Patient Mobility and Immobility Flashcards
potential causes of immobility
- direct injury/trauma to the musculoskeletal system
- central NS damage
- illness
- complications from surgery
developmental consideration in infants, toddlers and preschoolers
- delay is gross motor skills, intelectual development, or musculoskeletal development
developmental considerations in adolescents
- may effect growth patterns and the ability to gain independence
- social isolation can occur
developmental considerations in adults
- physiological systems at risk
- changes occur in family and social structures
developmental consideration in older persons
- progressive loss of total bone loss, muscle strength and aerobic capacity
- immobilization increases dependence on others and decreases their functional capacity fro self care
how can nurses contribute ot the loss of self care abilities
by doing too much for the patient
medically imposed mobility is also known as
bed rest
bed rest
- reduces physical activity and oxygen needs
- reduces pain )can also cause it)’- promotes safety for patients recovering form the effects of anaesthetics
- allows patient who are ill or debilitated to rest
- allows patient who are exhausted the opportunity for uninterrupted rest
deconditioning
a result of prolonged bed rest
etiology of deconditioning
- pre hosptial functional capacity and reserve
- sleep
- pain
- depression
- bed rest and immobility
- medical and surgical conditions and comorbidities
- inflammation
- nutrition
respiratory effects of immobility
- atelectasis
- hypostatic pneumonia
-mucous accumulation (can lead to bacterial growth, decrease gas exchange and cause dyspena) - decreased lung expansion
cardiovascular effects of immobility
- orthostatic hypotension
- CO diminishes
-potential for falls increases - thrombus
- embolism
thrombus
- blood clot that forms in a vessel as a result of injury (surgery), slow blood flow (bedrest), increased in blood viscosity (platelets or clotting factors)
what is the most common type of thrombus
DVT
- deep vein thrombus
Embolism
- dislodged venous thrombus (blood clot) can travel to parts of the body and cause ischemic event
ischemic event
- storke, myocardial infraction, pulmonary embolism
Gi effects of immobility
- decreased GI mobility (constipation, fecal impaction)
- positioning limitations (difficulty passing stool)
- pseudodiarrhea ( may be a result from fecal impaction)
psedodiarrhea
liquid stool passing around an area of impaction
- if left untreated could result in a mechanical bowel obstruction
urinary effects of immobility
- experience urinary problems (urine enters the bladder aided by gravity)
- increased risk of UTI and renal calculi (kidney stones)
- may be unable to void
- could lead to residual urine in the bladder (increases risk for infections)
musculoskeletal effects of immobility
- loss of lean body mass
- accelerated loss of bone if patient already has osteoporosis
- disuse osteoporosis
- joint contracture
- foot drop
muscle strenght drops ___% per day
3
disuse osteoporosis
- bone becomes less dense; increased risk of fractures
joint contracture
- abnormal and possibly permanent condition characterized by fixation of a joint
foot drop
- damage (possible permanent) to the peroneal nerve of the foot from constant flexion as a result of poor support
integumentary effects of immobility
- pressure injuries
- shear
- friction
- hygiene concernes
- potential delay in wound healing
psychological effects of immobility
- decreased social interaction
- social isolation
- sensory deprivation / alterations
- loss of independence
- role changes
- emotional reactions
- behavioural responses
- changes in coping
- depression
depression
an affective disorder characterized by exaggerated feelings of sadness, melancholy, dejection, worthlessness, emptiness, and hopelessness out of proportion to reality
Assessment
subjective information examples:
- degree of mobility or immobility
- has disability been present for an extended period of time
- is the patient fearful of mobilizing
- well adapted to the use of an assisted device or even a wheelchair
- degree of pain present
- effect of mobility on lifestyle, family functioning and sense of wellbeing
- patient expectations regarding mobilizing? do they expect assistacne
Assessment
objective information
- range of motion
- gait
- exercise tolerance and activity
- body alignment
- physical deformities
- level of conciouness
- affect, mood
respiratory intervention
cardiovascular interventions
Gi interventions
Urinary interventions
musculoskeletal interventions
integumentary interventions
physiosocial interventions
