Ch 45. Mobility

Question 1

Lack of physical activity cons

Answer 1

Muscular deconditioning (muscle atrophy)
Muscle strength drop 3% per day
Disease atrophy
Deconditioning. ●A process of physiological change.following a period of inactivity or bedrest.that results in a decrease in muscle.mass, weakness, functional decline

Question 2

Systemic effects of immobility: Metabolic

Answer 2

Endocrine metabolism (impacts hormones), calcium resorption, gastrointestinal function, negative nitrogen balance

Question 3

Systemic effects of immobility: Respiratory

Answer 3

Atelectasis (aveoli of lungs collapse, decrease in gas exchange) can’t cough properly and clear secretions

hypostatic pneumonia (inflammation of lung tissue, decrease in gas exchange)

Question 4

Systemic effects of immobility: Cardiovascular

Answer 4

Orthostatic hypotension (sudden drop in bp due to postural changes)
Thrombus (blood clot that attaches to vessel),
Embolus (when a thrombis becomes loose)
pulmonary emboli (when an embolus travel to lungs)
deep vein thrombosis (DVT)

Question 5

Systemic effects of immobility: Musculoskeletal

Answer 5

Loss of endurance, strength, and muscle mass

Decreased stability and balance, osteoporosis, joint contracture

Question 6

Systemic effects of immobility: Unirnary Elimination

Answer 6

Urinary stasis, urinary tract infection, urinary retention

Question 7

Systemic effects of immobility: Integumentary

Answer 7

Ischemia (inadequate blood supply to organ), pressure ulcer

Question 8

Psychosocial effects of immobility

Answer 8

Decreased social interaction 
Social isolation 
Sensory deprivation 
Loss of independence 
Role changes 
Worry
Depression

Question 9

Older persons Mobility considerations

Answer 9

Physical activity decreases
Hormonal changes occur
Bone reabsorption is common
Encourage as much self-care as possible

Question 10

Immobility and physiological assessment
Metabolic: 
Respiratory system:
Cardiovascular system:
Musculoskeletal: 
Integumentary: 
Elimination:

Answer 10

Metabolic: anthropometric measurements (height weight, etc), wound healing

Respiratory system: respiratory rate, breath sounds, lung expansion

Cardiovascular system: blood pressure (BP), pulse, peripheral circulation, signs of deep vein thrombosis (DVT)

Musculoskeletal: ROM; muscle strength, tone, and mass, activity intolerance

Integumentary: colour, integrity, turgor

Elimination: habits, intake

Question 11

Immobility and psychosocial assessment

Answer 11

Abrupt changes in cognition
Mental health concerns
Social isolation
Behaviour changes
Sleep–wake cycle

Question 12

Mobility Intervention
Metabolic: 
Respiratory system:
Cardiovascular system:
Musculoskeletal: 
Integumentary: 
Elimination:

Answer 12

Metabolic systems
High-protein, high-calorie, vitamin B, vitamin C

Respiratory system
Promotion of chest and lung expansion
Preventing stasis of pulmonary secretions
Maintenance of patient airway

Cardiovascular system
Reducing orthostatic hypotension
Reducing cardiac workload: discourage Valsalva manouvre
Preventing thrombus formation: medications, exercise, fluids, compression stockings, pneumatic compression, positioning

Musculoskeletal system
ROM
Continuous passive motion (CPM) machine

Elimination system
Hydration
Nutritional intake: fibre

Integumentary system
Pressure ulcer
Reposition and turning every 1 to 2 hours
Hygiene care
Protection: preventive aids

Question 13

Positioning devices and techniques

Answer 13

Supports: pillows, foot boot, trochanter rolls, sandbags, hand rolls, hand-wrist splints
Trapeze bar
Bed positions: Fowler’s, supine, prone, side-lying, Sims’