Mobility 1 Flashcards
Ergonomics is undertaken in an effort to_________
avoid injuries
What are the 4 elements of body movement
- Posture alignment
- Joint mobility
- Balance
- Coordination
What is mobility
The ability to move freely and easily independently
What can immobility lead to
fluid stasis and shortening of muscles
Prolonged immobility can lead to…
- deconditioning
- muscle weakness
- infections
- risk of thrombosis
What are two postural abnormalities
- Lordosis
- Kyphosis (hunchback)
What is the difference between hemipyliga and hemiperisis?
Pyliga: half of the body paralysis
Perisis: weakness to one side of body
What are some pathological influences on mobility
- Postural abnormalities
- Impaired muscle development
- Damage to CNS
- Musculoskeletal Trauma
- Illness/disease process
What can be some other influences on mobility
- Medication
- Motivation
- Knowledge deficit (babies)
- Restraints
- Bed rest
What are activities of daily living
Peoples self care daily activities
Can mobility affect communication?
Yes, non verbal communication
Alteration in mobility can cause risk for______
impairment in each body system
How can impaired mobility affect children’s growth and development in 3 ways
- Delay gross motor skills
- Intellectual development
- Musculoskeletal development
How can impaired mobility affect adolescents in 3 ways?
- Lag in peers in gaining independence
- Accomplishing skills (drivers license)
- Social isolation risk
How can impaired mobility affect adults in 2 ways?
- All systems at risk
- Risk for role changes
How can impaired mobility affect older adults in 2 ways?
- increased physical dependance on others
- accelerates functional losses
How can impaired mobility affect metabolism
Cause a negative nitrogen balance, can cause decreased GI motility and calcium resorption
Explain negative nitrogen balance (how it happens)
Sickness= decrease appetite = decreased protein= less aa’s = weight loss= muscle weakening= nitrogen increase= negative nitrogen balance
What is calcium resorption?
Calcium is released into circulation, increased urine calcium which can cause kidney stones
How can impaired mobility affect the respiratory system? Explain both
- Atelectasis: collapsing of the alveoli
- Hypostatic Pneumonia: inflammation of lungs from stasis of pooling secretions
What are 3 ways that impaired mobility affects the cardiovascular system
- Orthostatic hypotension
- Increased cardiac workload
- Thrombus formation
What are 4 ways impaired mobility can affect the musculoskeletal system
- Loss of endurance, strength and muscle mass
- Impaired joint mobility
- Increased risk of falls
- Impaired calcium metabolism
What is a contracture?
Fixation of a joint
Where is hypercalcemia?
Less dense bone because there is more calcium in your blood
What can impaired mobility do to effect the urinary system
- Increased risk of UTI
- Increased risk for renal calculi
Why would there be an increased for risk of UTI because of impaired mobility
- Urinary stasis
- Incomplete emptying of the bladder
- Bad perineal hygiene
- Increased urine concentration due to decreased fluid intake
What does renal calculi mean
Kidney stones
What can cause increased risk for renal calculi due to impaired mobility?
- Urinary stasis
- Altered calcium metabolism
- Concentrated urine
How can impaired mobility have an effect on the integumentary system?
- Pressure ulcers
- Secondary friction and shearing
What can impaired mobility do to someones psychological wellbeing
- Decreased social interaction/isolation
- Sensory deprivation
- Role change
- Independence loss
- Sleep wake alterations
How can we help metabolism when someone has decreased mobility
- Diet (increase protein, calories and vitamin C and zinc)
- Monitor Weight
How can we help the respiratory system when patient has immobility in 7 ways
- Position change q2h
- Deep breathing/ coughing every hour
- Incentive spirometry (get alveoli to expand)
- Adequate hydration
- Chest physiotherapy
- Suction secretions as needed
- Assess respirations, breath sounds and sputum
If someone has fluid in left lung, what positioning would make them more comfortable?
