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mobility 1 Flashcards

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1
Q

what are the 4 elements of body movement?

A

posture alignment, joint mobility, balance, coordination

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2
Q

what is posture alignment?

A

all body parts in good alignment (head on top of shoulders, on top of spine, on top of legs) for good body mechanics

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3
Q

what can affect posture?

A

diseases, pregnancy, atrophy, obesity, fractures, ligament/soft tissue injuries, static posture (sitting or standing a long time)

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4
Q

what is joint mobility?

A

keeping joints flexible and functioning through full and range of motion

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5
Q

what can decrease joint flexibiliy?

A

age, injury, musculoskeletal injuries (ex: arthritis)

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6
Q

what is balance?

A

the ability to maintain the body’s centre of mass over its base

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7
Q

what system is balance ruled by?

A

vestibular system

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8
Q

what can decreased balance lead to?

A

increased risk of falls

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9
Q

what is coordination?

A

a persons ability to move with synchronicity, exchanging information through body systems

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10
Q

what is gait?

A

a persons stride

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11
Q

what is ergonomics?

A

applied science concerned with designing and arranging things people use in a way that eliminates or reduces discomfort

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12
Q

what is mobility?

A

the ability to move freely, easily, and independently

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13
Q

what is immobility?

A

the inability to move freely

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14
Q

what does prolonged immobility lead to?

A

reconditioning: clinical syndrome which results in a decreased functioning of multiple body systems

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15
Q

what are the musculoskeletal effects on immobility?
what are the clinical manifestations?
what are the nursing interventions?

A

decreased muscle mass, strength, endurance, and joint mobility

clinical manifestations: fatigue, atrophy, decreased stability and balance

nursing interventions: ROM, isotonic, and isometric exercises… frequent ambulation, splints, proper body alignment

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16
Q

what are the integumentary effects on immobility?
what are the clinical manifestations?
what are the nursing interventions?

A

decreased O2 and nutrients to the tissues, inflammation

clinical manifestations: abrasions, pressure sores, infection

nursing interventions: frequent skin assessment, repositioning every 2 hrs keeping area clean and dry

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17
Q

what are the respiratory effects on immobility?
what are the clinical manifestations?
what are the nursing interventions?

A

decreased lung expansion, hypoventilation, impaired gas exchange

clinical manifestations: pneumonia, hypoxemia (low levels of O2 in blood), pulmonary edema, pulmonary embolism

nursing interventions: frequent respiratory assessment, positioning to promote lung expansion, deep breathing exercises, frequent ambulation

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18
Q

what are the circulatory effects on immobility?
what are the clinical manifestations?
what are the nursing interventions?

A

decreased cardiac output, venous pooling, peripheral edema

clinical manifestations: thrombus formation, orthostatic hypotension

nursing interventions: frequent circulatory assessment, compression stockings, passive ROM exercises, BP assessment prior to ambulation

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19
Q

what are the gastrointestinal effects on immobility?
what are the clinical manifestations?
what are the nursing interventions?

A

decreased peristalsis, fluid intake, and appetite

clinical manifestations: abdominal discomfort, constipation, ileus (stop of movement in intestines), and aspirations

nursing interventions: frequent GI assessment, frequent ambulation, diet high in protein, fibre, and fluid

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20
Q

what are pathological influences on mobility?

A

conditions or illnesses that put the client at risk for decreased mobility

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21
Q

what are congenital abnormalities? example?

A

illness or condition someone is born with
ex: multiple sclerosis, muscular dystrophy

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22
Q

what are postural abnormalities? examples?

A

illness effecting someones posture
ex: lordosis and kyphosis

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23
Q

what is lordosis?

A

curvature of the lower spine

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24
Q

what is kyphosis?

