Term
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Definition
| Coordinated efforts of the musculoskeletal and nervous systems |
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Term
| What is alignment and balance? |
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Definition
Also refers to posture.
Good body alignment means that the center of gravity is stable. Balance and good posture is required for repositioning of joints, tendons, ligaments, and muscles while standing, sitting, or lying. |
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Term
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Definition
| Weight force exerted on the body |
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Term
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Definition
| Force that occurs in a direction opposite to movement |
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Term
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Definition
| Weight is the force exerted by gravity, which is always directed downward. This is why an unbalanced object or patient falls. |
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Term
| What does the skeletal system supply? |
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Definition
Provides attachments for muscles and ligaments
Provides leverage for movement |
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Term
| What is the skeletal system comprised of? |
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Definition
| *The skeletal system is comprised of long, short, flat and irregular bones |
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Term
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Definition
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Term
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Definition
| Ligaments bind joints together and connect bones to other bones or cartilages |
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Term
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Definition
| Tendons connect muscles to bone. |
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Term
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Definition
| Cartilage is a supportive tissue located in joints, thorax, trachea, larynx, nose, and ears. |
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Term
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Definition
| Muscles are composed of fiber bundles that contract via electrochemical impulses from the nerves |
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Term
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Definition
| Muscle tone is the normal state of balances muscle tension. People who are immobile or have neuromuscular disease can have flaccid or decreased muscle tone (hypotonicity). |
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Term
| What controls voluntary skeletal muscle movement? |
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Definition
| Movement is regulated in the voluntary motor area in the cerebral cortex. Neurotransmitters transfer electric impulses from the nerve across the neuromuscular junction to the muscle. |
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Term
| What does the nervous system regulate? |
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Definition
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Term
| What is chemical is needed for movement? |
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Definition
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Term
| What are the electrolytes involved in movement? |
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Definition
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Term
| Why do spinal nerves need to be intact? |
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Definition
| must be intact to transmit impulses to the muscle |
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Term
| What is isotonic muscle contraction? |
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Definition
Building bulk or “tone”
Shortening of muscle but no flexion |
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Term
| What is isometric contractions? |
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Definition
Building strength
Length remains same but force is |
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Term
| Do isotonic and isometric exercises required energy? |
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Definition
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Term
| What are the pathological influences on mobility? |
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Definition
-Postural abnormalities
-Impaired muscle development
-Damage to CNS
-Musculoskeletal trauma |
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Term
| How do postural abnormalities effect mobility? |
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Definition
| Some deformities may affect or limit ROM. |
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Term
| Any disease that affects muscles or musculoskeletal function will ________ muscle development. |
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Definition
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Term
| How does CNS effect mobility? |
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Definition
| Damage to the CNS will affect body alignment, balance, and mobility. Damage can be a result of head trauma, stroke, meningitis, or injury to the cerebral cortex. |
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Term
| How does musculoskeletal trauma effect mobility? |
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Definition
| *Direct trauma to the musculoskeletal area can cause bruises, contusions, sprains, or fractures which can all cause muscle atrophy, loss of muscle tone, and joint stiffness.. |
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Term
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Definition
| An intervention that restricts clients for therapeutic reasons |
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Term
| What are the therapeutic reasons for bed rest? |
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Definition
to decrease pain
to decrease oxygen demand of body
Allows rest periods |
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Term
| What are hazards of mobility? |
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Definition
| Musculoskeletal deconditioning and lack of activity can result in a series of symptoms |
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Term
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Definition
| the actual cells and tissues reduce in size and function can occur as a result of prolonged inactivity. |
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Term
| What is immobilities effect on metabolism? |
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Definition
| disrupts normal metabolic rate and can cause a “stress” reaction within the endocrine system. |
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Term
| How does immobility effect respiratory system? |
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Definition
| Can cause atelectasis or hypostatic pneumonia |
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Term
| Why does inactivity cause problems with respiratory and cardiovascular systems? |
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Definition
| Prolonged bed rest increases the heart’s workload, producing an increase in oxygen demand which in turn stresses the respiratory system. Pneumonia can occur as secretions lay dormant from bedrest |
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Term
| Why does immobility cause loss of muscle mass and atrophy? |
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Definition
| *When the client is immobile, the body often excretes more nitrogen than it ingests protein, which causes a negative nitrogen balance leading to weight loss, decreased muscle mass, and weakness resulting from tissue breakdown (catabolism). |
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Term
| On what day do metabolism changes occur on bed rest? |
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Definition
| *According to evidence-based studies, calcium metabolism changes by the 2nd day of bedrest. |
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Term
| What it bed rest's effect on the skeletal system? |
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Definition
calcium loss continues for over 2 months, leading to bone fragility and increased risk for fractures in patients who are immobilized for long periods of time
Impaired calcium absorption
Joint abnormalities |
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Term
| What is immobility's effect on joints? |
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Definition
| Immobility can lead to joint contracture, which is characterized by abnormal fixation of a joint which limits range of motion. |
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Term
| What is immobility's effect on urinary elimination? |
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Definition
Urinary status and increased risk for kidney stones secondary to hypercalcemia can occu.
