Week 5 Assessing and Supporting Mobility Flashcards
Four basic elements of normal movement
- Body alignment (posture)
- Joint mobility
- Balance
- Coordinated movement
Element
- Permits optimal skeletal alignment
- No strain
- Increases lung expansion
Alignment and posture
Element
- Muscles are characterised according to the type of movement they produce on contraction
- Stronger of the muscle type will dominate the joints movement
Joint mobility
Range of motion
Active or Passive
Person moves each joint in the body through its complete range of movement, maximally stretching all muscle groups
Active ROM exercises
Another person moves each the persons joints in the body through its complete range of movement, maximally stretching all muscle groups
Passive ROM exercises
Awareness of posture, movement and changes in equilibrium and the knowledge of position, weight and resistance of objects in relation to the body
Proprioception
Balanced, smooth, purposeful movement
Coordinated movement
Proper functioning of cerebral cortex, cerebellum and basal ganglia
Coordinates motor activities of movement
Cerebellum
Maintains posture
Basal ganglia
Operates voluntary movement
Cerebral cortex
Musculoskeletal system benefits of exercise
- Maintains size, shape, tone and strength of muscles
- Nourishes joints
- Increases joint flexibility, stability and ROM
- Maintains bone density and strength
Musculoskeletal system effects of immobility
- Disuse osteoporosis
- Disuse atrophy
- Contractures
- Stiffness and pain in the joints
Respiratory system benefits of exercise
- Increases ventilation and O2 intake, improving gas exchange
- Prevents pooling of secretions in bronchi and bronchioles
- Decreases risk of infection
Respiratory system effects of immobility
- Decreased respiratory movement
- Pooling of respiratory secretions
- Atelectasis
- Hypostatic pneumonia
GI system benefits of exercise
- Improves apetite
- Increases GIT tone
- Facilitates peristalsis
- May improve IBS symptoms
GI system effects of immobility
- Decreased metabolic rate
- Negative nitrogen balance
- Anorexia
- Constipation
Metabolic/Endocrine system benefits of exercise
- Elevates metabolic rate
- Increases body heat production
- Decreases serum triglycerides and cholesterol
- Stabilises blood sugar and makes cells more responsive to insulin
Metabolic/Endocrine system effects of immobility
- Decreased metabolic rate
- Negative nitrogen balance
- Anorexia
- Negative calcium balance
Urinary system benefits of exercise
- Promotes blood flow to kidneys causing body wastes to be excreted more effectively
- Prevents stasis of urine in bladder
Urinary system effects of immobility
- Urinary stasis
- Renal calculi
- Urinary retention
- Urinary infection
Psychoneurological system benefits of exercise
- Elevates mood
- Relieves stress and anxiety
- Improves quality of sleep
Psychoneurological system effects of immobility
- Decline in mood elevating substances
- Perception of time intervals deteriorates
- Problem solving and decision making abilities deteriorate
- Loss of control over events causes anxiety
Cognitive and immune function benefits of exercise
- Positive effects on decision making and problem solving processes, planning and paying attention
- Induces cells in brain to build and strengthen neuronal connections
Cognitive and immune function effects of excessive exercise
- Pumps lymph fluid from tissues into lymph capillaries and vessels
- Increases circulation through lymph nodes
- Strenuous exercise may reduce immune function
- Leaving window of opportunity for infection during recovery phase
Integumentary system benefits of exercise
- Increased circulation to epidermis
- Increased nutrient supply to skin
- Increased exposure to sunlight for vitamin D production
- Decreased effect of fluid in dependent parts of the body
Integumentary system effects of immobility
- Skin atrophy
- Fluid shifts to dependent parts of the body
- Decreased circulation to skin
- Decreased nutrient supply to skin
Factors affecting body alignment and mobility
- Growth and development
- Nutrition
- Personal values and attitudes
- External factors (temp, humidity)
- Prescribed limitations (casts, braces)
Assessing and incorporating PCC
- Health history
- Physical examination
Physical examination
- Body alignment and gait
- Appearance and movement of joints
- Capabilities and limitations for movement
- Muscle mass and strength
- Activity tolerance
- Problems related to immobility
Angle for inclination
30’ lateral inclination alternating from side to side.
Fowlers position
- Semi sitting
- Bed head and trunk 30 to 90’
Low/semi Fowler’s position
Bed head and trunk 15 to 45’
High Fowler’s position
Bed head and trunk raised 90’
Ideal for difficult CVS and respiratory problems
Orthopnoeic position
- Facilitates maximum chest expansion
- Person sits either in bed or on side of bed with table across lap
Dorsal recumbent position
- Back lying position
- Head and shoulders slightly elevated on small pillow
Prone position
- Abdomen lying position with head turned to one side
- Prevents flexion contractors of hips and knees
- Promoted drainage from mouth
Supine position
- Back lying position
- Head and shoulders not elevated
Lateral position
- Side lying position
- Flexing top hip and knee
- Placing leg in front of body creates wider triangular base or support
Sims’ position
- Semi-prone position
- Halfway between lateral and prone
- Facilitates drainage of mouth and prevents aspiration
- Reduces pressure over sacrum and greater trochanter of hip
Steps to repositioning a person in bed
- Administer pain relief prior
- Prepare needed assistive devices and supportive equipment
- Plan
- Be alert to effects of medication
- Explain procedure
- Provide privacy
- Raise height of bed
- Put brakes on
- Assume broad stance
- Rock from front leg to back
Pressure injuries
- Localised damage to the skin and underlying soft tissue usually over a bony prominence or related to a medical/other device.
Stage 1 Pressure Injury
Non-blanchable
Stage 2 Pressure Injury
Partial thickness
Skin loss
Stage 3 Pressure Injury
Full thickness
Skin loss
Stage 4 Pressure Injury
Full thickness
Tissue loss
Unstageable Pressure Injury
Obscured
The type and amount of exercise or daily activities an individual can perform.
Activity tolerance
The nurse assesses an open area over a person’s greater trochanter that is approximately 10 cm in diameter. The tissue around the area is oedematous and feels boggy. The edges of the wound cup in towards the centre. Which additional finding would indicate to the nurse that this is a stage IV pressure injury?
The joint capsule of the hip is visible.
You are assisting Mr Harris ambulate with his single point stick. He is complaining of a sore left foot which he is unable to fully weightbear on. What would you advise him when using his stick?
Hold the stick on the opposite side as his sore foot and walk forward with his stick and his sore foot first.
Which of the following statements are true about a person who requires minimal assistance with their mobility?
- The person may require a transfer belt or other aids.
- The person may require guidance for initation, balance and/or stability during mobilising.
- The nurse should be standing directly next to the person at all times to provide hands on assistance ass required.
The person who requires the use of a wheeled walker should be instructed to____onto the handles when transferring from the bed to a standing position.
NOT hold on
SWL
Safe working load.
A hoist transfer should be a___ staff procedure.
TWO
