Hazards of Immobility Module 8

To review nursing content while thinking like a nurse To use Concept Maps to visualize how a wide variety of nursing information can fit together Practice some NCLEX questions!

Cannot move about freely

Hazards of Immobility Cardiovascular Concept Mapping Respiratory Endocrine Integument GI Musculoskeletal F&E Renal Psychosocial

Hazards of Immobility Cardiovascular Concept Mapping Respiratory Endocrine Integument GI Musculoskeletal F&E Renal Psychosocial

Hazards of Immobility Cardiovascular Concept Mapping Respiratory Endocrine Integument GI Musculoskeletal F&E Renal Psychosocial

3% Muscle Strength loss/day – Effect on physical therapy? Fatigue? – Atrophy Joint Mobility – Complication? – Nursing care (i.e. prevention)? Calcium metabolism (F&E, Endocrine) Disuse osteoporosis

Skin integrity – Pressure Ulcers! – Nursing Care?

Orthostatic hypotension (F&E) Increased Cardiac Workload Thrombus (clots) – DVT – Pulmonary embolism

Atelectasis Hypostatic pneumonia Decreased ability to cough Nursing Care? – Diagnoses? – Interventions?

Decreased metabolic rate (in general) Increase in metabolic rate in presence of fever/infection Negative Nitrogen Balance – More protein broken down than ingested – Weight loss – Decreased muscle mass – weakness F&E imbalances

Decreased Appetite Slower peristalsis – Constipation! – Fecal impaction: assessment finding? Calorie and Protein deficiency common – What does this mean for pt diet? Nursing interventions?

Calcium resorption – Hypercalcemia if kidneys can’t cope Respiratory acidosis

Lack of gravity Urinary stasis Renal calculi – Risk due to urinary stasis & bone resorption Decreased fluid intake – Dehydration Poor perineal care – UTI Use of Foley catheter

Depend on age and level of development – Infants/Toddlers: delay in gross motor skills – Adolescents: social isolation – Adults: change in family, social, career identity – Elders: BIG risk of functional losses (encourage ADLs) Depression, hostility, fear, anxiety Sleep-wake changes Coping mechanisms

Which of the following is an appropriate complete outcome statement for a patient with the diagnosis of immobility? a.Patient will be free of DVT by doing quadricep muscle contractions correctly 4 times a day. b.Patient will do active range of motion exercises daily. c.No evidence of skin breakdown will occur. d.Patient will have a daily bowel movement.

Which of the following is an appropriate complete outcome statement for a patient with the diagnosis of immobility? a.Patient will be free of DVT by doing quadricep muscle contractions correctly 4 times a day. b.Patient will do active range of motion exercises daily. c.No evidence of skin breakdown will occur. d.Patient will have a daily bowel movement.

a.“Your father’s breathing effort is driven by lower oxygen levels.” b.“Your father’s breathing effort is driven by a low carbon dioxide level.” c.“Your father will retain metabolic acids if the oxygen level is too high.” d.“Your father will breathe best when he has a moderately high oxygen level.”

a.* “Your father’s breathing effort is driven by lower oxygen levels.” b.“Your father’s breathing effort is driven by a low carbon dioxide level.” c.“Your father will retain metabolic acids if the oxygen level is too high.” d.“Your father will breathe best when he has a moderately high oxygen level.”

a.Cor pulmonale b.Atelectasis c.Pulmonary embolus d.Cardiac tamponade

a.Cor pulmonale b.* Atelectasis c.Pulmonary embolus d.Cardiac tamponade

a.Limiting fluids b.Having the client take three deep breaths c.Asking the client to spit into the collection container d.Asking the client to obtain the specimen after eating.

a.Limiting fluids b.* Having the client take three deep breaths c.Asking the client to spit into the collection container d.Asking the client to obtain the specimen after eating

a.Veal, potatoes, Jello-O, orange juice b.Peanut butter and jelly sandwich, cantaloupe, tea c.Chicken breast, broccoli, strawberries, milk d.Spaghetti with tomato sauce, garlic bread, ginger ale

a.Veal, potatoes, Jello-O, orange juice b.Peanut butter and jelly sandwich, cantaloupe, tea c.* Chicken breast, broccoli, strawberries, milk d.Spaghetti with tomato sauce, garlic bread, ginger ale

a.Under-nutrition b.Obesity c.Low serum albumin d.Low hemoglobin

a.Under-nutrition b.* Obesity c.Low serum albumin d.Low hemoglobin

a.Document patient’s behavior in her chart. b.Notify her physician c.Check her airway to make sure her brain is receiving enough oxygen. d.Coax her back to bed.

a.Document patient’s behavior in her chart. b.Notify her physician c.Check her airway to make sure her brain is receiving enough oxygen. d.* Coax her back to bed.

a.“I will get your pain medication.” b.“Tell me more about how you feel.” c.“I will report this to the doctor and see what we can do.” d.“Why are you useless?”

a.“I will get your pain medication.” b.* “Tell me more about how you feel.” c.“I will report this to the doctor and see what we can do.” d.“Why are you useless?”

Good luck!