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SCCCNursing-Mobility
SCCCNursing-Mobility
49
Nursing
Undergraduate 2
09/17/2012

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Cards

Term
Gordon's Activity-Exercise Health Pattern
Definition
  • Patterns of exercise, activity, leisure and recreation
  • Affected by musculoskeletal, neurological, cardiovascular, and respiratory status
  • Looks at activities of daily living, hobbies
Term
Mobility
Definition
  • Is the freedom and independence in purposeful movement
  • Refers to adapting to and having self-awareness of the environment
  • Depends on the successful interaction between the Musculoskeletal System and the Nervous System
Term
Nurse Activities and Mobility
Definition
  • Promote safety when mobility is impaired
  • Encourage increased mobility
  • Recognize and treat risk factors associated with immobility
  • Promote independence in performing activities of daily living
Term
Musculoskeletal System
Definition
  • Bones
  • Cartilage
  • Ligaments
  • Tendons
  • Muscles
  • Joints
Term
Bones
Definition
  • 206 bones in the body
  • Long, short, flat, and irregularly shaped
  • 5 functions:
    -Support
    -Protection
    -Movement
    -Mineral Storage and Homeostasis
    -Hematopoiesis (blood cell production)
Term
Skeletal Muscles
Definition
  • Span a joint and attach by tendons to two different bones, causing one to move at the joint
  • Function
    -Motion
    -Maintenance of posture
    -Heat production
Term
Joints
Definition
  • An articulation or connection between bones
  • Classified based on the amount of movement they permit
    -Fixed, Slightly Moveable, Freely Moveable (Synovial)
Term
Joint Movement - Abduction
Definition
moving away from midline
Term
Joint Movement - Adduction
Definition
moving towards midline
Term
Joint Movement - Circumduction
Definition
moving in a circular fashion - revolving around an axis
Term
Joint Movement -Flexion
Definition
bending, decreasing joint angle
Term
Joint Movement - Extension
Definition
straightening, increasing joint angle
Term
Joint Movement - Hyperextension
Definition
extreme extension, bending backwards, joint angle more than 180°
Term
Joint Movement -Lateral Flexion
Definition
tilting the neck laterally from midline towards the shoulder
Term
Joint Movement - Rotation
Definition
the process of turning on an axis
Term
Joint Movement - Inversion
Definition
Turning the sole of the foot medially
Term
Joint Movement -Eversion
Definition
Turning the sole of the foot laterally
Term
Joint Movement - Opposition
Definition
touching the thumb to the top of each finger of the same hand
Term
Joint Movements - Internal Rotation
Definition
turning toward midline
Term
Joint Movements - External Rotation
Definition
turning away from midline
Term
Joint types
Definition
  • Ball and Socket (shoulder, hip)
  • Condyloid (wrist)
  • Gliding (intervertebral joints)
  • Hinge (knee, elbow)
  • Pivot (neck)
  • Saddle (thumb)
Term
Body Mechanics
Definition
  • Body Alignment
  • Body Balance
  • Coordination
  • Joint Mobility
Term
Body Mechanics: Body Alignment
Definition
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Term
Body Mechanics: Balance
Definition
  • Line of Gravity - An imaginary vertical drawn from the top of the head through the center of gravity
  • Center of Gravity - The point around which mass is distributed below
  • Base of Support - Holds the body up
Term
Body Mechanics: Coordination and Joint Mobility
Definition
  • Coordination
    -Exists between the Nervous and Musculoskeletal systems
    -The Cerebellum coordinates movement by controlling posture, movement and a sense of position
  • Joint Mobility - Range of Motion
Term
American Culture and Immobility
Definition
  • Growth & Development
  • Nutrition
  • Lifestyle/Occupation
  • External factors
Term
Effects of Aging on Mobility
Definition
  • Lean muscle mass is replaced by fat deposits
  • Impaired Balance (wider stance, cognition)
  • Altered Calcium Metabolism (fragility of bones, changes in height and posture)
  • Degenerative Alterations in Joints (limited range of motion - pain)
Term
Diseases Affecting Physical Activity
Definition
  • Arthritis (osteo & rheumatoid)
  • Osteoporosis (more bone breakdown than buildup)
  • Disorders of the Central Nervous System (stroke, Parkinson's)
  • Impaired Oxygenation
  • Psychological
  • Trauma
  • Illnesses requiring Bedrest
Term
Hazards of Immobility
Definition
  • Atrophy
  • Joint Stiffness/Contractures
  • Calcium Loss/Renal Calculi/Fracture
  • Pooling of Secretions/Infection
  • Increase Workload on the Heart/Venous Stasis and Edema
  • Risk for Clotting/DVT
  • Orthostatic Hypotension
Term
Immobility Hazards Continued.....
Definition
  • Integument (skin breakdown)
  • Gastrointestinal (constipation, malnutrition)
  • Genitourinary (urinary tract infection)
  • Psychological (isolation, dependence, loss of dignity)
Term
Activity Exercise & The Nursing Process: Assessment
Definition
  • History & Physical
  • Do a special needs assessment on all patients admitted to the hospital (Braden Scale-risk for skin breakdown, Fall Risk, Risk for thromboembolus-done by physician for blood clotting)
  • Do a focused assessment on any patient who has musculoskeletal concerns, is obese, has limited mobility or is confined to bed or home (ask more questions about specific issue)
Term
Mobility Assessment: History
Definition
  • Medical and Surgial History
  • History of Falls
  • Sensory Impairment
  • Pain, Weakness, Numbness, Tremors, Tingling
  • Ability to perform activities of daily living
  • Exercise status
  • Fitness goals
  • External Factors (environment, use of assitive devices)
Term
Mobility Assessment: Physical
Definition
  • Use Inspection, Palpation, Percussion, Ausculation
  • Activity Tolerance (vital signs before, during, after)
  • Neurological Status
  • Nutritional Status
  • Diagnostics (lab work, MRI, Xray, etc.)
  • Joints (ROM for each joint, crepitus)
  • Muscle Tone, Strength, Mass
  • Deformity, Redness, Warmth, Swelling
  • Balance, Coordination
  • Body Alignment (standing, sitting, lying)
  • Gait (steady or abnormal)
  • Use of Assistive Devices (ambulation, transfer, reposition)

