Activity/Mobility (REVISED) Flashcards
What are the 4 shapes of bones? Include examples of each
Long bones: humerus, femur
Short bones: wrist, ankle
Flat bones: ribs, skull bones
Irregular bones: spinal column, jaw, sacrum
Perform (or know) the types of ROM exercises:
- Abduction
- Adduction
- Circumduction
- Dorsiflexion
- Eversion
- Extention
- External rotation
- Flexion
- Hyperextension
- Internal rotation
- Inversion
- Opposition
- Plantar Flexion
- Pronation
- Rotation
- Supination
- Abduction Lateral movement of a body part away from the midline of the body. For example, a person’s arm is abducted when it is moved away from the body.
- Adduction Lateral movement of a body part toward the midline of the body. For example, a person’s arm is adducted when it is moved from an outstretched position to a position alongside the body.
- Circumduction Turning in a circular motion, which combines abduction, adduction, extension, and flexion. For example, circling the arm at the shoulder, as in bowling or a serve in tennis.
- Dorsiflexion Backward bending of the hand or foot. For example, a person’s foot is in dorsiflexion when the toes are brought up as though to point them at the knee.
- Eversion Movement of the sole of the foot outward (occurs at the ankle)
- Extension The state of being in a straight line. For example, a person’s cervical spine is extended when the head is held straight on the spinal column.
- External rotation A body part turning on its axis away from the midline of the body. For example, a leg is rotated externally when it turns outward at the hip and the toes point away from the midline of the body.
- Flexion The state of being bent. For example, a person’s cervical spine is flexed when the head is bent forward, chin to chest.
- Hyperextension The state of exaggerated extension, often resulting in an angle greater than 180 degrees. For example, a person’s cervical spine is hyperextended when looking overhead, toward the ceiling.
- Internal rotation A body part turning on its axis toward the midline of the body. For example, a leg is rotated internally when it turns inward at the hip and the toes point toward the midline of the body.
- Inversion Movement of the sole of the foot inward (occurs at the ankle)
- Opposition Rotation of the thumb around its long axis (movement of the thumb across the palm to touch each fingertip of the same hand).
- Plantar flexion Flexion of the foot. For example, a person’s foot is in plantar flexion in the footdrop position.
- Pronation The assumption of the prone position. For example, a person is in the prone position when lying on the abdomen; a person’s palm is prone when the forearm is turned so that the palm faces downward.
- Rotation Turning on an axis or the turning of a body part on the axis provided by its joint. For example, a thumb is rotated when it is moved to make a circle.
- Supination The assumption of the supine position. For example, a person is in the supine position when lying on the back; a person’s palm is supine when the forearm is turned so that the palm faces upward.
Rickets is caused by a deficiency of _______
Vitamin D
What are the three types of exercise? Briefly describe each
-
Isotonic: muscle extention and shortening
-> walking, swimming, bicycling -
Isometric: isolation of contraction of muscke
-> plank, contraction of glutes/quads when holding yoga pose -
Isokinetic: muscle contraction with resistance
-> lifting weights, lifting leg and holding it in place
Describe Active vs Passive Exercise
Active Exercise
- pt independently moves joint through full ROM
Passive Exercise
- pt unable to move independently, so the nurse moves the joint through it s ROM
_______ exercise is the ONLY type to increase muscle mass, tone, strenght, and improve cardiac and respiratory function
Active exercise
What are 5 factors that affect movement and alignment
- Growth and Development (deformities)
- Physical Helath (illness/trauma)
- Nutrition (rickets)
- Diseases (gout, muscular dystophy)
- Age released (osteoporosis, decrease mvt)
For these body systems, identify the effects of exercise and the effects of immobility
- Cardiovascular
- Respiratory
- Gastrointestinal
- Urinary
- Muskuloskeletal
- Metabolic
- Integumentary
- Psychological Well Being
Check master notes lol
What is Venous Thrombosis
- AKA: deep vein thrombosis (DVT)
- blood clot that forms in a vein
How does an increased cardiac workload affect a person?
It forces the heart to work harder than normal, making the heart become less efficient overtime. This can possibly cause heart failure if the increased demand is sustained overtime
What is anklylosis
joint becomes permanelty fixed (fuses to bone that form joint)
Why are UTI common in those with immobility
Urine will remain in the ureters/bladder, leading to an accumulation of alkaline urine, which facilitates an environement for increased bacterial growth -> UTI
What is decubitus
injury due to pressure/bed sore
What are the 4 different stages that identify the type of skin breakdown
Stage 1: unbroken skin
Stage 2: broken skin/dermis
Stage 3: subcutaneous involvement
Stage 4: muscle/bone involvement
What are the stages of Maslows Hierachy of Need (go in order from bottom of pyramid to top)
- Physiological (air, water, food, shelter)
- Safety (employment, health)
- Love and belonging (family, sense of connection)
- Esteem (respect, status, freedom)
- Self actualization (desire to become the most that one can be)
Name 3 types of medical “devices” that can be used to promote circulation and prevent thrombosis
- SCDs (inflate)
- TEDs (compression socks)
- A-V Impulse Boots (inflate)
DO NOT massage _____ or hold limb at _______ of muscle
calves
belly
Why is elevating legs on pillows important?
- elevate to get heels off mattress (reduce pressure point injury)
- elevate lower extremities toward heart (promote venous return)
How often should the skin be assessed?
How often should a pt be turned?
