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Module 1 (Intro To Basics) > Mobility/Immobility > Flashcards

Mobility/Immobility Flashcards

(73 cards)

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1
Q

Mobility def

A

person’s ability to move about freely

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2
Q

Mobility examples

A

nonverbal gestures
self-defense
ADLs
recreational
satisfaction of basic needs
expression of emotion

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3
Q

Factors affecting Mobility and Activity

A

developmental
nutrition
lifestyle
stress
environment
diseases and abnormalities

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4
Q

Diseases and Abnormalities associated with Mobility

A

bones, muscles, and nervous system
pain
trauma
respiratory system
circulatory
psychological/social

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5
Q

Immobility

A

person’s inability to move about freely
- may involve a specific part of the body due to injury

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6
Q

Paraplegia

A

may involve lower part of body

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7
Q

Hemiplegia

A

paralysis on one side of the body
- common in strokes-

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8
Q

Tetraplegia/Quadriplegia

A

paralysis involving the entire body from the neck down

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9
Q

Bedrest

A

restricts pts to bed for therapeutic reasons

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10
Q

Bedrest reasons

A

sometimes prescribed for selected pts
reduces physical activity and O2 demand of the body
reduces pain
allow ill or debilitated pts to rest
allows exhausted pts to rest
duration depends on illness or injury and the prior state of health

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11
Q

Physical causes of immobility

A

bone fx
surgical procedure
major sprain or strain
illness/disease
cancer
aging process

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12
Q

Psychosocial causes on immobility

A

stress/depression
decreased motivation
hospitalization
long term care facility residents
voluntary sedentary lifestyles

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13
Q

Prolonged Immobility in order

A

-Reduced functional capacity
-Altered metabolism (slows down)
-Numerous physiological changes

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14
Q

Effects of Immobility in what systems?

A

musculoskeletal
lungs
heart and vessels
metabolism
integument
GI
GU
psychological

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15
Q

Immobility - Common effects on body systems
Musculoskeletal

A

brittle bones
contractures
muscle weakness and atrophy
foot drop

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16
Q

Immobility - Common effects on body systems
Nervous System

A

lack of stimulation
feelings of anxiety and isolation
confusion
depression

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17
Q

Immobility - Common effects on body systems
Digestive System

A

decreased appetite and low fluid intake
constipation and/or bowel obstruction
Incontinence
Electrolyte imbalances

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18
Q

Immobility - Common effects on body systems
Integumentary

A

decreased blood flow
pressure ulcer
infections
skin breakdown and pressure ulcers

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19
Q

Immobility - Common effects on body systems
Cardiovascular

A

blood clots
reduced blood flow

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20
Q

Immobility - Common effects on body systems
Respiratory

A

pneumonia
decreased respiratory effort
decreased O2 of blood

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21
Q

Immobility - Common effects on body systems
Urinary

A

reduced kidney function
incontinence
UTI
Urinary retention

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22
Q

Musculoskeletal Assessments

A

-activity intolerance (prolonged bedrest)
-anthropometric measurements (weak bones, muscle loss, stiffness)
-nutrition (need high proteins)

