wk 5 day 1
Activity & Exercise Overview
Page 1
Activity & Exercise Week 5 - Day 1
Page 2: Understanding Activity & Exercise Patterns
Definition: Routine of exercise, leisure, and recreation.
Includes:
Activities of Daily Living (ADLs) requiring energy expenditure (e.g., hygiene, cooking, cleaning, shopping, eating, working, home maintenance, sports, exercise).
Page 3: Mobility
Definition: Ability to move easily and independently.
Dependence: On an intact functioning musculoskeletal and nervous system.
Impairments: Can be temporary or permanent due to illnesses, surgeries, injuries, pain, and aging (Potter et al., 2019).
Page 4: Coordinated Activity and Exercise
Mechanism: Both musculoskeletal and nervous systems coordinate to maintain balance, posture, and body alignment.
Importance: Reduces risk of injury and facilitates movement without excessive muscle strain or energy use (Potter et al., 2019).
Page 5: Body Alignment
Definition: Relationship of one body part to another along a horizontal or vertical line.
Correct alignment: Prevents excessive strain on joints, tendons, ligaments, and muscles.
Muscle Tone: Internal state of muscle tension within individual muscles or groups (Potter et al., 2019).
Page 6: Body Balance
Achieved: When the center of gravity is over a stable base of support (center at pelvis).
Maintaining Balance:
Widen the base of support by separating feet.
Bring center of gravity closer by bending knees and hips while keeping trunk erect (Potter et al., 2019).
Page 7: Friction and Movement
Definition: A force opposing movement, which increases the risk of skin and tissue damage.
Reduction Principles:
Avoid manual lifting/moving patients when possible.
Use friction-reducing devices (e.g., slider sheets).
Utilize patient strength for transfers when possible.
Page 8: Case Study on Stroke
Patient Analysis:
Slumped posture indicates potential issues with line of gravity, center of gravity, and base of support.
Consider potential problems: vision, balance, muscle strain.
Nursing Diagnosis: Determine if it is an intolerance or mobility issue.
Page 9: Exercise and Activity Definitions
Exercise: Physical activity aimed at conditioning, health improvement, fitness maintenance, and therapy.
Activity: Physical movement for a specific purpose.
Activity Tolerance: Kind and amount of activity one can do without adverse effects.
Page 10: Isotonic Exercise
Definition: Causes muscle contraction and changes muscle length.
Benefits: Enhances circulatory and respiratory function, increases muscle mass, tone, and strength, promotes osteoblastic activity.
Examples: Walking, swimming, biking.
Page 11: Isometric Exercise
Definition: Involves tightening muscles without moving body parts.
Use: Beneficial for recovering individuals with limited range of motion to prevent muscle wasting and increase muscle mass, tone, strength, and circulation (Potter et al., 2019).
Example: Quad setting exercises using a towel between knees.
Page 12: Resistive Isometric Exercise
Definition: Gradually increasing resistance during muscle contraction.
Benefits: Increases muscle strength and endurance, enhances osteoblastic activity.
Examples: Planks and wall push-ups.
Page 13: Case Study and ROM
Patient Analysis: Consider effects of stroke on movement.
Definitions: Passive vs. Active ROM.
Active ROM: Maintains/increases muscle strength and cardiorespiratory function.
Passive ROM: No contraction, enhances joint flexibility.
Guideline: Canadian Physical Activity Guidelines suggest 150 mins/week.
Page 14: Regulation of Movement
Definition: Coordinated body movement through the integrated functioning of skeletal, muscular, and nervous systems (Potter et al., 2019).
Page 15: Skeletal System
Components: Bones, joints, ligaments, tendons, and cartilages.
Page 16: Skeletal Muscle
Definition: Consists of muscle groups including antagonistic, synergistic, and antigravity muscles.
Page 17: Nervous System Function
Proprioception: Awareness of body part position.
Balance: Controlled by the cerebellum and inner ear.
Posture: Regulated by the nervous system, requiring proprioception and balance coordination.
Page 18: Review Reminders
Review Principles of Body Mechanics, Safe Patient Transfer, and Positioning Techniques from PNUR105 and Potter et al., 2019.
Page 19: Cardiovascular Benefits of Exercise
Effects: Increased cardiac output, improved contraction of cardiac muscle, decreased resting heart rate, improved venous return (Potter et al., 2019).
Page 20: Pulmonary System Effects
Benefits: Increased respiratory rate, improved alveolar ventilation, decreased work of breathing, and improved diaphragmatic excursion (Potter et al., 2019).
Page 21: Metabolic System Effects
Increased Activity: Basal metabolic rate, glucose and fatty acid usage, triglyceride breakdown, gastric motility, heat production (Potter et al., 2019).
Page 22: Musculoskeletal System Benefits
Improvements: Muscle tone, joint mobility, endurance capacity, possible increase in muscle mass, reduction of bone loss (Potter et al., 2019).
