ch. 47 mobility and immobility

Question 1

body mechanics

Answer 1

musculoskeletal and nervous system

Question 2

alignment and balance

Answer 2

• center of gravity is stable
• correct body alignment
• contributes balance
• conservation of energy

Question 3

skeletal system

Answer 3

• attachments for muscles and ligaments
• provides leverage for movement
• consists of bones, joints, ligaments, tendons, cartilage

Question 4

skeletal muscles

Answer 4

-movement of bones and joints

Question 5

concentric

Answer 5

increased musce contraction causes muscle shortening, which results in movement

Question 6

eccentric

Answer 6

helps to control the speed and direction of movement

Question 7

isometric

Answer 7

static contraction (posture, muscle tone)

Question 8

isotonic

Answer 8

muscles that work together

Question 9

nervous systen

Answer 9

regulates movement and posture

Question 10

postural abnormalities

Answer 10

scoliosis

Question 11

impaired muscle dev.

Answer 11

muscular dystrophy

Question 12

damage to the CNS

Answer 12

spinal cord injury, meningitis

Question 13

direct trauma to the musculoskeletal system

Answer 13

fractures, contusions

Question 14

nursing knowledge base

Answer 14

• mobility: the ability to move about freely
• immobility: inability to move about freely
• bedrest: an intervention that restricts clients for therapeutic reasons

Question 15

systemic effects of immobility

Answer 15

-metabolic changes
+endocrine
+Gi function

-respiratory changes
+decreased respiratory movement (decrease oxygen and co2 exchange)

+stasis of secretion and decreased respiratory muscles
(atelectasis & hypostatic pneumonia)

Question 16

cardiovascular changes

Answer 16

-VS changes

Question 17

musculoskeletal changes

Answer 17

• loss of endurance and muscle mass and decreased stability
• muscle effects
• skeletal effects

Question 18

urinary elimination

Answer 18

• decrease output

- difficulty

Question 19

integumentary

Answer 19

• skin turgor

- skin breakdown

Question 20

psychosocial effects

Answer 20

sensory deprivation

Question 21

dev. changes

Infants, toddlers, and preschoolers

Answer 21

-prolonged immobility delays gross motor skills, intellectual dev., or musculoskeletal dev.

Question 22

dev. changes

adolescents

Answer 22

Delayed in gaining independence and in accomplishing skills

Question 23

dev. changes

adults

Answer 23

all physiological systems are at risk; changes in family and social structure

Question 24

dev. changes

older adults

Answer 24

• decreased physical activity, alterations in balance, hormonal changes
• women: menopause

Question 25

Range of motion

Answer 25

maximum amount of movement available at a joint in one of the three planes of the body

• sagittal
• frontal
• transverse

+ROM is active, passive or in between

Question 26

Planning

Answer 26

-goals and outcomes:
+goal: client’s skin remains intact
+outcome: client’s skin color and temp return to normal baseline within 20 minutes of position change

-setting priorities
-collaborative care:
+nursing assistant, physical therapists, wound care, specialists, resp. therapy

Question 27

implementation

Answer 27

-education
-acute care:
+metabolic system ( drink OJ with iron)
+ Resp system (make them cough)
+cardiovascular= check VS
+musculoskeletal: encourgaing them to move after surgery, compression stockings, ROM exercises, 3-4 times a day
+integumentary: position every 1-2
+elimination: fruits and veggies and fiber
+ psychosocial: story telling, have visitors (family), hygiene, make up, brush their hair

Question 28

Supported fowlers

Answer 28

sitting up. head is elevated 45-60 degrees and knees are slightly elevated

Question 29

supine

Answer 29

lying down facing ceiling

Question 30

prone

Answer 30

on belly and head supported with pillow

Question 31

side-lying

Answer 31

on the side, have pillows uner top arm and top leg, pillow under head

Question 32

sims

Answer 32

semiprone, position with pillow and sandbags in place

Question 33

canes

Answer 33

keep cane on stronger side, move cane forward 6-10 inches, then move weaker leg with the cane