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nursing 20030 > mobility: body mechanics and transfer techniques > Flashcards

mobility: body mechanics and transfer techniques Flashcards

1
Q

OSHA defines ergonomics as…

A

the practice of designing equipment and work tasks to conform to the compatibility of the worker and providing means for adjusting the work environment and work practices to protect and prevent the worker from injury

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2
Q

describe principles of body mechanics

A
  • will not completely eliminate injury but will optimize environment and conditions for pt care tasks
  • must always assess the situation before acting
  • modify environment and work at the appropriate height
  • use leverage, rolling, turning, and pivoting instead of lifting
  • move on a level surface
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3
Q

body mechanics

describe always assessing the situation before acting

A

–is the area safe?

  • what might happen next?
  • anticipate what may occur
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4
Q

Body Mechanics

describe working from the appropriate height

A
  • use a wide base of support (stand with legs shoulder width apart, soft knees)
  • face the direction of movement
  • bend knees and work close to the object to be moved
  • use arm and leg muscles
  • NOT back muscles
  • contract gluteal muscles and abdominal muscles while lengthening the spine
  • be conscious of core strength to stabilize and support your back
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5
Q

Body Mechanics

what should you use instead of lifting when moving a patient

A
  • use mobility devices
  • use leverage, rolling, turning, and pivoting instead of lifting
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6
Q

describe independent transfers

A

patient moves on own with no assistance

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7
Q

describe assisted transfer

A

somewhere in between an independent and total transfer, patient can do some or most of the work

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8
Q

describe total transfer

A

completely dependent for assistance

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9
Q

describe some examples of lateral transfers

A
  • one bed to another
  • one bad to a cart
  • moving on a level surface
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10
Q

describe boosting a patient up in bed

A
  • bed should be raised to caregivers hip height
  • pts arms should be folded across chest, raise head and have chin towards chest, count to three
  • can use gravity if tolerated (trendelenburg)
  • ask pt to assist if tolerable
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11
Q

name some different nursing diagnoses r/t mobility

A
  • impaired physical mobility
  • activity intolerance
  • impaired skin integrity
  • risk for injury
  • acute/chronic pain
  • disturbed body image
  • social isolation
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12
Q

name some different common bed positions

A
  • prone
  • supine
  • dorsal recumbant
  • lithotomy
  • semi fowlers
  • fowlers
  • sims
  • side lying
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13
Q

describe prone position

A
  • lays face down
  • arms may cushion head or be flexed
  • an alternative for immobilized pt, not used for abdominal surgery and in clients with respiratory or spinal problems
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14
Q

describe side lying position

A
  • lays on side with weight on hip and shoulder
  • pillows support and stabilize uppermost leg, arm, head, and back
  • choice position for clients with pressure on bony prominences of the back and sacrum, not used after hip replacement and other orthopedic surgery
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15
Q

describe supine position

A
  • lies flat on back
  • alternative position for clients on bed rest, used after spine surgery and some spinal anesthesia, not used for clients with dyspnea or at risk for aspiration
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16
Q

describe sims position

A
  • semiprone position
  • position is not for many spine and orthopedic conditions
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17
Q

describe fowlers position

A
  • sitting in bed at 80 to 90 degrees
  • improves cardiac output, promotes ventilation, eases eating, talking, and watching TV
  • not used after spine or brain surgery
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18
Q

describe semi fowlers position

A
  • semisitting position
  • head elevated 30-35 degrees
  • same advantages and contraindications as fowlers
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19
Q

describe dorsal recumbent position

A
  • supine with legs flexed and rotated outward
  • used for vaginal exams but not for abdominal assessment because it promotes contraction of abdominal muscles
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20
Q

describe lithotomy position

A
  • supine with hips flexed and calves and heels parallel to the floor
  • uncomfy, requires draping for privacy
  • used for vaginal and rectal exams
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21
Q

describe considerations to take with positioning

A
  • ensure natural alignment of body and extremities
  • promotes circulation and improved respiratory function
  • reduces continuous pressure on bony prominences
  • appropriate positioning can prevent complications
22
Q

name key points on positioning

A
  • patients who require assistance with positioning need to be repositioned at least every 2 hours (around the clock)
  • promote independence and choice when repositioning a patient
  • include range of motion activities with position changes
  • consider the use of supportive devices or specialty mattresses
23
Q

name some supportive devices

A
  • bed pillows/foam wedges
  • foot board/boots or high top sneakers (help prevent plantar flexion)
  • cradle (keep blankets and sheets off feet)
  • hand rolls (towels held in hands of pts who have limited mobility to prevent too much contraction of fingers)
  • trochanter rolls (rolled up blankets either side of pts thighs → prevent external rotation of femurs)
  • abduction pillow (triangular pillow placed between knees of a pt who has had hip surgery)
24
Q

name some assistive devices

A
  • side rails
  • draw sheet/pad
  • mechanical bed
  • trapeze
25
Q

describe range of motion

A
  • body part is moved through the entire range of motion to the fullest extent possible
  • can be active or passive, encouraging participation in ADLs
  • improves joint mobility and increases circulation
  • decreases complications
26
Q

describe passive range of motion

A
  • nurse or assistant moves the patients joints through a full range of motion to the fullest extent possible
  • move until there is resistance, but not pain
27
Q

name some mobility enhancing exercises

A
  • quadriceps
  • gluteal
  • abdominal sets
  • push ups/triceps dips
28
Q

define isometric exercise

A
  • increases muscle tension without much movement
  • hold contraction for a count of 4 seconds and relax for a count of 4 seconds; repeat two to three times an hour, four to six times a day
  • involves muscle contraction without shortening
  • potential benefits include increased muscle mass, tone, and strength; increased circulation to exercised body part; and increased osteoblastic activity
29
Q

describe isometric exercise with quadriceps

A

tighten the muscle on the front of the thighs (push knees towards the matress)

