Bed Rest Flashcards
What Systems are Affected by Bed Rest?
- Respiratory
- Psychological
- Bladder and Bowel System
- Musculoskeletal
- Cardiovascular
- Integumentary
What Cardiovascular Changes are Caused by Bed Rest?
Bed rest induces an elevated maximal heart rate which, in turn, is associated with decreased cardiac vessel tone, increased sympathetic catecholamine secretion, and greater cardiac beta-receptor sensitivity.
What Effects Does Immobilization have on the Cardiovascular System?
Immobilization leads to structural changes in the cardiovascular system; reduced venous return, increased heart rate and increased overall workload. Which will affect the functionality of the heart.
How is Risk of Clotting Increased During Bed Rest?
The decreased venous return will cause an accumulation of fluids. The increase of blood volume will increase the pressure within the vessels, the increased pressure will activate the coagulation cascade and platelets will begin to adhere to the site. The increase in platelets will thicken the viscosity of the blood and further cause a blockage/clot. This increases the risk of developing thrombosis, embolism, DVT, pulmonary embolisms.
Define Venous Stasis.
Decreased pumping action and the limited redistribution of blood will cause a pooling of blood. The pooling is caused by the increased workload put onto the heart paired with the decreased cardiac output, this leads to blood stasis as the blood is stagnant and has difficulty getting pumped through the body.
Integumentary Changes due to Bed Rest.
Pressure Ulcers!
Define Pressure Ulcers.
Breakdown of skin integrity due to unrelieved pressure.
What Causes Pressure Sores?
It is the breakdown of skin integrity due to unrelieved pressure. This can be from a bony area on the body that comes into contact with a hard surface or a medical device causing unrelieved pressure. In addition, pressure injuries can develop due to friction and shear.
What are the most common sites on the body for pressure injuries?
- Heels and Ankles
- Hips
- Sacrum
- Coccyx
- Elbow
- Shoulder
- Inside of the knee
- Occipital (back of the head) and Ears
Stages of Pressure Ulcers.
Stage 1: Skin is completely intact! However, the area is red and looks irritated
Stage 2: Skin is visibly damaged with PARTIAL loss of the dermis. No subq (fatty tissue) will be visible. The wound may be opened with a superficial red/pink opened ulcer or may have the formation of an opened or closed blister.
Stage 3: Skin is visibly damaged with FULL loss of the skin tissue. May see the subq (fatty tissue). Wound edges may be “rolled” away. Bone, tendon and muscle NOT visible.
Stage 4: Skin is visibly damaged with FULL loss of the skin tissue that will expose bone, muscle, tendon, and ligaments.
What Occurs During the First 24 Hours of Bed Rest?
- Cardiovascular changes
- Loss of Fluids (diuresis): The fluid shift causes an increase in sodium excretion by the kidneys and, as water tends to follow sodium, this leads to sodium diuresis that contributes to the reduction in plasma volume
What Occurs During the First 3 Days of Bed Rest?
- Cardiovascular decompensation
- Coagulopathy: Coagulopathy is a condition where the blood’s ability to coagulate (form clots) is affected. It may be caused by reduced levels or the absence of blood-clotting proteins. A defect in blood-clotting results in abnormal bleeding and thrombus formation. Coagulopathy results in prolonged prothrombin time and a decrease in the number of circulating platelets.
- Apparent body mass loss due to catabolism of muscles and fat
- Integumentary changes: Unrelieved pressure will lead to skin breakdown
What Occurs During the First 8 Days of Bed Rest?
Hematology alterations (low blood cell synthesis, low fibrin synthesis !)
What Occurs During More Than 15 Days of Bed Rest?
- Serious bone loss
- Serious muscle mass losses
- Psychological complications
- Pain
- Mood Changes
- Anxiety
- ICU psychosis
- Hormonal Changes
What kind of Metabolic Changes Occur During Bed Rest?
The hypoperfusion due to lack of mobility results in changes to cellular function and altered basal metabolic rate. The altered metabolism leads to
catabolism (Catabolism is the set of metabolic pathways that breaks down molecules into smaller units that are either oxidized to release energy or used in other anabolic reactions.)
