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IM 1 > Mobility And Immobility -exam 7 > Flashcards

Mobility And Immobility -exam 7 Flashcards

1
Q

A persons ability to move about freely

A

Mobility

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2
Q

Mobility - 6

A
  • nonverbal gestures
  • self defense
  • ADLs
  • recreational
  • satisfaction of basic needs
  • expression of emotion
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3
Q

Factors affecting mobility and activity - 6

A
  • developmental
  • nutrition
  • lifestyle
  • stress
  • environment
  • diseases and abnormalities
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4
Q

Diseases and abnormalities -6

A
  • bones, muscles, and nervous system
  • pain
  • trauma
  • respiratory system
  • circulatory
  • psychological/Social
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5
Q

May involve lower part of body

A

Paraplegia

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6
Q

A persons inability to move about freely

A

Immobility

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7
Q

May involve one side of body

A

Hemiplegia

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8
Q

May involve entire body from the neck down

A

Quadriplegia

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9
Q

Bedrest

A

restricts patients to bed for therapeutic reasons

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10
Q

sometimes prescribed for selected patients

A

Bed rest

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11
Q

reduces pain

A

Bed rest

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12
Q

Allows exhausted patients to rest

A

Bed rest

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13
Q

reduces physical activity and O2 demand of the body

A

bed rest

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14
Q

allow ill or debilitated patients to rest

A

bedrest

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15
Q

duration depends on illness or injury and prior state of health

A

bedrest

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16
Q

physical causes of immobility-6

A
  1. bone fracture
  2. surgical procedure
  3. major sprain or strain
  4. illness/disease
  5. cancer
  6. aging process
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17
Q

psychosocial causes of immobility - 5

A
  1. stress/depression
  2. decreased motivation
  3. hospitalization
  4. long term care facility residents
  5. Voluntary sedentary lifestyle
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18
Q

prolonged immobility

A
  • reduced functional capacity
  • alerted metabolism
  • numerous physiological changes
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19
Q

effects of immobility

A
  • musculoskeletal
  • lungs
  • heart and vessels
  • metabolism
    -integument
  • GI
    -GU
  • Psychological
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20
Q

immobility common effects - Musculoskeletal system

A

brittle bones
contractures
muscle weakness and atrophy
footdrop

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21
Q

immobility common effects -Nervous system

A
  • lack of stimulation
  • feelings of anxiety
  • feelings of isolation
  • confusion
  • depression
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22
Q

immobility common effects -digestive system

A
  • decreased appetite and low fluid intake
  • constipation and or bowel obstruction
  • incontinence
  • electrolyte imbalances
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23
Q

immobility common effects -integumentary system

A
  • decreased blood flow
  • pressure ulcers
  • infections
  • skin breakdown and pressure ulcers
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24
Q

immobility common effects -Cardiovascular System

A
  • blood clots
  • reduced blood flow
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25
Q

immobility common effects -respiratory system

A
  • pneumonia
  • decreased respiratory effort
  • decreased oxygenation of blood
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26
Q

immobility common effects -urinary system

A
  • reduced kidney function
    -incontinence
  • UTI
  • Urinary retention
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27
Q

Musculoskeletal assessment

A
  • activity intolerance
  • anthropometric measurements
  • nutrition
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28
Q

osteoclasts

A
  • move along surface of bone
  • dissolved material, including calcium, is passed through osteoclasts and into blood stream for recuse by the body
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29
Q

osteoblasts

A
  • occurs when bone is injured, added bone strength is required
  • deposits calcium into the bone
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30
Q

bone resorption - 2 ways

A
  • osteoclasts
  • osteoblasts
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31
Q

osteoporosis

A
  • females are more affected than males
  • insufficient exercise or too much exercise
  • poor diet
  • smoking
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32
Q

ROM

A

maximum amount of movement available at a joint

33
Q

joints not moved are at risk for

A

contractures

34
Q

ROM exercises improves

A

joint mobility

35
Q

ROM exercise is the easiest intervention to maintain or

A

improve joint mobility

36
Q

ROM exercises can be

A

coordinated with other activities

37
Q

What are 3 ROM exercises?

