What direction should the patient move toward?
Their strong side
What side do you stand on when ambulating a patient with a walker? Cane? No device?
- Walker: Strong side
- Cane: Affected side
- No device: Strong side
What side of the patient should be on the free side of the bed when lying down?
Their strong side
What are the metabolic effects of immobility?
- Fluid and electrolyte changes
- Bone demineralization
- Altered exchange of nutrients and gases
- Altered gastrointestinal functioning
What are the respiratory effects of immobility?
- Decreased lung secretions
- Pooling of secretions
- Atelectasis (lung collapse)
- Hypostatic Pneumonia
What are the cardiovascular effects of immobility?
- Orthostatic hypotension
- Increased cardiac workload
- Thrombus formation
What are the musculoskeletal effects of immobility?
- Decreased endurance
- Decreased muscle mass
- Decreased stability and balance
- Contracture formation
- Joint abnormalities
What are the integumentary effects of immobility?
- Decubitus ulcer formation (pressure ulcer)
- Ischemia (reduced blood flow)
What are the effects of immobility on elimination?
- Renal calculi (kidney stones)
- Stasis of urine
- Kidney infection
- Fecal constipation
- Fecal impaction
What are the psychological effects of immobility?
- behavioral changes
- change in sleep/wake cycle
- decreased coping abilities
- decreased problem-solving abilities
- decreased interest in surroundings
- increased isolation
- sensory deprivation
What are the developmental effects of immobility?
- retardation of developmental states
- elderly:increased rate of dependence
- increased rate of loss of system
- increased rate of loss of system functions
What is the nursing process?
What causes kyphosis?
osteoclasts take away more bone than osteoblasts can make
What pathologies influence mobility?
- postural abnormalities
- impaired muscle development
- damage to CNS
- musculoskeletal trauma
What happens to mucous in the lungs during immobility?
It thickens when sitting for too long, need to move and cough to prevent thickening.
What are the emotional and behavioral responses to immobility?
Activities of daily living
What is the physiological assessment for patients with immobility?
- Metabolic: inspection
- Respiratory: chest wall movement, breath sounds
- Cardiovascular: BP, pulse, peripheral circulation (color, adema), signs of deep vein thrombosis, swelling, redness
- Musculoskeletal: Active range of motion, muscle strength, tone and mass
- Integumentary: color, integrity, turgor
- Elimination: intake, output
a state in which an individual is at risk for deterioration of body systems owing to prescribed or unavoidable musculoskeletal inactivity
How do you prevent the metabolic hazards of immobility?
How do you prevent the respiratory hazards of immobility?
- promotion of chest and lung expansion
- maintenance of patent airway
- removal of secretions: drinking fluids thins mucous, easier to cough
- maintain oral care
How do you prevent the cardiovascular hazards of immobility?
- reducing orthostatic hypotensions (dangling at edge of bed)
- reducing cardiac workload: discourage valsalva maneuver
- preventing thrombus formation: medications, exercise, fluids, TED stockings, pneumatic compression (SCDs), positioning
How often do you check SCDs
once per shift
How do you prevent the musculoskeletal hazards of immobility?
- isometric exercises
- constant passive motion machines (cpm)
constant passive motion machines
sequential compression device
How do you prevent the integumentary hazards of immobility?
- turning every 1-2 hours
- hygienic care
- protection, preventative aids: padding
How often should you reposition a patient sitting in a chair?
every 15 minutes
How do you prevent the elimination hazards of immobility?
- nutritional intake: fiber
How do you prevent the psychosocial hazards of immobility?
- patient participation
How do you prevent the developmental hazards of immobility?
age appropriate activities
How do you prevent the positioning hazards of immobility?
- supports: footboards, trochancter rolls, hand rolls, splints
- trapeze bar
- bed positions: fowlers, supine, prone, side-lying, sims'