Mobility and Immobility

Question 1

anorexia

Answer 1

loss of apetite

Question 2

atelectasis

Answer 2

alveolar collapse

Question 3

chest physiotherapy

Answer 3

like chest percussions

Question 4

embolus

Answer 4

something that can occlude blood flow

Question 5

hypostatic pneumonia

Answer 5

due to atelectasis

Question 6

logroll

Answer 6

head and neck stay in alignment

Question 7

negative nitrogen balance

Answer 7

putting out more nitrogen than putting in

Question 8

renal calculi

Answer 8

kidney stones

Question 9

shear

Answer 9

opposing movement of two surfaces

Question 10

trochanter roll

Answer 10

a roll to put under the trochanter to relieve pressure

Question 11

urinary stasis

Answer 11

urine that pools in bladder

Question 12

What is the definition of mobility?

Answer 12

freedom and independence in purposeful movement

Question 13

What is contractures?

Answer 13

muscle fibers have permanent shortening?

Question 14

What is foot drop?

Answer 14

The foot is fixed in plantar flexion

Question 15

ankylosing joints?

Answer 15

collagen tissue becomes permanently immobile

Question 16

What does immobility do to our veins?

Answer 16

vasodilation and pooling.

Question 17

thrombus?

Answer 17

a blood clot

Question 18

What can immobility do to our respiratory system?

Answer 18

pooling and stasis of respiratory secretions

weakened respiratory muscles

Question 19

What can atelectasis cause?

Answer 19

collapse of a lobe or an entire lung

hypostatic pnemonia - pooled secretions in lobes is a good medium for bacteria to grow in

Question 20

What does immobility do to our cardiovascular system?

Answer 20

diminished cardiac reserve

increased use of valsalva maneuver

less fluid volume in circulatory system

decreased CO

increased oxygen requirements

dependent edema

thrombus formations

Question 21

What does immobility do to our endocrine system?

Answer 21

decreased BMR

negative nitrogen balance (cause by more catabolism (breakdown of proteins than anabolism of proteins or ingestion of proteins) can cause depletion of protein stores

anorexia (magnifies negative nitrogen balance)

negative calcium balance (more osteoclast activity than osteoblast activity) weakens bones

decreased protein intake=loss of muscle

weight loss

alterations in calcium, fluid and electrolytes

alteration in metabolism of fats, carbs, and proteins

Question 22

How doe simmobility effect the urinary system?

Answer 22

urinary stasis - gravity doesnt help drain the bladder

renal calculi - more calcium in body because of increased osteoclast activity because of decreased intake

urinary retention - bladder doesnt completely empty and gets distended

urinary infection - defense mechanisms are gone, flushing of urine, acidic nature of urine, makes a need for foley

Question 23

Effects of immobility on GI system?

Answer 23

decreased peristalsis

decreased fluid intake

constipation, then fecal impaction, then diarrhea

Question 24

effects of immobility of integumentary system?

Answer 24

increased pressure on skin

reduced skin turgor

decreased circulaton to skin and tissue

decubitus ulcer formation

Question 25

What are some psychological effects of immobility?

Answer 25

depression, poor self-esteem, apathy, regression anxiety altered coping abilities sleep-wake alterations (diurnal variation) signs of sensory deprivation

Question 26

What are some issues with infants toddlers and preschoolers with immobility?

Answer 26

slow development of gross motor skills slow intellectual and physical development unbalanced posture

Question 27

What are some issues with adolescents and immobility?

Answer 27

imbalanced growth spurt delayed development of independence social isolation

Question 28

What are some issues with adults and immobility?

Answer 28

alterations in family and social systems alterations in identity

Question 29

What are some issues with older adults and immobility?

Answer 29

alterations in balance steady loss of bone mass decreased coordination slower gait with smaller steps alterations in functional status increased dependence on family/caregivers staff

Question 30

What parts of the skin do we really really need to check

Answer 30

bony prominences use braden scale to assess risk for pressure ulcer observe for urine or bowel incontinence

Question 31

What is an incentive spirometer?

Answer 31

something that you inspire with that gets

Question 32

What are some other interventions combat respiratory effects of immobility?

Answer 32

TCDB every 2 hours Chest physiotherapy hydration (thins respiratory secretions) remove abdominal binder every 2 hours monitor ability to expectorate (cough and spit up phlegm) use suction if needed

Question 33

What are some cardiovasular interventions for immobility?

Answer 33

mobilize patient early after surgery PROM/AAROM/AROM use isometric exercises to increase tolerance of movement no valsalva maneuver SCD cuffs, TED hose, anticoagulants ROM for lower legs increased fluid intake low dose heparin call provider for suspected DVT

Question 34

musculoskeletal interventions for immobility?

Answer 34

ROM 2-3 times daily physical therapy exercises change position every 2 hours weight shifts in wheelcahir every 15 minutes nutritional monitoring and calcium CPM (continuous passive motion) is needed

Question 35

What are some important things to note about elimination interventions for immobility?

Answer 35

laxatives are a last resort!!

Question 36

What should we do with all of these interventions

Answer 36

cluster them together to give patient time to rest after

Question 37

What can we do for psychosocial

Answer 37

give room with alert roomate make patient assist with hygiene and ADLs maintain orientation to time, person, and place provide meaningful stimuli

Question 38

What does heat do to the body?

Answer 38

increases blood flow increases tissue metabolism relaxes muscles eases joijnt stiffness and pain

Question 39

What does the cold do to the body?

Answer 39

decreases inflammation and reduces swelling reduces bleeding reduces fever diminishes muscle spasms decreases pain

Question 40

what should we worry about with temperature therapy?

Answer 40

dont leave applications on for too long be cautious with fragile skin patients may not be able to sense or move from applications that are too hot or too cold avoid heat over bony prominences, pregnant abdomens, dont place under immobile patient, avoid heat over metal devices Avoid cold therapy for people with raynauds phenomenon (decreased sensation in extremities when cold, narrowing of small blood vessels), cold intolerance or vascular insufficiency

Question 41

How do we promote venous return?

Answer 41

thromboembolic devices (TED hose) apply external pressure for venous return SCDs and intermittent pneumatic compression (IPCs) wrap around legs and provide external compression as well ROM can contract leg muscles, promoting venous return increase fluid intake