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Fundamentals of Nursing > chapter 38: Activity and excercise > Flashcards

chapter 38: Activity and excercise Flashcards

1
Q

AHA benefits of physical activit

A
  • elevates mood and attitude
  • keeps us physically fit
  • helps ppl stop smoking
  • boosts energy levels
  • stress management
  • promotes better sleep
  • improves self image and confidence
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2
Q

Deconditioning

A

physiological changes aft period of inactivity

  • risk for hospitalized patients
  • gets in way of activities of daily living
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3
Q

Nature of movement

A

body mechanics = coordinated efforts of musculoskeletal and nervous systems

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4
Q

Alignment and balance

A

body alignment is basically posture –> position of joints, tendons, ligaments, and muscles while in dif positions

Correct body alignment reduces strain on musculoskeletal structures, maintains muscle tone, promotes comfort, helps with balance and energy conservation

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5
Q

Gravity and friction

A

Patients’ center of gravity is usually at 55-57% of standing height along the midline

Greater surface area = greater friction
Shear = friction bt one’s own skin and bone

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6
Q

Common friction issue in hospitals

A

when hospital bed is raised over 60 degrees, skin stays against the sheets and bony structures slide down
-stretches and damages tissue and blood vessels –> pressure injuries

Not usually a problem for surface tissue

Full body sling helps to move patients

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7
Q

Regulation of movement

A

Integration of musculoskeletal and nervous system

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8
Q

Skeletal system

A

4 bones: long, short, flat, and irregular

babies have flexible, but not sturdy bones
toddlers have stronger, but pliable bones
old ppl are mores succeptible to bone loss and osteoporosis

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9
Q

joints

A

3 types:

  • fibrous: close together and fixed (syndesmosis bt tibia and fibula)
  • cartilaginous: little mvmnt but elastic (synchondrosis bt ribs and costal cartilage)
  • synovial joins: true joints –> fee moving –> most common
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10
Q

ligaments, tendons, and cartilage

A

support skeletal system
-ligaments = dense fibrous tissue bands bt bone and cartilage –> elastic –> some are protective

-tendons –> connect muscle to bone –> achilles tendon is thickest and strongest (soleus muscle to calcaneal bone

cartilage -> nonvascular –> bears weight and absorbs shock bt bones –> permanent cartilage is unossified except in old age or disease

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11
Q

Skeletal muscle

A
  • bundles of miscle fibers –> ATP (powered by glucose and O2) powers movement of actin and myosin along each other to contract muscles when stimulated by electrochem stimulus across NMJ
  • disuse and use lead to atrophy ad hypertrophy
  • during contraction, one bone moves (insertion) while other remains in place (origin)
  • stretch reflex = body trying to maintain constancy of muscle length
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12
Q

Isotonic contractions

Isometric contractions

A

Isotonic

  • concentric = increased muscle contraction causing muscle shortening
  • eccentric = causes lengthening

isometric
-increase in muscle tension but no change in size of muscle

Voluntary movement combines the two

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13
Q

Prime mover
Antagonist
Synergists
Fixators

Muscle tone

A
  • muscle that directly performs a specific movement
  • muscle that directly opposes prime mover when it contracts
  • contracts at same time as prime and facilitates its action
  • muscles that stabilize joints - kinda like a synergist

normal state of balanced muscle tension

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14
Q

Nervous system

diseases that fuck up movement

A

Precentral gyrus = motor strip = major voluntary motor area in cerebral cortex
-most motor fibers descend from here and cross at medulla

  • Parkinson alters NT production
  • myasthenia gravis disrups NT transfer to muscle
  • multiple sclerosis impairs muscle activity
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15
Q

Proprioceptin

A

muscle sense that makes us aware of position of the body and its parts including body movement, orientation in space, and muscle stretch

Proprioceptors live in muscle spindles

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16
Q

Balance and alinment

-steps to maintaining it

A

maintained by sense organs in vestibule and semicircular canals of ears

  1. widen base by widening stance
  2. bring center of gravity close to base of support
  3. bend knees and flex hips til squatting and keep back erect
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17
Q

Physical activity and excercise

benefits of isotonic vs isometric

A 
Activity = any movement by muscle that expends energy
Exercise = PA that's planned, structured, and repetitive

Isotonic up circulatory and respiratory func –> increase muscle mass, tone, and strength –> promote bone health

Isometric are good for ppl who can’t tolerate more activity –> increase muscle mass, tone and strength –> circulation to that body part –> osteoblast activity

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18
Q

Conditions affecting body alignment and mobiity

A 
Congenital defects
bone, joint, and muscle disorders
inflammatory joint diseases
central nervous system disorders
musculoskeletal trauma
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19
Q

problems caused by obesity

A

musculoskeletal stuff: low back pain, gait disturbance, soft tissue damage, osteoprosis, gout, fibromyalgia, and CT disorders

Also HTN, atherosclerosis, heart disease, diabetes, high blood cholesterol, cancers, and sleep disorders

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20
Q

Overextension injuries

Ergonomics

A

Come from HCPs using too much effort at work (usually moving patients)

design of work tasks to best suit capabilities of workers

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21
Q

Factors influencing activity and excercies

A

Developmental changes
Patient behavior –> intrinic motivation
Lifestyle
Cultural background
Environmental issues –> work, home, schools, community
Family and social support (esp for women) –> also parents to kids

22
Q

Transtheoretical Model r/t self efficacy for PA

A

Precontemplation: no plan to change - unaware of need
Contemplation: aware of need for change - plan to w/in 6 months
Preparation: decided to take action w/in the month - have a plan
Action: making changes
Maintenance: exhibited behavior for 6 months and are preventing relapse

