, MISC)
Abnormalities Affecting Activity/Alignment:
- Cerebrovascular accident (strokes)
MISC:
- Refer to Image on table in Master Notes
Describe the following body system:
Cardiovascular
(Effects of Exercise, Effect of Immobility)
Effect of Exercise:
- ↑ heart efficiency
- ↑BF/oxygenation (of all body parts)
- ↓Resting HR/BP
Effect of Immobility:
- ↑Cardiac workload
- ↑Risk orthostatic hypertension
- ↑Risk venous thrombosis
Describe the following body system:
Respiratory
(Effects of Exercise, Effect of Immobility)
Effect of Exercise:
- ↑Rate/depth respiration
- ↑ Gas exchange
- ↑ Rate CO2 excretion
Effect of Immobility:
- ↓Rate/depth respiration
- Impaired gas exchange (acid base imbalance)
- Secretion pooling (-> hypostatic pneumonia)
- Atelectasis
Describe the following body system:
Gastrointestinal
(Effects of Exercise, Effect of Immobility)
Effect of Exercise:
- ↑ Appetite
- ↑ Intestinal tone
Effect of Immobility:
- Appetite disturbance
- Altered protein metabolism
- Altered digestion/utilization of nutritions
Describe the following body system:
Urinary
(Effects of Exercise, Effect of Immobility)
Effect of Exercise:
- ↑ BF to kidney
- ↑ Efficiency in maintaining fluid/acid-base balance
- ↑ Efficiency excreting body waste
Effect of Immobility:
- ↑ Risk UTI/urinary stasis
- ↑ Risk renal calculi
- ↓ Bladder muscle tone
Describe the following body system:
Musculoskeletal
(Effects of Exercise, Effect of Immobility)
Effect of Exercise:
- ↑ Coordination
- ↑ Efficiency of nerve impulse transmission
Effect of Immobility:
- ↑ Risk contracture formation
- ↓ joint mobility/flexibility
- ↓ endurance/stability
- Bone demineralization (↑risk fractures)
Describe the following body system:
Metabolic
(Effects of Exercise, Effect of Immobility)
Effect of Exercise:
- ↑ Efficiency of metabolic system
- ↑ Efficiency body temperature regulation
Effect of Immobility:
- ↑ Risk for electrolyte imbalance
- Altered exchange of nutrients and gases
Describe the following body system:
Integumentary
(Effects of Exercise, Effect of Immobility)
Effect of Exercise:
- ↓ Wrinkles
- Improves tone/color/turgor (elasticity)
Effect of Immobility:
- ↑ Risk skin breakdown/formation of decubitus ulcers (pressure sore)
Describe the following body system:
Psychological Well-Being
(Effects of Exercise, Effect of Immobility)
Effect of Exercise:
- Energy
- Improved sleep/appearance
- Improved self-concept
Effect of Immobility:
- ↑ Sense powerlessness
- ↓ Self concept
- ↓ Sensory stimulation (apathy)
- Altered sleep-wake patterns
Why is it important to take the health history and identify activitity level for patients?
- Provides indication of pt view of health
- Determines daily activity level, edurance, physical/mental health barriers and external factors
-> ex of external factors: access to physical activity services, safe neighborhoods, income - Able to adapt nursing interventions and adaptations tailored to the pt
Describe the following component:
Ease of Movement
(Normal Findings, Abnormal Findings)
Normal Findings:
- Voluntary controlled
- Fluid
- Coordinated
Abnormal Findings:
- Fasciculations
- Chorea
- Tremors
Describe the following component:
Gait/Posture
(Normal Findings, Abnormal Findings)
Normal Findings:
- Head erect, vertebrae straight
- Knees/feet forward
- Arms at side with flex elbows
- Arms swing freely in alternation with leg swings
- While one leg is in stance phrase, other is in swing phrase
Abnormal Findings:
- Spastic hemiparesis
- Scissors gait
- Sensory ataxia
- Use of assistive devices
Describe the following component:
Alignment
(Normal Findings, Abnormal Findings)
Normal Findings:
- Standar/sitting straight line can be drawn from ear through shoulder and hip
- In bed: head/shoulders/hip aligned
Abnormal Findings:
- Inability to maintani correct alignment independently
- Spinal curvatures
Describe the following component:
Muscle Mass/Tone/Strength
(Normal Findings, Abnormal Findings)
Normal Findings:
- Be strong lol
Abnormal Findings:
- Atrophy/Hypertrophy
- Hypotonicity (flaccidity)/Spasticity
- Paresis/paralysis
Describe the following component:
Endurance
(Normal Findings, Abnormal Findings)
Normal Findings:
- Ability to turn in bed and maintain correct alignment when sitting/standing/ambulating/performing self care activities
Abnormal Findings:
Inability to tolerate increase in activity:
- Increase HR, RR, BP after rest
- Dyspnea
- Pallor
- Vertigo
________ is the normal method of walking
Heel-to-Gait
As a nurse, how do you prevent back stress?
