Body Mechanics Flashcards
body mechanics definition
posture = alignment, promotes comfort, contributes to balance and control
balance can be affected by many things
pregnancy, neuro issues
what makes movement possible
bones along with muscle and cartilage
nervous system innervates
skeletal muscle - posture and movement
smooth muscle - digestive tract, bladder and blood vessels
cardiac muscle - contracts spontaneously
skeletal muscle movement is
spontaneous or involuntary (react to hot burner)
voluntary or intentional (pick up pen)
3 types of range of motion in joints
flexion, extension and hyperextension
abduction
away from body, like abduct a child is take it away
adduct
back towards the middle or body
rotation
twist, ex: turn the head
circumduction
putting your arm in circles
healthcare industry has the
worst rates of overexertion injuries among all US industries
how many overexertion injuries for every 10,000 full-time hospital workers
75 overexertion injuries
how many overexertion injuries for every 10,000 workers at a nursing or residential facility
107 overexertion injuries
hospital rates are nearly _____ the national average for all industries, and nursing homes are nearly ____ times as high
twice, three
nurses have the highest levels of _______ over other occupations
overexertion and bodily reaction injuries
what is the leading and most costly occupational health problem?
work-related musculoskeletal disorders
types of soft tissue damage
muscles
tendons
ligaments
joints
blood vessels
nerves
spinal discs
combination of risk factors - increase chances of issues
duration
frequency
intensity
ANA position
supports guidelines that eliminate all manual movement (want you to have a device that does it for you)
true or false: training nurses to use proper body mechanics alone will avoid injuries
false - person has to use those proper body mechanics as well
true or false: while lifting devices minimize risk, the risk of MSDs cannot be eliminated altogether.
true
true or false: studies have shown that patients feel more comfortable and secure when a mechanical transfer device is used.
true
true or false: it can actually take much longer to round up a team of colleagues to manually lift a patient than to find and use lifting equipment.
true
injuries - patient risk factors
weak/unable to help with transfers
unpredictable
vision or hearing loss
uncooperative
overweight
experiencing pain
poor communication
injuries - nurse risk factors
previous injuries
not trained properly
not compliant with policies and procedures
poor physical health
sleep deprivation
injuries - task-related risk factors
reaching and lifting with loads far from the body
lifting heavy loads
twisting while lifting
unexpected changes in load demand during lift
reaching
long duration
actions that will cause injuries
moving or carrying a load significant distance
awkward posture
pushing/pulling incorrectly
completing activity with bed or chair at wrong height
frequent/repeated lifting and moving
5 aspects that are the foundation of body mechanics
face the direction of movement
body alignment
center of gravity
balance
base of support
keep your center of gravity over a ____ base of support
wide
body mechanics principles
arrange for adequate help
flex knees, keep feet wide apart
keep back, neck, pelvis, feet aligned, avoid twisting
tighten stomach muscles and pull butt in
keep object close to self
use arms and legs, not back
use coordinated movements
activity orders
a doctor’s order that defines the type and amount of activity a hospitalized patient may have
check the _____ _____ before getting a patient up
activity orders
BR or CBR
bed rest / complete bed rest
BR with BRP
bed rest with bathroom privileges
up ad lib
as patient wants to/desires
up as tolerated
as patient is able to tolerate
dangle
patient may sit and dangle their feet over the edge of the bed
up in chair with assist
patient may transfer from bed to chair with help
NWB
non-weight bearing
TDWB
touch-down weight bearing
TTWB
toe-touch weight bearing
WBAT
weight bearing as tolerated
FWB
full weight bearing
fall bundle - standard precautions
2 patient identifers (name and date of birth)
bed locked in lowest position (for everyone, no exceptions)
call light within reach
room free of clutter
belongings within reach
bed locked in lowest position
non-skid socks
fall bundle - moderate precautions
fall magnet
yellow socks
yellow gown
fall bundle - high precautions
door opened
bed alarm/chair alarm
fall bundle
do not leave patients unattended in shower and do utilize shower shoes
utilize gait belts for ambulation and other assistive devices as appropriate
high Fowler’s
head of bed (HOB) 90 degrees - sitting up
Fowler’s
head of bed (HOB) raised to angle of 45 degrees or more
semi-Fowler’s
head of bed (HOB) raised to 30 degrees
Trendelenburg
entire bed tilted with head of bed down
ex: for vertigo, low blood pressure, to avoid air embolism when taking out a central catheter
contraindicated for high blood pressure because it would just add pressure to their heart
reverse Trendelenburg
entire bed tilted with foot of bed down
flat bed position
entire bed is horizontal to the floor
supine
laying flat on back
prone
laying flat on stomach
lateral
laying on side
lateral recumbent
laying on side with one leg higher than other
ex: to give suppository to patient
orthopneic
sitting up hunched over pillows in front of them
ex: if having trouble breathing
lithotomy
laying on back with knees up
ex: for gynecological exam
how to manual lift
assess the weight of the patient
get help
bend at the knees
use large muscles of legs instead of back to lift
use manual lifting as a ____ _____
last resort
consider these when moving patients
how capable is the patient?
assistive devices needed?
explain the transfer process
does equipment function properly?
bed in locked position
where does the gait belt go?
around the waist, below the belly button
stand on ____ side if injury related issue, on ____ side if neuro issue
strong side, weak side
does the thumb go up or down when holding the gait belt while the patient is walking?
thumbs up - because 4 fingers is stronger than thumb to have on the bottom
if the patient starts falling, you should
have a wide solid base, plant foot good extended and let them slide down, bend knees as they go down
using a slideboard
all side rails lowered, bed in highest position indicated best for everyone’s body mechanics, brakes are locked, make sure everyone is ready (coordinate with nurses so everyone knows what they’re doing), patient arms crossed on abdomen
use trapeze bar
alert patients can use to move up on the bed if ex: they have weakness in one leg
use hoyer lift
for patients with non-bearing status, not able to cooperate (really out of it)
2 people helping the patient
moving patients principles
use patient-handling equipment and devices
arrange for adequate help
raise bed to comfortable working height!!
encourage patient to help as much as possible - cross arms and bend at the knee if possible
use body mechanic principles
coordinate the lift by counting to 3
use manual lift as last resort
ambulation
the ability to walk
gait
the manner of walking
normal gait places body weight fully on each leg in turn
head erect, spine is aligned, hip and knees have appropriate flexion and arms swing freely in alternation with legs
assisting with ambulation
evaluate the environment for safety
assisting with ambulation
evaluate the environment for safety
obtain baseline blood pressure
dangle patient if indicated
support the patient at their waist
return patient to chair/bed if c/o dizziness or experiences syncope episode
support patient with hemiplegia or hemiparesis
when in doubt, get help!!
assistive devices
canes - single straight-legged, quad cane
crutches - axilla, forearm
walker - standard, two-wheel, rollator
proper cane and height position
bend of elbow is 15 degrees
sizing crutches
2-3 finger width space between axilla and top of crutch
prevents injury to brachial plexus nerves
wrists should line up with grab bars when arms are relaxed
when grasping handgrips, elbow flexion should be 15-30 degrees
