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Foundations II > Effects of Immobility: Exam 1 > Flashcards

Effects of Immobility: Exam 1 Flashcards

1
Q

Mobility critical for…

A

well-being

optimal system functioning

QOL

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2
Q

most COMMON reason for losses in functional abilities

A

Inactivity!!!

*chronic inactivity or sedentary lifestyle @ any age==negative

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3
Q

Inactivity/sedentary==negative on systems—>

A

DM

obesity

heart disease

some cancers

Prolonged bed rest+low lvls inactivity===> risk factors for acute + chronic cond’s

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4
Q

Pops w/ Low Rates of phys. activity

A
  • women gen less active than men @ all ages
  • lower income/less education
  • Af Americans/Hispanics
  • NE/S states vs. NC/W
  • People w/ disabilities
  • by 75yo
    • 1 in 3 men and 1 in 2 women DO NOT engage in reg. phys activity
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5
Q

Causes Immobility in Older pop.

MSK

A

OA, OP, Fx, foot probs, pain

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6
Q

Causes of Immobility in Older pop

Neuro

A

CVA

PD

AD

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7
Q

Causes of Immobility in Older pop

CV

A

CHF

CAD

PVD

COPD

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8
Q

Causes of Immobility in Older pop

Environmental

A
  • forced immobility
  • inadequate ADs
  • WC bound
  • building barriers
  • neighborhood safety
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9
Q

Causes of Immobility in Older pop

Other

A
  • fear falling
  • malnutrition
  • deconditioning
  • side effects drugs
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10
Q

Effects of Immobility/Bed Rest

A
  • single joint OR entire body
    • negative effects–> lying down, hydrostatic press’s
    • multi-jt system impairs
      • CV
      • pulm
      • MSK
      • neuro
      • integument
      • genito-urinary
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11
Q

CV Impairs (3)

A
  1. cardiac deconditioning
  2. venous stasis
  3. postural or OH
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12
Q

CV impairs:

Cardiac Deconditioning

A
  • INC resting and exercise HR== DEC SV
    • 3-4wks bedrest
      • RHR INC by 1/2 BPM (11-14)
  • DEC cardiac size==DEC CO (HR*SV)
    • DEC cardiac capacity to resp to any lvls phys act
  • INC cardiac workload 2* to elevating HR
    • heart works HARDER to pump blood
    • no change in BP
    • DISASTER!!!
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13
Q

CV impairs:

Venous Stasis

A
  • predispo to DVT
    • Ca+ released during inactivity==inc’s blood coaguability/clotting
    • supine/sidelying==lack of MM pump
    • mech compression of LEs damages vessels
      • lose calf blood flow==DVT==PE
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14
Q

CV Impairs:

OH

A
  • more rapidly in older adults + CV cond’s
    • can be any age
  • lose mm pumps
  • body cannot accommodate to posture
    • ex. supine to stand

NOTE: if you are transferring pt to EOB and they get OH, keep them there 1-3mins and have them do ankle pumps or if no use of legs do arm curls/shoulder shrugs!!!

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15
Q

Pulmonary Impairments:

Atelectasis

A
  • Lung collapse + PNA
    • supine pos DECs chest expansion and breathing mechanics
      • fewer deep breaths==inc work of breathing
    • VC DEC (ability to take deep breaths + full exhales)
    • inc bacterial growth–> poor oxygenation
      • secretion build up
    • poor gas exchange
      • impaired V/Q and DEC arterial oxygenation
        • O2 desat, hypoxemia
    • aspiration PNA and PE
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16
Q

MSK Impairs (3)

A
  1. atrophy
  2. Dec wt bearing forces===change in props of jt caps and synovium
  3. Osteoporosis
17
Q

MSK impairments:

Atrophy

A
  • dec strength + endurance
    • 1/8 mm strength lost in first wk of bedrest
      • fatigue==dec mitochondria function and oxidative capacity
    • antigravity mm loss
      • postural mm’s==extensors esp in supine
  • resting mm length changes w/ shortening of conncect tissue
    • contractures
      • hips, knees, ankles
18
Q

MSK impairments:

DEC wt. bearing forces on jts causes change in props of jt caps and synovium

A
  • remember WOLFF’S LAW!!
  • collagen becomes dense==shortened tendons
  • jts stiffen==water loss in jts
    • 5 days of immob.
      • 45% shortening in 5wks
19
Q

MSK impairments:

Contractures

A
  • occur in positions of comfort
  • most @ risk in supine?
    • hips, knees, ankles
  • prevention?
    • pos. changes
  • interfere w/?
    • gait, flex, mob, etc..
20
Q

MSK impairs:

Osteoporosis

A
  • loss bone mass==decline gravity forces==bone demineralization
  • bones thin, porous, fragile due to imbalance of osteaclastic (destroy)/osteoblastic (create) activity
    • inc Fx risk
  • early as 3rd day after immob
  • Wolff’s Law: bone is laid down in direction of stresses it must w/stand
    • ​NO STRESS== bones diffuse rather than uniform==lose tensile strength
    • KEY== restore wt bearing forces to rev. process
21
Q

Neuromuscular impairs (2)

A
  1. lmtd mvmt leads to inactivity of Vestib system
  2. Mental status altered
22
Q

Neuro system Impairs:

inactivity of Vestib System

A
  • Balance dysf
  • coord. deficits
  • compression neuropathies
  • sensory deprivation
    • hallucinate, mood change, vivid dreams
  • altered sleep
  • prolonged rxn times
23
Q

Neuro impairs:

Mental status

A
  • depressed
  • lack of motivation
  • distortion of time
  • mood swings
  • learned helplessness
24
Q

Integumentary impairments

Tissue Necrosis (death)/Pressure ulcers

A
  • prolonged compress==skin circ/perfusion DEC==infarction to skin
    • esp over boney prominences
  • skin vulnerable to shearing (tear), pressure, moisture
  • healing SLOWED by impaired metabolism
25
Q

Integumentary impairments:

Pressure Wounds

A
  • early signs:
    • red
    • dusky
    • cyanotic–blue
  • Prevention***
    • approp. pos. and pos. changes
      • turning schedule q 2 hrs
      • press relief bedding/devices
      • timely mgmt B&B secretions for immobile indiv’s
26
Q

Who is @ risk for Integumentary changes?

A

sensory deficits pts

dependent pts

incontinent pts

obese pts

pts w/ poor nutrition

older adults

pts unable to move

27
Q

Other systems Impairs:

Urinary function

A
  • stagnation of urine
  • changes in urine Ca* lvls
  • DEC pH predisposes kidneys to stones
  • crystalloids + UTIs
28
Q

Other systems impaired:

GI

A
  • DEC appetite, alterations in GI, constipation
29
Q

Other systems impaired:

Metabolic Imbalances

A
  • GLU intolerance from DEC metabolism and INC PRO lysis (breakdown)
  • Hypercalcemia
    • cramping
    • constipation
    • mm weakness
    • lethargy
    • nausea
30
Q

Strategies to Min. negative effects of immobility

  1. Min duration of bedrest
A
  • encourage mvmt
    • stand 30-60s during transfers
    • walking
  • protect skin
    • street clothes instead of gowns
    • orthotics
    • pos. changes
  • elicit help
    • all disciplines + caregivers
31
Q

Healthy People 2020

A

National health objectives

progress over time

2 goals== 1. inc QOL healthy life 2. eliminate health disparities

32
Q

Interventions to use for pt w/ immobility issues

A

Designated MMT, ankle pumps, mandatory mvmt @ designated times

Foundations II (13 decks)

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