Exam 1 review

Question 1

Body mechanics

Answer 1

is the way we move our bodies. it includes body alignment, balance, coordination, and joint mobility.

-teaches patients how to move
-teaches us how to move

Question 2

Body alignment

Answer 2

• posture.
• places spine in a neutral position.
• allows movements to occur with less fatigue.
• work at peak efficincy
• normal functioning of the nervous system

Question 3

Balance

Answer 3

Your line of gravity must pass through your center of gravity

Center of gravity should be close to your base of support

Question 4

How to balance

Answer 4

• Use a wide stance, with feet apart and one foot forward when standing for a long period of time.
• The broader the base of support, the lower the center of gravity, and the easier it is the maintain balance.

Question 5

Coordination

3 components

Answer 5

Smooth movement requires coordination between the nervous system and the MSK.
* cerebral cortex : Initiation VOLUNTARY movement
* cerebellum: Coordinates movements; PROPRIOCEPTION, the awareness of posture, movement, and position sense
* basal ganglia: located deep in the cerebellum. Coordination of movement

Question 6

Joint Mobility

Answer 6

ROM
AROM
PROM

ability to move within the environment.

Question 7

Baseline activity

Answer 7

light intensity ADLS such as standing, walking slow, lifting objets that are lightweight.

Question 8

Exercise

Answer 8

health enchancing physical activity

Question 9

Isometric Exercises

Answer 9

muscle contraction without motion. They are usually performed against an immovable surface or object, for example, pressing the hand against a wall. The muscles of the arm contract, but the wall does not move. Each position is held for 6 to 8 seconds and repeated 5 to 10 times. Isometric training is effective for developing total strength of a muscle or group of muscles.

Question 10

Benefits of isometric exercises

Answer 10

Often used for rehabilitation because the exact area of muscle weakness can be isolated and strengthening can be administered at the proper joint angle
Requires no special equipment
Little chance of injury
Can be used by patients who are confined to bed to maintain or regain muscle strength

Question 11

Isotonic Exercise

Answer 11

movement of the joint
during the muscle contraction. A classic example of an isotonic exercise is weight training with free weights. As the weight is moved throughout the ROM, the muscle shortens and lengthens. Calisthenics, such as chin-ups, push-ups, and sit-ups, all of which use body weight as the resistance force, are also isotonic exercises.

Question 12

Isokinetic exercise

Answer 12

performed with specialized apparatuses that provide variable resistance to movement. Isokinetic exercise combines the best features of both isometrics and weight training by providing resistance at a constant, preset speed while the muscle moves through the full ROM. Specialized machines available at health and fitness facilities and physical therapy departments are used for this form of exercise.

Question 14

Aerobic exercise

Answer 14

acquires energy from metabolic pathways that use oxygen—the amount of oxygen taken into the body meets or exceeds the amount of oxygen required to perform the activity. Aerobic exercise uses large muscle groups, can be maintained continuously, and is rhythmic in nature. It increases the heart and respiratory rates, thereby providing exercise for the cardiovascular system while simultaneously exercising the skeletal muscles. Jogging, brisk walking, and cycling are common forms of aerobic exercise.

Question 15

Anaerobic exercise

Answer 15

Anaerobic exercise occurs when the amount of oxygen taken into the body does not meet the amount of oxygen required to perform the activity. Therefore, the muscles must obtain energy from metabolic pathways that do not use oxygen. Rapid, intense exercises such as lifting heavy objects and sprinting are examples of anaerobic exercise.

