Mobility Flashcards
regulation of movement
- skeletal system: bones and joints
- muscles
- nervous system
- problem with any of these affects mobility
Factors that affect mobility: age
- Infant
a. Spine flexed, no anteroposterior curve until infant raises head
b. Thoracic spine straightens
c. Lumbar spinal curve appears allows sitting & standing
d. Posture awkward–head & upper trunk carried forward–child off balance,
falls easily - Toddler
a. Posture slightly swayback with protruding abdomen
b. Walk–legs & feet far apart & feet slightly everted - School age
a. By third year taller, slimmer & better balanced
b. Improved posture & muscle strength fine motor coordination - Older adult
a. Bones—osteoporosis risk of fx of wrist, vertebrae & neck.
b. Muscles–Regeneration slowed, atrophied tissue replaced with fiber
c. Joints Breakdown in component of joint capsule–arthritis
d. Posture–Height 1.2 cm/20 yrs, long bones remain same length
Factors that affect mobility: physical health
- Congenital disorders—cerebral palsy, spina bifida
- NS disorders—Parkinson’s disease, Spinal cord injury, stroke
- MS disorders—arthritis, fractures. Amputations
- Inner ear injections–vertigo
Factors that affect mobility: mental health
- Depression –> can affect posture
- Chronic stress –> fatigue, decrease in exercise
Factors that affect mobility: nutrition
- Poor nutrition –> muscle weakness, fatigue
- Vitamin D deficiency –> bone deformity
- Calcium deficiency –> Osteoporosis
- Obesity –> altered posture, balance
Factors that affect mobility: personal values
- Sedentary vs active lifestyle
- Value of personal appearance
Factors that affect mobility: external factors
- Weather
- Availability of recreational facilities
Factors that affect mobility: prescribed limitations
- Casts, braces, splints, traction
- Ordered immobility
nursing history: subjective data
- height/wt (pt report)
- activity & rest patterns
- diet: intake of calcium and vit D –> affects bone health
- meds
- arthritis, CNS depressants, sedatives
- do they use a walker, a cane, do they have difficulty ambulating
nursing history
- Functional status
o Walking, standing, sitting up, getting into/ out of bed or chair, ADLs
o Assistive devices—crutches, walker, braces, feeding or grooming aids
o Activity tolerance - Environmental barriers/ aids
- Past history of falls/ injuries
- Symptoms associated with MS problems
- pain/stiffness with movement
- weakness
- dominant hand
physical assessment: objective data
- Height, weight, stature, posture
- Body alignment
- Movement
- In bed, lying –> sitting –> standing
- Get idea of flexibility, agility,
control - gait – steady?
- get up and go test
times get up and go test
- begin timing
- rise from standard arm chair
- walk to line on floor (approximately 10 ft away from chair)
- turn and return to chair
- sit in chair again
- end timing
- should take 7 to 10 seconds
joints
- Swelling, redness, deformity, contractures (unable to stretch their arm out), crepitation (crackling)
- ROM
- Use of cane, walker, crutches, prosthesis
- evidence of past injuries
- any bruises, scratches, scrapes
functional status
- Dressing, bathing, feeding, toileting
- NOC Scale:
0–completely independent
1—requires use of an assistive device
2—needs minimal help
3—needs assistance or some supervision
4—needs total supervision
5—needs total assistance or unable to assist
diagnostics
- X-rays
- Fracture sites—old or new
- DXA (or DEXA) Scan (bone density scan)
- Dual-emission X-ray absorptiometry
- Bone density
- white = more dense
impaired physical mobility
- difficulty or inability to facilitate movement
- Ex: older adult who has experienced a fracture
- someone who broke their leg in their 20s and isn’t able to move around adequately
self-care deficit syndrome
- the state in which an individual experiences an impaired motor fxn or cognitive fxn causing a decreased ability in performing each of the 5 self-care activities (feeding, bathing, toileting, dressing, instrumental things like cooking)
- ex: someone who had a stroke –> cog motor fxn = altered
sedentary lifestyle
- reports a habit of life that is characterized by a low physical activity level
- couch potato, lots of work from a computer
principles of body mechanics
- use proper body mechanics and equipment to protect pt and self
- maintain a wide stable base with ur feet
- put the bed at the correct height
- waist level when providing care
- hip level when moving a pt
- try to keep the work directly in front of u to avoid rotating the spine
- keep the pt as close to ur body as possible to minimize reaching
lifting risks in nursing
- Awkward postures/reaching
- Heavy loads
- No nurse should lift over 35 pounds
- Excessive pushing/ pulling
- Frequent/ repeated lifting and
moving - Tasks that take a long time
- Lack of help
- Lack of equipment
- pt should be able to assist you or you need some medical equipment
- if you had 2 nurses and pt was 100 lbs
Nursing interventions
- do this after you figure out the cause
- should not be lifting more than 35 lbs
- Use mechanical equipment whenever necessary for moving patients
- Increase limb mobility
• ROM exercise 4x/day
• Support extremity to reduce swelling - Medicate for pain
- Positioning
• Maintain body alignment
Active ROM
- they move around themselves
- best form of ROM
Passive ROM
- we assist them to move around if they are unable to do it themselves
Positioning
• Maintain body alignment
• Use the appropriate position: Fowler’s, Semi-Fowler’s, Dorsal Recumbent, Prone, Lateral, Sim’s