Page 23: Activity Tolerance
Outcome: Improved tolerance and decreased fatigue (Potter et al., 2019).
Page 24: Psychosocial Benefits
Improvements: Stress tolerance, overall well-being, decreased illness incidence (Potter et al., 2019).
Page 25: Deconditioning Effects
Definition: Decreased functional capacity affecting multiple body systems including muscle strength and mobility (Potter et al., 2019).
Page 26: Risks of Deconditioning - Respiratory
Risks:
Decreased lung expansion, hypoventilation, gas exchange impairment, pneumonia, atelectasis, and pulmonary embolism.
Actions: Regular respiratory assessment, deep breathing exercises, incentive spirometry (Potter et al., 2019).
Page 27: Risks of Deconditioning - Circulatory
Risks:
Venous pooling, decreased cardiac output, thrombus formation.
Actions: Monitor circulatory system, apply compression stockings, perform passive ROM, daily ambulation (Potter et al., 2019).
Page 28: Risks of Deconditioning - Integumentary
Risks:
Decreased oxygen delivery, skin breakdown, pressure injuries.
Actions: Regular skin assessments, repositioning, skin barrier application (Potter et al., 2019).
Page 29: Risks of Deconditioning - Musculoskeletal
Risks:
Reduced muscle mass, strength impairment, joint mobility issues.
Actions: Isotonic and isometric exercises, active/passive ROM, daily ambulation (Potter et al., 2019).
Page 30: Risks of Deconditioning - Gastrointestinal
Risks:
Decreased peristalsis, appetite reduction, constipation.
Actions: Regular abdominal assessments, encourage mobility, ensure healthy diet (Potter et al., 2019).
Page 31: Case Study - Broken Leg
Analyze potential problems of the patient on bed rest with a broken leg:
Analysis: Consider factors affecting mobility, NANDA-I diagnoses, risk for activity intolerance.
Page 32: Clinical Frailty Scale
Importance: Assessing patient’s dependency and activity level on a scale from very fit (#1) to completely dependent (#7).
Page 33: Frailty Scale Application
Application: Observe and score individual's energy and ability from #1 to #7.
Page 34: Influencing Factors of Activity & Exercise
Developmental Changes
Behavioural Aspects
Environmental Issues
Cultural and Ethnic Influences
Page 35: Developmental Changes
Consider how changes from infancy to older age affect activity and exercise.
Page 36: Behavioural Aspects
Influences:
Adaptability, family support, and knowledge of activity and exercise.
Page 37: Environmental Issues
Impact of work sites, schools, and community on activity and exercise participation.
Page 38: Cultural and Ethnic Influences
Considerations regarding appropriateness, religious practices, and enjoyment in exercise habits.
Page 39: Study Questions on Immobility
Identify effects of inactivity on various body systems.
Patient concerns regarding complete bed rest (CBR).
Page 40: Common Abbreviations for A&E
CBR: Complete Bed Rest
BRP: Bathroom Privileges
AAT: Activity as Tolerated
Page 41: Crutch Walking Gait Types
Types:
NWB: Non Weight Bearing
PWB: Partial Weight Bearing
FWB: Full/Feather Weight Bearing
WBAT: Weight Bearing as Tolerated
ROM: Range of Motion (passive and active).
Page 42: Nursing Process: Assessment
Guide: Data collection for Activity & Exercise assessment, including factors affecting needs and individual analysis.
Page 43: A&E Physical Assessment Components
Includes pain, expectations, body alignment, range of motion, mobility, and activity tolerance.
Page 44: A&E Nursing Assessment Questions
Nature of the Problem: Discuss patient issues with physical activities. Frequency, types, and preferences in exercise.
Page 45: Signs and Symptoms
Questions to determine exercise-related pain, shortness of breath in relation to activities.
Page 46: Severity of Symptoms
Scale for ranking leg pain and breathlessness during activities.
Page 47: Barriers to Exercise and Activity
Questions surrounding chronic illnesses, physical limitations, and environmental access to help understand barriers.
Page 48: Patient Values Assessment
Elicit beliefs related to regular exercise and confidence in performing recommended exercises.
Page 49: Effects on Patient Life
Discussion around the impact of exercise routine on weight, fatigue levels, and exertion-related symptoms.
Page 50: PNUR105 Lab Class
Practices: Focus on body mechanics, safe patient transfer, range of motion exercises, and ambulation techniques.
Page 51: Nursing Diagnosis
Importance of accurate diagnostic labeling based on defined characteristics and related factors.
Page 52: Common NANDA-I Labels for A&E
Recognizing issues such as activity intolerance, impaired mobility, and risk for injury.
Page 53: Specificity in Nursing Diagnosis
Importance of specifying affected body parts in nursing diagnoses.
Page 54: Nursing Process: Planning
Define patient goals/outcomes with SMART criteria and plan nursing interventions.
Page 55: Min Case Study
Case Considerations: Analyze Min’s routine, mobility after injury, leg usage with crutches, and exertion levels.