Intro to Nursing- Activity and Exercise

AHA recommends ___ mins of moderate exercise a week

150 mins

CDC recommends that adults need at least 2 hours and 30 minutes (150 minutes) of moderate-intensity aerobic activity (i.e., brisk walking) every week and......

muscle-strengthening activities on 2 or more days a week.

A purposeful TYPE OF ACTIVITY that is planned structured and repetitive, done to improve or maintain one or more components of physical fitness

EXERCISE

Activities of Daily Living

Bathing self
Self toileting
Oral hygiene
Dressing

Instrumental Activities of Daily Living

Use of phone
shopping
food prep
Housekeeping
Laundry
Transportation
Med administration
Handling finances

amt of o2 taken in is greater than the amt used to supply the energy large muscle groups involves repetitive rhythmic motions - great for cardiovascular health

aerobic exercise

the muscles cannot get enough O2 from the blood and has to use anaerobic pathways to provide additional energy. (Kreb cycle) weight lifting - sprinting

anaerobic exercise

Activity that someone else is initiating

passive

activity initiating by self

active

isotonic muscle contraction

Muscle Shortens, tone is same, and active movement

isometric muscle contraction

Muscle does not shorten, just tenses

isokinetic muscle contraction

Against Resistance, tone and length changes. muscle contraction with resistance.

Adequate posture. In the sitting and standing positions, a straight line can be drawn from the ear through the shoulder and hip. In bed, the head, shoulders, and hips are aligned.

Proper Body Alignment

The negative effects of hospitalization begin quickly and they progress rapidly by the ________ of hospitilization.

2nd day

Benefits of movement and body weight bearing

Increased muscle efficiency (strength) and flexibility
Increased coordination
Reduced bone loss
Increased efficiency of nerve impulse transmission

Hazards of Immobility

Disuse Atrophy- muscle decrease from immobility
Contractures- shortening of flexion muscle
EX: foot drop
Disuse Osteoporosis
Stiff Painful Joints: Ca+ in blood makes joints stiff

Cardiovascular System Benefits OF EXERCISE

Increases the strength of contraction
Increases cardiac output
Decreases resting Heart rate and Blood Pressure
Improves Venous return: muscle moves blood back to heart.
Increase fibrinolysin
substance that breaks up small clots

Cardiovascular Hazards of Immobility

Decreases Cardiac Reserve
Increases use of the Valsalva Maneuver
Increases pressure and decreases venous return
Orthostatic Hypotension- Risk of falling! Dangle!
Venous Vasodilation & Stasis
Dependent Edema: pooling blood, water out of vein and blood is t

1. Decreased Venous Return
2. Hyper-coagulable Blood: increased Ca+ makes blood sticky thick dehydrated pooling blood has leaked out fluid
3. Vessel Wall Injury: Stretching and tears occur I endothelium of vessels. Increased risk of DVT.

Virchow's Triad- Cardiovascular System - Hazards of Immobility

Respiratory System Benefits of activity & exercise

Increases O2 intake: by 20X
Improved diaphragmatic excursion
Improved alveolar ventilation
Prevents pooling of secretions, breaks up with movement!
Decreases effort of Breathing

Respiratory System Hazards of Immobility

Decreases Respiratory Movement
Pooling of Secretions
Decreases Surfactant
Atelectasis: collapsed alveoli
Hypostatic Pneumonia: from not moving around

Urinary System Benefits from exercise

Increased circulation improves efficiency of waste removal
Prevents stasis in bladder
Alkaline Urine
Infection
Kidney stones: from Ca+ break down from not weight bearing.
Urinary Retention/Overflow

Gastrointestinal System Benefits from exercise

Improves appetite
Increases GI tone
Improves peristalsis

Gastrointestinal System Hazards of Immobility

Constipation (Positioning, Embarrassment of pooping in hospital)
Overuse Valsalva Maneuver (Cardiac Risk- MI)

Psych/neurological System Benefits

Increases sense of well-being
Improves stress tolerance

Psychoneurological System Hazards of Immobility

Awareness of dependency
Time Perception Changes: time blends together
Lack of Intellectual Stimulation
Anxiety

Metabolic System Benefits

Increases metabolic rate
Decreases triglycerides
Decreases cholesterol
Enhances insulin (lowers WBG)

Integumentary System Benefits of Activity/ Exercise

Increases the flow of blood to the skin
Immobility decrease skin turgor
Immobility increases the risk for pressure ulcers

Assessment -Physical of activity and exercise level

Body alignment
Appearance and movement of joints
Capabilities and limitations of movement
Muscle mass and strength
Activity intolerance
Problems related to immobility

Devices to Position Patients

Pillows: behind back
Mattresses
Adjustable beds
Bed side rails
Trapeze bar

The method used to roll a patient with a possible back or spinal cord injury

Log Rolling

A nurse applies padded boots to maintain the foot in dorsiflexion on a client who is comatose. The nurse is protecting the client from what?

Foot Drop

When assisting a client from the bed into a wheelchair, the nurse assesses the client for signs of dizziness upon standing. For what adverse condition is the nurse assessing the client?

Orthostatic Hypotension

The nurse is assisting a client to ambulate following knee surgery. What is a key concern when assisting clients with activity?

Safety

Jogging is an example of isometric exercise

FALSE

A nurse stretches out a patient's leg and moves it in a circle. This is an example of what type of body movement?

Circumduction