FUNDAMENTALS OF NURSING LESSON 5 PROMOTING ACTIVITY AND MOBILITY

HAZZARDS OF IMMOBILITY DR. DIETRICK EXPERIMENT 1948 NURSES ARE LEGALLY AND MORALLY ACCOUNTABLE FOR DECREASING THE EFFECTS OF IMMOBILITY

HAZZARDS OF IMMOBILITY MUSCULOSKELETAL SYSTEM HYPERTROPHY—INCREASES IN SIZE WHEN USED ATROPHY—DECREASES IN SIZE WITH NON-USE

HAZZARDS OF IMMOBILITY MUSCULOSKELETAL SYSTEM

HAZZARDS OF IMMOBILITY MUSCULOSKELETAL SYSTEM

HAZZARDS OF IMMOBILITY MUSCULOSKELETAL SYSTEM Osteoporosis=loss of bone mass Pt’s need an increase in Ca and adequate activity to maintain bone strength

HAZZARDS OF IMMOBILITY MUSCULOSKELETAL SYSTEM Contractures: stiffness in JOINT caused by shortened muscle

HAZZARDS OF IMMOBILITY MUSCULOSKELETAL SYSTEM end stage renal disease patient

HAZZARDS OF IMMOBILITY MUSCULOSKELETAL SYSTEM

HAZZARDS OF IMMOBILITY GASTROINTESTINAL SYSTEM NEGATIVE NITROGEN BALANCE ANOREXIA DECREASED PERISTALSIS

HAZZARDS OF IMMOBILITY CARDOVASCULAR SYSTEM ORTHOSTATIC HYPOTENSION HEART WORKS 30% HARDER THROMBUS FORMATION

HAZZARDS OF IMMOBILITY RESPIRATORY SYSTEM DECREASED RESPIRATORY MOVEMENT THICK AND STICKY LUNG SECRETIONS

HAZZARDS OF IMMOBILITY URINARY SYSTEM KIDNEY STONES INCREASED BLOOD CALCIUM INCREASED URINE pH UTI—KIDNEY INFECTION D/T STASIS OF URINE

HAZZARDS OF IMMOBILITY SKIN DECUBITUS ULCERS LATIN WORD FOR LYING DOWN, RECLINING

HAZZARDS OF IMMOBILITY SKIN

HAZZARDS OF IMMOBILITY SKIN

HAZZARDS OF IMMOBILITY SKIN

HAZZARDS OF IMMOBILITY SKIN

HAZZARDS OF IMMOBILITY SKIN

HAZZARDS OF IMMOBILITY NERVOUS SYSTEM NERVE IMPAIRMENT—PRESSURE ON NERVE OR BLOOD SUPPLY DECREASED INTELLECTUAL AND SOCIAL ABILITIES DECREASED SPEED OF PERCEPTIONS AND REACTIONS INCREASED PAIN PERCEPTION

HAZZARDS OF IMMOBILITY PSYCHOSOCIAL DECREASED SELF CONCEPT DECREASED MOTIVATION DECREASED DRIVES INCREASED EMOTIONAL DISTURBANCES

BODY MECHANICS BODY MECHANICS = USING THE BODY EFFICIENTLY AS A MACHINE A KEY FACTOR IN PROPER BODY MECHANICS IS MAINTAINING PROPER BODY ALIGNMENT

PRINCIPLES OF BODY MECHANICS ESTABLISH A WIDE BASE OF SUPPORT FOR BETTER STABILITY AND BALANCE

PRINCIPLES OF BODY MECHANICS MAINTAIN EQUILIBRIUM BEND OR FLEX THE KNEES USE LARGE MUSCLE GROUPS (FACE DIRECTION OF MOVEMENT) ADJUST THE WORK LEVEL. (LEVEL SURFACE=LESS WORK) CARRY OBJECTS CLOSE TO MIDLINE

WHY USE PROPER BODY MECHANICS? PREVENT STRAIN & INJURY TO PATIENT PREVENT STRAIN & INJURY TO YOU PATIENT SAFETY

5 MOST COMMON INJURIES LIFTING PATIENT (50%) HELPING PATIENT OUT OF BED (30%) MOVING A BED (8%) LIFTING PATIENT TO STRETCHER (7%) CARRYING EQUIPMENT (5%)

PURPOSES FOR PROPERLY POSITIONING THE PATIENT PRIMARY REASON: TO REDUCE PRESSURE ULCERS TO MAINTAIN BODY ALIGNMENT TO PROVIDE MOVEMENT FOR PATIENT—PROMOTE SKIN INTEGRITY TO PREVENT CONTRACTURES TO PREPARE PATIENT FOR PROCEDURE

ACTIVITY AND MOBILITY ***THE NURSE SHOULD TURN AN INACTIVE PT EVERY 2 HOURS TO AVOID PRESSURE SORES (a great nurse will turn more often if time permits!!)