Laying on left side so that right lung can fully expand
What are 6 ways to promote cardiovascular health for a patient who is immobile
- Mobilize as soon as possible
- Change position slowly/gradually
- Raise to fowlers 10 minutes before standing
- Dangle feet before standing
- Avoid valsalva maneuver
- Aware of thrombosis
What is the Valsalva Maneuver
What we do on planes to pop our ears
What are 4 ways to promote musculoskeletal system when patient is immobilized
- Ambulate
- Exercise ROM and isometric exercises
- Proper support and alignment
- Use of assistive devices
How to be promote ‘elimination’ when a patient is immobilized
- Adequate hydration
- Assess urinary output
- Catheterize for retention when needed
- Diet of fruit, veggies and fibre
- Assess bowel moments
- Stool softness, etc
What are 4 ways to promote integumentary system during immobilization
- Reposition every 2 hours
- Skin care
- Pressure offloading devices
- Therapeutic sleep surfaces
What are 4 ways to promote psychosocial health in an immobilized patient
- Provide routine socialization
- Provide stimuli to maintain orientation
- Encourage ADL’s
- Minimize sleep interruptions
What is isometric exercise
Joint angle and muscle length do not change
What is isotonic exercise?
muscle contraction occurs without movement of body parts
What is isokinetic exercise?
Range of motion, muscle movement with constant rate of motion
What should we teach patients about post exercise recovery?
Teach about overexertion and regular rest periods
What does ACES stand for
A: alert, energetic
C: cooperative
E: extremities working enough for transfer
S: sits unsupported
What is the orthopneic position?
Patient in sitting position or over beside table, leaning forward
When would we use orthopneic position?
COPD or congestive heart failure
What is the dorsal recumbent position
Supine except shoulders slightly elevated (on pillow)
What is the only position that allows for full extension of hip and knee joints?
Prone
What is the lateral position?
Lies on side with top leg in front of bottom leg, hip and knees flexed
What can lateral position be good for?
To reduce lordosis, and reduces pressure on sacrum
What is the Sims or semi prone position?
Halfway between lateral and prone position
What is 30 degree lateral position?
Halfway between supine and lateral
When would the trendelenburg position be used?
- Boost patient to top of bed
- For chest excretions
- Increase venous return
- Inserting PIK line
What should we assess on a patient before repositioning (6 things)
- Degree of exertion allowed
- Activity tolerance
- Ability to assist
- Ability to understand/follow instructions
- Weight
- Pain
What should the nurse assist about themselves before repositioning a patient?
- Strength/ability to move patient
- Assistive devices available
- Plan to care for IV’s, etc
- Aware of effects of patents meds to alter alertness, strength and mobility
What should the nurse assist about themselves before repositioning a patient?
- Strength/ability to move patient
- Assistive devices available
- Plan to care for IV’s, etc
- Aware of effects of patents meds to alter alertness, strength and mobility
What are the 4 P’s.
Pain, potty, positioning and possessions
What are the guidelines to be able to use transfer belt
Patient needs to be able to fully weight bear once standing
Which side is a cane held on?
Held on strong side
Cane moves forward along with ______ leg
Weak
What order do we move walker with our steps
Move walker then take step
How high should crutches be on patent
3-4 finger widths from axilla
When going up stairs, which leg goes first? Going down?
Unaffected up first , affected down first
What is the max weight a person should lift without an assistive device?
35 pounds
Where should pillows be placed for supporting prone position
Pillow under head, under abdomen, feet over end of mattress or pillow under lower legs
Where should support be placed for lateral position
Head and neck, upper arm, leg and thigh
Dehydration can lead to increased risk of _____ when in bed
Pressure ulcers
What is a static low air loss bed?
4-5 air filled cushions which allow pressure to be reduced but increase body area support
What is an active LAL bed?
like a low air loss bed but it gently pulsates from side to side to stimulate capillary blood flow and stimulates pulmonary secretion movement
What is an air fluidized bed?
air moves around tiny silicone coated beads producing fluid like movement
What is hemiplegia?
Loss of movement on one side of body
How long should client be sitting up before ambulation?
1 minute
What are some falling risks for older adults?
- Medications
- Neurological disorders
- Orthopedic problems
- Environmental hazards
- Orthostatic hypotension
What is a lofstrand crutch
Extends to forearm, has metal cuff around forearm
What is the 4 point alternate gait?
Move right crutch ahead, move left foot forward, move left crutch, right foot
What is a 3 point gait?
Move both crutches, weaker foot then stronger foot
What is 2 point gait?
move left crutch and right foot forward, then right crutch left foot
