Activity,exercise & immobility

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By: hamed549 (109 month(s) ago)

thank you

By: emman_abz (121 month(s) ago)

thank you sooo much maam!! God Bless you always! P.S. i hope it's not that big (the size). hehehe..

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Activity, Exercise and Immobility : 

Activity, Exercise and Immobility Whitehair, MSN, ARNP-BC

Body Mechanics : 

Body Mechanics Coordinated efforts of the musculoskeletal and nervous systems to maintain balance, posture, and body alignment Used during lifting, bending, moving, and performing activities of daily living

Body Mechanics—cont’d : 

Body Mechanics—cont’d Body alignment Relationship of one body part to another Body balance Achieved by low center of gravity; enhanced by posture Friction Effect of rubbing or resistance when a moving body meets a surface when turning

Regulation of Movement : 

Regulation of Movement Skeletal system Bones provide support, protection, movement, mineral storage, and blood cell formation. Joints Connection of bones Ligaments Bind joints and connect bones and cartilage Tendons Connect muscle to bones Cartilage Nonvascular, supportive tissue that acts as a shock-absorber pad between articulating bones

Skeletal Muscles : 

Skeletal Muscles Skeletal muscles Determine body form and contour Muscle movement Located near skeletal region, lever system Muscle and posture Exerts pull on bones in opposite directions Muscle groups Coordinated by nervous system and maintain posture Synergistic muscles Contract to accomplish same movement Antigravity muscles Involved with joint stabilization

Nervous System : 

Nervous System Regulates movement and posture Neurotransmitters are chemicals that transfer electric impulses from nerves across the myoneural junctions to stimulate muscles. Proprioception Balance

Pathological Influences on Body Alignment, Exercise, and Activity : 

Pathological Influences on Body Alignment, Exercise, and Activity Congenital defects Osteogenesis imperfecta, scoliosis Disorders of bones, joints, and muscles Osteoporosis, arthritis, noninflammatory joint disease CNS damage Damage to component that regulates voluntary movement Musculoskeletal trauma Bruises, contusions, sprains, and fractures

Growth and Development : 

Growth and Development Throughout the life span the appearance and functioning of the body undergo change. Newborn Toddler Ages 3 through 12 Adulthood and aging

Body Alignment : 

Body Alignment Standing: head erect and midline; body symmetrical; spine straight; abdomen tucked; knees straight; hips and ankles flexed; feet flat Sitting: head erect; neck straight; weight on buttocks and thighs; feet on the floor; forearms supported Recumbent: lateral position; vertebrae straight without curves

Mobility : 

Mobility Range of joint motion Used to determine limitation/injury to a joint Gait Manner or style of walking, including rhythm, cadence, and speed Exercise/activity tolerance Physical activity for conditioning body, improving health, maintaining fitness, therapy

Lifting Techniques : 

Lifting Techniques Tighten stomach muscles and tuck pelvis. Bend at the knees. Keep weight lifted close to the body. Maintain trunk erect and knees bent. Avoid twisting. Maintain a center of gravity.

Positioning Techniques : 

Positioning Techniques Fowler’s HOB elevated, support and align hips and spine Supine Back lying, support with pillows, trochanter rolls, splints Prone Face down Lateral Side lying with proper spine alignment Sims’ Semiprone on right or left side with weight placed on ilium, humerus, and clavicle

Transfer Techniques : 

Transfer Techniques Immobilized patient Use of proper body mechanics moves patients safely and protects nurse from injury Dependent patient Assists patient with regaining optimal independence, joint movement, increases strength, promotes circulation, relieves pressure on skin, improves respiratory and urinary function

Joint Mobility and Ambulation : 

Joint Mobility and Ambulation Range of joint motion Active: patient is able to move his or her joints Passive: nurse moves the patient’s joints Walking Canes Crutches Measurements

Factors Affecting Mobility : 

Factors Affecting Mobility Physiological Psychological Developmental Very young Older adult Sociocultural Environmental Factors Surrounding conditions

Physiological Effects of ImmobilityIdentify Significant Physiological Changes caused by Immobility. : 

Physiological Effects of ImmobilityIdentify Significant Physiological Changes caused by Immobility. Respiratory _______________ Metabolism _______________ Fluid and Electrolytes _______________ Gastrointestinal _______________ Cardiovascular _______________ Musculoskeletal _______________ Skin _______________ Bowel and Bladder Elimination _______________

Psychological Effects of Immobility : 

Psychological Effects of Immobility Immobility can cause emotional changes. Depression Sleep-wake disturbances Impaired coping

Developmental Effects of Immobility : 

Developmental Effects of Immobility In young children immobility can cause delays in motor skills and intellectual development. In older adults immobility can cause an increase in physical dependence on others causing a rapid decline in his/her physiologic system.

Sociocultural Effects of Immobility : 

Sociocultural Effects of Immobility Immobility can cause an excessive amount of time and energy for the care-giver; as well as, financial constraints. Living conditions for the client: Hospitalization. Extended care facility. Rehabilitation facility Home Care.