A
  • active ROM
  • active assist ROM
  • Passive ROM
38
Q

Active ROM

A

done by the patient

39
Q

Active assist ROM

A

done by patient but with help

40
Q

Passive ROM

A

done by the nurse or caregiver
- continuous passive motion (CPM)

41
Q

Range Of Motion

A
  • 3 times a day
  • support the extremity
  • encourage active ROM if possible
  • stretch the muscle only to the point of resistance/pain
  • start gradually and move slowly using smooth motions
42
Q

respiratory assessment

A
  • lung sounds
  • O2 sats
  • respiratory rate
  • activity tolerance (SOB)
  • chest xray
  • arterial blood gas
43
Q

Cardiac assessment

A
  • BP
  • Pulse rate
  • Heart sounds
  • Activity tolerance (BP, HR, chest pain)
  • calf pain ***
44
Q

Deep vein thrombosis (DVT)

A
  • decreased muscle activity
  • pooling of blood
  • clot formation
45
Q

Ways to prevent DVTs

A
  • ambulation
  • TED hose
  • SCDs
46
Q

TED Hose

A
  • post surgical
  • non walking patients
  • no wrinkles
  • take off periodically to exam skin
47
Q

Sequential compression device (SCDs)

A
  • sleeves around the legs
  • alternately inflate and deflate
  • post surgical/ circulatory disorders
48
Q

Metabolism assessment

A
  • decreased appetite
  • weight loss
  • muscle loss
  • weakness
  • labs
49
Q

Integument assessment

A
  • skin assessment
  • nutrition
  • incontinence
50
Q

Pressure injury

A
  • impairment of the skin as a result of prolonged ischemia in tissues
51
Q

Ischemia

A

Decreased blood supply

52
Q

Which Patients are at highest risk for pressure injury?

A

Immobile patients

53
Q

GI assessment

A
  • bowel sounds
  • abdominal palpation
  • bowel habits
  • I&O
54
Q

GU assessment

A
  • I&O
  • palpate abdomen
  • incontinence
  • urine
55
Q

Urinary stasis

A

When the renal pelvis fills before urine enters the ureters because peristaltic contractions of the ureters are insufficient to overcome gravity

56
Q

Urinary elimination changes

A

-immobility
- decreased fluid intake
- dehydration
- concentrated urine
- increased risk for UTI and kidney stones

57
Q

Psychosocial assessment

A
  • mood
  • orientation
  • speech
  • affect
  • sleep
58
Q

Psychosocial effects

A
  • social isolation
  • loneliness
  • decreased coping
  • depression
  • anxiety
  • withdrawal
  • delirium
59
Q

Benefits of mobility

A
  • strengthen muscles
  • joint flexibility
  • stimulates circulation
  • prevents constipation
  • prevents osteoporosis
  • stimulates the appetite
  • prevents urinary incontinence
  • relieves pressure
  • improves self esteem
  • decreases anxiety and depression
60
Q

Ambulation is the best intervention to

A

Prevent immobility complications

61
Q

Mobility level 1

A

Dependent

62
Q

Mobility level 2

A

Moderate assistance

63
Q

Mobility level 3

A

Minimum assistance

64
Q

Mobility level 4

A

Modified independent

65
Q

Non-violent restraints

A
  • unable to follow commands and comply with safety instructions
  • attempts to pull out tubes, drains or other lines
  • requires every 2 hours monitoring and documentation
  • new order required every calendar day
66
Q

Restraint types

A
  • extremity
  • mitten
  • posey
  • belt
  • papoose or mummy restraint
67
Q

Alternative measures to restraints

A
  • Orient family and patient to environment
  • offer diversionary
  • use calm simple statements
  • promote relaxation techniques
  • attend to needs
  • use of glasses/ hearing aids
68
Q

Modify the environment

A
  • increase or decrease the light
  • place personal items within reach
  • place near nurses station
  • reduce environmental noise
  • keep call button accessible
  • use special furniture accordingly (bed alarms)
69
Q

Camouflage

A

-Camouflage IV lines and tubes

70
Q

Encourage

A

Encourage family to stay with patient and being familiar objects from home

71
Q

Orient

A

Orient patient to person, place, Time

72
Q

Involve

A

Involve patient in conversation

73
Q

Give

A

Give patient something to do

74
Q

Restraint guidelines

A
  • doctor must order prior to applying
  • new order ~ daily
  • must be discontinued at the earliest time
  • monitoring varies
  • assessment
75
Q

Risk of using restraints

A
  • increase in injury or death
  • loss of self - esteem
  • humiliation
  • fear
  • anger
  • increased confusion and agitation
76
Q

Complications of restraints

A
  • impaired skin integrity
  • lower extremity edema
  • altered nutrition
  • physical exhaustion
  • social isolation
  • immobility complications
  • death
77
Q

Intervention application of restraints

A
  • restrict movement as little as possible
  • make sure restraint fits properly
  • always tie (slip knot/bow tie) to bed
  • always explain the need for restraint
  • never leave patient unattended
  • pad bony prominences
78
Q

Assessment of restraint

A
  • assess the need for restraints
  • inspect placement area
  • patients behavior
  • circulation, motion, sensation
  • fits properly
  • vital signs
  • skin color, edema
  • palpate for skin temp
  • palpate pulse
  • check capillary refill
  • mental status
79
Q

Interventions of restraints

A
  • ROM
  • Reposition
  • nutrition/ hydration/ toileting
  • release at the earliest possible time

IM 1 (34 decks)

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