Week 3: SPHM, Mobility and Immobility Flashcards
Body mechanics
- Coordinated efforts of MSK and nervous systems to maintain posture, balance and body alignment during lifting, bending, moving and performing ADLs
- Proper body mechanics reduce amount of energy we expend, stress and strain, and increases nursing and patient safety
Ergonomics
fitting the job to the worker (e.g., providing a step-stool)
Lift
to move a patient who cannot weight bear on 1 leg (uses a mechanical device)
Transfer
to guide/assist a patient who can weight bear on at least 1 leg and an assisted device (collaborative)
Principes of Safe Client Handling (8)
- Ask for help
- Use patient transfer devices where possible
- Encourage the patient to assist
- Position yourself in close proximity to the patient
- Tighten core muscles and keep back, neck, pelvis, and feet aligned
- Avoid twisting
- Bend at the knees and keep your feet wide apart
- Use your arms and legs, NOT your back
Purpose of Safe Patient Handling (SPH) Aids
Help bear most of the low and lower friction between pt skin and clothing to reduce injury risk
Mechanical Lifts (2)
- Hoyer (portable, requires 2 people)
2. Ceiling lift (mounted)
Transfer/Slide Board
- Helps move patient between bed and stretcher/table or between two beds when both surfaces are at the same height
- Help reduce friction
Transfer belt / Gait belt
- Helps maintain pt stability during transfer, reduces falls risk
- Like a handle around pt waist
Stand-assist device
-Used if pt has partial weight-bearing ability in the upper body
Trapeze bar
-Helps pts reposition in bed themselves or with assistance
Bed rest
An intervention that restricts patients for therapeutic reasons
- Can lead to various complications (especially in older adults)
- Movement is important for body systems to work well
Tissue ischemia
Reduced blood flow to the area; can result in necrosis if left for a long time
Friction
- The force that occurs in a direction opposing movement (e.g., dragging)
- Affects top layer of skin (shallow injuries)
Friction
- The force that occurs in a direction opposing movement (e.g., dragging)
- Affects top layer of skin (shallow injuries)
Shear
- Force exerted against the skin while the skin remains stationary
- Can result in deep tissue damage and deep tissue death (necrosis)
Body Alignment/Posture
Positioning of joints, tendons, ligaments and muscles while standing, sitting and lying.
Correct alignment should:
- be stable
- reduce strain on musculoskeletal system
- minimize risk of fall
- maintain muscle tone
- contribute to balance
Contracture
Result of immobility
Fixation of a joint into a non-functional position, possibly permanent.
Foot drop
Result of bed rest
Contractue of the foot in permanently fixed plantar flexion
Systemic effects of immobility (6)
- Metabolic changes
- Respiratory changes
- Cardiovascular changes
- Musculoskeletal changes
- Urinary elimination changes
- Integumentary changes
Immobility: Metabolic changes (3)
- changes in endocrine metabolism (homeostasis)
- calcium resorption (decreased bone mass, kidney problems)
- GI funciton (constipation)
Immobility: Respiratory changes (2)
- atelcatsis (collapse of alveoli)
- hypostatic pneumonia
Immobility: Cardiovascular changes (3)
- orthostatic hypotension (reduced BP)
- thrombus formation (blood clots)
- embolus (dislodged clot that travels through circ system)
Immobility: Muskuloskeletal changes (3)
- disuse atrophy
- disuse osteporosis (from calcium resorption)
- contractures
Immobility: Urinary Elimination changes (3)
- urinary stasis (UTI risk)
- renal calculi (kidney stones)
- incontinence/bed-wetting
Immobility: Integumentary changes (1)
- pressure injuries
ROM exercises (10)
- Hinge (joint)
- Circumduction (shoulder/arm circles)
- Flexion
- Extension
- hyperextension (bend back)
- supination (turn up)
- pronation (turn down)
- abduction (toward you)
- adduction (away from you)
- opposition
(Have pt support the joint_
Active ROM exercises
Pt moves joint
Passive ROM exercises
Nurse moves joint for pt
Support surfaces (4)
- Low-Air-Loss (good air flow, moisture control)
- Nonpowered (foam)
- Air-Fluidized Beds (electric)
- Lateral Rotation (passive motion mattress)
