Chapter 32 Flashcards
Exercise & Activity Needs
Where can you find the person’s activity level & needed exercise?
Care plan & assignment sheet
______ refers to a person’s ability to move. ______ is the inability to move
- Mobility
- Immobility
______ whether mild or severe, affects every body system and mental well-being
Immobility
________ loss of muscle strength from inactivity
Deconditioning
________ means restricting a person to bed and limiting activity for health reasons
Bed rest
Common reasons for a patient being on bed rest are to:
* Reduce ________ needs
* Reduce ______
* Reduce ________
* Promote _________
- Reduce oxygen needs
- Reduce pain
- Reduce swelling
- Promote healing
What are the 4 types of bed rest?
- Strict (complete) bed rest
- Bed rest
- Bed rest with commode privilage
- Bed rest with bathroom privileges
What is strict bed rest?
Everything is done for the person. All activities of daily living (ADL) are done in bed
_____ rest, the person performs some ADL. Self-feeding, oral hygiene, bathing, shaving, and hair care are often allowed.
Bed rest
What serious complications can occur with immobility?
- Pressure injuries
- Constipation
- Fecal impaction
- Urinary Tract infection
- Renal Calculi (kidney stones)
- Blood clots
- Pneumonia
Immobility can affect the _________ system
Musculo-skeletal system
For normal movement, you must help prevent?
- Contracture
- Atrophy
- Postural Hypotension
A ________ is decreased motion and stiffness of a joint caused by shortening (________) of a muscle
- Contracture
- Contracting
The _______ muscle is fixed into position, is deformed and cannot stretch
Contracted
What are common sites for contractures?
- Fingers, wrists, elbow, toes, ankles, knees, hips
- Neck & spine
______ is the decrease in size or the wasting away of tissue
Atrophy
______ ______ is a decrease in size or a wasting away of muscle
Muscle atrophy
______ ______ is abnormally low blood pressure when the person suddenly stands up
Postural hypotension
What’s another word for fainting?
Syncope
_______ helps prevent contractures and muscle atrophy
Exercise
- Range-of-motion exercises promote _____ _____
- Weight-bearing exercises are needed to?
- Joint mobility
- Gain muscle stength
The person progresses mobility in 4 stages, what is the 1st stage?
Supine to Fowler’s position
After the patient has progressed from supine to fowler’s position, what is the 2nd stage?
Fowler’s position to sitting on the side of the bed
After the patient has progressed fowler’s position to sitting on the side of the bed, what is the 3rd stage?
Sitting on the side of the bed to standing
After the patient has progressed from sitting on the side of the bed to standing, what is the 4th stage?
Standing to walking or sitting in a chair
The patient progresses in stages from
1. Supine to Fowler’s position
2.
3. Sitting on the side of the bed to standing
4.
- Supine to Fowler’s position
- Fowler’s position to sittiing on the side of the bed
- Sitting on the side of the bed to standing
- Standing to walking or sitting in a chair
Slowly changing positions is key to preventing?
Postural hypotension
What is ROM?
Range of motion exercises
ROM exercises are done ____ times a day
2 times
The movement of a joint to the extent possible without causing pain is the?
Range of motion (ROM)
ROM exercies are ______, _______, or _______
- Active
- Passive
- Active-assistive
Active ROM exercises are?
done by the person
What is Passive ROM (PROM) exercises?
You move the joints through their range of motion
Active-assistive ROM exercise is?
The person does the exercises with some help
_______ is moving the body part away from the mid-line of the body
Abduction
_______ is moving a body part toward the mid-line of the body
Adduction
_______ is touching an opposite finger with the thumb
Opposition
Flexion is?
Bending a body part
Extension is?
Straightening a body part
Dorsiflexion is?
bending the toes and foot up at the ankle
Hyperextension is?
Excessive straightening of a body part
Plantar flexion is?
Bending the foot down at the ankle
Rotation is?
