Immobility

Question 1

What effects does immobility have on the musculoskeltal system?

Answer 1

• Muscle atrophy
• Decrease in stability
• Impaired caclium metabolism
• Acceleration of bone loss (osteoperosis)

Question 2

What is the leading cause of bone fractures in men and women over the age of 50?

Answer 2

Osteoperosis

Question 3

What effects does immobility have on the cardiovascular system?

Answer 3

Increased Vasodilation and stasis

Increased thrombus formation

Increase risk for orthostatic hypotension

Question 4

What effects does immobility have on the respiratory system?

Answer 4

• Increased pooling of secretions
• Increased risk for atelectasis
• Increased risk for pneumonia

Question 5

What is atelectasis?

• What does it result in?

Answer 5

Collapse of alveoli when secretions block airways.

• Results in mucus accumulation in bronchi

Question 6

What is hypostatic pneumonia

Answer 6

Bacterial infection of lungs caused by accumulation of mucus in airways.

Question 7

What are these metabolic effects caused by immobility:

• Negative nitrogen balance
• Negative calcium balance

Answer 7

Negative nitrogen balance

Body excretes more nitrogen than it uses for protein breakdown: causes tissue breakdown

Negative calcium balance

Calcium is pulled from bones to blood stream (bones weaken)

Question 8

How does immobility increase the risk for UTIs?

Answer 8

Immobility increases urinary stasis/retention as bladder muscle decreases.

Question 9

What is urinary stasis?

Answer 9

Occurs when person lies flat:

Ureter peristalsis cannot push urine to bladder against gravity so urine just sits in ureters.

Question 10

What effects does immobility have on the gastrointestinal system?

Answer 10

Decreased peristalsis

Increased risk for constipation/impaction

Question 11

What risks does immobility cause for the integumentary system?

Answer 11

• Decrease skin turgor
• Delayed wound healing
• Pressure ulcers

Question 12

What types of lifting techniques are used for patients that cannot assist?

Answer 12

Only use:

Mechanical lifts

Lift teams (3 or more people for patients >200 lbs)

Question 13

What should be assessed on patients prior to transferring?

Answer 13

Vital signs

Fall risk

Orthostatic hypotension (allow patient to sit on edge of bed 1-2 mins before standing)

Question 14

What are joint contractures?

What are they caused by?

Answer 14

Abnormal shortening of connective tissue that decreases ROM

Caused by:

• Disuse
• Atrophy

Question 15

Walkers

Who uses these?

What must patient know before using?

Answer 15

Used for:

Weak patients with balance problems.

For use:

Keep elbows slightly flexed

Never use to stand up

Question 16

How is a walker properly set up for a patient?

Answer 16

Line the walker at the crease of the wrists

Question 17

Cane

What patients use these?

Which side of body is it held/used?

Answer 17

Used for:

Patients with unilateral leg strength

Used on:

Strong side of body

(Held in opposite hand of weaker leg)

Question 18

Crutches

How are crutches set up for patients?

Answer 18

• 2-3 finger lengths below armpit
• Hand grips placed at wrists

Question 19

What crutch gaits are used for:

• Partial weight on both legs
• No weight on affected legs
• Paralyzed extremeties

Answer 19

Partial weight on both legs

• 4-point gait
• 2-point gait

No weight on affected leg

• 3 point gait

For paralyzed extremity

• Swing through