Activity/Mobility Notes Flashcards
(85 cards)
1
Q
Atrophy
A
decreased muscle size
2
Q
hypertrophy
A
increased muscle mass resulting from exercise/training
3
Q
muscle tone
A
residual tension that remains in a resting normal muscle with an intact nerve supply
4
Q
flaccidity
A
decreased tone caused by disuse or neurological impairment
- describe as weakness
5
Q
spasticity
A
increased tone that interferes with movement caused by neurological impairment
- described as stiffness, tightness or pulling of the muscle
6
Q
- paresis
- hemiparesis
A
- paresis: impaired muscle strength/weakness
- hemiparesis: weakness 1/2 body
7
Q
Paralysis
- Hemiplegia
- Paraplegia
- Quadriplegia
A
Paralysis: absence of strength long secondary to nervous impairment
- Hemiplegia: paralysis of 1/2 body
- Paraplegia: paralysis of legs
- Quadriplegia: paralysis of arms and legs
8
Q
Ligamentss
A
- bone to bone (or cartilage)
- stability and joint support
9
Q
Cartilage
A
found in joints that act as shock absorber and reduces friction
10
Q
Tendons
A
- Muscle to bone
- Facilitates movement
11
Q
Tonus
A
Slight contraction
12
Q
Contractures
A
permanent contraction of muscle (caused by prolonged bed rest)
13
Q
Roughage
A
foods high in fiber
14
Q
Basal Ganglia
A
in the cerebrum that help move muscles via nerve impulses (walking, swimming, laughing)
15
Q
Parkinson’s Disease
A
degeneration of basal ganglia, affecting walking/coordination
16
Q
Cerebellum
A
allows for smooth body movements and coordination (assists motor complex and basal ganglia)
17
Q
Atelectasis
A
incomplete expansion/collapse of lung tissue (b/c decreased use of lung tissue)
18
Q
Footdrop
A
inability to raise foot due to weakened/paralyzed dorsiflexors
19
Q
Fibrinolysin
A
breaks down blood clots
20
Q
active exercise
A
- pt independently moves joint through full ROM
only active exercise increases muscle mass, tone, strength and improves cardiovascular and respiratory function
21
Q
passive exercise
A
pt cannot move independently and nurse move joints through its ROM
22
Q
What is the role of the skeletal system?
A
- Support
-> soft tissues - Maintains body form adn posture
- Protection
-> ex: Brain, heart, lugs and spinal cord - Fixated strucutre for movement
- Stores minerals
-> calcium and fat - Blood cell production
-> RBC + WBC
23
Q
Joints
A
classified based on amount of movement permitted AND basis of material between adjoining bones
24
Q
Describe the following joint type:
Fibrous
(Movement, Examples)
A
Movement:
- Immovable (synathrosis)
Material Between Bones:
- X
Examples:
- Sutures between bones and skull
25
Describe the following joint type:
**Cartilaginous**
(Movement, Examples)
**Movement:**
- Slightly movable (amphiarthrosis)
**Material Between Bones:**
- X
**Examples:**
- Pubic symphisis
- joints between bodies of vertebrae
26
Describe the following joint type:
**Synovial**
(Movement)
**Movement:**
- Freely Movable (diarthrosis)
**Material Between Bones:**
- X
**Examples:**
- X
27
Describe the following joint type:
**Ball & socket**
(Movement, Material Bewteen Bones, Examples)
**Movement:**
- Freely Movable (diarthrosis)
**Material Between Bones:**
- Synovial Fluid
**Examples:**
- Shoulder/Hip joints
28
Describe the following joint type:
**Condyoid**
(Movement, Material Bewteen Bones, Examples)
**Movement:**
- Freely Movable (diarthrosis)
**Material Between Bones:**
- Synovial Fluid
**Examples:**
- Wrists joint and joints connecting fingers to palms
29
Describe the following joint type:
**Gliding**
(Movement, Material Bewteen Bones, Examples)
**Movement:**
- Freely Movable (diarthrosis)
**Material Between Bones:**
- Synovial Fluid
**Examples:**
- Carpal bones of wrist adn tarsal bones of feet
30
Describe the following joint type:
**Hinge**
(Movement, Material Bewteen Bones, Examples)
**Movement:**
- Freely Movable (diarthrosis)
**Material Between Bones:**
- Synovial Fluid
**Examples:**
- Elbow, knee and ankle joints
31
Describe the following joint type:
**Pivot**
(Movement, Material Bewteen Bones, Examples)
**Movement:**
- Freely Movable (diarthrosis)
**Material Between Bones:**
- Synovial Fluid
**Examples:**
- Joints between the atlas and axis of the neck
- between the proximal ends of the radius and the ulna at the wrist
32
Describe the following joint type:
**Saddle**
(Movement, Material Bewteen Bones, Examples)
**Movement:**
- Freely Movable (diarthrosis)
**Material Between Bones:**
- Synovial Fluid
**Examples:**
- Joints between trapezium and metacarpal of the thumb
33
What are the roles of the Muscular System? What three muscle tyes make up the Muscular System?
