Mobility Flashcards
Moving a joint toward the middle of the body
adduction
Moving a joint away from the midline of the body
abduction
Decreasing angle between two bones
flexion
Straightening a joint
extension
turning the body or a body part to face upward
supination
turning the body or a body part to face downward
pronation
Three lifespan mobility considerations for newborns and infants
reflexes
gross motor skills
milestones
Toddler mobility considerations
wide stance and unsteady gait
fine motor skills
Child and adolescent mobility considerations
growth spurts
school sports
Recommendation for strenuous aerobic exercise
30 min 3x/wk
Musculoskeletal factors affecting mobility
osteoporosis
calcium, phosphorus, vitamin B (vitamin D)
paraplegia
decreased motor and sensory function of legs
hemiplegia
one leg and one arm on the same side is impacted
tetraplegia
both arms and both legs impacted
congenital conditions that impact movement
spina bifida, cerebral palsy
Can depression and affective disorders affect mobility?
yes
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
What is the work area in nursing
wherever the patient is
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
Requires oxygen to use the energy provided by the metabolic activities of the skeletal muscles
aerobic
Static exercise by which the patient tenses a muscle
isometric
isotonic exercise
form of exercise with muscle tension, contraction, and active movement
anaerobic exercise
skeletal muscle activity using energy metabolized without energy
increased, rapid muscle tone
spasticity
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?
no
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
