MMOBILITY / ACTIVITY​ power point

Question 1

Musculoskeletal System ​controls

Answer 1

Bones

Muscle

Question 2

Nervous System ​ controls

Answer 2

voluntary movement, posture, balance, and gait ​

Neurotransmitters communicate electrical impulses from nerves to muscles, facilitating movement ​

Question 3

Cardiac System ​provides

Answer 3

Provides oxygen and circulates nutrients to body tissues ​

Question 4

Altered Structure and Function of Movement​: Musculoskeletal System ​

Answer 4

osteoporosis (due to inadequate calcium and Vitamin D intake) ​

Flaccidity or hypotonicity (due to lack of physical activity, injury or neurologic impairment) ​

Question 5

Altered Structure and Function of Movement​: Nervous System ​

Answer 5

Damage (ischemia) to brain or spinal cord may impair ability to move ​

Hemiparesis, hemiplegia, paraplegia, quadriplegia ​

Question 6

Altered Structure and Function of Movement​: Cardiopulmonary System​

Answer 6

Compromised cardiac function or diminished respiratory capacity affect ability to perform ADLs and exercise ​

Question 7

Immobility Effects: Musculoskeletal System ​

Answer 7

Immobility predisposes a person to weakness, decreased muscle tone and muscle mass, muscle atrophy, and contracture (including footdrop), disuse osteoporosis, and pathologic bone fractures ​

Question 8

Assessment of the musculoskeletal system includes

Answer 8

observation of gait and coordination, testing range of motion, fall risk assessment

Question 9

Immobility Effects: Nervous System ​

Answer 9

Immobility, especially prolonged periods, can alter proprioception and equilibrium ​

Question 10

Immobility Effects: Nervous System ​assessment

Answer 10

Observe the patient’s gait, posture, and balance; issues with this may indicate problem with cerebellum ​

Question 11

Immobility Effects: Nervous System ​assessment steps

Answer 11

Dangle the patient at the side of the bed before getting them up ​

Assess ability to stand unassisted before allowing ambulation ​

Question 12

Immobility Effects: Cardiopulmonary System ​

Answer 12

Cardiac workload increased, lung expansion decreased (risk for atelectasis, pneumonia), circulatory stasis (risk for DVT), activity intolerance develops ​

DVT / PE: Deep vein thrombosis (DVT) and pulmonary embolism (PE) great risk with immobility​

Question 13

Symptoms of DVT

Answer 13

unilateral leg swelling, redness, and pain ​

Question 14

Symptoms of PE include

Answer 14

confusion, SOA​

Question 15

Effects of Immobility: Nutrition

Answer 15

Basal metabolic rate (BMR) is reduced​

May cause nausea / anorexia because body’s needs are reduced ​

Question 16

Effects of Immobility: Elimination​

Answer 16

Urinary stasis causes UTIs and renal calculi ​

Hypomobility of the GI tract causes constipation ​

Question 17

Effects of Immobility: Skin

Answer 17

Tissue ischemia caused by pressure may lead to necrosis ​

Pressure injuries develop due to inactivity and pressure on bony prominences ​

Question 18

skin assesment include

Answer 18

observation of color, texture, warmth, and intactness; assess for tissue blanching ​

Question 19

Effects of Immobility: Psychosocial​

Answer 19

Isolation and sensory deprivation (lack of external stimuli) may result from decreased interaction with others ​

Self-concept may be altered; traditional coping strategies may not be effective, causing irregular patterns of behavior​

Sleep and rest patterns may be disturbed ​

Question 20

Psychosocial immobility symptoms observe

Answer 20

mood, behavior, and sleep patterns ​

Question 21

Planning for Care of Immobilized Patients: Collaboration with Healthcare Team ​

Answer 21

PT, OT, and SW provide ambulation support, assistive devices, activities, and psychosocial resources ​

Dietitians address nutritional concerns​

Speech therapists assess patients’ ability to chew and swallow ​

UAPs aid RNs by turning and repositioning patients, ROM exercises, transfers, and assistance with ambulation​

Question 22

Planning for Care of Immobilized Patients: Musculoskeletal and Nervous System Interventions​

Answer 22

Early ambulation after injury, illness, or surgery should be encouraged if not contraindicated​

Passive or active ROM exercises should be done if patient is on bedrest; stop when resistance is met or patient has pain ​

Medicate patients before moving to optimize exercise; medicate for appropriate pain level; complementary therapies also used- goal is to reduce the need for opioids​

Pillows, washcloths, and rolls can be placed to support patients’ bodies​

Patients with spinal cord injuries may require logrolling ​

Fall prevention is a high priority ​

Question 23

Ambulation Aids extra

Answer 23

crutches

Transfer belts​

Canes ​

Walkers​

Mechanical Lifts ​

Question 24

Safe patient handling is needed to decrease

Answer 24

handling injuries

Question 25

Safe patient handling safety measures

Answer 25

Nurses and UAPs should be properly trained on lift equipment ​ If patients have mobility, they should be taught to shift weight at least every 15 minutes while awake ​ Patients with upper body strength may use the upper side rails or a trapeze to pull themselves up​

Question 26

Planning for Care of Immoblized Patients: Cardiopulmonary System Interventions ​

Answer 26

Promote lung expansion by raising HOB (if able), TCDB, incentive spirometer, turn and reposition patient regularly ​ Prevent DVT / PE by teaching leg/ankle exercises, antiembolism hose or SCDs, ambulation​ Dangle legs on side of bed before standing ​

Question 27

Planning for Care of Immobilized Patients: Nutrition Interventions​

Answer 27

Include lean protein in diets ​ Involve patients in dietary choices ​ Increase activity as tolerated ​ Encourage adequate fluid intake ​

Question 28

Planning for Care of Immobilized Patients: Elimination Interventions ​

Answer 28

Adequate fluid intake ​ Position changes ​ Toileting program ​ Bedside commode / bed pan ​ Increased fiber ​ Early ambulation ​ Treating constipation ​

Question 29

Planning for Care of Immobilized Patients: Skin Interventions​

Answer 29

Turn patients at least every two hours ​ Use pressure relieving / pressure reducing mattresses ​ Use appropriate positioning and pillow placement ​ Use heel and elbow protectors ​