Question 16

People who shouldn’t exercise

Answer 16

SOB, dizzy, chest pain, joint pain, weight loss unexplained, fever w/ no infection, eye problems, blood clot, hernia, recent hip or joint surgery

Question 17

Prolonged immobility MSK

Answer 17

• muscle wasting 10% of strength per week losing stability muscles in legs
• stiff joints
• Contractures (flexors pull the joints leading to joint ankyloses)

Question 18

Cardio immobility

Answer 18

• Venous stasis
• less cardiac reserve
• edema
• risk for thrombosis - leads to compression so can’t clear out coag. factors. Blood clots. Virchows triad of stasis, activation of clotting, and vessel injury.
• Increased risk of DVT
• Orthostatic hypotension because baroreceptors become inactive

Question 19

Respiratory

Answer 19

• Decreased ventilation due to less strength of respiratory muscles
• secretions pool in lungs
• atelectasis risk
• pneumonia risk

Question 20

Integumentary immobility

Answer 20

• pressure injury due to compression of capillaries

Question 21

Metabolism immobility

Answer 21

• Decreased energy, increased lactic acid; less ATP
• glucose intolerance.
• decr. muscle mass so less metabolism
• calcium excretion increased, osteoporosis, renal calculi and incr. risk for fractures
• Stressed from immobility. hormones activated: TH, NE, ACTH, aldosterone
• protein isnt being built, fat is instead built

Question 22

GI immobility

Answer 22

• Slowed peristalsis
  *consitpation, gas, slowed stool
  *Paralytic ileus (complete cessation of parastalsis can occur)
• Appetite diminished
• Muscle is used as fuel

Question 23

Urinary immobility

Answer 23

• Supine makes it harder from urine to travel from kidney to bladder, risk for infection
• increased calcium freed in blood, which means calcium is getting filtered in kidney. stone formation
• Bedpan or urinal is hard to use

Question 24

Psychological effects of immobility

Answer 24

• Depression, anxiety, hostility, bad sleep, apathy, poor body concept
• Cognition - less conc, recall, problem solving
• Self care - hard

Question 25

Complications of immonility general outline

Answer 25

• pressure injury
• Constipation
• Joint contraction
• Muscle weakness
• Balance problems
• DVT
• Pooling of secretions lungs
• DVT
• Orthostatic hypotension
• Increased risk of mortality

Question 26

How often to assess immobile patient

Answer 26

Regularly monitor all body systems for indications or complications like exertional dyspnea, pain or discomfort with movement, decreased rxns, limited ROM, hard time turning, diff w. ADLs

Question 27

Immobile collab?

Answer 27

• OT, PT
• wound specialist
• dietician

Question 28

Interventions for immobility

Answer 28

• position in bed where their lungs can expand (orthopneic)
• protein rich diet
• support skin integrity by turning every 2 hours
• bed clean and dry to avoid maceration or pressure injury
• don’t tuck them in too tight which restricts movement
• sit before stand
• conditioning exercises
• assist when standing and ambulation
• use positioning devices to maintain body alignment
• active ROM encouraged. provide PROM as needed.
• seek help for depression

Question 29

Paresis vs paraplegia vs parasthesia vs quadriplegia

Answer 29

• Paresis is incomplete paralysis
• Parasthesia is numbness, tingling, burning
• Quadriplegia is 4 extremity paralysis
• Paraplegia is paralysis of lower trunk and lower extremities

Question 30

how to test activity tolerance

Answer 30

Assess and record vital signs before having the patient engage in 3 minutes of activity.
Select an activity appropriate for the patient. For example, if the patient uses a walker, ask the patient to walk down the hallway. For a patient without obvious health limitations, consider asking them to run in place for 3 minutes.

Observe the patient throughout the exercise. IIf they show any signs of distress, stop the exercise, immediately take a set of vital signs, and repeat the vital signs every minute until they have returned to baseline.
**If the patient can exercise continuously for 3 minutes, assess the patient at the end of the 3-minute period and at 1-minute intervals. **Note the change in heart rate, blood pressure, and respiratory rate.

This type of approach is not appropriate for patients who easily become short of breath, develop chest pain, or are very unsteady on their feet. Instead, for example, limit your assessment to determining the amount of assistance the patient needs to turn in bed or get out of bed.

Question 31

Hospital bed positioning

Answer 31

You should raise the bed to waist height when providing care so that you can use proper body mechanics; place the bed in its lowest position before helping a patient get out of bed or if the patient is at risk for falling.