A

curvature of the upper spine

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25
what are illnesses affecting the CNS? examples?
stroke paralysis, ALS, head or spinal cord injury, parkinson's
26
what are diseases affecting the musculoskeletal system?
osteoporosis, arthritis, fractures, muscle tears, dislocation of joints
27
what are some influences on mobility?
age, motivation, age, pain, surgery
28
what is the purpose and benefit to maintaining mobility?
patients often perceive their health status based on their mobility levels
29
how does immobility affect metabolism?
decreases metabolic rate, disrupts GI processes resulting in decreased appetite and slowing of peristalsis
30
what does decreased appetite lead to?
weight loss, muscle wasting, breaking down of amino acids... resulting in nitrogen
31
what are the consequences on immobility and its affect on the negative nitrogen balance?
negative nitrogen balance: when more nitrogen is excreted than ingested (more lost than taken in) cause: decreased appetite due to decreased metabolic rate from immobility causes in decrease of amino acid breakdown that produces nitrogen... creating less nitrogen than is being ingested ACTIVATING TISSUE METABOLISM
32
what are the consequences of immobility on calcium reabsorption?
calcium reabsorption: loss of calcium from the bones cause: calcium is released into the circulation and gets excreted by the kidneys... hypercalcemia may result if there is kidney impairment
33
what are the consequences of immobility on the respiratory system?
decreased mobility puts client at risk for atelectasis (collapsed alveoli), which can lead to hypostatic pneumonia... both cause decrease oxygenation
34
what is atelectasis?
collapsed alveoli
35
what are the consequences of immobility on the cardiovascular system?
puts patients at risk for orthostatic hypotension, increased cardiac workload, and thrombus formation there is a decrease in the volume of blood circulating which pools the blood in the lower extremities... this puts patients at risk for clot formation and then possibly pulmonary embolisms
36
what are the consequences of immobility on the musculoskeletal system?
often leads to loss of endurance, strength, and muscle mass... decreased balance puts patients at risk for falls skeletal system is impacted by the impaired calcium metabolism
37
what are the consequences of immobility on the urinary system?
often immobile patients are in the supine, lateral, and other position causing urine to be on a level plane as the kidneys, ureters, and bladder... this makes it more difficult for patients to empty their entire bladder (urine retention) causing an increased risk of UTI's and renal calculi (kidney stones)
38
what is urinary stasis?
urine retention
39
what are the consequences of immobility on the integumentary system?
pressure injuries: caused by friction and shearing because the patient is unable to move themselves
40
what is shearing?
a combination of pressure and friction when a patient is unable to move themselves and is placed in the sitting position... the sliding down in their seat and pressure on their body causes sores
41
what are the consequences of immobility on ones psychosocial well-being?
cause a decrease in social interaction, loss of independence, changes in body image... all can lead to emotional and behavioural changes like hostility, depression, fear, and anxiety
42
what are the consequences of immobility on growth and development? (children, adolescents, and older adults)
children: significant delays in gross motor functions adolescents: can lag in independence compared to peers, at risk for social isolation older adults: increased physical dependance on others
43
what are the metabolic interventions for increasing mobility?
high protein diet (replenish depleted protein) high calorie diet (meet metabolic needs) vitamin C and zinc supplements (wound healing)
44
what are the respiratory interventions for increasing mobility?
change position every 2 hrs (allows lungs to re-expand and clears secretions) chest physio (help drain secretions) hydration (thin secretions) suction secretions assess RR, O2 sats, chest sounds deep breathing and coughing
45
what are the cardiovascular interventions for increasing mobility?
mobilize as soon as possible changing positions slowly (decreases orthostatic hypotension) avoid valsalva (holding breath while bearing down, moving, pooping ect.)... increases intrathorcic pressure and decreases venous return and cardiac output increase in ROM exercises decrease deep vein thrombosis and venous thromboembolisms
46
what are the musculoskeletal internventions for increasing mobility?
ambulation ROM exercises to prevent muscle atrophy isometric exercises (muscle tighten for 10sec then relax) using proper support and alignment
47
what are the bodily elimination interventions for increasing mobility?
assessing urinary output and bowel movements hydration sitting or standing diet rich in fibre, fruits and veggies (normalize peristalsis) provide stool softeners, laxatives, enemas, suppositories