Movement
Maintain Posture
Heat Production
3 Types of Muslce:
- Skeletal
- Cardiac
- Smooth
34
What are the roles of the Nervous System?
Nerve impulses stimualte muscles to contract
Neurons conduct impulses from one part of the body to another
- Afferent neurons convey information from receptors to the central nervous system (CNS).
- Efferent neurons convey the response from the CNS to skeletal muscles via the somatic nervous system.
35
Describe the elements of correct alignment/balance
Stability enhanced with a wide base and lower center of gravity
Body balance enhanced with feet spread apart and flex at hip/knee
- Abdominal muscles help upward, with abdomen tucked in and buttocks downward
- Knees are slightly flexed
- Weight distributed through soles/heels
36
Describe the following problem:
**Problems with Bone formation/Muscle development**
(Abnormalities Affecting Activity/Alignment)
**Abnormalities Affecting Activity/Alignment:**
- Congenital problems (achondroplasia -> dwarfism)
- Vit D deficiency (-> deformities in skeletal sys/rickets)
- Osteoporosis
**MISC:**
- X
37
Describe the following problem:
**Problems Affecting Joint Mobility**
(Abnormalities Affecting Activity/Alignment)
**Abnormalities Affecting Activity/Alignment:**
- Arthritis (-> bone spurs)
**MISC:**
- X
38
Describe the following problem:
**Trauma to Muscoloskeletal Systems**
(Abnormalities Affecting Activity/Alignment, MISC)
**Abnormalities Affecting Activity/Alignment:**
- Break in bone/cartilage (fracture)
- Soft tissue injuries (sprains, strains, dislocation)
**MISC:**
- Sprain = least serious injury
39
Describe the following problem:
**Problems Affecting the Nervous System**
(Abnormalities Affecting Activity/Alignment, MISC)
**Abnormalities Affecting Activity/Alignment:**
- Cerebrovascular accident (strokes)
**MISC:**
- Refer to Image on table in Master Notes
40
Describe the following body system:
**Cardiovascular**
(Effects of Exercise, Effect of Immobility)
**Effect of Exercise:**
- ↑ heart efficiency
- ↑BF/oxygenation (of all body parts)
- ↓Resting HR/BP
**Effect of Immobility:**
- ↑Cardiac workload
- ↑Risk orthostatic hypertension
- ↑Risk venous thrombosis
41
Describe the following body system:
**Respiratory**
(Effects of Exercise, Effect of Immobility)
**Effect of Exercise:**
- ↑Rate/depth respiration
- ↑ Gas exchange
- ↑ Rate CO2 excretion
**Effect of Immobility:**
- ↓Rate/depth respiration
- Impaired gas exchange (acid base imbalance)
- Secretion pooling (-> hypostatic pneumonia)
- Atelectasis
42
Describe the following body system:
**Gastrointestinal**
(Effects of Exercise, Effect of Immobility)
**Effect of Exercise:**
- ↑ Appetite
- ↑ Intestinal tone
**Effect of Immobility:**
- Appetite disturbance
- Altered protein metabolism
- Altered digestion/utilization of nutritions
43
Describe the following body system:
**Urinary**
(Effects of Exercise, Effect of Immobility)
**Effect of Exercise:**
- ↑ BF to kidney
- ↑ Efficiency in maintaining fluid/acid-base balance
- ↑ Efficiency excreting body waste
**Effect of Immobility:**
- ↑ Risk UTI/urinary stasis
- ↑ Risk renal calculi
- ↓ Bladder muscle tone
44
Describe the following body system:
**Musculoskeletal**
(Effects of Exercise, Effect of Immobility)
**Effect of Exercise:**
- ↑ Coordination
- ↑ Efficiency of nerve impulse transmission
**Effect of Immobility:**
- ↑ Risk contracture formation
- ↓ joint mobility/flexibility
- ↓ endurance/stability
- Bone demineralization (↑risk fractures)
45
Describe the following body system:
**Metabolic**
(Effects of Exercise, Effect of Immobility)
**Effect of Exercise:**
- ↑ Efficiency of metabolic system
- ↑ Efficiency body temperature regulation
**Effect of Immobility:**
- ↑ Risk for electrolyte imbalance
- Altered exchange of nutrients and gases
46
Describe the following body system:
**Integumentary**
(Effects of Exercise, Effect of Immobility)
**Effect of Exercise:**
- ↓ Wrinkles
- Improves tone/color/turgor (elasticity)
**Effect of Immobility:**
- ↑ Risk skin breakdown/formation of decubitus ulcers (pressure sore)
47
Describe the following body system:
**Psychological Well-Being**
(Effects of Exercise, Effect of Immobility)
**Effect of Exercise:**
- Energy
- Improved sleep/appearance
- Improved self-concept
**Effect of Immobility:**
- ↑ Sense powerlessness
- ↓ Self concept
- ↓ Sensory stimulation (apathy)
- Altered sleep-wake patterns
48
Why is it important to take the health history and identify activitity level for patients?