30
Q

describe isometric exercise with gluteal sets

A

contract buttocks

31
Q

describe isometric exercise with abdominal sets

A

contract abdominal muscles

32
Q

name some different ambulation/activity orders

A
  • bedrest
  • bedrest with BRP
  • dangle
  • up to chair
  • up with assistance or with assistive device
  • unrestricted/ ad lib
33
Q

describe bed rest

A
  • most restrictive ambulation order
  • not allowed out of bed
34
Q

describe dangling

A
  • elevate head using the bed, stand in front of pt and help swing legs over side of bed, allow legs to dangle
  • used for pts who have been immobile for a while
  • important to evaluate how body responds to the change in position
  • may be an order or nursing judgement
  • can cause dynamic shift in body fluid; fluid rushes to lower extremities and pt may experience dizziness, cold sweat, or nausea
35
Q

describe pt assessment with ambulation

A
  • recent vital signs, pain
  • history of falls
  • activity tolerance
  • use of assistive devices
  • ROM and muscle strength/tone/mass
  • body alignment/gait/posture/balance
  • cognition, memory, and judgement
  • motivation
  • body size
  • activity orders
36
Q

describe environment assessment with ambulation

A
  • slipper socks or shoes
  • wheels locked
  • clear path
  • tubes managed
  • assistive devices available
  • enough help
  • opportunities for rest periods
37
Q

describe assisting with ambulation

A
  • wash hands, identify patient, verify order, explain plan, ensure you have adequate and appropriate equipment
  • use a gait belt around the patient
  • walk behind patient and to one side (if one side is weaker, walk on that side)
  • if necessary, have someone else follow the patient with wheelchair
38
Q

describe assisted falls

A
  • assume a wide base of support and attempt to slow the patient’s descent
  • call for help
  • attempt to protect the patient from injury as they fall
  • must write incident report and reassess fall risk
39
Q

name some different assisted devices

A
  • cane
  • crutches
  • walker
  • wheelchair
40
Q

describe canes

A
  • widen a persons base of support
  • different types such as functional grip, quad (more stabilizing), or C cane
  • cane should fit so that when pt stands with the 10cm to the side of foot, cane extends from the floor to the crease of the wrist
  • cane should be on opposite side of the one that needs support, if used for stability, may be held iin either hand
41
Q

describe crutches

A
  • used to avoid using one leg or to help strengthen one or both legs
  • most common types used are axillary and forearm crutches
  • remind pt that support of body weight should come primarily from the hands and arms, not axillary areas
42
Q

describe what you should know before using a wheelchair

A
  • where and how to lock wheels
  • rests can be moved or elevated
  • arm rests can be removed or replaced
43
Q

describe walkers

A
  • improve balance by increasing base of support
  • handles should be at the crease of the wrists when the patient is standing in the middle of the walker with arms relaxed
  • different types are used according to arm strength and balance of the patient
  • important to remember: when rising from seated position, use the chair arms/bed for support, once up, then use walker for support
44
Q

describe gait while using canes

A
  • user should stand straight and tall
  • cane forward
  • weaker leg to meet cane
  • stronger leg forward
45
Q

what are the different gait patterns used for crutches

A
  • 2 point
  • 3 point
  • 4 point
46
Q

describe gait used for walker

A
  • push up from bed or chair
  • once standing grasp the handles of walker
  • stand upright, advance the walker
  • advance the first (weaker) leg into the center of the walker
  • advance the other leg into meet the first leg
  • advance the walker
47
Q

describe the use of crutches or canes on stairs

A
  • use cane/one crutch and the handrail
  • up with the good and down with the bad
48
Q

describe ascending on stairs with canes or crutches

A
  • stronger leg ascends step first
  • crutch and weaker leg follows
49
Q

describe descending on stairs with canes or crutches

A
  • place crutch/cane on lower step
  • step down with weaker leg to meet crutch/cane
  • step down with the stringer leg to same step
50
Q

describe the use of hydraulic lifts

A
  • used with sling to support patients weight
  • should be used with two caregivers present (one to manage lift, one for pt)
  • can be either mobile or ceiling mounted
  • can be used to lift pts out of bed or chair, off the bed for linen change, from bed to toilet, off the floor after a fall
51
Q

describe progression of mobility

A
  • encourage frequent mobility as allowed and as able
  • functional mobility is the goal
  • minimal pain, minimal cardiac or respiratory distress with movement
  • teach patient adaptive strategies such as taking rest periods, modifying activity, and the use of tools

nursing 20030 (31 decks)

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