Mobility

Question 1

What does “posture aligned” refer to?

Answer 1

stable– head over the shoulders, shoulder in line with the hips, hips in line above the knees, and knees in line with the ankles– all body curves in line for good body mechanics

Question 2

Define joint mobility

Answer 2

when the joint is flexible and functioning through full and fluid range of motion

Question 3

What can decrease joint flexibility?

Answer 3

age, injury, certain musculoskeletal injuries

Question 4

Define ergonomics

Answer 4

an applied science (education) concerned with designing and arranging things people use so that the people and things interact most efficiently and safely

Question 5

What are the different effects of immobility?

Answer 5

-musculoskeletal effects, such as muscle weakness
-integumentary effects, such as pressure sores
-respiratory effects, such as hypoxemia
-circulatory effects, such as orthostatic hypotension
-gastrointestinal effects, such as constipation

Question 6

What are some conditions or illnesses that can put a client at risk of decreased mobility?

Answer 6

congenital anomalies– multiple sclerosis, congenital scoliosis, muscular dystrophy

postural anomalies– lordosis, kyphosis

CNS damage and conditions– head/spinal trauma, Parkinson’s disease

Disease process of musculoskeletal system– arthritis, MS trauma

Illness/disease process– COPD, asthma, diabetes

Question 7

Factors that impact mobility include:

Answer 7

-medication
-motivation
-age
-pain
-surgery

Question 8

What is shearing?

Answer 8

in terms of a patient, it’s when their is a combo of friction and pressure which occurs commonly when a patient assumes a sitting position– ex. when the patient slides down from their sitting position

Question 9

Why is positioning, transferring and ambulation important?

Answer 9

-prevents muscle discomfort
-prevents undue pressure resulting in pressure ulcers
-prevents damage to superficial nerves and blood vessels
-prevents contractures
-maintains muscle tone and stimulates postural reflexes

Question 10

What does ACES stand for and when do you check for it?

Answer 10

prior to transfer or ambulation

A- alert and energetic enough to perform the transfer
C- cooperative
E- extremities working sufficiently for the transfer
S- sits unsupported

Question 11

What needs to be checked before ambulation?

Answer 11

strength, any physio requirements, orders, and vital signs

Question 12

What are the 4 types of mechanical lifts?

Answer 12

mobile floor-based lifts (Hoyer)
Sit-to-stand lifts (Sara)
Ceiling mounted lifts (Guldmann)
Tub chair lifts (Ambulift)

Question 13

What needs to happen prior to using a mechanical lift?

Answer 13

-explain the procedure to the client
-provide prompts
-encourage independence
-remove glasses
-position in center of sling

DO NOT: leave the client alone in the lift or use lift to transport client

Question 14

Describe the Mobile Floor-Based lift (Hoyer)

Answer 14

used for clients that are unable to weight bear, unable to maintain upright posture, uncooperative/unable to follow instructions, above a certain weight level

–it requires 2 HCWs

Question 15

Describe the sit-to-stand lift (Sara)

Answer 15

assists with clients who are able to weight bear at least through one leg/partial weight bear both legs, pull up with at least one arm, have trunk control, follow instructions, and are cooperative

DO NOT use if the patient has anything wrong with their abdomen or back, or is at a high risk for skin tears or bone fractures

– requires 2 HCWs

Question 16

Describe the ceiling mounted lift (Guldmann)

Answer 16

for clients that are unable to weight bear, the client does not need to be able to cooperate or follow instructions
– limited to the area covered by track on ceiling

Question 17

Describe the tub chair lifts (ambulift)

Answer 17

moves client in and out of bathtub, client must be able to have control of their trunk, lift legs, cooperate, and follow instructions

Question 18

What are the 3 forms of restraints?

Answer 18

physical restraint– a manual or physical device that the individual cannot remove, and which restricts freedom of movement

chemical restraint– a pharmaceutical agent given to control or prevent aggressive or agitated behaviour when that behaviour may place the patient or others at risk

environmental restraint– barriers to free personal movement which serve to confine clients to specific areas

Question 19

How often should restraints be monitored and removed?

Answer 19

monitor a minimum of q2h– check safety, respiratory status, hydration status, LOC, emotional status, CWCMS, skin integrity, restraint integrity

remove restraints for minimum of 10 min q2h to provide opportunity for ROM, repositioning, elimination, nutrition, hydration, hygiene, etc.