- Use correct alignment; hold in stomach muscles, keeping shoulders back/relaxed/neutral, flex knees
- Avoid using back muscles; instead use long/strong muscles of arm/legs
- Stabilize pelvis by using internal girdle (contract glutes) and long midriff
- Work closely to object being lifted
- Avoid twisting
- Push > pull
As a nurse, how do you ensure safe pt handling and mobility?
- Remove obstacles
- Use appropriate SPHM equipment
- Administer prescribed meds (pain) in advance of transfer
- Use friction reducing devices
- Move pt in smooth, rhythmic motion
- Avoid grabbing extremity by its muscle
Describe the following Safe Patient Handling and Mobility (SPHM) Equipment:
Gait Belts
(Purpose, Patient Suitability, Key Considerations)
Purpose:
- Used to steady pt when transferring/assisting ambulation/pivoting; not used to lift
Patient Suitability:
- Pt with leg strength; cooperative and require minimal assistance
Examples:
- X
Key Considerations:
DO NOT US ON:
- pt with abdominal or thoracic incisions/chest trauma
- Behavioral Aggression
- Suicide Risk
Describe the following Safe Patient Handling and Mobility (SPHM) Equipment:
Standing Assist and Repositioning Aids
(Purpose, Patient Suitability)
Purpose:
- Used to help pt stand up
Patient Suitability:
- Pt needing minimal assistance to stand; can grasp and lift themselves
Examples:
- X
Key Considerations:
- X
Describe the following Safe Patient Handling and Mobility (SPHM) Equipment:
Lateral-Assist Devices
(Purpose, Patient Suitability, Examples)
Purpose:
- Reduced pt-surface friction during side-to-side transfers
Patient Suitability:
- Pt requiring lateral transfers who cannot assist or are unable to move
Examples:
- Roller/slide/transfer boards
- Inflatable mattresses
Key Considerations:
- X
Describe the following Safe Patient Handling and Mobility (SPHM) Equipment:
Friction Reducing Sheets
(Purpose, Key Considerations)
Purpose:
- Pvt skin shearing when moving pt in bed and assisting with lateral transfers
Patient Suitability:
- X
Examples:
- X
Key Considerations:
- May require excessive force and overexertion
Describe the following Safe Patient Handling and Mobility (SPHM) Equipment:
Transfer Chairs
(Purpose, Patient Suitability)
Purpose:
- Help lift/move pt
Patient Suitability:
- Pt with no weight-bearing capacity
- Pt who cannot follow directions/ cooperate
Examples:
- X
Key Considerations:
- X
Describe the following Safe Patient Handling and Mobility (SPHM) Equipment:
Powered Stand-Assist and Repositioning Lifts
(Purpose, Patient Suitability, Key Considerations)
Purpose:
- Help lift/move pt
Patient Suitability:
- Pt with some weight-bearing ability
- Pt who can follow directions/ cooperative
Examples:
- X
Key Considerations:
- Limit time spent in slings to reduce pressure injuries
Describe the following Safe Patient Handling and Mobility (SPHM) Equipment:
Powered Full-Body Lifts
(Purpose, Patient Suitability, Key Considerations)
Purpose:
- Help lift/move pt
Patient Suitability:
- Patients who cannot bear any weight (and need to be moved out of bed, into a chair, or to a commode/stretcher)
Examples:
- X
Key Considerations:
- Limit time spent in slings to reduce pressure injuries
Describe the following Safe Patient Handling and Mobility (SPHM) Equipment:
Gait Belts
(Purpose, Patient Suitability, Examples, Key Considerations)
Purpose:
- X
Patient Suitability:
- X
Examples:
- X
Key Considerations:
- X
Describe the purpose of the following Device/Method used for Positioning pt in Bed:
Trapeze Bar
Purpose:
- Helps with moving and turning
- Helps pt perform exercises that strengthen muscles of upper extremities
Describe the purpose of the following Device/Method used for Positioning pt in Bed:
Trochanter Rolls
Purpose:
- Supports hips/legs to prevent external rotation of hips
Describe the purpose of the following Device/Method used for Positioning pt in Bed:
Hand Wrist/Roll
Purpose:
- Keeps thumb in correct position
Describe the purpose of the following Device/Method used for Positioning pt in Bed:
Foot board/spints/high top sneakers
Purpose:
- Helps avoid foot drop
Describe the following pt position:
Fowler’s Position
(Descriptions, Purspose, Potential Complications)
Descriptions:
- 45 to 60 Degrees
Purpose:
- Promotes cardiac and respiratory function
- Used for eating, conversation, and urinary/intestinal elimination
Potential Complications:
- Buttocks, sacrum, scapulae risk for skin breakdown
- Flexion contracture of the neck
- Exaggerated curvature of the spine
- Impaired lower extremity circulation
Describe the following pt position:
High-Fowler’s Position
(Descriptions, Purspose, Potential Complications)
Descriptions:
- 90 Degrees
Purpose:
- Allows for maximal lung expansion
Potential Complications:
- Flexion contracture of the neck
- Exaggerated curvature of the spine]
- Impaired lower extremity circulation
Describe the following pt position:
Low-Fowler’s/Semi-Fowler’s Position
(Descriptions, Potential Complications)
Descriptions:
- 30 Degrees
Purpose:
- X
Potential Complications:
- Risk for increased shearing force over the sacral area
Describe the following pt position:
Supine (Dorsal Recumbent) Position
(Descriptions, Potential Complications)
Descriptions:
- Pt lies flat on the back with head and shoulders slightly elevated with a pillow (unless contraindicated)
Purpose:
- X
Potential Complications:
- Do not use on spinal anesthesia/surgery on spinal vertebrae
Describe the following pt position:
Side-Lying (Lateral) Position
(Descriptions, Purspose, Potential Complications)
Descriptions:
- Patient lies on their side, weight is borne by the lateral aspect of the lower scapula and lower ilium
Purpose:
- Relieves pressure on scapulae, sacrum, heels
- Allows legs to be comfortably flexed
Potential Complications:
- Twists spine
- Interferes with respiration
Describe the following pt position:
Oblique Position
(Descriptions, Purspose)
Descriptions:
- Variation of side-lying where patient is turned toward side with hip of top leg flexed at a 30-degree angle;
- knee flexed at 35 degrees.
