Fundamentals

Risk factors for immobility

Anything affecting mobility/coordination
stroke, history of falls, parkinson’s
Prolonged immobility causes SYSTEMIC COMPLICATIONS

Immobility complications

Delirium, social isolation
atelectasis, pneumonia
UTI, constipation
Edema, DVT
Pressure injuries
Atrophy, Contractures

What are contractures?

a permanent tightening or shortening of muscles, tendons, skin, or other tissues that causes joints to become stiff and restricts normal movement

Interventions for mobility

#1: EARLY AMBULATION
reposition every 2 hrs
SCD devices
ROM exercises

Positioning goals

Enhances comfort, ventilation, perfusion, prevents complications

Fowler’s position

Supine w/ head of bed elevated
IMPROVES CHEST EXPANSION IN CLIENTS W RESP PROBS
LOWERS RISK FOR ASPIRATION
DEPENDENT DRAINAGE AFTER NECK SURGERY

Supine

flat on back

PREVENTS SIDS
CONTRA: RESPIRATORY DISTRESS

Prone

flat on front
helps lungs in ARDS
prevents flexion contractures after amputation

Lateral

offloads vena cava pressure
PUT PTS IN THIS POSITION AFTERS SEIZURES
Put patient ‘good lung down’ after pneumonia to increase oxygen saturation

Sims

front with one leg up
left sims for suppository/enema

Trendelenburg

helps postural drainage
Contraindicated in clients with ICP

Reverse Trendelenburg

backup Fowler

what to do when client is falling in front of you

Use leg to assist to ground