NURS Fundamentals Exam Prep - Mobility

What is mobility?

coordinated function of the musculoskeletal + neurologic systems

What is the goal of nursing care?

maintain the patient’s highest safe level of function and independence

What are muscles?

produce movement

What are bones/joints?

provide structure and leverage

What is the nervous system?

initiates and coordinates movement

What is balance/proprioceptioin?

maintains position and stability

What factors affect mobility?

ade/development, pain, MSK disorders, neurological disorders, surgery/injury etc.

What are factors of assessing mobility?

history + baseline mobility, gait, posture, balance, strength, ROM, weight-bearing ability, assistive devices, activity tolerance

What tools score patients on factors affecting their mobility/mobility assessment?

fall hisotry, cognition, medications, weakness, toileting, environment

What are examples of fallr isk and mobility assessments?

hendrich and johns hopkins

What are nursing considerations for fall risk and safety assessment?

bedrest → first OOB → dangle → assess dizziness/tolerance → stand → ambulate

What is immobility?

inability to move one or more body parts

What are the effects of immobility?

system and musculoskeletal

What are musculoskeletal complications of immobility?

atrophy, decrezsed muscle strength, joint stifness, decreased ROM, contractures, foot drop, bone demineralization/remodeling, postural changes/kyphosis

What is muscle atrophy?

loss of muscle mass and strength

What are contractures?

permanent shortening/tightening of muscles and joints

What is kyphosis/postural changes?

altered spinal alignment, particularly with prolonged immobility

What is bone remodeling/demineralization?

decreases weight bearing → loss of bone density

What are cardiovascular effects of immobility?

venous stasis, orthostatic hypotension, increased cardiac workload/deconditioning, DVT/VTE risk

What are respiratory effects of immobility?

atelectasis, retained secretions, pneumonia

What are skin effects of immobility?

pressure injury risk

What are GI effects of immobility?

decreased peristalsis, constipation

What are GU effects of immobility?

urinary stasis/retention, increased risk for UTI/renal calculi

What are preventing complications of immobility?

early mobility, active/passive ROM, proper positioning/alignment, frequent repositioning, foot drop prevention

Who has an increased risk for DVT development?

immobile patients or have limited mobility

What is DVT/VTE prevention?

mobility, mechanical compression, subcutaneous anticoagulation

What is active ROM?

patient independently move the joint

What is active-assisted ROM?

patient moves the joint with some assistance

What is passive ROM?

caregiver moves the joint for the patient

What is proper body mechanics?

wide base, good posture, face the direction you are going, reduce friction, use your large muscles

What are transfers and ambulation before getting OOB?

verify activity/weight-bearing orders, assess pain, check for dizziness/orthostatic symptoms

What are assistive devices?

canes, walkers, crutches

What are canes?

should be used on strong side; weak leg to strong leg

What are walkers?

weak/affected leg to strong/unaffected leg

What are crutches?

weight through the hands, not axillae

What is some mobility equipment?

gait belts, friction-reducing sheets, transfer chairs, powered full-body lifts

What is the purpose of Fowler's positioning?

aspiration/SOB

What is the purpose of supine positioning?

when moving up in bed

What is the purpose of sim’s position?

rectal exam or medication administration

What are devices for positioning and alignment?

wedges and pillows, mattresses, adjustable beds, bed size rails, trapeze bar