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23
Q

For every week on bed rest, the person loses ___% of their muscle mass

A

10

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24
Q

Bone Reabsorption: Osteoclasts

A

dissolve bone and pass all Ca into the blood stream

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25
Bone Reabsorption: Osteoblasts
grow bone and deposit Ca back into the bone
26
Osteoporosis risk factors Which gender? Especially after?
sex (females are more affected especially after menopause) insufficient exercise or too much exercise poor diet ( low in Ca and protein) smoking pt on bedrest
27
Osteoporosis def
porous bone with dead space and easily broken
28
How to prevent osteoporosis?
Calcium and Vitamin D (sunlight, dairy, green leafy veggies, eggs, and fish Protein diet ROM and exercise
29
Bone density is strongly related to
estrogen
30
ROM def
maximum amount of movement available at a joint -exercise improves joint mobility -easiest intervention to maintain or improve joint mobility coordinated with other activities - no moving is at risk for contractures (can be formed within 8 hours
31
Active ROM
Done by pt completely and instructed by the nurse
32
Active assist ROM
Done by pt but with help by nurse
33
Passive ROM
done by nurse continuous passive motion
34
If a patient reports pain or muscle spasms during ROM, _____________ exercises immediately to prevent injury
discontinue
35
ROM essentials and criticals to remember
3 times daily (after bath, midday, bedtime) support extremity start gradually and move slowly using smooth motions stretch the muscle only to the point of resistance/pain encourage active ROM if possible
36
Contractures
joints flex into an angle and stay there - shortening of the muscles (hands, arms, and foot drop
37
What is the natural angle for hands to be?
fingers angled and prone
38
Respiratory Assessment
lung sounds O2 Sats Respiratory rate Activity tolerance (SOB) CXR (black is good, white clouds bad) ABG
39
When should you do respiratory assessments of immobile pts? At risk of developing fluid in lungs
general every 8 hours critical care every 4 hours
40
Cardiac Assessment
B/P Pulse rate Heart sounds Activity tolerance (BP, HR, chest pain) **Calf pain**
41
When the patient is laying down and has calf pain, the person is at risk of
DVT
42
DVT is caused by
decreased muscle activity pooling of blood clot formation DVTs
43
How do prevent DVTs?
ambulation TED Hose SCDs
44
TED Hose
Thrombo-embolic deterrent hose -post surgical -nonwalking patients
45
SCDs
Sequential Compression Devices - sleeves around the legs -alternatively, inflate and deflate post-surgical/circulatory disorders
46
Metabolism Assessment
Decreased appetite Weight loss Muscle loss Weakness Labs GI slows down: constipation, bowel obstruction, or perfusion
47
Integument Assessment
Skin assessment -color changes -integrity Nutrition Incontinence
48
Pressure Injury
Impairment of the skin as a result of prolonged ischemia (decreased blood supply) in tissues
49
Develops when pressure on the skin is greater than the pressure inside the small peripheral blood vessels supplying blood to the skin
inflammation forms over bony prominences longer pressure applied the greater risk of injury
50
GI Assessment
Bowel sounds Abdominal palpation Bowel habits (last bowel movement?) I & O
51
GU Assessment
I & O Palpate abdomen Incontinence Urine (color, smell, clarity?)
52
Kidney stones are formed by
Calcium
53
Urinary Stasis
when the renal pelvis fills before urine enters the ureters because peristaltic contractions of the ureters are insufficient to overcome gravity
54
Development of kidney stones and UTIs
When a person is lying, urine can settle in the renal pelvis and bladder, urine is concentrated and thick with calcium
55
Urinary Elimination Changes
immobility (decreased activity) decreased fluid intake dehydration concentrated urine increased risk for UTI and kidney stones
56
Psychological Assessment
Mood Orientation Speech Affect Sleep
57
Psychosocial Effects
social isolation loneliness decreased coping depression anxiety withdrawal delerium
58
Benefits of Mobility
strengthen muscles (abdomen and legs) joint flexibility (hips, knees and ankles) stimulates circulation (helps prevent phlebitis and clot development) prevents constipation (stimulates intestinal tract) prevents osteoporosis (mineral loss and when they do not bear weight) stimulates appetite prevents urinary incontinence and infection relieves pressure (prevent pressure injuries) improves self-esteem decreases anxiety and depression (induced by hospitalization)
59
Best intervention to prevent immobility complications
ambulation
60
Mobility Levels
1-dependent 2-moderate assistance 3-minimum assistance 4-modified independent
61
Restraints
Any manual method, physical or mechanical device, material, or equipment that immobilizes or reduces the ability of a patient to move arms, legs, body, or head freely
62
Non-Violent Restraints are used when the patient
Actions impede medical care Lack of awareness of potential harm to self and others Unable to follow commands and comply with safety instructions Attempts to pull out tubes, drains, or other lines/devices medically necessary for treatment **Requires every 2 hours monitoring and documentation New orders required every calendar day** When discontinuing, the date & time must be documented.
63
Covenant's Restraint Policies
Prior to restraining, alternatives must be attempted: Reorientation Limit setting Use of sitter Increased observation and monitoring Change the patient’s physical environment Review and modification of medication regimens
64
Alternative Measures - Nurses
Orient family and patient to the environment Offer diversionary activities Use calm simple statements Promote relaxation techniques Attend to needs (bathroom) Use of glasses/hearing aids
65
Alternative Measures by modifying measures
increase or decrease the light place personal items within reach place near nurse station reduce environmental noise keep call button accessible use special furniture accordingly (bed alarms)
66
Alternative Measures - Nursing Interventions
Camouflage lines and tubes encourage family to stay with pt and bring familiar objects from home orient pt to person, place and time involve pt in conversation give pt something to do
67
Restraint Guidelines
Practioner must order prior to applying. In emergencies – may apply but practioner must be notified immediately. A new order must be obtained daily. Must be discontinued at the earliest possible time. Monitoring varies depending on patient needs and situational factors (could be continuous, every 15 min or every 2-3 hours) Assessment includes vital signs, hydration and circulation, skin integrity and patient’s level of distress)
68
Risks of Using Restraints
Increase in injury or death Loss of self-esteem Humiliation Fear Anger Increased confusion and agitation Make sure all other measures have been taken to avoid restraints
69
Complications of Restraints
Impaired skin integrity Lower extremity edema Altered nutrition Physical exhaustion Social isolation Immobility complications Death
70
Intervention application
Restrict movement as little as is necessary Make sure restraint fits properly Always tie (slip knot or bow tie) to bed frame/mattress springs Always explain the need for restraint Never leave patient unattended without the restraint Pad bony prominences DOCUMENT, DOCUMENT, DOCUMENT
71
Documentation
any medical evaulation for restraint Description of the patient’s behavior and the intervention used Any alternatives or other less restrictive interventions attempted. Patient’s condition or symptom that warranted the use of restraints Patient’s response to the intervention used and rationale for continued use of the intervention. individual pt assessments and reassessments intervals for monitoring revisions to the plan of care orders, consultations, teaching, reponse
72
easiest intervention to maintain or improve joint mobility
ROM
73
Requires every ___ hours monitoring and documentation New orders required every ________
2 hours; Calendar day

Module 1 (Intro To Basics) (32 decks)

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