- Provides indication of pt view of health
- Determines daily activity level, edurance, physical/mental health barriers and external factors
-> ex of external factors: access to physical activity services, safe neighborhoods, income
- Able to adapt nursing interventions and adaptations tailored to the pt
49
Describe the following component:
**Ease of Movement**
(Normal Findings, Abnormal Findings)
**Normal Findings:**
- Voluntary controlled
- Fluid
- Coordinated
**Abnormal Findings:**
- Fasciculations
- Chorea
- Tremors
50
Describe the following component:
**Gait/Posture**
(Normal Findings, Abnormal Findings)
**Normal Findings:**
- Head erect, vertebrae straight
- Knees/feet forward
- Arms at side with flex elbows
- Arms swing freely in alternation with leg swings
- While one leg is in stance phrase, other is in swing phrase
**Abnormal Findings:**
- Spastic hemiparesis
- Scissors gait
- Sensory ataxia
- Use of assistive devices
51
Describe the following component:
**Alignment**
(Normal Findings, Abnormal Findings)
**Normal Findings:**
- Standar/sitting straight line can be drawn from ear through shoulder and hip
- In bed: head/shoulders/hip aligned
**Abnormal Findings:**
- Inability to maintani correct alignment independently
- Spinal curvatures
52
Describe the following component:
**Muscle Mass/Tone/Strength**
(Normal Findings, Abnormal Findings)
**Normal Findings:**
- Be strong lol
**Abnormal Findings:**
- Atrophy/Hypertrophy
- Hypotonicity (flaccidity)/Spasticity
- Paresis/paralysis
53
Describe the following component:
**Endurance**
(Normal Findings, Abnormal Findings)
**Normal Findings:**
- Ability to turn in bed and maintain correct alignment when sitting/standing/ambulating/performing self care activities
**Abnormal Findings:**
**Inability to tolerate increase in activity:**
- Increase HR, RR, BP after rest
- Dyspnea
- Pallor
- Vertigo
54
________ is the normal method of walking
Heel-to-Gait
55
As a nurse, how do you prevent back stress?
- Use correct alignment; hold in stomach muscles, keeping shoulders back/relaxed/neutral, flex knees
- Avoid using back muscles; instead use long/strong muscles of arm/legs
- Stabilize pelvis by using internal girdle (contract glutes) and long midriff
- Work closely to object being lifted
- Avoid twisting
- Push > pull
56
As a nurse, how do you ensure safe pt handling and mobility?
