Chapter 9- activity

Activity & Mobility Significance

Mobility affects every body system; prolonged immobility can lead to complications.

Benefits of Mobility

Helps maintain muscle strength, joint mobility, circulation, independence with ADLs, psychological well-being, and reduces complications of immobility.

ROM

Range of Motion; the complete extent to which a joint normally moves.

AROM

Active Range of Motion; the patient performs the movement independently.

PROM

Passive Range of Motion; the nurse moves the patient’s joints.

SPHM

Safe Patient Handling and Mobility; emphasizes using mechanical devices to protect both patient and healthcare worker.

NCLEX Priority for Mobility

Assess first, choose the safest level of assistance/device, protect the patient and nurse, then reassess tolerance.

Patient Safety Equipment

Use of mechanical devices for lifting patients rather than manual lifting to reduce risk of injury.

Bariatric Consideration

For patients over 300 lb, 100 lb over ideal weight, or BMI > 40; requires specialized equipment and planning.

Gait Belt Purpose

Provides a secure grip for caregivers to assist with mobility, aiding in stability and reducing injury risk.

Proper Crutch Fitting

Top of the crutch should be 2–3 finger widths below the axilla with elbows slightly flexed.

Cane Positioning

Cane should be held on the strong side to distribute weight away from the weak side.

Four-Point Gait Sequence

Right crutch → Left foot → Left crutch → Right foot; one point moves at a time.

Safe Patient Transfer

Always assess the patient's ability to cooperate, bear weight, maintain balance, and use upper extremities before transferring.

Signs of Orthostatic Hypotension

Dizziness, lightheadedness, weakness, or faintness when moving from lying to sitting or standing.

When to Stop ROM

Stop if the patient reports pain or if significant resistance is encountered; do not force movement.

Walker Basics

A walker increases stability; proper height keeps elbows slightly flexed at approximately 15°.

Assistive Personnel — AP Role

AP may assist with ambulation and transfers after assessment and teaching by the RN.

Documentation Post-Mobility

Document activity type, distance walked, patient tolerance, and any significant observations.

NCLEX Safety Sequence

1. Assess 2. Prepare 3. Protect 4. Mobilize 5. Reassess 6. Document.

Unexpected Dizziness Protocol

If a patient becomes dizzy, stop the activity and safely return them to bed or a chair.

Why Not Lean on Axilla with Crutches?

Prolonged pressure can cause brachial nerve damage leading to loss of sensation or weakness.