Mobility Flashcards by Chris Letts

Moving a joint toward the middle of the body

adduction

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Moving a joint away from the midline of the body

abduction

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Decreasing angle between two bones

flexion

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Straightening a joint

extension

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turning the body or a body part to face upward

supination

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turning the body or a body part to face downward

pronation

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Three lifespan mobility considerations for newborns and infants

reflexes
gross motor skills
milestones

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Toddler mobility considerations

wide stance and unsteady gait

fine motor skills

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Child and adolescent mobility considerations

growth spurts

school sports

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Recommendation for strenuous aerobic exercise

30 min 3x/wk

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Musculoskeletal factors affecting mobility

osteoporosis

calcium, phosphorus, vitamin B (vitamin D)

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paraplegia

decreased motor and sensory function of legs

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hemiplegia

one leg and one arm on the same side is impacted

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tetraplegia

both arms and both legs impacted

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congenital conditions that impact movement

spina bifida, cerebral palsy

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Can depression and affective disorders affect mobility?

yes

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Applied principles of body mechanics (4)

adjust height of the work area
hold objects close to body when lifting
use mechanical devices when appropriate
holding one’s breath during physical activity is an indication of muscle strain

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What is the work area in nursing

wherever the patient is

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How do you prevent back injury

plan ahead: get help, ensure good height of bed, reposition to lift with legs

DON’T hold far away, twist while lifting, lift with back

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Requires oxygen to use the energy provided by the metabolic activities of the skeletal muscles

aerobic

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Static exercise by which the patient tenses a muscle

isometric

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isotonic exercise

form of exercise with muscle tension, contraction, and active movement

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anaerobic exercise

skeletal muscle activity using energy metabolized without energy

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increased, rapid muscle tone

spasticity

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rhythmic repetitive motion that can occur at rest and may interfere with fine motor control

tremor

spontaneous brief involuntary muscle twitching of the limbs or facial muscles

chorea

gait characterized by walking with the feet wide apart in a duck-like fashion

waddling

progressive shortening of a muscle and loss of joint mobility resulting from fibrotic changes in tissues surrounding the joint

contracture | this can be a problem in long term care facilities

largest reportable problem related to mobility

falls anything that impairs mobility increases the risk for a fall falls lead to hospitalizations, increased costs, increased morbidity and mortality

fall risk factors (6)

``` history of falls secondary diagnosis ambulatory aid IV/heparin lock gait/transferring mental status ```

fall risk factors (6)

``` history of falls secondary diagnosis ambulatory aid IV/heparin lock gait/transferring mental status ```

causes of pain from immobility (4)

renal calculi (from calcium leeched from the bones), contractures, atrophy, joint pain

cardiovascular issues with immobility

orthostatic hypotension | barioreceptors dull with immobility

injury from immobility

pressure ulcers

infection from immobility

urinary stasis, UTI

infection from immobility

urinary stasis, UTI

thrombus formation with immobility

- low velocity > precipitates - venous return to the heart decreases platelets, fibrin, and cell elements can attach - to vessel walls

Does immobility increase blood viscosity?

Three main tools to prevent immobility-related thrombus

compression, ambulation, Lovenox (anticoagulant)

pneumonia potential with with immobility (4)

- restricted movement of diaphragm - shallower breathing due to lack of demand - alveoli collapse due to underinflation of lungs: atelectasis - ambulate to reduce risk

nitrogen-related immobility sequelae

inadequate protein synthesis delayed wound healing muscle atrophy

diagnostic tools for mobility-related issues

x-ray and arthroscopy | labs: hemoglobin/hematocrit

types of physical fitness to recommend (SATA for test)

``` tai chi group activities membership to a local health club strength training physical therapy ```

what is osteoporosis

osteoclasts dominate over osteoblasts | low bone mass, deterioration of bone tissue, disruption of bone architecture

osteoporosis recommendations

``` smoking cessation alcohol and caffeine limit calcium and vitamin D weight-bearing exercise bone density testing medications ```

risk factors for osteoporosis

``` post menopausal family history history of fractures alcohol abuse cigarette smoking prolonged immobility ```

patient lies with head 30 to 40 degrees lower than feet

trendelenburg

head elevated 30 to 45 degrees

semi-fowler's

face down pt

prone

pt lying on side

side-lying or lateral

head elevated 80-90 degrees

fowler's (or true fowler's)

pt lies supine with hips flexed and calves and heels parallel to floor

lithotomy

foot boots

keeps foot in flexed position

hand roll

keeps hand in functional position and prevents finger contraction

abduction pillow

maintains hip abduction after hip surgery to prevent hip dislocation

side rail

help weak patients turn protects patients from falling out of bed bed has 4 side rails (all four up is a restraint)

how often should skin under mobility aids be visualized for integrity

every 4 hours

what activity is encouraged after surgery related to mobility

ambulation

benefits of early ambulation

- reduces venous clots - reduces atelectasis - prevents pneumonia - promotes bowel motility

atelectasis

collapse of alveoli related to incomplete inhalation (happens with immobility)

What to do when pt can't ambulate

range of motion exercises pt should perform independently as much as possible, but passive ROM is possible

when do you stop performing ROM exercises

resistance or pain

How to prevent postural hypotension when ambulating

dangling

Signs or symptoms of postural/orthostatic hypotension

hypotension, dizziness, diaphoresis, shortness of breath, light-headedness

equipment concerns for pt ambulation

oxygen IV tubing IV pole portable oxygen

non-equipment concerns for pt ambulation

medications surgical limitations baseline

transfer equipment

transfer belt various lifts friction reducting sheets

cane basics

``` 2 points of supports at all times cane on stronger side move cane forward first move weak leg same distance as cane move stronger leg forward beyond cane and weak legs ```

discharge mobility considerations

what pt has and needs at home has someone checked environment for fall hazards referrals for home health and follow up

Does a pt with oxygen needs special equipment before ambulating?

Yes - oxygen tank