Mobility and Immobility

Question 1

What is mobility ?

Answer 1

the ability to move freely, easily, rhythmically, and purposefully in the environment, is an essential part of living

Question 2

What is reduced sensation ?

Answer 2

where your senses are reduced so much that you don’t realize that you need to move
- legs are so numb that you don’t feel the need to change positions
- Ex.) can happen in diabetes pt’s

Question 3

What are some benefits to ambulation ?

Answer 3

• improves muscle strength
• increases well-being and independence
• decreases length of stay

Question 4

What is the first step you perform prior to ambulating a patient ?

Answer 4

performing a mobility assessment

Question 5

What is the proper alignment for a cane ?

Answer 5

• top of cane should be level with the inside of the pt’s wrist when they have their hands relaxed
• elbow bent at 15-30 degrees

Question 6

When climbing the stairs on what side should the cane be ?

Answer 6

on the same level as the weaker leg

Question 7

What is the proper alignment for a walker ?

Answer 7

• the top should be at the same level as the wrist
• elbows bent at a 15 degree angle

Question 8

On what side should you hold the cane ?

Answer 8

on the unaffected (stronger) side

Question 9

When using crutches on what part do you bear your body weight ?

Answer 9

on the hand grip
- requires more upper body strength

Question 10

Why don’t you want to bear your weight on your armpits when using crutches ?

Answer 10

have nerves under your arms that can be damaged

Question 11

What is the proper alignment for using crutches ?

Answer 11

• 2-3 inches below axilla
• advance 4-6 inches in front of shoes
• elbows flexed 15-30 degrees

Question 12

When going up stairs with crutches, which leg should be near the railing ?

Answer 12

stronger leg should be next to railing
- will step up first with that unaffected (stronger) leg

Question 13

When going down with crutches, which leg should be near the railing ?

Answer 13

stronger leg should be next to railing
- step down first with affected (weaker) leg

Question 14

Where do pressure injuries happen most often on ?

Answer 14

on bony prominences
- heels, head, shoulders, elbow, buttocks. toes, sacrum

Question 15

How is your urinary system affected by immobility ?

Answer 15

kidneys can’t function properly if your position is poor (hypercalcemia can occur)
- Conditions: urinary retention, renal calculi (kidney stones)
- Solutions: increasing fluids, and semi-full fowlers position can help improve this

Question 16

How is your bowel eliminations affected by immobility ?

Answer 16

need bodily movement for bowel movements
- constipation, GERD
- increasing fluids, assess/diet choices, sit pt up in bed can improve this, increase fiber

Question 17

How is your integumentary (skin) system affected by immobility ?

Answer 17

can increase chances of pressure injuries
- Solutions: frequent turning, use of pillows/waffle items like the boot can decrease the chances of this

Question 18

How is your cardiovascular system affected by immobility ?

Answer 18

orthostatic hypotension, thrombus (blood clots), cardiac deconditioning
- Sequential compression device (SCDs), anticoagulation, mobilize patients as soon as possible, monitor for increased HR and decreased pulse pressure and drop in BP can help improve this

Question 19

How is your respiratory system affected by immobility ?

Answer 19

atelectasis, hypostatic pnemonia
- monitor RR and characteristics of respiratory system
- monitor breath sounds q2 hrs
- positioning to improve lung expansion/exercise
- deep breathing
- adequate fluid intake

Question 20

How is your psychosocial health affected by immobility ?

Answer 20

depression
- listen to pt, identify changes, and assess sleep/wake cycle can improve this

Question 21

How is your metabolism affected by immobility ?

Answer 21

decreased appetite leads to a Negative nitrogen balance
- Conditions: weight loss, decreased muscle mass and weakness; hypercalcemia can occur; and you can get decreased GI motility
-Solutions: monitor I & O, high protein/high calorie diet, monitor wound healing, monitor lab value, monitor % of food intake improve this

Question 22

How is your musculoskeletal system affected by immobility ?

Answer 22

diffuse osteoporosis, joint contracture, foot drop, sacropenia
- Solutions: assess/screen, calcium supplements & foods, get up when able, ROM, splints/boots, promote neural alignment can improve this