SPHM, Mobility/Immobility Flashcards Preview

350 Week 4 > SPHM, Mobility/Immobility > Flashcards

Flashcards in SPHM, Mobility/Immobility Deck (46)
Loading flashcards...
1

Define body mechanics

The coordinated efforts of the msk and nervous systems to maintain balance, posture, and body alignment during motion/movement

2

Define health care ergonomics

Designing and arranging workplace settings in such a way that people interact more effectively with the objects they encounter in that environment

3

Define impaired physical mobility

limitation of physical movement

4

What respiratory changes are caused as a result of immobility?

Increased risk of
- atelectasis (collapse of alveoli in lungs resulting in impaired gas exchange)
- hypostatic pneumonia (inflammation of the lung from stasis or pooling of secretions)

5

What MSK changes are caused as a result of immobility?

- reduced muscle mass (can progress to disuse atrophy)
- impaired calcium metabolism (can lead to disuse osteoporosis)
- joint abnormalities (ex. joint contractures)

6

What are joint contractures? What is a common example?

abnormal (sometimes permanent) fixture of a joint. Limits ROM and may leave joints in a non-functional position.
Ex. footdrop

7

What urinary elimination changes are caused as a result of immobility?

urinary stasis - increases risk of urinary tract infection and renal calculi (kidney stones)

8

What integumentary changes are caused as a result of immobility?

Pressure injuries - localized damage to the skin and/or underlying soft tissue as a result of decreased blood supply in the
tissues

9

Name 5/11 nursing goals for a patient who is immobilized?

- maintain optimal nutritional/metabolic state
- promote expansions of chest and lungs
- prevent stasis of pulmonary secretions
- maintain patient airway
- reduce orthostatic hypotension
- reduce cardiac workload
- prevent thrombus formation
- maintain muscle strength and joint mobility
- maintain normal urinary elimination patterns
- prevent pressure injury/ulcer
- maintain usual psychosocial state

10

Identify two nursing interventions to meet the following nursing intervention: promote expansions of chest and lungs

- Assist the patient with repositioning every 2 hours
- Patient should be encouraged to deep breathe and cough every 1-2 hours

11

Identify two nursing interventions to meet the following nursing intervention: maintain optimal nutritional/metabolic state

- Make sure patient is getting a high-protein, high-calorie diet.
- Ensure patient is taking vitamin B and C if necessary.

12

Identify two nursing interventions to meet the following nursing intervention: prevent stasis of pulmonary secretions

- Change patient’s position every 2 hours
- Make sure patient is getting adequate fluid intake

13

Identify two nursing interventions to meet the following nursing intervention: maintain patient airway

- actively work with patients to deep breath and cough every 1 to 2 hours
- Implement chest physiotherapy (CPT) (percussion and positioning) to prevent mucous plugs

14

Identify two nursing interventions to meet the following nursing intervention: reduce orthostatic hypotension

- attempt to get the patient moving as soon as the physical condition allows, even if this only involves sitting at the side of the bed (dangling) or moving to a chair
- Reminding patient to change positions slowly and gradually

15

Identify two nursing interventions to meet the following nursing intervention: reduce cardiac workload

- Instructing patients to avoid using a Valsalva manoeuvre when moving up in bed, defecating, or lifting household objects. During a Valsalva manoeuvre a patient holds the breath and strains.
- The patient should be reminded to breathe out while defecating, lifting, or moving side to side or moving up in bed

16

Identify two nursing interventions to meet the following nursing intervention: prevent thrombus formation

- Leg exercises, position changes, encourage fluid intake, teaching patient of preventative measures, compression stocking
- Continually assess patient for signs of bleeding Ex. Bruising, bleeding gums, etc.

17

Identify two nursing interventions to meet the following nursing intervention: maintain muscle strength and joint mobility

- Promote exercise or perform passive ROM exercises 2-3 times a day
- Teach patients to integrate exercises during ADLs

18

Identify two nursing interventions to meet the following nursing intervention: maintain normal urinary elimination patterns

- Ensure adequate hydration
- Assess freq and amount of urine output; teach bladder training if necessary; may need to insert Foley catheter

19

Identify two nursing interventions to meet the following nursing intervention: prevent pressure injury

- Turning patients every 1-2 hours. Amount of time sitting uninterrupted should be monitored – limited to <1hour. Patients in wheelchairs should move every 15 minutes
- Use devices to relieve pressure on the skin.

20

Identify two nursing interventions to meet the following nursing intervention: maintain psychosocial state

- Use assessment data to identify the psychosocial effects of prolonged immobilization
- Observe patient’s ability to cope and provide formal/informal socialization.

21

Define Tissue Ischemia

a restriction in blood supply to tissues, causing a shortage of oxygen that is needed to keep tissue alive (causes ulcers)

22

Defining blanching

when blood flow to a region of skin is prevented, making that skin appear white

23

Compare:
Shearing force vs. friction

Shearing - when the skin and subcutaneous layers adhere to the surface of the bed, while layers of muscle and the bones slide in the direction of body movement
Friction - friction is present when there is a mechanical force exerted on the skin

24

Define DVT

accumulation of platelets, fibrin, clotting factors, and the cellular elements of the blood attached to the interior wall of a vein

25

What are elastic stockings (TED stockings) used for?

specialized hosiery designed to help prevent the occurrence of, and guard against further progression of, venous disorders

26

What is an embolus

a dislodged venous thrombus (clot)

27

Define hemiplegia

muscle paralysis on one side of the body

28

What factors can you assess to determine the effectiveness of safe patient handling in an institution?

- rate of msk injuries in nurses
- rate of falls in patients
- rate of deconditioning in patients
- rate of pressure ulcers in patients
- rate of functional decline in patients

29

List 4 risk factors for injury occurrence in nurses.

previous history of back pain
lack of personal physical conditioning
stress
not taking the time to obtain assistance

30

List 3 risk factors in the work environment that may cause injury.

- Workplace with poor ergonomics: slippery or wet surfaces, uneven floor surfaces, physical obstructions, small spaces, uneven work spaces, etc.
- staffing levels, patient assignment, availability of equipment etc.
- Poor body mechanics: reaching and lifting loads far from the body, heavy loads, twisting while lifting, changes during lifting, frequent lifting, etc.