Question 32

Types of specialized beds

Answer 32

• alternating, low air loss, immersion, oscillating.
• circular bed and Stryker frame for severe mobility restrictions to rotate from supine to prone

Question 33

Pillows

Answer 33

Pillows are the most common devices used to assist with positioning, provide support, and elevate body parts (Fig. 29-6). They help position a patient by molding to the body and expanding the weight-bearing area. You
Avoid slippery or wet surfaces during ambulation or moving patients.
Remove physical obstructions (e.g., cabinets, toilets) when moving or transferring patients.
Arrange a clutter-free environment that allows for free movement of equipment and personnel.
Watch out for uneven floor surfaces or movable rugs. Lock wheels of furniture and equipment before moving
patients.
Avoid moving patients through too small a path or doorway. Wear supportive shoes with nonslip soles.

will need a variety of sizes to position patients who are unconscious, paralyzed, frail, or have had surgery. To obtain the right size or type (e.g., abductor pillows), or if pillows are not available, you can use folded blankets or towels. Foam wedge pillows are useful for elevating the upper body when an adjustable bed is not available and for abducting the hips after hip surgery.

Question 34

Siderails

Answer 34

Ensure safety. Remind patient to call for assistance before getting out of bed. Provide a grip so that they can reposition themselves.

• Can be a source of injury if patients get tangled up in the railing or fall between the bed and the rail.
• confused patients might try to climb over it and injure themselves

Question 35

Trapeze Bar

Answer 35

overhead bed frame to help get out of bed and exercise upper extremities

Question 36

Footboard

Answer 36

A footboard is a device placed at the end of the bed to prevent footdrop and outward hip rotation, but it does not relieve heel pressure. For the footboard to be effective, the heels must be touching it. Each time you turn the patient, you may need to reposition the footboard to ensure proper position.

Question 37

Cradle boots

Answer 37

made of spongy rubber with heel cutouts and ankle cushioning prevent footdrop, skin breakdown, and external hip rotation

Question 38

Foot cradles

Answer 38

Plastic that keeps bedding up off the feet to allow for free movement

Question 39

1.

Trochanter rolls

Answer 39

Trochanter rolls are placed snugly adjacent to the hips and thighs to prevent external rotation of the hips. They are commonly used with hip fracture or after hip replacement surgery.

Question 40

Fowler positions

Answer 40

Fowler position is a semi-sitting position, in which the head of the bed is elevated 45° to 60°. This position promotes respiratory function by lowering the diaphragm and allowing the greatest chest expansion. It is also an ideal position for some patients with cardiac dysfunction. Common variations include:

Question 41

Different kinds of Fowler positions

Answer 41

• Semi-Fowler position, in which the head of the bed is elevated only 30°
• High-Fowler position, in which the head is elevated 90°
• Orthopneic position, in which the head of the bed is elevated** 90°** and an **overbed table with a pillow on top is positioned in front of the patient **(Fig. 29-11). Have the patient lean forward, resting their arms and head on the pillow. This position is helpful for a patient with shortness of breath.

Question 42

1.

Lateral positions

Answer 42

The lateral position is a side-lying position with the top hip and knee flexed and placed in front of the rest of the body. The lateral position creates pressure on the lower scapula, ilium, and trochanter but relieves pressure from the heels and sacrum.

Lateral recumbent position is side-lying with legs in a straight line

Oblique position is an alternative to the lateral position that places less pressure on the trochanter. The patient turns on the side with the top hip and knee flexed; however, the top leg is placed behind the body

Question 42

Sims

Answer 42

Sims Position
This is a semiprone position where the lower arm is positioned behind the patient, and the upper arm is flexed. The upper leg is more flexed than the lower leg. Sims position facilitates drainage from the mouth and limits pressure on the trochanter and sacrum. This is an ideal position for administering an enema or a perineal procedure.

Question 43

Supine

Answer 43

dorsal recumbent position, the patient lies on the back with head and shoulders elevated on a small pillow. The spine is aligned with the arms and hands comfortably resting at the side.