FUNDAMENTALS CH. 39 ACTIVITY AND EXERCISE/ CH. IMMOBILITY

What is body alignment?

relationship of one body part to another

What is body balance?

achieved by low center of gravity; enhanced by posture

What is coordinated body movement?

A result of weight, center of gravity, and balance

What is friction?

Force that occurs in a direction to oppose movement

What is activity tolerance?

type and amount of exercise or work that a person is able to perform

What is isotonic exercise?

increasing muscle tone by MOVING the joints
Examples: Running, ROM, Activities of daily living

What is isometric exercise?

An exercise in which muscles are contracted and held for a few seconds, but the body/joints doesn't move.
Example: Butt Crunches

What are the three types of joints?

Fibrous, Cartilagenous, and Synovial Joints

What is fibrous joint?

immovable joint

What is a cartilaginous joint?

-It allows slight movement
-Near the ends of a bone. An example would be the manubrium and the sternum.

What is a synovial joint?

freely moveable joint

What are pathological influences on body alignment, mobility, and activity?

1)Congenital defects
2)Disorders of bones, joints, and muscles
3)Central nervous system damage
4)Musculoskeletal trauma

What are factors that influencing activity and exercise?

-Developmental changes
-Behavioral aspects
-Environmental issues
-Cultural and ethnic influences
-Family and social support

What is the correct standing position?

Head: erect, midline
Body: symmetrical
Spine: Straight with normal curvatures
Abdomen: tucked
Knees: slightly flexed
Feet: Pointed forward and slightly apart
Arms: at sides

What is the correct sitting position?

Head: erect
Neck and vertebral column: straight alignment
Body weight: distributed on buttocks and things
Thighs: parallel and in a horizontal place
Feet: supported on the floor
Forearms: supported on the armrest, in the lap, or on a table in front of the

What is recumbent position?

Vertebrae in straight alignment without observable curves

What should you teach the patient about activity and exercise?

Calculate maximum heart rate
Proper body mechanics

How can you help a pt walk?

-Assess pt ability to walk safely
-Evaluate environment for safety
-Assist patient to sitting position, dangle pt legs over the side of the bed 1-2 mins before standing (Getting up abruptly could cause dizziness)
-Provide support at the waist so the pt ce

How can you help the pt with ADLs?

Implement strategies to assist them

How should a pt use a walker?

Hold handgrips on the upper bars
Take a step
Move the walker forward
Take another step

How can a pt use a cane?

-Keep on stronger side
-Place cane forward 6-10inches (keep body weight on both legs)
-Weaker leg is moved forward (Divide weight between cane and STRONGER leg)
-Stronger leg is advanced past cane (Divide weight between cane and WEAKER leg)

How can a pt use a crutch?

Measuring the crutches to fit the patient
Armpits should not be at the top of the crutch

How can a pt use crutches up the stairs?

Good leg goes to HEAVEN then pull the crutch then next leg & the bad leg goes to HELL and pull the crutch down too

How to sit in a chair with crutches?

Make sure chair touches the back of the knees
Have crutches on strong side
Lean down in chair without weight on weak foot/leg

What is gravity?

Weight force exerted on the body

What is mobility?

Person's ability to move about feely

What is immobility?

the inability to do so

What is disuse atrophy?

decrease in muscle mass due to inactivity
"You don't use it, you lose it

How can immobility affect metabolic system?

Hypertension
Calcium Absorption
GI function decreased

How can immobility affect Cardiovascular?

Orthostatic hypotension
Thrombus - (Blood Clot)
Increased cardiac workload = HTN

How can immobility affect muscles?

Loss of muscle mass
Muscle atrophy

How can immobility affect urinary elimination?

Urinary stasis
Renal calculi

How can immobility affect respiratory system?

Atelectasis
Hypostatic pneumonia

How can immobility affect the musculoskeletal system?

Loss of endurance and muscle mass
Decreased stability and balance

How can immobility affect skeletal?

Impaired calcium absorption
Joint abnormalities (Contracture: shortening of the joint)

How can immobility affect integumentary system?

Pressure Ulcer
Ischemia

How does immobility disrupt normal metabolic functioning?

Decreases metabolic rate
Alters metabolism
Causes GI disturbances

What are immobile patients with respiratory changes at greatest risk for?

Atelectasis
Hypostatic Pneumonia
Intervention: Incentive Spirometer

Who is at greatest risk for integumentary changes?

Older adults

What psychosocial effects do immobile ppl have?

Altered sleep patterns
Depression, sadness, dejection
Hostility, giddiness, fear, and anxiety

What are the three types of planes?

Sagittal
Transverse
Frontal

Frontal Plane

Divides the body into front and back portions.

Sagittal Plane

divides body into left and right

Transverse Plane

horizontal division of the body into upper and lower portions

What are contractures?

Joints not moved periodically through their full ROM
Neck, shoulder, elbow, forearm, wrist, fingers, and thumb
Ankle and foot
Toes

Body alignment

Determining normal physical changes
Identifying deviations in body alignment
Patient awareness of posture
Identifying postural learning needs of patients
Identifying trauma, muscle damage, or nerve dysfunction
Obtaining information on incorrect alignment

Nursing Diagnosis for Immobility

-activity intolerance
-ineffective airway clearance
-ineffective breathing pattern
-ineffective individual coping
-risk for disuse syndrome
-risk for fluid volume deficit
-impaired gas exchange
-risk for infection
-risk for injury
-impaired physical mobil

How to help immobile patients with respiratory issues?

Cough and deep breathe every 1-2 hrs
Provide CPT

How to help immobile patients with metabolic issues?

High protein
High calories diet w/ Vitamin B & C supplements

How to help immobile patients with cardiovascular issues?

SCDs
TED hose
Leg exercises

How to help immobile patients with musculoskeletal system?

ROM

How to help immobile patients with Integumentary system?

Reposition every 1 to 2hrs
Provide skin care

How to help immobile patients with Elimination system?

Provide adequate hydration
Serve a diet rich in fluids, fruits, veggies, and fiber

What is trochanter roll?

Rolled towel support placed against the hips and upper leg to prevent external rotation of the legs when a patient is supine

Fowlers

the head of the patient's bed is raised 90

What is a trapeze bar?

Used to facilitate movement and positioning of patient

Semi Fowlers

HOB raised 45-60 degrees

Supine

lying on the back

Prone

lying face down

Sims

body position in which a person is lying on his left side with the upper knee flexed and raised toward the chest

What is important to consider when moving patients?

Safety is first priority
Ask patient to help as much as possible
Determine if patient comprehends what is expected
Determine patient's comfort level
Determine if you need assistance in moving the patient