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Module 1 > Mobility And Immobility > Flashcards

Mobility And Immobility Flashcards

1
Q

Mobility

A

Nonverbal gestures
Self defense
ADLs
Recreational
Satisfaction of basic needs
Expression of emotion

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2
Q

What are factors that can affect mobility and activity?

A

Developmental
Nutrition
Lifestyle
Stress
Enviroment
Diseases and abnormalities

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3
Q

Diseases and abnormalities that can affect the ability to move

A

Bones, muscle and nervous
Pain
Trauma
Respiratory system
Circulatory
Psychological/social

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4
Q

Paraplegia

A

Paralysis lower part of the body

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5
Q

Hemiplegia

A

Paralysis Half of the body

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6
Q

Quadriplegia / tetraplegia

A

Person paralyzed from the neck down

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7
Q

What can be the good points of bed rest?

A

Reduces pain
Allows patient to rest
Reduce physical activity and O2 demand

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8
Q

What can the duration of bed rest be?

A

Duration depends on illness or injury and proper state of health

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9
Q

Physical causes of immobility

A

Bone fracture
Surgical procedure
Major sprain or strain
Illness/disease
Cancer
Aging process

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10
Q

Psychosocial causes of immobility

A

Stress/depression
Decreased motivation
Hospitalization
Long term care facility residents
Voluntary sedentary lifestyle

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11
Q

Prolonged immobility ( bad effects of bed rest)

A

Reduced functional capacity
..
Altered metabolism
..

Numerous physiological changes

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12
Q

What are common effects of bed rest?

A

Weakened muscles
Weakened joint/ stiffness
Bones will break down
Skin break down
Blood clots
Etc
See slide 11

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13
Q

How much muscle mass does a person lose on bed rest?

A

For every week 10%

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14
Q

Anthropometric measurement

A

Body weight, bmi, body measurements

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15
Q

What is important for a person who is on bed rest to have in their diet?

A

Protien

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16
Q

Osteoclast

A

Dissolve bone “clast” to break

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17
Q

Osteoblast

A

To grow——- deposits calcium into the bone

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18
Q

Why would an immobile person have decrease bone mass?

A

Osteoclast come in and they start to wear down the bone

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19
Q

Osteoporosis

A

Bone that has a plot of dead spaces “porous”

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20
Q

What is the primary cause of osteoporosis?

A

Insufficient excercise or too much excercise

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21
Q

Who is prone to osteoporosis?

A

Females(after menopause)
Excercise (too little too much)
Poor diet (low in CA and protien)
Smoking

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22
Q

What can be done to a patient to avoid osteoporosis?

A

Excercise, ROM
Adequate died
Calcium and vitamin d

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23
Q

What we must have with calcium

A

Vitamin D!!!

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24
Q

What are some sources of vitamin d?

A

The sun
Dairy milk, cheese, yogurt
Green leafy vegetables
Eggs
Fish
Or supplements

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25
Q

What is bone density strongly link to?

A

Estrogen- that’s why in women we see a peak in our 30s and a drop off after menopause

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26
Q

Contractures

A

It is when a joint fixates in a specific place

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27
Q

What can improve joint quality and is the easiest intervention to maintain or improve joint mobility?

A

ROM

28
Q

Active ROM (AROM)

A

Done by the patient

ex patient does 15 shoulder raises on his own

29
Q

Active assist ROM

A

Done by patient but with help

Ex. Patient can’t do complete shoulder raises so he gets assistance

30
Q

Passive ROM

A

Done by nurse or caregiver
Continuous passive motion machine (CPM)

31
Q

How many times a day should ROM be practiced?

A

3 times a day
After bath
Mid day
Bedtime

32
Q

What should you do if a person reports pain or muscle spasms during ROM?

A

D/C immidietly!!

33
Q

During ROM

A

Start gradually and move slowly using smooth motion
Support extremity
Stretch the muscles only to the point of resistance/pain
Encourage active ROM

34
Q

What kind of assessments is important to do when we have a patient who can not move?

A

Respiratory
Cardiac
Metabolism
Integument
Gastrointestinal
Genitourinary
Urinary stasis
psychosocial

35
Q

Respiratory assessment

A

Lung sounds
O2 sats
Respiratory rate
Activity tolerance (SOB)
Chest X-ray
Arterial blood gases

36
Q

What can be critical to watch on a patient?