 

Term
Nursing Diagnosis
Definition
  • Activity and Exercise Problems
    -Imparied Physical Mobility
    -Risk for Disuse Syndrome
    -Activity Intolerance
  • Mobility Problems as Etiology
    -Risk for Injury
    -Self-Care Deficit
    -Risk for Impaired Skin Integrity
    -Pain
Term
Nursing Diagnoses for Mobility Dysfunction
Definition
  • Impaired Physical Mobility r/t pain and limited ROM to hip secondary to surgery
  • Risk for Disuse Syndrome r/t prolonged bed rest
  • Activity Intolerance r/t shortness of breath on exertion
  • Risk for Injury r/t unsteady gait
  • Self-Care Deficit r/t limited ROM in right (dominant) arm
  • Risk for Skin Breakdown r/t inability to reposition self in bed
Term
Planning Interventions
Definition
  • Nursing interventions are designed to maintain mobility and prevent or minimize complications of immobility
  • The best intervention is prevention!
  • Interventions to Promote Mobility/Exercise
  • Interventions to Prevent Complications of Immobility
  • Interventions to Prevent Injury to Client and Self
Term
Interventions to promote mobility
Definition
  • Assist client with ADL's whenever appropriate and encourage independence when possible
  • Encourage and assist with transfer from bed to chair, ambulation
  • Healthy diet to build muscle and bone mass or nutritional status
  • Assist in developing an exercise regimen
  • Set attainable goals to motivate
  • Medicate prior to activity as needed
  • Collaborate with Physician and PT or OT
Term
Interventions to promote safety
Definition
  • To prevent orthostatic hypotension, have patient dangle at side of bed before rising
  • Assist with ambulation (use gait belt, have someone follow, have patient wear skid free socks)
  • Teach patient proper use of cane, rolling walker, wheelchair, etc.
  • Teach hip precautions after surgery (to prevent hip joint from popping out)
  • Support affected side when transferring or ambulating
  • If patient starts to fall while ambulating, gently assist in lowering to floor
  • Okay to delgate ambulation when cleared by physical therapy
Term
Benefits of Exercise
Definition
  • Decreased risk of cardiovascular disease
  • Increased muscle tone and flexibility
  • In some cases Resting Energy Expenditure (REE) increases up for to 48 hours after exercise
  • Decreased risk of diseases associated with obesity
  • Possible decrease in appetite
  • Beta-endorphin released for improved mood
Term
Exercise Benefits for the Older Adult
Definition
  • Decreased
    -Bone and Muscle Loss
    -Functional Decline
    -Fall-Related Injuries
    -Pressure Ulcers
  • Improved
    -Bone Strength
    -Self-Esteem
    -Independence