23
Q

Objectives of assessing body alignment

A
  • determine normal changes from growth and development
  • identify deviations caused by bad posture
  • let patient view their own posture
  • identify need to teach patient about posture
  • identify trauma, muscle damage, or nerve damage
  • Obtain info on things that could affect body alignment, like fatigue, malnutrition, and psychosocial problems
24
Q

Positions to check patient’s mobility

A

Sitting: BMAT - can use side rail

Standing: BMAT - can use help (cane etc) - need to have butt off chair for 5 secs

ROM:

  • too much = CT disorder, ligament tears, and possible joint fractures
  • too little = inflammation, fluid in joint, altered nerve supply, and contractures

Gait = heal strike of one leg to heal strike of next leg

25
Q

How much exercise should an adult get?

A

150 mins of moderate intensity aerobic activity

muscle-stregthening on at least 2 days that target all major muscle gps

26
Q

Activity intollerance vs fatigue

A

Activity intollerance comes with abnormal heart rate and mild shortness of breath after exercise

27
Q

Nursing diagnoses associated with activity/exercise

A 
activity intollerence
risk for fall-related injury
impaired mobility in bed
impaired mobility
acute or chronic pain
28
Q

What kind of exercise do older adults have to do that younger ones don’t?

A

Balance exercises

29
Q

How to calculate targeted heart rate during exercise

A

subtract age from 220 (max HR)

60-90% of max is the target

30
Q

What should be included no matter what exercise perscription is given?

A

warm up and cool down periods
Warm up = 5-10 mins –> stretching , calisthenics, low-level aerobics
Cool down = 5-10 mins –> stretching and mind-body awareness

31
Q

Early mobility

  • risks of limited activity/ prolonged bed rest
  • who needs it most?
A

-especially for those in acute care –> avoid deconditioning

Risks:
-reduced phys func, sleep deprivation, delirium, altered nutrition

Important for: critically ill, orthopedic patients, those who’ve had general/neural surgery

32
Q

Isometric exercises
general procedure
specific examples

A

General: flex/contract muscles for 10 secs and then relax w/o joint involvement –> work up to 8-10 reps –> work up to 4 times a day –> quads and gluts help with prepping to walk

Specific:

  • palm stretches
  • plantar flexion/dorsiflexion
  • arm lifts
33
Q

Types of ROM exercises

A

active
active assisted
passive

34
Q

contraindictions to AROM

A 
healing fracture site
healing surgical site
severe/acute soft tisue trauma
joint pain
limited joint movement
joint inability, deformation, and contractures
35
Q

Orthostatic hypotension and Neurogenic orthostatic hypotension

A

SBP drops 20 mm Hg within 3 mins shifting to upright position

sustained reduction in BP upon standing caused by autonomic dysfunction

36
Q

Who’s at risk for orthostatic hypotension and neurogenic orthostatic hypotension

A

ppl who’ve been in bed a long time
old ppl
those with chronic illnesses (diabetes mellitius or cardiovascular disease)

Neurogenic: e.g. Parkinsons

37
Q

gait belt dos and don’ts

A

keeps patients center of gravity at midline
helps stabilize patient if they lose balance
fit it snugly below belly button with room for 2 fingers
hold from behind with palms facing up

Dont lift or carry patient by waist with this
don’t place over incisions, stitches, tubes, or IV lines
Don’t do this with pregnant person

38
Q

How to catch a falling patient

A

wide base with one foot in front of other

let patient slide against leg and lower them to floor while protecting their head

39
Q

Restorative and continuing care

A

implementing activity and exercise strategies to help a patient perform ADLs after acute care is no longer needed

Includes activities and exercises that restore optimal func in patients with specific chronic diseases like coronary heart disorder (CHD), HTN, COPD, and diabetes mellitus

40
Q

Reasons for using assistive devices for walking

A

reduce risk of falls
decrease pain with mobility
increase balance

41
Q

What not to do with a walker

A

walk behind it
lean on it
use it on the stairs

42
Q

How to use a cane

A

put cane forward 15-25 cm
move weaker leg forward
move strong leg past cane

43
Q

when are quad canes appropriate?

A

partial or complete leg paralysis or some hemiplegia

same steps as normal cane

44
Q

Standard crutch gaits

A

four-point alternating: left crutch, right foot, right crutch, left foot
three point alternating: both crutches, good foot, both crutches good foot
two point alternating: left crutch AND right foot, right crutch AND left foot
swing through:

45
Q

tripod position for crutches

A

Assumed position before walking

crutches in front of feet
erect head and neck
straight vertebrae 
extended hips and knees
no weight on axillae
46
Q

Up and down stairs with crutches

A

one crutch and hand rail

Up stairs: hand rail, good leg, crutch, bad leg

Down stairs: hand rail, bad leg and crutch, good leg

47
Q

sitting in chair with crutches

A

legs touch back of chair
hold crutches in one hand opposite affected leg
hold arm of chair with other hand
lower self into chair

48
Q

Coronary artery disease interventions

A

promote regular moderate exercise

49
Q

HTN interventions

A

low to moderate intensity exercise

relaxation exercises to combat stress

50
Q

COPD interventions

A

tailored to individual

w/o it patients have dyspnea

51
Q

Diabetes mellitus intervention

A

moderate to high intensity exercise

Type 1: increases heart and lung fitness, decreases insulin resistance, and improves lipid levels and endothelial func

Type 2: reduction in HbA10, triglycerides, blood pressure, insulin resistance

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