- Calf of the top leg is positioned slightly behind the body’s midline.
Purpose:
- Places less pressure on the trochanter and sacrococcygeal areas
Potential Complications:
- X
Describe the following pt position:
Sims’ Position
(Descriptions, Purspose, Potential Complications)
Descriptions:
- Pt lies on their side, lower arm is behind pt, and upper arm is flexed at shoulder and elbow
Purpose:
- Weight is borne by the anterior aspects of the humerus, clavicle, and ilium
Potential Complications:
- Lateral flexion of the neck
- Twists spine
- Footdrop
Describe the following pt position:
Prone Position
(Descriptions, Purspose, Potential Complications)
Descriptions:
- Pt lies on abdomen with head turned to the side
Purpose:
- Helps pvt flexion contractures of hips and knees
Potential Complications:
- Contraindicated for people with spinal problems
Describe the following equipment used to increase circulation:
Graduated Compression Socks
(PT Suitability, Purspose, Special Complications)
PT Suitability:
Use on pt at risk for:
- Venous thromboembolism
- Pulmonary embolism
- Helps pvt thrombophlebitis
Purpose:
- Applies pressure, increasing venous return to the heart
Special Complications:
- Perscribed intervention
Describe the following equipment used to increase circulation:
Pneumatic Compression Devices (PCD/SCD)
(PT Suitability, Purpose, Special Complications)
PT Suitability:
Use on pt who are/have:
- High-risk surgical pt
- Pt with decreased mobility
- Pt chronic venous disease
- Pt at risk for deep vein disorders
Purpose:
- Apply intermittent pressure to legs to stimulate venous return
Special Complications:
- Perscribed intervention
- Should be kept on at all times, except when walking
When turning a pt, the bed should….
be at the height of caregivers elbows
When transferring a pt, always…
transfer to pt stronger side
What do you do when assisting a pt with their ROM?
- Move each joint until their is resistance, but not pain
- Report uncomfortable reactions and stop exercises until further instructions are obtained
- Use ROM 2x/day
- RR and HR will increase, but resting rates should return back to normal levels within 3 minutes
Describe the following device:
Walker
(Purpose, How to Use)
Purpose:
- Enhances stability during ambulation
- DO NOT apply full body weight
Types:
- X
How to Use:
- Wear non skid shoes/slippers
- Top of walker should line up with crease on the inside of the pt wrist
- Elbows slightly flexed (15°)
- Push walker forward, then place weaker leg into the walker
- Push straight down on grips of walker and step forward with remaining foot
Describe the following device:
Canes
(Purpose, Types, How to Use)
Purpose:
- Enhances stability during ambulation
DO NOT apply full body weight
Types:
Single-ended canes
- Half-circle handle: Pt needing minimal support and use stairs frequently
- Straight handle: Pt with hand weakness
Canes with tripod/quad cane
- PT with poor balance
How to Use:
- Pt stands with canes tip 4 inches from side of food
- Cane extends from the floor to crease in pt wrist
- Elbow stays slightly bent (15°)
- Hold cane in hand opposite to side that needs support
- Advance with weaker foot forward, then bring stronger leg forward
Describe the following device:
Braces
(Purpose)
Purpose:
- Support weakened leg muscles
Types:
- X
How to Use:
- X
Describe the following device:
Crutches
(Purpose, Types, How to Use)
Purpose:
- Assists Ambulation
Types:
- Axillary crutches
-> Require significant upper body/arm strength to use - Forearm crutches
-> Have supportive frames
How to Use:
- Do not place in axilla; 1-2 inches below axilla
- Place weight in hands; not underarm
- Typically advance stronger leg first
- Pvt crutches from getting closer than 12 inches
