Exam II - Immobility

Question 1

immobilization

Answer 1

physical restriction of movement to a body part

Question 2

hospital-associated deconditioning (HAD)

Answer 2

loss of muscle mass, functional reserve, and decreased activity tolerance and the functional decline in ADLs and mobility

Question 3

orthostatic hypotension

Answer 3

decrease in BP of 40+ mm Hg in systolic or 20+ mm Hg in diastolic upon rising from a sitting position

Question 4

recumbence

Answer 4

position of lying down at rest

Question 5

deep vein thrombosis (DVT)

Answer 5

A blood clot/thrombus in a deep vein, usually in the legs.

Question 6

atelectasis

Answer 6

collapse of alveoli

Question 7

hypostatic pneumonia

Answer 7

inflammation of lung from stasis or pooling of secretions

Question 8

joint contracture

Answer 8

preventable, abnormal, and possibly permanent condition char. by limited movement or fixation of the joint

Question 9

footdrop

Answer 9

gait abnormality involving a significant weakness of ankle and toe dorsiflexion

Question 10

pressure injury

Answer 10

localized damage to skin and/or underlying soft tissue, usually over a bony prominence or r/t a medical or other device.

Question 11

venous thromboembolism (VTE)

Answer 11

blood clot in the vein; r/t DVT and pulmonary embolus

Question 12

pulmonary embolus

Answer 12

deep vein clot that breaks free from vein wall, travels to the lungs, and blocks some or all of the blood suply

Question 13

Negative nitrogen balance, and when/why it appears

Answer 13

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.

Question 14

Diuresis

Answer 14

Increased urine excretion

Question 15

Disuse osteoporosis

Answer 15

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)

Question 16

Activity tolerance

Answer 16

How much physical movement/activity a patient can endure. Reviewed at assessment to assist in setting goals.

Question 17

Range of Motion (ROM)

Answer 17

Important as a baseline measurement to compare and evaluate whether loss in joint mobility is developing or has occurred.

Question 18

Abduction

Answer 18

The movement of an extremity away from the midline of the body

Question 19

Adduction

Answer 19

The movement of an extremity toward the midline

Question 20

Changes expected during assessment of an immobilized patient:

Answer 20

Decreased muscle strength, loss of muscle tone and mass, and contractures.

Question 21

Anthropometric measurements

Answer 21

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.

Question 22

Thromboprophylaxis

Answer 22

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.

Question 23

What parts of the body do friction, shear, and pressure cause the most wear and tear?

Answer 23

Bony prominences. Pay special attention to these areas in patients with mobility issues.

Question 24

Trochanter rolls

Answer 24

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.

Question 25

A foot boot helps prevent:

Answer 25

Foot drop, and helps to maintain proper alignment, and provide freedom of movement for the feet.

Question 26

The prone position and its use

Answer 26

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.

Question 27

Hand-wrist splints

Answer 27

Are individually molded for a patient to maintain proper alignment of the thumb.

Question 28

Trapeze bar

Answer 28

A triangular device that hangs from a securely fastened overhead bar that is attached to a pts. bed frame.

Question 29

Instrumental Activities of Daily Living (IADLs)

Answer 29

Activities such as shopping, preparing meals, banking, taking medications, and ADLs.