Mobility
Refers to a person’s ability to move about freely.
Immobility
Refers to the inability to move about freely.
Bed Rest
An intervention ordered by the provider that restricts a patient to the bed for therapeutic reasons and is sometimes prescribed for selected patients. Decreases the body’s oxygen need, reduces cardiac workload, reduces pain, l and allow the patient to get rest.
True
True or False: Clients experience a functional decline in the healthcare in the healthcare setting due to deconditioning.
Functional Decline
Loss of the ability perform self-care or activities of daily living. Loss of muscle tone, ROM, etc.
Deconditioning
Physiological change following a period of inactivity, bed rest, or sedentary lifestyle. Results in functional losses in such areas as mental status, degree of continence, and ability to accomplish activities of daily living.
Body Mechanics
Coordinated efforts of the musculoskeletal and nervous systems.
Alignment and Balance
This refers to posture and center of gravity.
Gravity
Weight force exerted on the body.
Friction
Force that occurs in a direction opposite to movement.
Skeletal System
Provides attachments for muscles and ligaments
Protects vital organs
Aids in calcium regulation.
Provides leverage for mobility.
Calcium and Phosphorus
What the bones are made of.
Types of Bones
Long, short, flat, and irregular
Joint
Where two or more bones are attached.
Skeletal Muscles
The working elements of movement because of their ability to contract/relax.
Nervous System
Transfers impulses from the nerve to the muscle.
Kyphosis
Increased convexity in the curvature of the thoracic spine. (Upper Spine)
Lordosis
Exaggeration of the anterior convex curve of the lumbar spine. (Lower spine.)
Scoliosis
Lateral S or C-shaped spinal column with vertebral rotation, unequal heights of hips and shoulders.
Metabolic Changes
Decreased metabolism rate
Impaired calcium resorption
Constipation
Respiratory Changes
Immobile patients are at high risk for developing pulmonary complications.
Decreased respiratory movement
Reduced lung capacity
Pooling of respiratory secretions
Hypostatic Pneumonia
Atelectasis
The tiny air sacks constrict and get stuck together.
Cardiovascular Changes
Orthostatic hypotension
Increased cardiac workload
Thrombus formation
Musculoskeletal Changes
Lean body mass loss
Muscle weakness/atrophy
Joint contracture
Urinary Elimination Changes
Urinary stasis
Increased risk for UTI
Renal calculi
Urinary retention
Infection
Integumentary Changes
Pressure ulcers
Reduced skin turgor
Psychosocial Effects
Hostility
Giddiness
Fear
Anxiety
Altered sleep patterns
Depression
Sadness
Dejection
True
True or False: Older adults are more likely to decline faster.
Range of Movement (ROM)
The maximum amount of movement available at a joint in one of the three planes of the body: sagittal, transverse, or frontal. Active, active assisted, passive.
Passive
You are doing the ROM for the patient.
Contracture
Develop when a patient’s joints are not moved periodically, their body part gets stuck in that position. Commonly seen in: neck, shoulder, elbow, forearm, wrist, fingers, etc.
Activity Tolerance
The type and amount of exercise a patient is able to perform without undue exertion or edurance.
Activity Tolerance Factors
Skeletal abnormalities
Muscular impairment
Endocrine or metabolic illnesses
Hypoxemia
Decreased cardiac function
Decreased endurance
Impaired physical stability
Pain
Sleep pattern stability
Pain
Sleep pattern disturbance
Prior exercise patterns
Infectious processes and fever
Anxiety
Depression
Chemical addiction
Motivation
Age
Sex
Pregnancy
Know patient limitations
Assessment findings that indicate the client is not tolerating the activity
Dyspnea
Chest pain
Shortness of breath
BP changes dramatically
Respiration problems
Gait
The manner or style of walking. Impairments can shift the center of gravity and make falls more likely.
Nursing Diagnosis for Clients With Impaired Mobility
Social isolation
Impaired elimination
Impaired physical mobility
Risk for impaired skin integrity
Ineffective airway clearance.
Blood Clot Intervention Methods
Compression stockings
Blood thinners
Fall
An event that results in a person coming to rest inadvertently on the ground, floor, or other lower level. A major health problem, ranking as the second leading cause of accidental or unintentional injury deaths worldwide.
True
True or False: Falls are the leading cause of both fatal and non-fatal injuries for those 65 years and older.
Intrinsic Factors
Predisposing factors (within the patient)
Extrinsic Factor
Increase the susceptibility of an individual to fall (environmental.)
Universal Fall Precautions
Apply to all patients regardless of fall risk. Ex:
Familiarize the patient with their surroundings
Have patient demonstrate call light use
Maintain call within patient’s reach
Non-slip footwear
Keep hospital bed brakes locked
Keep floors clean and dry
Have sturdy handrails
Place bed in lowest position.
Assisted fall
Stand with feet apart to provide a broad base of support.
Extend one leg and let the patient slide against it to the floor.
Bend knees to lower body as patient slides to the floor.
Walker
A lightweight, movable device that stands about wait high with four widely placed sturdy legs.
Used by patients with generalized lower extremity weakness or problems with balance.
Cannot be used on stairs and wheels may contribute to a patient falling.
Cane
Less bulky supportive device for patients that still have one strong side.
Instruct patient to keep device on stronger side.
Less stable and provide less support than other options, patients should be instructed that two points of support must be on the ground at all times when walking.
Physiological Changes in Older Adults Contributing to Falls
Slowed reaction time
Decreased bone bass
Decreased ROM
Less flexibility/strength
Visual/hearing alterations
Nocturia
Impaired memory
More medication use
Chemical Restraint
Medications administered to agitated patients to control unsafe physical movements and behaviors
Physical Restraints
Wrapped, buckled, or tied to a patient’s body to limit or restrict movement.
Seizure
A hyperexcitation and disorderly discharge of neurons in the brain leading to sudden, violent jerking, falling, etc.
Seizure Precautions
Guidelines to protect those with seizures from injury:
Always have a pillow under the head
Pad handrails to protect the head
Have bed in lowest position
Encourage side lying
Have patient in loose clothing
False
True or False: You can administer chemical restraints on a patient FIRST.
Reasons for Restraints
Patients removing medical devices.
Confused or wandering patients.
Patients ambulating without assistance constantly.
Patients that pose a threat to themselves or others.
True
True or False: If a patient is being aggressive, you can apply restraints without a doctor’s order as long as they are notified within a timely manner.
False
True or False: Ativan is a good chemical restraint on older adults.