If the pt is independent, how often should they move>
- assess skin every 2 hours
- every 2 hours
- move every 15 minutes (if pt is independent)
How often should a nurse assess a patients respiratory status?
every 2 hours
True or False: A patient who is on bed rest and is at risk for thrombosis can be placed on SCDs and antiembolic stockings by the nurse
FALSE, these require a prescription, meaning by doctor order only. The nurse is allowed to put them on, but is unable to put them on the pt without an order.
Describe ways to prevent back stress for nurses
- 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
Name ways that you can ensure safe patient 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
In order to help prevent complications associated with the respiratory system, the patient shoudl TCDB (turn, cough, deep breathe) every ________ while awake
1-2 hours
A nurse is helping a patient through their ROM, but the patient suddenly says “Ouch!” What should the nurse do next? Why?
The nurse should immediatley stop because the nurse move each joint only until their is resistnace, but no pain. She should later report the patients reaction, evaluate the plan of care, and stop further exercises until further notice.
What are 2 ways to prevent foot drop?
- Use footboard/foot boots/splints
- Wear high-top sneakers
A patient is on bed rest and is at risk for complications to their metabolism due to inactivity. The nurse should assess their _______ and _______ every ____________, their intake/output every _______ - ________. They should also count _____ and perform laboratory tests.
- height and weight every week
- intake/output every 8-12 hours
- calories
Nurses should encourage active or provide passive ROM how many times per day?
2-3x/day
True/False: A nurse can get stool softerners for an immobile patient who states that they have not pooped in 4 days.
False, the nurse is unable to give the patient stool softners without a doctor order. The nurse is able to ask the MD for an order, if needed.
In order to maintain hydration, a patient should consume at least _________ mL/day
2,000 (2-3L)
What areas are highly as risk for skin breakdown? (hint: bony prominences)
- heels
- sacrum
- scapulae
- elbows
- buttocks
T/F: A gait belt should be used with patients with no leg strength to lift onto other transfer devices, such as wheelchairs
False, gait belts should be used on patients WITH leg strength to STEADY patients when assisting with AMBULATION; NOT USED TO LIFT
What type of patients should gait belts never be used on?
- Pt with abdominal/thoracic incisions or chest trauma
- Behavioral aggression
- Suicide risk
What is the purpose of a Trapeze bar?
- Helps with moving and turning
- Helps pt perform exercises that strengthen muscles of upper extremities
What is the purpose of a Trochanter roll?
- Supports hips/legs to prevent external rotation of hips
What is the purpose of a Hand Wrist/Roll
- Keeps thumb in correct position
What is the purpose of a Footboard/splint/hightop sneakers
- pvt foot drop
Fowlers Position
(Description and Purpose)
Description
- 45 - 60 degrees
Purpose
- Promotes cardiac and respiratory function
- Used for eating, conversation, and urinary/intestinal elimination
High Fowlers Position
(Description and Purpose)
Description
- 90 degrees
Purpose
- Maximal lung expansion
Low Fowlers/Semi Fowlers Position
(Description, Purpose, and Avoid)
Description
- 30 degrees
Purpose
- Promote cardiac/respiratory function
Avoid
- if pt risk skin integrity (bc it increases force on sacral area)
Supine (Dorsal Recumbent) Position
(Description, Purpose)
Description
- Pt lies flat on the back with head and shoulders slightly elevated with a pillow (unless contraindicated)
Purpose
- Promote optimal muskuloskeletal balance
Side-Lying (Lateral) Position
(Description and Purpose)
Description
- 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
- Used when pt cannot comfortably be in supine position
Orthopneic Position
(Description and Purpose)
Description
- Pt sits and leans forward
Purpose
- Helps to relieve dyspnea
Sims Position
(Description and Purpose)
Description
- Pt lies on their side, lower arm is behind pt, and upper arm is flexed at shoulder and elbow
Purpose
- Drains oral secretions
- Relieves pressure on sacrum
- Pressure redistribution to anterior aspects of humerus, clavicle, ilium
Prone Position
(Description and Purpose)
Description
- Pt lies on abdomen with head turned to the side
Purpose
- Pvt flexion contractures of hips and knees
How to use a cane
- Keep cane on the strongest side of the body
- Move the cane forward 6-10 inches (15-25cm)
- Move the weaker leg toward the cane
- Advance the stronger leg past the cane
- Ambulate looking FOWARD (not down)
ALWAYS MAINTAIN TWO POINTS OF SUPPORT ON THE GROUND AT ALL TIMES
How to use a crutch
- Support body weight at the hand grips with elbows flexed 20-30 degrees
- Tripod position: Place crutch 6 inches (15cm) in front and 6 inches (15cm) to the side of each foot
- Stand with straight back/hips/neck and DO NOT PLACE ANY WEIGHT ON THE AXILLAE (monitor for skin breakdown)
- Alternate weight from one leg to crutches
Know the types of gaits
idk youtube
(Four point gait, three point gait, two point gait)
https://www.youtube.com/watch?v=ElZkPye4WtA
How to use a Walker
- Ensure walker heigh is at the inside of the clients wrist while standing straight
- Elbows flexed 30 degress
- Stand behind client with walker on one side
- Client move walker forward (6-8 inches) then set the walker down on the floor with all four feet
- Client should wear nonskid shoes
Practice terms on master notes
A patient who is experiencing a pulmonary embolism should be placed in a ________ position
high fowlers
Remove SCDs/Antiembolic stockings every ________ hours
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