ATI Chapter 40: Mobility and Immobility Flashcards

1
Q

what is mobility?

A

-is freedom and independence in purposeful movement
-refers to adapting to and having self-awareness of the environment
-Functional musculoskeletal and nervous systems are essential for mobility

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2
Q

what immobility?

A

-inability to move freely and independently at will
-Periods of immobility or prolonged bed rest can cause major physiological and psychosocial effects

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3
Q

what is cutaneous stimulation in the form of cold and heat helps?

A

-applications helps to relieve pain and promotes healing. -Promoting venous return is another key component of reducing the complications of immobility

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4
Q

immobility can be the following:

A

-Temporary (following knee arthroplasty)
-Permanent (paraplegia)
-Sudden onset (a fractured arm and leg following a motor-vehicle crash)
-Slow onset (multiple sclerosis)

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5
Q

what is body mechanics?

A

involve coordination between the musculoskeletal and nervous systems and the use of alignment, balance, gravity, and friction

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6
Q

what is ROM

A

range of motion (ROM)

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7
Q

factors affecting mobility

A

Alterations in muscles
Injury to the musculoskeletal system
Poor posture
Impaired central nervous system
Health status and age

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8
Q

what is ischemia

A

a condition in which blood flow (and thus oxygen) is restricted or reduced in a part of the body

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9
Q

immobility on integumentary

A

-Increased pressure on skin, which is aggravated by metabolic changes
-Decreased circulation to tissue, causing ischemia, which can lead to pressure injury

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10
Q

respiratory on immobility

A

-Decreased respiratory movement resulting in decreased oxygenation and carbon dioxide exchange
-Stasis of secretions and decreased and weakened respiratory muscles, resulting in atelectasis and hypostatic pneumonia
-Decreased cough response

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11
Q

immobility on cardiovascular

A

-Orthostatic hypotension
-Less fluid volume in the circulatory system
-Stasis of blood in the legs
-Diminished autonomic response
-Decreased cardiac output, leading to poor cardiac effectiveness, which results in increased cardiac workload
-Increased oxygenation requirement
-Increased risk of thrombus development

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12
Q

immobility on metabolic

A

-Altered endocrine system
-Decreased basal metabolic rate
-Changes in protein, carbohydrate, and fat metabolism
-Decreased appetite with altered nutritional intake
-Negative nitrogen balance
-Decreased protein resulting in loss of muscle
-Loss of weight
-Alterations in calcium, fluid, and electrolytes
-Resorption of calcium from bones
-Decreased urinary elimination of calcium, resulting in hypercalcemia

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13
Q

immobility on GU and GI systems

A

Genitourinary:
-Urinary stasis
-Change in calcium metabolism with hypercalcemia, resulting in renal calculi
-Decreased fluid intake and increased use of indwelling urinary catheters, resulting in urinary tract infections

Gastrointestinal:
-Decreased peristalsis
-Decreased fluid intake
-Constipation, increasing the risk for fecal impaction

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14
Q

immobility on musculoskeletal

A

-Decreased muscle endurance, strength, and mass
-Impaired balance
-Atrophy of muscles
-Decreased stability
-Altered calcium metabolism
-Osteoporosis
-Pathological fractures
-Contractures
-Foot drop
-Altered joint mobility

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15
Q

immobility on neurologic/psychosocial

A

-Altered sensory perception
-Ineffective coping
-Changes in Emotional Status: Depression, alteration in self-concept, and anxiety

-Behavioral Changes: Withdrawal, altered sleep/wake pattern, hostility, inappropriate laughter, and passivity

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16
Q

immobility on infants, toddlers and preschoolers

A

-Slower progression in gross motor skills and intellectual and musculoskeletal development
-Body aligned with line of gravity, resulting in unbalanced posture

17
Q

immobility on adolescents

A

-Imbalanced growth spurt possibly altered with immobility
-Delayed development of independence
-Social isolation

18
Q

immobility on adults

A

-Alterations in every physiological system
-Alterations in family and social systems
-Alterations in job identity and self-esteem

19
Q

immobility on older adults

A

Alterations in balance resulting in a major risk for falls and injuries
Steady loss of bone mass resulting in weakened bones
Decreased coordination
Slower walk with smaller steps
Alterations in functional status
Increased dependence on staff and family, which can become long-term

20
Q

types of gait

A

-Four-point gait requires the client to bear weight on both legs. The client alternates each leg with the opposite crutch so three points of support are on the floor at all times.
-Three-point gait requires the client to bear all weight on one foot while using both crutches. The affected leg should never bear weight or touch the ground.
-Two-point gait requires the client to have partial weight bearing on both feet. The client moves a crutch while moving the opposite leg at the same time. This is to mirror the movements of normal arm and leg motion during walking.

21
Q

therapeutic effects: heat vs cold

A

Heat:
Increases blood flow.
Increases tissue metabolism.
Relaxes muscles.
Eases joint stiffness and pain.

Cold:
Decreases inflammation.
Prevents swelling.
Reduces bleeding.
Reduces fever.
Diminishes muscle spasms.
Decreases pain by decreasing the velocity of nerve conduction.

22
Q

Elastic (antiembolic) stockings cause?

A

external pressure on the muscles of the lower extremities to promote blood return to the heart.

23
Q

SCDs and IPC

A

have plastic or fabric sleeves that wrap around the leg and secure with hook-and-loop closures. The sleeves are then attached to an electric pump that alternately inflates and deflates the sleeve around the leg. These machines are set to cycle, typically a 10- to 15-second inflation and a 45- to 60-second deflation.

24
Q

Specific ROM exercises that help prevent thrombophlebitis include

A

ankle pumps, foot circles, and knee flexion.

25
Q

pulmonary embolism

A

a potentially life-threatening occlusion of blood flow to one or more of the pulmonary arteries by a clot. The clot or embolus often originates in the venous system of the lower extremities.
-Prepare to give thrombolytics or anticoagulants