BODY POSITIONS AS APPLIES TO NURSING INTERVENTIONS DORSAL (SUPINE) FLAT ON BACK DORSAL RECUMBENT

BODY POSITIONS AS APPLIES TO NURSING INTERVENTIONS SEMI FOWLERS HOB AT 30° FOWLERS HOB AT 45-60° HIGH FOWLERS HOB AT 90° TRENDELENBERG

BODY POSITIONS AS APPLIES TO NURSING INTERVENTIONS ORTHOPNEIC: LITERALLY SITTING UP

BODY POSITIONS AS APPLIES TO NURSING INTERVENTIONS SIMS POSITION OF CHOICE FOR ENEMA OR RECTAL EXAM

BODY POSITIONS AS APPLIES TO NURSING INTERVENTIONS LATERAL SIDE-LYING

BODY POSITIONS AS APPLIES TO NURSING INTERVENTIONS RARELY USED EXCEPT LOWER EXTREMITY AMPUTATIONS P R O N E

BODY POSITIONS AS APPLIES TO NURSING INTERVENTIONS GENUPECTORAL LITHOTOMY

RANGE OF MOTION DEFINED: THE MAXIMUM MOVEMENT THAT IS POSSIBLE FOR A JOINT INFLUENCED BY GENETIC INHERITANCE DISEASE NORMAL AMOUNT OF ACTIVITY INJURY DEVELOPMENTAL PATTERNS

TYPES OF RANGE OF MOTION ACTIVE—PATIENT PERFORMS INDEPENDENTLY PASSIVE—PERFORMED FOR PT BY NURSE OR PHYSICAL THERAPIST ACTIVE ASSISTED ISOMETRIC ISOTONIC CONTINUOUS PASSIVE MOTION—CPM MACHINE

PURPOSES FOR RANGE OF MOTION TO PREVENT CONTRACTURES TO RESTORE, INCREASE, OR MAINTAIN THE STRENGTH OF MUSCLES TO MAINTAIN OR INCREASE FLEXIBILITY OF JOINTS

PURPOSES FOR RANGE OF MOTION TO MAINTAIN OR PROMOTE THE GROWTH OF BONES THROUGH STRESS IF NOT STRESSED THEY BEGIN TO DECALCIFY TO IMPROVE FUNCTION OF OTHER BODY SYSTEMS (GI OR CV) HOSPITALIZATION DECREASES MOBILITY EVERY SYSTEM IS AT RISK OF IMPAIRMENT

NURSE’S RESPONSIBILITY ASSESS PATIENT’S LEVEL OF FUNCTION IF PARTIALLY IMMOBILE, ASSIST WITH ROM EXERCISES ASSESS NEED AND IMPLEMENT INTERVENTIONS TO PREVENT COMPLICATIONS ROM NEEDS TO BE STARTED EARLY TO PREVENT COMPLICATIONS

ANGLES OF RANGE OF MOTION INTERNAL ROTATION CIRCUMDUCTION SUPINATION PRONATION OPPOSITION INVERSION EXERSION FLEXION EXTENSION HYPEREXTENSION LATERAL FLEXION ROTATION ABDUCTION ADDUCTION EXTERNAL ROTATION

PRINCIPLES OF PERFORMING ROM MOVE FROM HEAD TO TOE SUPPORT THE JOINT CPM DOCUMENTATION DEFINITIONS

TECHNIQUES FOR MOVING PATIENTS PROPRIOCEPTION CHECK EQUIPMENT IV’S, FOLEYS, FEEDING TUBES, RESTRAINTS DON’T ATTEMPT >35% OF YOUR OWN BODY WEIGHT PROTECT SKIN PRESSURE, FRICTION, SHEARING PROTECT YOURSELF DANGLE PATIENT ORTHOSTATIC HYPOTENSION BEDREST HYPOVOLEMIA—DECREASED CIRCULATING BLOOD HYPOKALEMIA—LOW SERUM POTASSIUM MEDICATIONS

TECHNIQUES FOR MOVING PATIENTS LOSS OF SENSATION HEMIPLEGIA—ONE SIDED WEAKNESS OR PARALYSIS PARAPLEGIA—PARALYSIS OF LOWER LIMBS SPASTIC—SPASMS PARESIS—PARTIAL PARALYSIS PARALYSIS—LOSS OF MUSCLE FUNCTION OR LOSS OF SENSATION FLACCID—WEAK, SOFT, FLABBY, LOSS OF TONE QUADRIPLEGIA—LOSS IN ALL 4 LIMBS

TECHNIQUES FOR MOVING PATIENTS AMBULATING NORMAL WALKING POSITION IF FALLS: CALL FOR HELP ARMS AROUND WAIST, LOWER PT TO FLOOR SLOWLY STAY WITH PT UNTIL HELP ARRIVES HOYER LIFT LOG ROLL BED TO STETCHER

INDICATIONS FOR PERFORMING ROM PHYSICIAN ORDER IMMOBILITY MUSCLE ATROPHY OR WEAKNESS INJURY TO JOINT DISEASE PROCESSES

DATA TO KNOW R/T ROM AND CPM ASSESS THE PATIENT PAIN INCISION INFLAMMATION, DRAINAGE OTHER CHECK CPM MACHINE CORRECT FLEXION AND EXTENSION ALL PARTS OPERABLE SPEED CONTROL

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