A

Respiratory rate -make sure to count every single time

37
Q

Cardiac assessment

A

BP
Pulse rate
Heart sounds
Activity tolerance (what goes up when they move around
calf pain

38
Q

What does calf pain indicate?

A

DVT (deep vein thrombosis)

39
Q

DVT

A

Describes muscle activity>
Pooling of blood>
Clot formation >
DVTs

40
Q

What is the big worry about DVT?

A

It can go to the lungs and cause a pulmonary embolism (can be deadly) depending where they lay

41
Q

How can we prevent DVTs?

A

Ambulation
TED hose
SCDs

42
Q

Why do we encourage early ambulation?

A

To prevent DVT

43
Q

TED Hose

A

Thrombosis-Embolic deterrent hose
Post surgical
Non walking patients
Always measure right away
Check for skin break down

44
Q

SCDs

A

Sequential compression devices
Sleeves around the legs alternately inflate and deflate
Post surgical/ circulatory disorders

Compress and sequence to push blood back up to the heart to prevent blood clots

45
Q

What happens if patient soils TED hose?

A

Change it and wash it

46
Q

What happens when SCDs are soiled

A

Change it and throw it away

47
Q

Metabolism assessment

A

Decreased appetite
Weight loss
Muscle loss
Weakness
Labs

48
Q

Integumentary assessment

A

Skin assessment
Color changes
Integrity
Nutrition
Incontinence
PREVENT skin break down

49
Q

What kind of nutrition should an immobile patient have?

A

HIGH PROTIEN

50
Q

For gastrointestinal assessment what do we want to make sure of?

A

That the patient has good and active bowel sounds -if there is no sound it can indicate constipation which can lead to a bowel obstruction

51
Q

Genitourinary assessment:

During bone break down calcium gets released into the blood. What does this have to do with the Genitourinary assessment?

A

Kidney stones

1) calcium is the number one culprit of kidney stones

52
Q

When a person is laying down the urine settles in the renal area. What happens when the urine is still?

A

It grows bacteria
It becomes more concentrated
Calcium build up in urine

Perfect enviroment to develop kidney stones and UTI

53
Q

What psychosocial effects can someone who is immobile go through?

A

Loneliness
Delirium
Withdrawal
Decreased coping
Depression
Anxiety
Social isolation

54
Q

Benefits of mobility

A

Strengthen muscles
Joint flexibility
Stimulates circulation
Prevents constipation
Prevents osteoporosis
Stimulates the appetite
Prevents urinary incontinence and infection
Relieves pressure
Improves self esteem
Decreases anxiety and depression

55
Q

What is the best intervention to prevent immobility complications?

A

Ambulation

56
Q

What does mobility level 1 mean (red)

A

Dependent

57
Q

What does mobility level 2 mean (orange)

A

Moderate assistance

58
Q

Mobility level 3 (yellow)

A

Minimum assistance

59
Q

Mobility level 4 (green)

A

Modified independent Level 4 (green)

60
Q

Restraints

A

Any manual method, physical or mechanical device, material or equipment that immobilizes or reduces the ability of a patient to move arms legs bodu or head freely

Application of a force that can not easily removed without individual permission

61
Q

WHY would you use a Non violent restraint?

A

Actions impede medical care
Lack of awareness of potential harm self and others
Unable to follow commands and comply with safety instructions
Can pull out tubes drains or other lines
Requires every 2 hours monitory and documentation
When discontinuing date and time must be documented

62
Q

Restraint types

A

Extremity
Mitten
Posey
Belt

63
Q

Papoose or mummy restraint

A

Used in pedi population

64
Q

Covenants restraint policies

A

Prior to restraining
Reorientation
Limit setting
Use of sitter
Increased observation and monitoring
Change the patients physical environment
Review and modification of medication regimens

Ex turning on the lights changing the blinds

65
Q

How can you discontinue the restraints

A

A trial is the best way like during abed bath, med admin and during feeding to see if they can feed themselves

66
Q

Which restraint can be of risk of strangulation?

A

Posey- watch carefully!

67
Q

Interventions for immobility

A

ROM
Reposition
Neutrino/hydration/toileting
Releases at the earliest possible time

Module 1 (18 decks)

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