Urinary stasis
Renal calculi (kidney stones) |
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Term
| What is immobility's effect on the skin? |
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Definition
| *The risk for skin breakdown over pressure areas is a combination of the metabolic changes that occur from prolonged bedrest. Even just 3 hours of immobility can cause a pressure area with potential skin breakdown. Add to that the effects of gravity, poor nutrition, chronic disease, or impaired fluid intake and you have the perfect set-up for pressure ulcers. |
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Term
| What are the Emotional and behavioral responses to immobility? |
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Definition
| Hostility, giddiness, fear, anxiety |
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Term
| What are the sensory alterations to immobility? |
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Definition
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Term
| What are the changes in coping with immobility? |
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Definition
| Depression, sadness, dejection |
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Term
| What are the developmental changes r/t infants/toddlers/preschool? |
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Definition
Prolonged immobility delays gross motor skills, intellectual development or musculo-
skeletal development |
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Term
| What are the developmental changes r/t adolescents? |
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Definition
Delayed in gaining independence and in accomplishing skills
Social isolation can occur |
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Term
| What are the developmental changes r/t adults? |
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Definition
Physiological systems are
at risk for changes in family and social structures |
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Term
| What are the developmental changes r/t older adults? |
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Definition
Decreased physical activity
Hormonal changes
Bone reabsorption |
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Term
| How do you assess mobility? |
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Definition
ROM
Gait
Exercise & Activity Tolerance
Body alignment |
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Term
| At what 3 positions do you look at body alignment? |
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Definition
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Term
| When assessing ROM, NEVER what? |
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Definition
| push a joint beyond the point of resistance or pain as this could cause injury to the patient. |
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Term
| How does ROM affect gait? |
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Definition
| Dragging of an extremity, shifting of hips, or shuffling gaits may be indicative of disease process or injury and can affect safety. |
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Term
| When does immobility occur? |
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Definition
| . Immobility occurs when one is able to move but restricted by some event or condition. |
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Term
| What is activity tolerance? |
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Definition
| occurs when movement is NOT impaired, but causes excessive cardiac, resp, or psychological distress. |
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Term
| What does a metabolic assessment r/t mobility include? |
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Definition
| anthropometric measurements (Ht, Wt, Skinfold Thickness) and analysis of intake and output to assess for dehydration. |
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Term
| What does a respiratory assessment r/t mobility include? |
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Definition
| inspecting the chest for wall movement auscultating the lungs for decreased breath sounds, crackles, and wheezes. |
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Term
| What does a cardiovascular assessment r/t mobility include? |
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Definition
| measurement of vital signs, peripheral pulses, apical pulse, orthostatic hypotension, DVT, and edema. |
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Term
| What does a musculoskeletal assessment r/t mobility include? |
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Definition
| includes assessing muscle strength and tone, loss of muscle mass, incidence of contractures, and ROM. ID pts at risk for osteoporosis. |
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Term
| Why do we do an integumentary assessment? |
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Definition
| The skin needs to be assessed for integrity or early changes in skin condition. The Braden Scale is a tool used to ID high risk clients and is assessed every shift. Skin assessment should occur at least q2h and documented. |
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Term
| What does an elimination assessment r/t mobility include? |
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Definition
| intake and output, bowel sounds, and bowel and bladder habits need to be checked. Dehydration increases the risk for thrombus formation, electrolyte imbalances, skin breakdown, infections and impaired elimination. |
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Term
| What is the focus of a psychosocial assessment? |
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Definition
| you will focus on the client’s emotional state, behavior, and sleep-wake cycle. How does the pt seem to be handling the immobility? Acute confusion (known as delirium) must be further analyzed for cause and treated appropriately. |
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Term
| What does the developmental assessment look at? |
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Definition
| how immobility affects the normal development of clients across the lifespan. Altered family roles and response to the pt can be significant |
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Term
| What are the nursing diagnoses r/t mobility? |
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Definition
Impaired physical mobility
Risk for disuse syndrome
Risk for injury
Impaired skin integrity
Social isolation |
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Term
| How should you provide metabolism support to immobile patients? |
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Definition
Provide high-protein, high-caloric diet with vitamin B and C supplements
The body needs protein and calories to repair damaged or injured tissues and to rebuild any depleted stores. Vitamins B & C are needed for skin integrity and wound healing. |
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Term
| How should you provide respiratory support to immobile patients? |
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Definition
Cough & deep breathe every 1 to 2 hours (q1-2h)
Chest physiotherapy (CPT)
Incentive spirometer (IS)
You must turn, cough, and deep breathe the client at least q2h to assist in lung expansion and airway clearance. Chest physiotherapy (CPT) consisting of percussion and positioning will clear airways and help prevent pneumonia. Incentive spirometers may also be ordered for your client to provide visual reminders to ventilate adequately. |
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Term
| How should you provide cardiovascular support to immobile patients? |
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Definition
Immobilized clients have an increased workload on the heart, can experience orthostatic hypotension, and can experience thrombus. SCDs and TEDs may be ordered for your clients.
Progress from bed to chair to ambulation
SCDs, TED hose, and leg exercises |
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Term
| How should you provide musculoskeletal support to immobile patients? |
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Definition
Passive ROM
Con’t passive motion (CPM) equipment
Active ROM
Assist clients with active and passive ROM exercises to decrease the incidence of hazards of immobility. CPM may be ordered esp for post-op joint replacements to prevent contractures and increase circulation. |
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Term
| How should you provide integumentary support to immobile patients? |
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Definition
Repositioning every two hours and providing skin care will help to prevent pressure ulcers along with adequate fluids and nutrtion.
Skin care |
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Term
| How do you provide elimination system support to immobile patients? |
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Definition
| Clients need between 2000 to 3000 ml of fluids per day to help prevent renal calculi and UTIs. Monitor intake and output to ensure the fluid balance is maintained. |
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Term
| What is fowler's position? |
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
| aving a patient lie on their left side, left hip and lower extremity straight, and right hip and knee bent. It is also called lateral recumbent position. |
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Term
| What does the evaluation do? |
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Definition
| Gauges the effectiveness of specific interventions designed to promote body alignment, improve mobility, and protect the client from hazards of immobility |
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