chapter Body Mechanics Activity and Exercise

 Refers to persons routines of exercise, activity, leisure and recreation needs for rest and mobility.

Exercise  Any physical activity involving muscles that elevates the heart rate above resting levels  Reduces joint pain and stiffness.  Increases flexibility, muscle strength, and endurance.  Weight reduction and improved sense of well-being

Types of exercise:  Isotonic (dynamic exercise): Muscle shortens to produce contraction and active movement.e.g. running, walking, swimming, cycling) * Advantages: 1- Increase muscle tone, mass, strength 2- Maintain joint flexibility and circulation  Isometric (static or setting) * as strengthen abdominal, gluteal muscle) * No change in muscle length * No joint movement * Maintaining strength in immobilized muscle

Types of exercise:  Isokinetic: (resistive exercise) * Muscle contraction or tension against resistance can be either isometric and isotonic

Benefits of exercise on body system  Musculoskeletal System: * Increase and maintain muscle tone, size, shape * Increase joint mobility, flexibility, and range of motion. * Maintain ob bone intensity.  Cardiovascular System: * Improve cardiovascular function, by increasing cardiac output and strength of heart muscle contraction.

Benefits of exercise on body system  Respiratory System: *Increase ventilation  GI tract System: *Improve appetite, digestion and elimination  Metabolic System: *Increase metabolic rate  Urinary System: *Improve excretion of the urinary waste

Benefits of exercise on body system  Psychoneurologic System: * Enhance sense of wellbeing and improve tolerance to stress * Enhance of sleep pattern related to increase energy level * Improve self concept and self esteem by decrease depression  Intigumentary System: * Maintain skin integrity

Positions  Performing by the nurse for procedure and protect client body from injury and maintain muscle tone and prevent complication.

Positions and Uses  Dorsal (supine): * Place patient on back for comfort, change position * used for physical assessment  Dorsal recumbent: * Place patient on back, legs flexed and slightly rotated outward *Used for pelvic examination, female catheterization, perinal care  Semi-fowler’s position: * Sitting position with or without positioning pillow at head degree. used for eating and facilitate breathing

Positions and Uses  High fowler’s position: * Patient sits straight up in the bed at 90 degree angle  Lithotomy position: * Supine position with flexed knee and hips, thigh abducted and rotated externally * Used for Vaginal examination, vaginal hysterecectomy  Prone position: * Laying flat on the abdomen, arm flexed toward head, head aside

Factors Affecting Mobility  Health Status  Developmental Stage Children Adolescents Adults

Factors Affecting Mobility  Environment Attitudes and Beliefs Lifestyle

Nursing Diagnoses  Activity Intolerance  Impaired Physical Mobility  Risk of Disuse Syndrome  Self-Care Deficits  Altered Health Maintenance  Risks for Falls

Planning and Outcome Identification  Interventions Bed Rest Restorative Nursing Care Health Promotion and Fitness

Implementation  Range-of-Motion Exercises Performed several times a day. Each joint is placed through its full functional motion.

Implementation  Transfer Techniques Moving clients Logrolling the client Transferring from bed to chair Transferring from bed to stretcher Assistive devices

Implementation  Assisting with Ambulation Preparing the client to walk Client education Preambulating exercise

Assisting with Ambulation  Nurse promotes safety of a client using a quad cane.

Assisting with Ambulation  Assistive Devices Canes Walkers Crutches