Exam 3: Immobility

Question 1

Think of a ____ with varying degrees

Answer 1

Continuum

Question 2

Mobility —>

Answer 2

Immobility

Question 3

The longer the patient is immobile, the

Answer 3

Greater and more pronounced the consequences. Duration impacts outcome

Question 4

Nature of movement

Answer 4

Optimized mobility correlates POSITIVE patient outcomes

Question 5

Mobility

Answer 5

Ability to move freely

Question 6

Immobility

Answer 6

Inability to move about freely

Question 7

Bed rest

Answer 7

An intervention that restrict patients for therapeutic reasons

Question 8

Metabolic changes

Answer 8

• Decrease metabolic rate
• Slows metabolism of CHO, protein, fat
• GI disturbances
• Negative nitrogen balance from amino acid breakdown exceeding protein intake
• calcium resorption
• weight loss
• fluid & electrolyte imbalances
• Dehydration
• Slowed wound healing

Question 9

Respiratory changes

Answer 9

• High risk of respiratory complications
• Atelectasis
• Pneumonia
• Decrease oxygenation
• Decrease cough
• Increase secretions

Question 10

Cardiovascular changes

Answer 10

• Orthostatic hypotension
• Increased cardiac workload
• Thrombus formation

Question 11

Musculoskeletal changes can be

Answer 11

Permanent or temporary

Question 12

Musculoskeletal changes

Answer 12

• Muscle effects

- Skeletal effects

Question 13

Urinary elimination changes

Answer 13

Urinary stasis

Question 14

Urinary stasis

Answer 14

Urine in renal pelvis longer r/t lying flat

• –renal calculi from hypercalcemia
• UTIs!!

Question 15

Integumentary changes

Answer 15

Pressure ulcers

• • Ischemia
• inflammation
• over bones prominences

Question 16

individuals high risk for pressure ulcers

Answer 16

Older adults at greater risk
Paralyzed/MS/ALS
Hip Fracture
Long-term Care Residents
Diabetics 
Those in critical care units

Question 17

Psychosocial effects

Answer 17

• Emotional and Behavioral
• Sensory alterations (sleep patterns/sensory deprivation)
• Changes in coping

Question 18

Immobility changes in infants, toddlers, and preschoolers

Answer 18

• -Typically immobilized r/t trauma or correction of congenital issue
• -May delay gross motor skills, cognitive development, and musculoskeletal development.

Question 19

Immobility changes in adolescents

Answer 19

• Trauma, illness, or surgery

- Social Isolation, loss or delay of experiences (driving, prom, etc.)

Question 20

Immobility changes in adults

Answer 20

• All systems at risk
• Family/social structure may be disrupted
• Job loss and socio-economic status jeopardized

Question 21

Immobility changes in older adults

Answer 21

• Significant risks
• Often experience major mobility and ADL losses
• Increased dependence on others
• Long term health outcomes increased in this population

Question 22

Mobility assessment

Answer 22

• Gait
• Energy level
• Exercise/Activity tolerance
• —Physiological
• —Emotional
• —Developmental
• Fatigue
• Body alignment

Question 23

Body alignment assessment

Answer 23

• Standing
• Lying
• Functional alignment is extremely important to maintain mobility
• ——How do you achieve correct body alignment/posture in an immobilized patient?

Question 24

ROM:

Answer 24

Active and passive

Question 25

Positioning techniques

Answer 25

Pillows Ankle Foot Orthotic devices Trochanter roll Trapeze bar

Question 26

Fowlers position

Answer 26

Sitting up right

Question 27

Trendelenburg

Answer 27

Supine but bed is on incline where feet above head

Question 28

Supine

Answer 28

Laying on back

Question 29

Prone

Answer 29

Laying on stomach

Question 30

Sim's position

Answer 30

"rescue position"

Question 31

Symptoms of Deep Vein thrombosis

Answer 31

``` Swollen extremity Pain Warmth Temperature elevation 80% asymptomatic Homan sign not reliable ```

Question 32

Treatment for DVT

Answer 32

Enoxaparin (QD) Heparin (BID) Avoid massage/movement

Question 33

Nurses are exposed to

Answer 33

Hazards related to lifting and transferring patients

Question 34

Safety guidelines for transferring

Answer 34

``` Communicate clearly. Mentally review transfer steps. Assess patient mobility and strength. Determine assistance needed. Raise side rail on opposite side of bed. Arrange equipment. Evaluate body alignment. Understand use of equipment. Educate patient. ```