Exam II - Immobility Flashcards
immobilization
physical restriction of movement to a body part
hospital-associated deconditioning (HAD)
loss of muscle mass, functional reserve, and decreased activity tolerance and the functional decline in ADLs and mobility
orthostatic hypotension
decrease in BP of 40+ mm Hg in systolic or 20+ mm Hg in diastolic upon rising from a sitting position
recumbence
position of lying down at rest
deep vein thrombosis (DVT)
A blood clot/thrombus in a deep vein, usually in the legs.
atelectasis
collapse of alveoli
hypostatic pneumonia
inflammation of lung from stasis or pooling of secretions
joint contracture
preventable, abnormal, and possibly permanent condition char. by limited movement or fixation of the joint
footdrop
gait abnormality involving a significant weakness of ankle and toe dorsiflexion
pressure injury
localized damage to skin and/or underlying soft tissue, usually over a bony prominence or r/t a medical or other device.
venous thromboembolism (VTE)
blood clot in the vein; r/t DVT and pulmonary embolus
pulmonary embolus
deep vein clot that breaks free from vein wall, travels to the lungs, and blocks some or all of the blood suply
Negative nitrogen balance, and when/why it appears
With metabolic changes occurring, because of immobility, glucose cannot enter the cells properly and this causes the body to begin breaking down its protein stores for energy; resulting in a negative nitrogen balance and increased oxygen demands.
Diuresis
Increased urine excretion
Disuse osteoporosis
A disorder characterized by increased bone resorption from immobilization. Osteoporosis peaks at 4 to 6 weeks with bone density decreasing 40% after 12 weeks (in the case of patients with spinal cord injury)
Activity tolerance
How much physical movement/activity a patient can endure. Reviewed at assessment to assist in setting goals.
Range of Motion (ROM)
Important as a baseline measurement to compare and evaluate whether loss in joint mobility is developing or has occurred.
Abduction
The movement of an extremity away from the midline of the body
Adduction
The movement of an extremity toward the midline
Changes expected during assessment of an immobilized patient:
Decreased muscle strength, loss of muscle tone and mass, and contractures.
Anthropometric measurements
Include upper arm circumference, and triceps skinfold measurements. Most commonly assessed by a registered dietitian to determine if there is a loss of muscle mass. Take this measurement every 2 to 4 weeks.
Thromboprophylaxis
The prevention of thromboembolic disease, in the home setting. Adherence to prescribed anticoagulants, proper positioning, and safe use of antiembolic stockings help reduce thrombus formation. PTs must understand their risk for bleeding.
What parts of the body do friction, shear, and pressure cause the most wear and tear?
Bony prominences. Pay special attention to these areas in patients with mobility issues.
Trochanter rolls
A rolled towel often used to prevent rotation of the hips. Things like pillows, heel boots, hand rolls, or arm splints increase comfort and reduce injury to the skin of musculoskeletal system.
A foot boot helps prevent:
Foot drop, and helps to maintain proper alignment, and provide freedom of movement for the feet.
The prone position and its use
it is used for critically ill patients on mechanical ventilation and who have acute respiratory distress syndrome (ARDS). Use of prone position ventilation has been shown to improve oxygenation in selected patients with ARDS. Assess factors of PT before assuming this position.
Hand-wrist splints
Are individually molded for a patient to maintain proper alignment of the thumb.
Trapeze bar
A triangular device that hangs from a securely fastened overhead bar that is attached to a pts. bed frame.
Instrumental Activities of Daily Living (IADLs)
Activities such as shopping, preparing meals, banking, taking medications, and ADLs.