48
what are the integumentary interventions for increasing mobility?
repositioning every 2 hrs limiting head of the bed at 30 degrees good hygiene and skincare support with pressure offloading device
49
what are the psychosocial interventions for increasing mobility?
providing a routine minimize sleep interruptions encourage family visits
50
why is exercise important?
helps limit effects of immobility
51
what are the 2 types of exercise?
aerobic and strength building
52
what are the 3 types of strength building exercise?
muscle strengthening, bone strengthening, post exercise recovery
53
what are muscle strengthening exercises? (3 types and examples)
isometric: contracts muscle without noticeable muscle shortening (kegals, plank) isotonic: contracts muscle with muscle shortening and joint angle changing (lifting weights) isokinetic: contracts and shortens muscle at a constant controlled rate (specialized dyanometers)
54
what are bone strengthening exercises? examples?
increasing strength of the bone mass ex: running and jumping
55
what are post exercise recovery exercises? examples?
not overexerting muscles stopping if there is pain rest, stretch, and cool down
56
what are some benefits of exercise?
positive impact on cognition reduce physical difficulties prevents cardiovascular disease decreases weight increases mood prevents diabetes increases life expectancy
57
why is transferring, positioning, and ambulation so important?
prevents muscle discomfort, prevents repeating pressure leading to pressure ulcers, prevents superficial nerve and blood vessel damage, maintains muscle tone
58
what is the ACES assessment and why is it important?
A - alert and energetic enough to perform a transfer C - cooperative E - extremities working sufficiently enough to transfer S - sits unsupported important to assess if it is safe to move a patient
59
where do you raise the bed to when performing a transfer?
to waist height of the shortest nurse helping
60
what factors are important to note when performing a transfer?
degree of exertion permitted patients tolerance to moving ability to assist with move weight of patient nurses strength the need for assistive devices tubes, medical devices, IV's, ect. medication impairment (alertness, balance, ect)
61
what is High Fowler's position?
head of bed - 60-90 degrees used when - client having severe breathing impairment
62
what is Fowlers' position
head of bed - 45-60 degrees (average 45 degrees) used when - patients are experiencing chronic breathing problems (COPD, pneumonia) or heart problems gravity pulls body down allowing for better lung expansion
63
what is Semi-Fowler's position?
head of bed - 15-45 degrees (average 30 degrees) used when - patients need pressure reduction... the higher you sit up, the more pressure on the coccyx minimum requirement for when patient is at risk for aspirations
64
what is Orthopneic position?
the tripod position when the person is leaning over the side of the bed or table used to - help with chest expansion
64
what is Dorsal Recumbent position?
head and shoulders slightly elevated on pillow
65
what is Supine positon?
head and shoulders flat, feet flat lying on back no pillow
66
what is Prone position?
lying on tummy with head turned to one side issues include: - the pull of gravity on back causing curve (lordosis) - causes strain on cervical and lumbar spine - causes planter flexion - inhibits chest expansion used for - amputees, prevents hip flexion... also used in PEDS
67
what is Lateral postion?
side lying reduces lordosis... promotes good back alignment relieves pressure on sacrum and heels
68
what is the 30 degree Lateral position?
halfway between supine and lateral has fewer pressure points (less pressure on greater trochanter and sacrum)
69
what is Sim's Position (Semi-prone)
halfway between lateral and prone positions used to maintain airway for unconscious people used for enemas or if needing to reduce pressure on sacrum or greater trochanter
70
what is trandelenburg and reverse trandelenburg?
reverse trandelenburg: head of bed raised and foot lowered - used to increase venous return trandelenburg: foot of bed raised and head of bed lowered - decreases venous return and increases venous drainage
71
what is a transfer or gait belt used for and how is it used?
aids in patient transfer and ambulation... maintains stability and reduces risk of falling should be 2 finger breaths between body and belt
72
what is a friction reducing device (slliders) used for and how is it used?
used to reposition patient in bed or transfer place slippery side away from patient's body and centre device under patients shoulders, hips, and bum remove slider when finished transferring
73
what is a cane used for and how is it used?
safe length is the distance between the floor and crease at wrist held on the stronger side of the body move cane with the weaker leg when walking
74

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