Exam 6 - Need for Mobility Flashcards
Inability to move about freely
Immobility
The ability to move about freely
Mobility
What is mobility?
Interaction of bones, muscles, and nervous system
Four components of body mechanics
Body alignment
Balance
Coordination
Joint mobility
What three physiological systems must successfully interact for movement to occur?
Skeletal system
Muscular system
Nervous system
What is the leading cause of disability in the United States?
Arthritis
What account for more than 420,000 hospitalizations yearly among the elderly?
Falls
What is the most common musculoskeletal condition that necessitates hospitalizations in patients who are at least 65 years of age?
Hip fracture
How many bones are in the body?
206
How much of your bodies calcium is present in bones?
98%
How much calcium is recommended for daily intake for appropriate bone mass?
1500 mg
What stimulates bone formation and remodeling?
Weight-bearing
Where does body movement occur?
Joints
What is the breakdown or weakness of muscles due to nonuse?
Atrophy
How quickly does muscle strength decrease when confined in bed?
7 to 10% of muscle strength is lost per week
How much of your bodyweight the skeletal muscle comprise?
40 to 50%
What controls the movement of the musculoskeletal system?
The nervous system
What are regulated by the nervous system? Two things
Movement
Posture
What controls involuntary muscles such as heart and glands?
Autonomic nervous system
What system controls voluntary skeletal muscles?
Somatic nervous system
What type of immobility is expected to end, caused by broken bones, bedrest, surgery recovery?
Temporary
What type of immobility is not temporary caused by stroke, paralysis, loss of limbs?
Permanent
What type of immobility is due to a disease process that will eventually become permanent for example rheumatoid arthritis, muscular dystrophy, Parkinson’s disease
Progressive
What is loss of blood supply?
Ischemia
What is tissue death?
Necrosis
What is a result of pressure on bony prominences?
Pressure ulcer
What is the collapse of alveoli?
Atelectasis
What is inflammation of the lung from stasis or pooling of secretions?
Hypostatic pneumonia
TCDB
Turn cough and deep breathe
Loss of balance
Ataxic
Upper body moves faster than lower body
Propulsive
Muscle spasms while walking
Spastic
Footdrop
Steppage
Exaggerated hip movement
Waddling
Tighten and release muscle for strengthening. Muscle contraction without motion.
Isometric
Active exercise, joint movement
Isotonic
Exercise against resistance
Resistive
Exercise, machines control speed of contraction
Isokinetic
Amount of oxygen taken into body exceeds and Oxygen required to perform activity
Aerobic exercise
Amount of oxygen does not meet the amount of oxygen required to perform activity
Anaerobic exercise
Effects of immobility on metabolism system
Decreased metabolic rate, altered metabolism of carbs, fats, and protein.
Leads to fluid electrolyte and Ca imbalances.
Decline in calories / protein
Negative nitrogen balance
ca reabsorption
Constipation fecal impaction
Nursing intervention
Monitor Ht/wt and skin fold thickness
I and O
Bowel sounds
Increase dietary fiber high calories/protein. Monitor amount eaten
Fluid replacement
Therapy for exercise
Monitor lab values electrolytes, serum protein levels, and blood urea nitrogen (BUN)
Integumentary System problems
Pressure ulcers as a result on bony prominences
Nursing interventions
Turn every 2 hours
Assess skin integrity every 2 hours
Assess nutritional intake
Musculoskeletal problems
Overall decline in endurance, strength, muscle mass, stability and balance
Muscle atrophy
Disuse osteoporosis -due to bone reabsorption can lead to pathological fractures
Osteoporosis
Joint contracture foot drop
Nursing interventions
Monitor dietary intake
Progressive exercise program
ROM
Foot support while in bed
Respiratory system problems
Atelecatasis-collapse of alveoli
Hypostatic pneumonia-inflammation of the lung from stasis or pooling of secretions
Nursing interventions
Change position every 2 hours Respiratory exercise High fowlers positioning Assessment Encourage cough/deep breathe exercise
Cardiovascular system problems
Orthostatic hypotension
Increased cardiac workload
Thrombus formation
Nursing interventions
BP monitoring AP/Peripheral pulses Assess edema Homan's sign Assess extremities color, temp, calf circumference Use of TED hose or SCD's No massaging of calf muscle
Gastrointestinal system problems
Slows peristalsis
Constipation, gas, difficulty having bowel movement
Paralytic ileum (cessation of peristalsis)
Body muscle is broken down as a fuel source, causing muscle wasting
Nursing interventions
Assess bowel sounds Monitor bowel habits closely Increase fluid intake Encourage movement Encourage healthy diet (vitamins, minerals, proteins, carbs) Provide privacy
Genitourinary system problems
Inhibits drainage of urine
Urine becomes stagnant
Ideal environment for infection / kidney stone formation
Urine calcium levels rise with immobility
Decreased muscle tone leads to a decrease in bladder control
Nursing interventions
I and O
Assess bladder distention
Maintain adequate fluid intake
May have to decrease calcium intake
Psychological effects problems
Prolonged immobility leads to isolation, mood changes Depression Anxiety Hostility Sleep disturbances Disorientation Apathy
Nursing interventions
Encourage to verbalized feelings
Encourage interactions among family/friends
Intensive treatment to deal with current reality of condition/prognosis.
Lab test
Serum Ca, phosphorus, alkaline phosphatase, serum muscle enzymes