Turning the joint
What is:
Internal rotation
Turning the joint inward
What is:
External Rotation
Turning the joint outward
What is:
Pronation
Turning the joint downward
What is:
Supination
Turning the joint upward
As each joint is exercised, what should you ask the person?
- Feels that the joint cannot move any further
- Feels pain or discomfort in the joint
- Needs to stop or rest
______ the part being exercised at all times
Support
Before performing range of motion exercises, what’s the first two steps of the procedure?
- Position person in surpine
- Cover the person with the bath blanket. Fan fold top linens to the foot of the bed
When exercising the neck where can you as a CNA provide support?
- Placing hands over ears
- Support jaw with fingers
An ______ is a device used to support a muscle, promote a certain motion, or correct a deformity
Orthotic
What does placing your hands over the patients ears do?
Support the head
What helps prevent plantar flexion that can lead to footdrop?
Foot-board
Paralysis and muscle weakness are common reasons for ________ devices
Orthotic
______ is when the foot falls down at the ankle
Footdrop
_______ also serve as bed cradles by keeping top linens off of the feet & toes
Foot-board
What keeps the weight of top linens off of the feet & toes?
Bed cradle
Bed cradles prevent?
Footdrop & pressure injuries
What prevents the hips and legs from turning outward?
Trochanter roll
A _____ _____ is folded to the desired length and rolled up tightly. The _____ end is placed under the person from the ____ to the ____. The ____ is tucked along side the body
- Bath blanket
- Flat
- hip to the knee
- roll
_________ keeps the hips apart
Hip abduction wedge
Where is the hip abduction wedge placed?
Placed between the person’s legs
______ & _____ prevents contractures of the thumb, fingers, and wrist
Hand rolls & Finger cushions
What is the difference between finger cushions and hand rolls?
The fingers are separated in finger cushions
______ keeps elbows, wrists, thumbs, fingers, ankles, or knees in the normal position
Spint
A ______ is applied over the ankle, knee, or back
Brace
What does a brace do?
- Supports a weak body part
- Prevents or corrects deformities
- Prevents joint movement
Ankle-foot orthosis provides ______ & ______ to the ankle and foot.
support & alignment
AFO is common after a _____
Stroke
AFO is common after a stroke and is also used for _______
footdrop
_____ is worn with a sock and shoe and secured with a velcro strap
AFO
Canes are used for?
Weakness on 1 side of the body
_____ tip and ___ point (___) canes are common
Single-tip and 4-point (quad)
A cane is held on which side?
Strong side
Which cane will stand freely?
4-point (quad) cane
Which cane needs to be securely propped in place?
Single-tip cane
The tip of the cane is positioned about __ to __ inches to the side of the strong foot
6 to 10 inches
T/F: The cane is moved forward along with the strong leg
FALSE: It’s the weak leg
To walk, the person pushes the walker about __ to __ inches in front of the feet
6 to 8 inches
A walker gives more support than a ______
cane
Baskets, pouches, and trays can attach to the walker for needed items. This allows more __________
Independence
T/F: You can push the walker when the person is seated in it
FALSE: Never push the walker when person is seated
T/F: Crutch tips can be worn down, torn, or wet.
FALSE: replace worn or torn crutch tips, dry if wet
For crutches:
* Check the crutch ____
* Check the crutches for ____
- Tips
- Flaws
Tighten all ____ on crutches
bolts
______ is the act of walking
Ambulation
_______ increases as the person gains ________
- Distance
- Strength
Before ambulating, explaining the procedure promote?
Comfort & reduces fear
T/F: Encourage shuffling, sliding, and walking on tip-toes
FALSE! Discourage it!
Patient is bringing the head forward. The chin touches the chest. What range of motion is this?
Flexion of the head
After a patient has flexioned their neck, what is the movement called when they straighten the head?
Extension
Describe the movement when a patient extensions their neck.
Straighten the head
What is hyperextension of the neck?
Bring the head back until the chin points up
Describe rotation of the neck
Turn the head from side to side
Moving the head to the right and to the left is what joint movement?
