ATI Chapter 40: Mobility and Immobility Flashcards
what is mobility?
-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
what immobility?
-inability to move freely and independently at will
-Periods of immobility or prolonged bed rest can cause major physiological and psychosocial effects
what is cutaneous stimulation in the form of cold and heat helps?
-applications helps to relieve pain and promotes healing. -Promoting venous return is another key component of reducing the complications of immobility
immobility can be the following:
-Temporary (following knee arthroplasty)
-Permanent (paraplegia)
-Sudden onset (a fractured arm and leg following a motor-vehicle crash)
-Slow onset (multiple sclerosis)
what is body mechanics?
involve coordination between the musculoskeletal and nervous systems and the use of alignment, balance, gravity, and friction
what is ROM
range of motion (ROM)
factors affecting mobility
Alterations in muscles
Injury to the musculoskeletal system
Poor posture
Impaired central nervous system
Health status and age
what is ischemia
a condition in which blood flow (and thus oxygen) is restricted or reduced in a part of the body
immobility on integumentary
-Increased pressure on skin, which is aggravated by metabolic changes
-Decreased circulation to tissue, causing ischemia, which can lead to pressure injury
respiratory on immobility
-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
immobility on cardiovascular
-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
immobility on metabolic
-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
immobility on GU and GI systems
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
immobility on musculoskeletal
-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
immobility on neurologic/psychosocial
-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
immobility on infants, toddlers and preschoolers
-Slower progression in gross motor skills and intellectual and musculoskeletal development
-Body aligned with line of gravity, resulting in unbalanced posture
immobility on adolescents
-Imbalanced growth spurt possibly altered with immobility
-Delayed development of independence
-Social isolation
immobility on adults
-Alterations in every physiological system
-Alterations in family and social systems
-Alterations in job identity and self-esteem
immobility on older adults
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
types of gait
-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.
therapeutic effects: heat vs cold
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.
Elastic (antiembolic) stockings cause?
external pressure on the muscles of the lower extremities to promote blood return to the heart.
SCDs and IPC
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.
Specific ROM exercises that help prevent thrombophlebitis include
ankle pumps, foot circles, and knee flexion.
