Mobility, Activity, Mechanical Lifts

Question 1

Contracture

Answer 1

permanent shortening of a muscle

CONTRACTure

Question 2

Spasticity

Answer 2

sudden prolonged involuntary muscle contractions

random, Charley Horse

Question 3

Rigidity

Answer 3

resistancy of a relaxed limb to passive movement

stiff

Question 4

Range of Motion

Answer 4

ROM

maximum movement possible for each joint

Question 5

Active Range of Motion

Answer 5

AROM

patient moves joint independently to full ability of their ROM

Question 6

Passive Range of Motion

Answer 6

PROM

another person moves patient’s joints through ROM

Question 7

Active-Assistive Range of Motion

Answer 7

AAROM
aka Active-Passive Range of Motion (APROM)

patient uses stronger arm or leg to move weaker arm or leg through ROM

Question 8

Abduction

Answer 8

away from body

Question 9

Adduction

Answer 9

add to body

Question 10

Eversion

Answer 10

sole of foot turns outward

Question 11

Inversion

Answer 11

sole of foot turns inward

Question 12

Pronation

Answer 12

palms of hands face down

Question 13

Supination

Answer 13

palms of hands face up

Question 14

Continuous Passive Motion

Answer 14

used on knees or shoulders possibly after surgery; device that continues movement for almost 24 hours/day

Question 15

Considerations Before Performing ROM Exercises

Answer 15

1. establish client’s ability
2. consider pre-medicating before
3. know restrictions client may have
4. always AIDET, hygiene, etc.
5. only show body part you need, don’t reveal too much, keep covered up
6. RN’s role = maintain mobility and contractures

Question 16

Performing ROM Exercises (9)

Answer 16

1. work head-to-toe
2. repeat at least 5 times per exercise
3. support above & below joint
4. slow, gentle movements
5. don’t hyperextend the joints
6. ask patient how they’re doing during
7. assess for pain
8. CV system, may increase HR or sweat
   (if these signs appear STOP & assess)
9. every joint can be moved

Question 17

Bedrest

Answer 17

BR

stay in bed
Risks: pressure ulcers, blood clots, depression
Is it right for patient?

Question 18

Bathroom Privileges

Answer 18

BRP

can get up to go to bathroom

Question 19

Bedside Commode

Answer 19

BSC

portable toilet (no flushing system)

Question 20

Chair (activity order)

Answer 20

can sit in chair, may need assistance, may have time frame or specific times, must document

Question 21

Ambulate

Answer 21

walk; distance, time frame

Question 22

Up ad lib

Answer 22

no restrictions; can get up and move on own

Question 23

Positioning Interventions to Promote Comfort and Alignment (7)

Answer 23

1. keep bed dry
2. no wrinkles in sheet
3. no friction/shearing
4. reposition every 2 hours
5. assess pt preferences, but can have some concerns
6. be mindful of bony prominences
7. if on lateral position, knees are a bony prominences, add pillow between knees

Question 24

Bony Prominences

Answer 24

back of head
shoulder blades
elbows
coccyx
hips
ankles
heels

Question 25

Supportive Devices

Answer 25

suspension boots wedge trochanter (hip) roll pressure reduction mattresses

Question 26

Gait Belt

Answer 26

tag=outward around waist fit 2 fingers snug not tight transfer w/ 1 or 2 assists

Question 27

Transfer Board/Sheet

Answer 27

paraplegic pt often Slipp device

Question 28

Sit-to-stand Life

Answer 28

assist pt from sit to stand position belt around waist platform for feet hands on handles must be able to bear weight and follow commands to use machine

Question 29

Mobile Floor-Based Lift

Answer 29

total lift (sling) minimum 2 people assist do NOT use brakes when patient in it

Question 30

Wheelchairs

Answer 30

WC back pt onto elevator big wheels first wheels locked foot pedals out of the way

Question 31

Ambulation Safety

Answer 31

use gait belt non-skid socks have pt dangle feet on side of bed make sure pt feet are touching ground may have someone follow behind w/ wheelchair (WC)

Question 32

Where to stand if patient is moderately weak?

Answer 32

stand on WEAK side of pt because you can support the weaker side

Question 33

Where to stand if patient weak and unstable?

Answer 33

stand on STRONG side of pt because pt will lean to stronger side and you can support the stronger side, there is something to support on that side

Question 34

What if patient starts to fall?

Answer 34

lower to floor and support pt head

Question 35

Cane

Answer 35

goes on strong side to the side and 6" in front of pt if assisting, must use gait belt and stand on weak side proper height

Question 36

Crutches

Answer 36

proper height weight should be on hands NOT axilla tripod: 6" in front and to the side

Question 37

4 Point Gait w/ Crutches

Answer 37

safest right crutch left foot left crutch right foot (staggered)

Question 38

3 Point Gait w/ Crutches

Answer 38

both crutches and strong/unaffected leg

Question 39

2 Point Gait w/ Crutches

Answer 39

partially weight bearing on each left crutch right foot simultaneously right crutch left foot simultaneously

Question 40

Getting in and out of Chair w/ Crutches

Answer 40

pushed against wall hold crutches w/ weak arm/side hold chair arm w/ strong arm/side

Question 41

Stairs w/ Crutches

Answer 41

up w/ good, leg then crutches down w/ bad, crutches then leg

Question 42

Ambulating w/ Walker

Answer 42

w/ assist use gait belt waist height the more tennis balls the less stable don't overload the basket on front make sure open fully and locked in place