Mobility Flashcards
What are some potential causes of immobiltly?
-Direct injury / trauma to the musculoskeletal system (Bruises, sprains, and fractures)
-Central nervous system damage
Examples: brain trauma, stroke, ALS (Lou Gehrig’s disease), MS (Multiple Sclerosis)
- Illness
Any kind of debilitating illness (examples: myocardial infarction, systemic infection, cancer)
Complications from surgery
Advanced age with or without illness or trauma
What are some developmental considerations in regards to mobility?
Older persons
Progressive loss of total bone mass, muscle strength and aerobic capacity occurs naturally with aging
Immobilization of older persons increases their dependence on others and decreases their functional capacity for self-care
Encourage as much self-care as possible
Nurses can contribute to loss of self-care abilities by doing too much for patients
Developmental considerations for infants, toddlers, preschoolers, adolescents and adults?
Infants, toddlers, preschoolers:
Delay in gross motor skills, intellectual development, or musculoskeletal development
-Newborns: spine is flexed and lacks curves
ALL are immobilized due to: trauma, need to correct a congenital sk abnormality
Adolescents: 6-12
May affect growth patterns and ability to gain independence
Social isolation can occur
-Body image impacts
Adults: 20-40
Physiological systems are at risk
Changes occur in family and social structures
Few changes that cause affects
Pregnancy
Physiological systems are at risk
Changes occur in family and social structures
Older adults:
Women are at increased risk of osteoporosis with decrease in estrogen
Spine shifts forward, center of gravity shifts forward = falling
Scared of falling, so they decrease movement = muscle atrophy
Progressive loss of total bone mass, muscle strength and aerobic capacity occurs naturally with aging
Immobilization of older persons increases their dependence on others and decreases their functional capacity for self-care
What are some systemic effects of immobility on the musculoskeletal system?
Loss of lean body mass
Muscular deconditioning / atrophy
Muscle strength drops 3% per day
Accelerated bone loss if patient already has osteoporosis
The bone tissue is less dense, putting the patient at risk for pathological fractures
Joint contracture
An abnormal and possibly permanent condition characterized by fixation of a joint
Foot drop
Damage (possibly permanent) to the peroneal nerve of the foot from constant flexion as a result of poor support
General objectives of bedrest?
1.) Reduce physical activity and O2 needs of the body
2.) Reduce pain, including postoperative pain, and the need for large doses of analgesics or who are sedated
3.) To allow patients who are ill or debilitated to rest
4.) To allow patients who are exhausted the opportunity for uninterrupted rest
*Duration depends on the illness or injury and the patients prior state of health
What does the term disease atrophy refer to?
Describes the tendency of cells and issue to reduce in size and function in response to prolonged inactivity resulting from bedrest, trauma, casting of a body part, or local nerve damage
When there is an alternation in mobility, each body system is at?
Is at risk for imparement
Effects of imbobilitly on the metabolic system?
Disrupts normal metabolic functioning, decreasing the metabolic rate; altering the metabolism of carbohydrates, fats and proteins causing fluid, electrolyte, and calcium imbalances; and causing gastrointestinal disturbances such as decreased appetite and slowing of perostasis
Effects of mobility on the respiratory system?
Increase ventilation and oxygen intake
Improves gas exchange
Prevents pooling of secretions in the
bronchi and bronchioles
Systemic effects of imobility on the respiratory system?
Atelectasis (collapse of alveoli – can lead to collapse of lung)
Hypostatic pneumonia(inflammation of the lung from pooling of secretions)
Mucus accumulates in the dependent regions of the airways which can lead to bacterial growth
Increased lung secretions can impair gas exchange and cause dyspnea
Decreased lung expansion
What is Orthostatic hypotention? Symptoms
Drop in BP greater than 20mm Hg in systolic BP and of 10mm Hg in diastolic BP
-Dizziness, light-headness, nausea, tachycardia, pallor, or fainting when the patients changes from lying or sitting position to a standing position
Effects of immobility on the Cardiovascular system?
Orthostatic hypotension:
Blood pressure drops when the patient changes from a lying or sitting position to a standing position, especially evident in older persons
Cardiac output diminishes when on bedrest so heart can’t always keep up when changing vertical position = orthostatic hypotension + dizziness
Potential for falls increases
Effects of mobility on the cardiovascular system?
Increases HR
Strengthens heart contractions
Increases blood supply to the heart and muscles
Mediates harmful effects of stress
What is a thrombus? What is the most common type?
Blood clot that forms in a vessel as a result of vessel injury (surgery), slow blood blow (bed rest), increase in blood viscosity, increase in platelets or clotting factors)
Is an accumulation on platelets, fibrin, clotting factors, and the cellular elements of the blood attached to the interior wall of a vessel or artery, sometimes occluding the lumen of the vessel
Most common type is DVT
What is an Embolus?
Embolus
Dislodged venous thrombus (blood clot) can travel to other parts of the body and cause an ischemic event (stroke, myocardial infarction (heart attack), pulmonary embolism)
Effects of mobility on metabolic and GI systems?
Elevates the metabolic rate
Decreases serum triglycerides and cholesterol
Stabilizes blood sugar and makes cells more responsive to insulin
Improves the appetite
Increases GI tract tone
Facilitates peristalsis
Effects of immobility on the GI system?
Decreased mobility in the GI tract
Can cause constipation
Can cause difficulty passing stool due
to positioning limitations
Pseudodiarrhea may result from a fecal impaction (accumulation of hardened feces):
-Liquid stool passing around the area of impaction
-Left untreated, fecal impaction can result in a mechanical bowel obstruction that may partially or completely occlude the intestine
What is it called when there is a fixation of the joint?
Joint contracture
Effects of mobility on the urinary system?
Promotes blood flow to the kidneys
Excretes body wastes more effectively
Prevents stasis (stagnation) of urine in the bladder
What occurs when a foot drop occurs?
the foot is permanently fixed in plantar flexion
Systemic effects of immobility on the urinary system?
-A patient that lies flat for prolonged period can experience urinary problems
-Urine must enter the bladder unaided by gravity and can causeurinary stasis
-Increases the risk of urinary tract infection and renal calculi (kidney stones)
-Also, patients may be unable to void or completely empty their bladder leading to residual urine in the bladder, which increases the risk of infection
Effects of mobilitly on the integumentary system?
Clean, intact, well hydrated skin
Absence of pressure signs: (Pallor, redness, increased warmth, tenderness)
Systemic effects of immobility on the integumentary system?
Pressure injury
Friction
Shear
Hygiene concerns
Potential delay in wound healing
sychosocial effects of immobilitly?
Decreased social interaction
Social isolation
Sensory deprivation
Loss of independence
Role changes
Emotional reactions
Behavioural responses
Sensory alterations
Changes in coping
Depression