- Remove obstacles
- Use appropriate SPHM equipment
- Administer prescribed meds (pain) in advance of transfer
- Use friction reducing devices
- Move pt in smooth, rhythmic motion
- Avoid grabbing extremity by its muscle
57
Describe the following Safe Patient Handling and Mobility (SPHM) Equipment:
**Gait Belts**
(Purpose, Patient Suitability, Key Considerations)
**Purpose:**
- Used to steady pt when transferring/assisting ambulation/pivoting; not used to lift
**Patient Suitability:**
- Pt with leg strength; cooperative and require minimal assistance
**Examples:**
- X
**Key Considerations:**
**DO NOT US ON:**
- pt with abdominal or thoracic incisions/chest trauma
- Behavioral Aggression
- Suicide Risk
58
Describe the following Safe Patient Handling and Mobility (SPHM) Equipment:
**Standing Assist and Repositioning Aids**
(Purpose, Patient Suitability)
**Purpose:**
- Used to help pt stand up
**Patient Suitability:**
- Pt needing minimal assistance to stand; can grasp and lift themselves
**Examples:**
- X
**Key Considerations:**
- X
59
Describe the following Safe Patient Handling and Mobility (SPHM) Equipment:
**Lateral-Assist Devices**
(Purpose, Patient Suitability, Examples)
**Purpose:**
- Reduced pt-surface friction during side-to-side transfers
**Patient Suitability:**
- Pt requiring lateral transfers who cannot assist or are unable to move
**Examples:**
- Roller/slide/transfer boards
- Inflatable mattresses
**Key Considerations:**
- X
60
Describe the following Safe Patient Handling and Mobility (SPHM) Equipment:
**Friction Reducing Sheets**
(Purpose, Key Considerations)
**Purpose:**
- Pvt skin shearing when moving pt in bed and assisting with lateral transfers
**Patient Suitability:**
- X
**Examples:**
- X
**Key Considerations:**
- May require excessive force and overexertion
61
Describe the following Safe Patient Handling and Mobility (SPHM) Equipment:
**Transfer Chairs**
(Purpose, Patient Suitability)
**Purpose:**
- Help lift/move pt
**Patient Suitability:**
- Pt with no weight-bearing capacity
- Pt who cannot follow directions/ cooperate
**Examples:**
- X
**Key Considerations:**
- X
62
Describe the following Safe Patient Handling and Mobility (SPHM) Equipment:
**Powered Stand-Assist and Repositioning Lifts**
(Purpose, Patient Suitability, Key Considerations)
**Purpose:**
- Help lift/move pt
**Patient Suitability:**
- Pt with some weight-bearing ability
- Pt who can follow directions/ cooperative
**Examples:**
- X
**Key Considerations:**
- Limit time spent in slings to reduce pressure injuries
63
Describe the following Safe Patient Handling and Mobility (SPHM) Equipment:
**Powered Full-Body Lifts**
(Purpose, Patient Suitability, Key Considerations)
**Purpose:**
- Help lift/move pt
**Patient Suitability:**
- Patients who cannot bear any weight (and need to be moved out of bed, into a chair, or to a commode/stretcher)
**Examples:**
- X
**Key Considerations:**
- Limit time spent in slings to reduce pressure injuries
64
Describe the following Safe Patient Handling and Mobility (SPHM) Equipment:
**Gait Belts**
(Purpose, Patient Suitability, Examples, Key Considerations)
**Purpose:**
- X
**Patient Suitability:**
- X
**Examples:**
- X
**Key Considerations:**
- X
65
Describe the **purpose** of the following Device/Method used for Positioning pt in Bed:
**Trapeze Bar**
**Purpose:**
- Helps with moving and turning
- Helps pt perform exercises that strengthen muscles of upper extremities
66
Describe the **purpose** of the following Device/Method used for Positioning pt in Bed:
**Trochanter Rolls**
**Purpose:**
- Supports hips/legs to prevent external rotation of hips
67
Describe the **purpose** of the following Device/Method used for Positioning pt in Bed:
**Hand Wrist/Roll**
**Purpose:**
- Keeps thumb in correct position
68
Describe the **purpose** of the following Device/Method used for Positioning pt in Bed:
**Foot board/spints/high top sneakers**
**Purpose:**
- Helps avoid foot drop
69
Describe the following pt position:
**Fowler's Position**
(Descriptions, Purspose, Potential Complications)
**Descriptions:**
- 45 to 60 Degrees
**Purpose:**
- Promotes cardiac and respiratory function
- Used for eating, conversation, and urinary/intestinal elimination
**Potential Complications:**
- Buttocks, sacrum, scapulae risk for skin breakdown
- Flexion contracture of the neck
- Exaggerated curvature of the spine
- Impaired lower extremity circulation
70
Describe the following pt position:
**High-Fowler's Position**
(Descriptions, Purspose, Potential Complications)
**Descriptions:**
- 90 Degrees
**Purpose:**
- Allows for maximal lung expansion
**Potential Complications:**
- Flexion contracture of the neck
- Exaggerated curvature of the spine]
- Impaired lower extremity circulation
71
Describe the following pt position:
**Low-Fowler's/Semi-Fowler's Position**
(Descriptions, Potential Complications)
**Descriptions:**
- 30 Degrees
**Purpose:**
- X
**Potential Complications:**
- Risk for increased shearing force over the sacral area
72
Describe the following pt position:
**Supine (Dorsal Recumbent) Position**
(Descriptions, Potential Complications)
**Descriptions:**
- Pt lies flat on the back with head and shoulders slightly elevated with a pillow (unless contraindicated)
**Purpose:**
- X
**Potential Complications:**
- Do not use on spinal anesthesia/surgery on spinal vertebrae
73
Describe the following pt position:
**Side-Lying (Lateral) Position**
(Descriptions, Purspose, Potential Complications)
**Descriptions:**
- Patient lies on their side, weight is borne by the lateral aspect of the lower scapula and lower ilium
**Purpose:**
- Relieves pressure on scapulae, sacrum, heels
- Allows legs to be comfortably flexed
**Potential Complications:**
- Twists spine
- Interferes with respiration
74
Describe the following pt position:
**Oblique Position**
(Descriptions, Purspose)
**Descriptions:**
- Variation of side-lying where patient is turned toward side with hip of top leg flexed at a 30-degree angle;
- knee flexed at 35 degrees.
