NCHP Chapter 38: Activity and Exercise

exercise guideline

• at least 150 min of aerobic exercise/week

• muscle strengthening at least 2 days/week

cardiovascular benefits of exercise

• increased cardiac output

• stronger heart muscle

• decreased resting HR

• improved venous return

pulmonary benefits of exercise

• better alveolar ventilation

• decreased WOB

• quicker return resting state

metabolic benefits of exercise

• increased basal metabolic rate

• glucose/fatty acid use

• triglyceride breakdown

• gastric motility

musculoskeletal benefits of exercise

• improved tone

• joint mobility

• possible muscle mass gain

• reduced bone loss

psychosocial factors of exercise

• better stress tolerance

• reports “feeling better”

• decrease in cold/flu

isotonic exercise

• muscle shorten, movement occurs

• walking, jogging, swimming, biking

• in bed: arm lifts, plantar flexion

isometric exercise

• muscle tension WITHOUT movement - stationary

• plank, tightening/contracting muscle groups (quad sets), hip lifting

resistive exercise

• muscle works against resistance

• push ups, weights

aerobic exercise

• raises heart rate, uses oxygen

• walking, cycling, dancing

safety guidelines for nursing skills

• know the pt’s level of mobility

• assess risk for activity intolerance

• mentally review transfer steps before beginning

• stand on UNAFFECTED side

• determine transfer equipment needed

• raise side rail on opposite side

• arrange equipment

• evaluate for correct body alignment

• understand equipment before starting

implementation/generate solutions

• health promotion: isotonic (walk swim bike) and isometric (pushup hip lifting)

• acute car: early mobility

  • isotonic: arm lift, plantar flexion

  • isometric: tighten/contract muscle groups

  • ROM exercises

implementation/take action

implementation: restorative and continuing car

• assistive devices for walking → walkers, canes, crutches

activities and exercises to restore functioning for pts with:

• CAD, HTN, COPD, DM

bedside mobility assessment tool (BMAT)

level 1: sit and shake

• sit on bed, shake hand

• trunk strength and balance

• fail → total lift/slide sheet

level 2: stretch and point

• stretch and point toes

• leg strength

level 3: stand

• fail = standing aid needed

level 4: step

• march in place

• standing balance, gait

• pass = independent