Lateral flexion of the neck
When exercising the shoulders, support the ______ with 1 hand, then support the ______ with the other hand
- Wrist
- Elbow
Raising the arm straight up in front and over the head is what range of motion?
- Flexion of the arm
- ROM for shoulder
What is extension of the arm?
Bringing the arm down
What is hyperextension of the shoulder?
Moving the arm behind the body
Hyperextension of the arm is done if the person is in a _______ _______ chair or is ________
- Straight-backed
- Standing
What is abduction of the arm?
Moving the arm straight away from the body
What is adduction of the arm?
Moving the straight arm to the side of the body
Internal rotation is when you bend the _____. Place it at the same level as the _________. Move the __________ and _______ so the ________ point down
*Elbow
* Shoulder
* Forearm and hand
* fingers
What ROM has you moving the forearm and hand so the fingers point up?
External rotation
How many times should the patient repeat ROM?
5 times or the number of times stated on the care plan
What is flexion of the elbow?
Bend the arm so the same-side shoulder is touched.
When you’re straightening the arm, what ROM is this?
Extension of the elbow
A patient is exercising their shoulder, which one describes extension of the arm?
1. Straighten the arm
2. Bring the arm down
- Bring the arm dwon
A patient is exercising the forearm, what is the description for pronation?
Turn the hand so the palm is down
A patient turns the hand so the palm is up, what ROM is this and for which exercise?
- Supination
- Exercise the forearm
What is flexion of the hand?
Bending the hand down
What exercises involve supporting the wrist and elbow?
- Shoulder
- Elbow
- Forearm
What is hyperextension of the hand?
Bending the hand back
A patient is turning the hand toward their thumb, what ROM is this and for which exercise?
- Radial flexion
- Exercise the wrist
What is extension of the hand?
Straighten the hand
A patient is turning the hand toward the little finger, what ROM is this and for which exercise?
- Ulnar flexion
- Exercise the wrist
What is opposition?
Touch each fingertip with the thumb
Moving the thumb out from the inner part of the index finger is what ROM?
Abduction
What is adduction of the thumb?
Moving the thumb back next to the index finger
Flexion of the thumb is?
Bending the thumb into the hand
Moving the thumb out to the side of the fingers is what ROM?
Extension
What is abduction & adduction of the fingers?
- Abduction-spread the fingers apart
- Adduction-bring the fingers together
Making a fist is what ROM?
Flexion
Straighten the fingers so the fingers, hand, and arm are straight is what ROM?
Extension
When a patient is exercising the wrist, how can you provide support?
Support the wrist with both hands
When a patient is exercising the thumb, how can you provide support?
Support the persons hand with 1 hand, support the thumb with your other hand
To support the leg during a hip and knee exercise, place 1 hand under the _____, then place your other hand under the _______
- Knee
- Ankle
For the hip exercise, when you’re raising the leg, this is a _______ ROM
flexion
When you’re straightening the leg, this is a _______ rom
extension
What is hyperextension of the leg?
Move the leg behind the body
T/F: A person does not have to be standing when doing a hyperextension of the leg
FALSE: You do it if the person is standing
What is abduction of the leg?
Moving the leg away from the body
What is adduction of the leg?
Moving the leg toward the other leg
You’re doing a hip exercise…
- What is internal rotation?
- What is external rotation?
- Turn the leg inward
- Turn the leg outward
To support the foot and ankle during an ankle or foot exercise, place 1 hand under the ______, and place your other hand under the ______
- Foot
- Ankle
When you bend your knee, what ROM is this?
Flexion
When you straighten the knee, what ROM is this?
Extension
What is dorsiflexion?
Pull the foot upward, push down on the heel at the same time
What is plantar flexion?
Turn the foot down, or point the toes
_______ is turning the outside of the foot up and the inside down
Pronation
_______ is turning the inside of the foot up and the outside down
Supination
What is pronation?
turn the outside of the foot up and the inside down
______ is curling of the toes
flexion
________ is straightening of the toes
extension
__________ is spreading the toes
Abduction
_____ putting the toes together
Adduction