Chapter 23 Body Mechanics, Positioning, and Moving

مع صباح هذا اليوم اللهم بلغنا ما نود ؛ و اجعل لنا دعوة لا ترد ؛ وهب لنا رزقا لا يعد .. و افتح لنا بابا إلى الجنة لا يسد. اللهم كن لإخواننا في حلب عونا و نصيرا..اللهم استر عوراتهم و امن روعاتهم و اكفهم بقدرتك أعداءك

Introduction to Dangers of Inactivity Inactivity leads to deterioration of health Disuse syndrome: signs and symptoms resulting from inactivity in as little as 24 hours

Dangers of Inactivity

Maintaining Good Posture Good posture affects a person’s appearance, stamina, and ability to use the musculoskeletal system efficiently Poor posture often results in muscle spasms

Maintaining Good Posture (cont’d)

Maintaining Good posture Posture: is the position of the body, or the way in which it is held. Good posture is important for both clients and midwives to avoid muscle spasm (sudden, forceful, and involuntary muscle contraction). Standing: To keep good posture in standing: Keep the feet parallel (10-20 cm wide) Distribute weight equally on both feet Bend knees slightly Hold the chest up & slightly forward Keep the spin properly aligned Old the head erect

Sitting: Both feet rest on the floor Knees are free from the edge of the chair Lying down: The same as standing; the person is horizontal

Standing Posture

(Refer to Figure 23-4 in the textbook.) Lying-Down Posture Good lying-down posture Head, neck centered between shoulders Shoulders level; arms, hips, knees slightly flexed Trunk straight; hips level; legs parallel; feet at right angles to legs (Refer to Figure 23-4 in the textbook.)

Body Mechanics Proper body mechanics Increase muscle effectiveness Reduce fatigue Avoids repetitive strain injuries

Body mechanics Nursing guidelines 23-1, p. 497 Use the longest & strongest muscles of the arm & legs When lifting a heavy load, center it on the feet Hold objects close to the body Bend the knees Pull, push, or roll objects rather than lifting them Keep wide base of support

Positioning Clients General principles for positioning Change the inactive client’s position at least every 2 hours Enlist the assistance of at least one other caregiver Remove pillows and positioning devices

Positioning Clients (cont’d) Common positions Supine position Foot drop: permanent dysfunctional position caused by shortening of the calf muscles and lengthening of the opposing muscles on the anterior leg

Foot Drop

Positioning Clients (cont’d) Common positions (cont’d) Lateral Lateral oblique Prone Sims’ and Fowler’s

Common Positions

Positioning Clients (cont’d) Turning and moving clients Assistive devices and additional caregivers are needed when turning or moving a client who cannot change from one position to another independently

Transferring Clients Examples of transferring aids Transfer handle Transfer belt Transfer boards Mechanical lift

Nursing Implications Nursing diagnoses for inactive clients Impaired physical mobility Risk for injury Risk for disuse syndrome Risk for perioperative-positioning injury Impaired bed mobility

Chapter 24 Therapeutic Exercise

Exercise Beneficial to all age groups Sedentary lifestyle is a health risk Individualized Nurses assess fitness level before initiating exercise program

Types of Exercise Fitness exercise Develops and maintains cardiorespiratory function, muscular strength, endurance 2 categories Isotonic Isometric

Types of Exercise (cont’d) Isotonic exercise Involves movement and work Increases cardiorespiratory function Aerobic exercise

Types of Exercise (cont’d) Isometric exercise Stationary exercise, usually against resistance Increases circulation but does NOT promote cardiorespiratory function Weight lifting Body building

Types of Exercise (cont’d) Therapeutic exercise Activity performed by people with health risks that prevents complications and restores lost function Isotonic or isometric Active exercise is performed independently by client after instruction Passive exercise is performed by client with assistance when client is unable to move body parts

Types of Exercise (cont’d) Range-of-motion exercises Therapeutic activities to move joints Performed to assess joint flexibility; maintain joint mobility and flexibility in inactive clients; prevent ankylosis; stretch joints for strenuous activities; and evaluate response to therapeutic exercise program Performed for care of inactive client

Nursing Implications Nursing diagnoses to be treated with activity or exercise regimen Impaired physical mobility Disuse syndrome Unilateral neglect Delayed surgical recovery Activity intolerance