1. CONCEPT OF NURSING Promoting Healthy Physiologic Responses Body Mechanics Activity and Exercise

2.  Activity-exercise pattern: Refers to a person’s routine of exercise, activity, leisure and recreation needs for rest and mobility.  Exercise: A type of physical activity involving the muscles performed to maintain or improve physical fitness.

3. Types of exercise:  Isotonic (dynamic) exercises: 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) exercises: There is muscle contraction without moving the joint * useful for strengthening abdominal, gluteal muscles) * No change in muscle length * No joint movement * Maintaining strength in immobilized muscle

4. Types of exercise:  Isokinetic (resistive) exercises:  It involves muscle contraction or tension against resistance, can be either isotonic and isometric.  These exercises are used in physical conditioning & are often done to build up certain muscle groups.

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

6. Benefits of exercise on body system  Respiratory System: *Improves gas exchange by increasing the ventilation & oxygenation.  GI tract System: *Improve appetite, digestion and elimination.  Metabolic System: *Increase metabolic rate, thus increase the production of body heat and calorie use.

7. Benefits of exercise on body system  Urinary System: *Improve excretion of body waste through the kidneys.  Psycho-neurologic System: * Enhance sense of well-being and help to relieve stress. * Improves the quality of sleep. * Improve self concept and self esteem by decreasing depression.  Intigumentary System: * Maintain skin integrity

8. Positioning Clients Performed by the nurse:  For certain procedures or surgeries.  To protect the client body from injury.  To maintain muscle tone.  To prevent complications.

9. Positions and Uses  Dorsal (supine): * Place patient on back with head and shoulders are slightly elevated. * Used for physical assessment, to provide comfort, & change position.

10. Positions and Uses  Dorsal recumbent: * Place patient on back, legs flexed and slightly rotated outward *Used for pelvic examination, female catheterization, perinal care

11. Positions and Uses  Semi-fowler’s position: * Sitting position with or without positioning pillow at head 45-60 degree. used for eating and facilitate breathing.

12. Positions and Uses  High fowler’s position: *Head & trunk are raised 60-90 degrees, used for some people with heart problems or having difficulty breathing.

13. Positions and Uses Prone position: * Lying flat on the abdomen, arm flexed toward head, & head turned to one side. Useful for some unconscious patients.

14. Factors Affecting Mobility  Health Status  Developmental Stage Children Adolescents Adults  Environment Attitudes and Beliefs Lifestyle

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

16. Planning and Outcome Identification Bed Rest Restorative Nursing Care (Changing position) Health Promotion and Fitness

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

18. Implementation  Transfer Techniques Moving clients Transferring from bed to chair Transferring from bed to stretcher Assistive devices

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

20. Assisting with Ambulation  Assistive Devices -Canes -Crutches -Walkers