Assessment of the Immobile Client : 

Assessment of the Immobile Client Must assess the patient’s past and present mobility and the potential effects of immobility. Health History Physical Examination of Mobility Body alignment Gait Joints Skeletal muscles Neurovascular function

Interventions to Prevent Disuse : 

Interventions to Prevent Disuse Positioning Maintaining Joint Mobility: ROM Muscle Strengthening Controlling Pain and Discomfort

Interventions to Improve Activity Tolerance: See pg. 997 Focused Patient Assessment : 

Interventions to Improve Activity Tolerance: See pg. 997 Focused Patient Assessment Building Muscle Mass and Strength Isometric exercises Isotonic exercises Mobilizing the Client Progressively Controlling Pain and Discomfort

Assessment of the Immobile Client Continued: : 

Assessment of the Immobile Client Continued: Physiological Systems Continued Respiratory system Metabolic system – Fluid & Electrolytes Cardiovascular system Musculoskeletal system Skin Integrity Elimination system Psychological condition Developmental state Sociocultural factors

Nursing Interventions: Respiratory : 

Nursing Interventions: Respiratory Turn, cough, deep breath every 1-2 hours. Increase fluid intake to 2000ml/day. Encourage incentive spirometer every 2-4 hours.

Nursing Interventions: Metabolic, Fluid & Electrolyte : 

Nursing Interventions: Metabolic, Fluid & Electrolyte Increase Proteins, Carbohydrates & Fats in daily diet. Monitor I & O every shift. Monitor Lab Values weekly (or as ordered) K+, Na, Ca, H&H, PT, PTT

Nursing Interventions: Cardiac : 

Nursing Interventions: Cardiac Orthostatic Hypotension Assist with progressive movement slowly. Dangle feet 5-10 minutes before getting up. Valsava Maneuver Instruct client to breathe out while moving to avoid straining. DVTs Assist with AROJM or PROJM every 4 hours. Apply Antiembolic elastic stockings daily. Apply SCDs (Sequential compression devices) daily. Administer Anticoagulant therapy as ordered. Heparin Low molecular weight heparin (Lovanox)

Nursing Interventions: Musculoskeletal : 

Nursing Interventions: Musculoskeletal Establish an individualized progressive exercise program. Passive/Active ROJM 3-4 times/day. Maintain proper positioning. See pg 1010 Table 34-3 for list of devices.

Nursing Interventions: Skin : 

Nursing Interventions: Skin Assess skin every 2-4 hours daily. Reposition every 1-2 hours daily. Provide pressure relieving devices: Air mattress bed/chair.

Nursing Interventions: Elimination : 

Nursing Interventions: Elimination Assess amount and characteristics of urine/BM daily. Promote hydration/fluids. Frequent toileting every 2-4 hours. Monitor I & O every shift.

Nursing Interventions: Psychological : 

Nursing Interventions: Psychological Schedule nursing care to promote minimal sleep interruptions. Assess (Anticipate) for feelings of depression and/or failure to cope with immobility. Encourage normal activities of daily living to enhance body image.

Nursing Interventions: Sociocultural : 

Nursing Interventions: Sociocultural Provide routine and informal socialization daily. Provide frequent stimuli to promote orientation.

Nursing Interventions: Developmental : 

Nursing Interventions: Developmental Provide activities that enhance current developmental level. Age appropriate games/activities/exercises. Promote cognitive awareness of surroundings/limitations.

Nursing Process: ImmobilityComplete a Nursing Care Plan for each area identified as a complication of immobility (excluding Impaired Physical Mobility). See page 1000 for examples. : 

Nursing Process: ImmobilityComplete a Nursing Care Plan for each area identified as a complication of immobility (excluding Impaired Physical Mobility). See page 1000 for examples. Nursing Diagnosis Actual vs. Potential Patient Outcome Patient Specific Measurable Nursing Interventions Health Promotion Acute Care Restorative Care Evaluation

Physiological Nursing Care Plan : 

Physiological Nursing Care Plan Mobility - Activity Nursing DX ______________________________ Pt. Outcome Statement ______________________________ Nursing Interventions ______________________________ ______________________________ Evaluation ______________________________

Physiological Nursing Care Plan : 

Physiological Nursing Care Plan Respiratory system Nursing DX ______________________________ Pt. Outcome Statement ______________________________ Nursing Interventions ______________________________ ______________________________ Evaluation ______________________________

Physiological Nursing Care Plan : 

Physiological Nursing Care Plan Metabolic system – fluid & electrolytes Nursing DX ______________________________ Pt. Outcome Statement ______________________________ Nursing Interventions ______________________________ ______________________________ Evaluation ______________________________

Physiological Nursing Care Plan : 

Physiological Nursing Care Plan Cardiovascular system Nursing DX ______________________________ Pt. Outcome Statement ______________________________ Nursing Interventions ______________________________ ______________________________ Evaluation ______________________________

Physiological Nursing Care Plan : 

Physiological Nursing Care Plan Musculoskeletal system Nursing DX ______________________________ Pt. Outcome Statement ______________________________ Nursing Interventions ______________________________ ______________________________ Evaluation ______________________________

Physiological Nursing Care Plan : 

Physiological Nursing Care Plan Gastrointestinal system Nursing DX ______________________________ Pt. Outcome Statement ______________________________ Nursing Interventions ______________________________ ______________________________ Evaluation ______________________________

Physiological Nursing Care Plan : 

Physiological Nursing Care Plan Elimination system Nursing DX ______________________________ Pt. Outcome Statement ______________________________ Nursing Interventions ______________________________ ______________________________ Evaluation ______________________________

Preventing Complications of Immobility through PT/OT. : 

Preventing Complications of Immobility through PT/OT. http://www.youtube.com/watch?v=5ARU8Nbrry8 http://www.youtube.com/watch?v=8KX4htNDQdk

Physical Therapy : 

Physical Therapy

Occupational Therapy : 

Occupational Therapy

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