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What direction should the patient move toward?
Their strong side
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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
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What side of the patient should be on the free side of the bed when lying down?
Their strong side
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What are the metabolic effects of immobility?
- Fluid and electrolyte changes
- Bone demineralization
- Altered exchange of nutrients and gases
- Altered gastrointestinal functioning
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What are the respiratory effects of immobility?
- Decreased lung secretions
- Pooling of secretions
- Atelectasis (lung collapse)
- Hypostatic Pneumonia
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What are the cardiovascular effects of immobility?
- Orthostatic hypotension
- Increased cardiac workload
- Thrombus formation
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What are the musculoskeletal effects of immobility?
- Decreased endurance
- Decreased muscle mass
- Atrophy
- Decreased stability and balance
- Contracture formation
- Osteoporosis
- Joint abnormalities
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What are the integumentary effects of immobility?
- Decubitus ulcer formation (pressure ulcer)
- Ischemia (reduced blood flow)
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What are the effects of immobility on elimination?
- Renal calculi (kidney stones)
- Stasis of urine
- Kidney infection
- Fecal constipation
- Fecal impaction
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What are the psychological effects of immobility?
- depression
- behavioral changes
- change in sleep/wake cycle
- decreased coping abilities
- decreased problem-solving abilities
- decreased interest in surroundings
- increased isolation
- sensory deprivation
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What are the developmental effects of immobility?
- young:
- retardation of developmental states
- elderly:increased rate of dependence
- increased rate of loss of system
- increased rate of loss of system functions
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What is the nursing process?
- Assessment
- Diagnosis
- Planning
- Implementation
- Evaluation
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What causes kyphosis?
osteoporosis
-
osteoporosis
osteoclasts take away more bone than osteoblasts can make
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What pathologies influence mobility?
- postural abnormalities
- impaired muscle development
- damage to CNS
- musculoskeletal trauma
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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?
- hostility
- giddiness
- fear
- anxiety
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ADL
Activities of daily living
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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
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disuse syndrome
a state in which an individual is at risk for deterioration of body systems owing to prescribed or unavoidable musculoskeletal inactivity
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How do you prevent the metabolic hazards of immobility?
nutritional needs
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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
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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
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How often do you check SCDs
once per shift
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How do you prevent the musculoskeletal hazards of immobility?
- rom
- isometric exercises
- constant passive motion machines (cpm)
-
CPM
constant passive motion machines
-
SCD
sequential compression device
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How do you prevent the integumentary hazards of immobility?
- turning every 1-2 hours
- hygienic care
- protection, preventative aids: padding
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How often should you reposition a patient sitting in a chair?
every 15 minutes
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How do you prevent the elimination hazards of immobility?
- hydration
- I&O
- nutritional intake: fiber
-
How do you prevent the psychosocial hazards of immobility?
- orientation
- communication
- patient participation
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How do you prevent the developmental hazards of immobility?
age appropriate activities
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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'
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