- Calf of the top leg is positioned slightly behind the body's midline.
**Purpose:**
- Places less pressure on the trochanter and sacrococcygeal areas
**Potential Complications:**
- X
75
Describe the following pt position:
**Sims' Position**
(Descriptions, Purspose, Potential Complications)
**Descriptions:**
- Pt lies on their side, lower arm is behind pt, and upper arm is flexed at shoulder and elbow
**Purpose:**
- Weight is borne by the anterior aspects of the humerus, clavicle, and ilium
**Potential Complications:**
- Lateral flexion of the neck
- Twists spine
- Footdrop
76
Describe the following pt position:
**Prone Position**
(Descriptions, Purspose, Potential Complications)
**Descriptions:**
- Pt lies on abdomen with head turned to the side
**Purpose:**
- Helps pvt flexion contractures of hips and knees
**Potential Complications:**
- Contraindicated for people with spinal problems
77
Describe the following equipment used to increase circulation:
**Graduated Compression Socks**
(PT Suitability, Purspose, Special Complications)
**PT Suitability:**
**Use on pt at risk for:**
- - Venous thromboembolism
- Pulmonary embolism
- Helps pvt thrombophlebitis
**Purpose:**
- Applies pressure, increasing venous return to the heart
**Special Complications:**
- Perscribed intervention
78
Describe the following equipment used to increase circulation:
**Pneumatic Compression Devices (PCD/SCD)**
(PT Suitability, Purpose, Special Complications)
**PT Suitability:**
**Use on pt who are/have:**
- High-risk surgical pt
- Pt with decreased mobility
- Pt chronic venous disease
- Pt at risk for deep vein disorders
**Purpose:**
- Apply intermittent pressure to legs to stimulate venous return
**Special Complications:**
- Perscribed intervention
- Should be kept on at all times, except when walking
79
When turning a pt, the bed should....
be at the height of caregivers elbows
80
When transferring a pt, always...
transfer to pt stronger side
81
What do you do when assisting a pt with their ROM?
- Move each joint until their is resistance, but not pain
- Report uncomfortable reactions and stop exercises until further instructions are obtained
- Use ROM 2x/day
- RR and HR will increase, but resting rates should return back to normal levels within 3 minutes
82
Describe the following device:
**Walker**
(Purpose, How to Use)
**Purpose:**
- Enhances stability during ambulation
- DO NOT apply full body weight
**Types:**
- X
**How to Use:**
- Wear non skid shoes/slippers
- Top of walker should line up with crease on the inside of the pt wrist
- Elbows slightly flexed (15°)
- Push walker forward, then place weaker leg into the walker
- Push straight down on grips of walker and step forward with remaining foot
83
Describe the following device:
**Canes**
(Purpose, Types, How to Use)
**Purpose:**
- Enhances stability during ambulation
DO NOT apply full body weight
**Types:**
**Single-ended canes**
- Half-circle handle: Pt needing minimal support and use stairs frequently
- Straight handle: Pt with hand weakness
**Canes with tripod/quad cane**
- PT with poor balance
**How to Use:**
- Pt stands with canes tip 4 inches from side of food
- Cane extends from the floor to crease in pt wrist
- Elbow stays slightly bent (15°)
- Hold cane in hand opposite to side that needs support
- Advance with weaker foot forward, then bring stronger leg forward
84
Describe the following device:
**Braces**
(Purpose)
**Purpose:**
- Support weakened leg muscles
**Types:**
- X
**How to Use:**
- X
85
Describe the following device:
**Crutches**
(Purpose, Types, How to Use)
**Purpose:**
- Assists Ambulation
**Types:**
- Axillary crutches
-> Require significant upper body/arm strength to use
- Forearm crutches
-> Have supportive frames
**How to Use:**
- Do not place in axilla; 1-2 inches below axilla
- Place weight in hands; not underarm
- Typically advance stronger leg first
- Pvt crutches from getting closer than 12 inches