 

Term
Risk Associated with Exercise
Definition
  • Cardiac Injury
  • Musculoskeletal Injury
  • Dehydration
  • Hyper/Hypothermia and Heat Exhaustion
  • Attention people with eating distorders
Term
Types of Exercise
Definition
  • Isotonic (moving joint during muscle contraction-weight training with free weights)
  • Isometric (muscle contraction without movement-low risk for injury, can be used when on bedrest)
  • Isokinetic (machines that control resistance and move joints through full ROM)
  • Aerobic (acquires energy from metabolic pathways that use oxygen-jogging, biking, brisk walking, swimming)
  • Anaerobic (when amount of oxygen taken in does not meet the needs required by the body)
Term
Encourage, Motivate, Promote Dignity, Facilitate Coping
Definition
  • Planning should involve the patient
  • Goals should be set together
  • Offer choices about care
Term
Interventions to prevent complications of immobility
Definition
  • Reposition patient every 2 hours (Log Rolling if necessary)
  • Position for optimal lung expansion
  • Teach Deep Breathing and Coughing
  • Skin Assessment and Care
  • Use of pillows, air mattress, trochanter rolls
  • Use of pull sheets
  • Use of mechanical lifts and transfer boards
Term
Range of Motion as Interventions
Definition
  • Assist or perform ROM to all of client's extremities
  • Teach client's family to perform ROM and have them demonstrate skill
  • Can be done while performing bed bath or other care
  • Perform 2x daily
  • Can be delegated
Term
Performing Active Assist or Passive Range of Motion
Definition
  • Support extremity or limb, above and below the joint
  • Slow, smooth rhythmic motion
  • Move until resistance is felt, NOT pain
  • Move each joint through ROM 3-5 times and return to neutral position (in good alignment)
Term
Prevent Complications of Bedrest: Proper Alignment: Positioning
Definition
  • Fowler's (sitting position at different degrees)
  • Lateral (lying on side)
  • Supine (on back)
  • Dorsal Recumbent (on back with knees bent)
  • Prone (on belly)
  • Sims' (on side with upper leg bent and in front of bottom leg - used for enemas)
Term
Avoid Injury to Self
Definition
  • Use a gait belt when ambulating
  • Use assistive devices when transferring
  • Ask for help from staff
  • Refer to physical therapy as ordered
  • Know proper body mechanics
Term
Principles of Body Mechanics
Definition
  • Stand with body in alignment and erect posture
  • Use wide base of support
  • Keep items close to your body
  • Avoid bending and twisting
  • Use the muscles of your legs as the power for lifting
  • Face the direction of movement
  • Raise or lower height of bed to maintain good posture
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