Patient Mobility and Immobility

Question 1

potential causes of immobility

Answer 1

• direct injury/trauma to the musculoskeletal system
• central NS damage
• illness
• complications from surgery

Question 2

developmental consideration in infants, toddlers and preschoolers

Answer 2

• delay is gross motor skills, intelectual development, or musculoskeletal development

Question 3

developmental considerations in adolescents

Answer 3

• may effect growth patterns and the ability to gain independence
• social isolation can occur

Question 4

developmental considerations in adults

Answer 4

• physiological systems at risk
• changes occur in family and social structures

Question 5

developmental consideration in older persons

Answer 5

• progressive loss of total bone loss, muscle strength and aerobic capacity
• immobilization increases dependence on others and decreases their functional capacity fro self care

Question 6

how can nurses contribute ot the loss of self care abilities

Answer 6

by doing too much for the patient

Question 7

medically imposed mobility is also known as

Answer 7

bed rest

Question 8

bed rest

Answer 8

• reduces physical activity and oxygen needs
• reduces pain )can also cause it)’- promotes safety for patients recovering form the effects of anaesthetics
• allows patient who are ill or debilitated to rest
• allows patient who are exhausted the opportunity for uninterrupted rest

Question 9

deconditioning

Answer 9

a result of prolonged bed rest

Question 10

etiology of deconditioning

Answer 10

• pre hosptial functional capacity and reserve
• sleep
• pain
• depression
• bed rest and immobility
• medical and surgical conditions and comorbidities
• inflammation
• nutrition

Question 11

respiratory effects of immobility

Answer 11

• atelectasis
• hypostatic pneumonia
  -mucous accumulation (can lead to bacterial growth, decrease gas exchange and cause dyspena)
• decreased lung expansion

Question 12

cardiovascular effects of immobility

Answer 12

• orthostatic hypotension
• CO diminishes
  -potential for falls increases
• thrombus
• embolism

Question 13

thrombus

Answer 13

• blood clot that forms in a vessel as a result of injury (surgery), slow blood flow (bedrest), increased in blood viscosity (platelets or clotting factors)

Question 14

what is the most common type of thrombus

Answer 14

DVT
- deep vein thrombus

Question 15

Embolism

Answer 15

• dislodged venous thrombus (blood clot) can travel to parts of the body and cause ischemic event

Question 16

ischemic event

Answer 16

• storke, myocardial infraction, pulmonary embolism

Question 17

Gi effects of immobility

Answer 17

• decreased GI mobility (constipation, fecal impaction)
• positioning limitations (difficulty passing stool)
• pseudodiarrhea ( may be a result from fecal impaction)

Question 18

psedodiarrhea

Answer 18

liquid stool passing around an area of impaction
- if left untreated could result in a mechanical bowel obstruction

Question 19

urinary effects of immobility

Answer 19

• experience urinary problems (urine enters the bladder aided by gravity)
• increased risk of UTI and renal calculi (kidney stones)
• may be unable to void
• could lead to residual urine in the bladder (increases risk for infections)

Question 20

musculoskeletal effects of immobility

Answer 20

• loss of lean body mass
• accelerated loss of bone if patient already has osteoporosis
• disuse osteoporosis
• joint contracture
• foot drop

Question 21

muscle strenght drops ___% per day

Answer 21

3

Question 22

disuse osteoporosis

Answer 22

• bone becomes less dense; increased risk of fractures

Question 23

joint contracture

Answer 23

• abnormal and possibly permanent condition characterized by fixation of a joint

Question 24

foot drop

Answer 24

• damage (possible permanent) to the peroneal nerve of the foot from constant flexion as a result of poor support

Question 25

integumentary effects of immobility

Answer 25

• pressure injuries
• shear
• friction
• hygiene concernes
• potential delay in wound healing

Question 26

psychological effects of immobility

Answer 26

• decreased social interaction
• social isolation
• sensory deprivation / alterations
• loss of independence
• role changes
• emotional reactions
• behavioural responses
• changes in coping
• depression

Question 27

depression

Answer 27

an affective disorder characterized by exaggerated feelings of sadness, melancholy, dejection, worthlessness, emptiness, and hopelessness out of proportion to reality

Question 28

Assessment
subjective information examples:

Answer 28

• degree of mobility or immobility
• has disability been present for an extended period of time
• is the patient fearful of mobilizing
• well adapted to the use of an assisted device or even a wheelchair
• degree of pain present
• effect of mobility on lifestyle, family functioning and sense of wellbeing
• patient expectations regarding mobilizing? do they expect assistacne

Question 29

Assessment
objective information

Answer 29

• range of motion
• gait
• exercise tolerance and activity
• body alignment
• physical deformities
• level of conciouness
• affect, mood

Question 30

respiratory intervention

Question 31

cardiovascular interventions

Question 32

Gi interventions

Question 33

Urinary interventions

Question 34

musculoskeletal interventions

Question 35

integumentary interventions

Question 36

physiosocial interventions