Activity/Mobility

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Author:
KristaDavis
ID:
168239
Filename:
Activity/Mobility
Updated:
2012-08-30 20:43:52
Tags:
Activity Mobility
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Description:
Exam 1
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  1. Role of the Skeletal System in reference to activity/mobility:
    = framework of bones, joints and cartilage

    • *Supports the soft tissue (maintains form and posture)
    • *Protection (brain, spinal cord, heart)
    • *Furnishing surfaces for attachment of muscles/tendons/ligaments
    • *Producing Blood Cells
  2. Role of the Muscular System in reference to activity/mobility:
    • *Provides movement by contraction of its cells
    • *Motion
    • *Mantaining Posture
    • *Heat Production
    • (1) Smooth Muscle
    • (2) Skeletal Muscle
    • (3) Cardiac Muscle
  3. Role of the Nervous System in response to activity/mobility:
    • = Stimulates muscle contractions
    • *Neurons conduct impulses
    • *Afferent Nervous System (ANS) conveys info from the body --> CNS
    • *CNS--> Response movement
    • *Efferent System conveys from CNS--> Skeletal Muscle
  4. The application of mechanical laws to the human body, specifically in regard to structure, function, and position of the body
    Body Mechanics
  5. The practice of designing equipment and work tasks to conform to the capability of the worker in relation to the patient care
    Patient Care Ergonomics
  6. Correction or prevention of disorders of the body structures used in locomotion:
    Orthopedics
  7. Factors Affecting Movement/Alignment:
    • *Growth and development
    • *Stress
    • *Physical Health
    • *Mental Health
    • *Lifestyle variables
    • *Attitude
    • *Fatigue
    • *Weather
  8. Coordinated effort of the musculoskeletal and nervous systems to maintain posture, balance, and body alignment during lifting, bending, and moving
    Body Mechanics
  9. Force that occurs opposite of a movement
    Friction

    ...The GREATER the surface area, the GREATER the friction
  10. Examples of Protective Positioning for a patient:
    • *Trochanter Roles= prevent external rotation
    • *Foot boards= prevent "foot drop"
    • *Cradle
    • *Sandbags
    • *Hand-wrist splints
  11. Types of Joint Movements:
    • Abduction = away from body
    • Adduction = toward body
    • Flexion = bent
    • Extension 
    • Rotation
    • Supination
    • Pronation
  12. What kind of muscles are used when moving a patient?
    Longest and Strongest of the Arms and Legs
  13. What do you use to stabilize the pelvis and to protect the abdominal viscera when stooping, reaching, lifting, or pulling??
    Internal Girdle
  14. Postioning Patients with:
    • Adjustable Bed
    • Side rails
    • Trapeze bars
    • Pillows
    • Matresses
  15. What should you (as the nurse) teach the family and patient about their positioning?
    ›Correct position techniques

    ›Change position frequently

    ›Time schedule
  16. Fowler's Position:
    40-90 degrees
  17. Variables leading back to INJURY:
    žUncoordinated lifts

    žHeight-weight differential among lifters

    žLifting when fatigued

    žLifting after recent recovery from back injury

    žLack of training in body mechanics

    žStanding for long periods of time

    žTransferring patients
  18. Liting Techniques:
    1.1st assess

    2.Medicate if necessary

    3.Verify orders

    4.Raise bed, lower side rails (if appropriate)

    5.Remove all pillows

    6.Obtain extra help if needed

    • 7. Adjust tubes, poles, catheters
    • 8.Lower HOB to lowest position

    • 9.Tighten
    • stomach muscles and tuck pelvis

    • 10.Bend at
    • the knees- let the legs do the lifting

    • 11.Keep the
    • weight to be lifted as close to the body as possible

    • 12.Maintain
    • the truck erect and the knees bent

    • 13.Avoid
    • twisting
  19. Transfer Techniques:
    žAssess

    žMove immobile client up in bed

    žAssist client move up in bed (one or two nurses)

    • žMove immobile client up in bed with draw sheet or pull
    • sheet (two nurses)

    žPosition client in supported Fowler’s position 
  20. Turning a Patient:
    1.Gather any positioning aids or supports, if necessary.

    2.Identify the patient. Explain the procedure to the patient.

    3.Perform hand hygiene and put on gloves, if necessary.

    4.Close the room door or curtains. Place the bed at an appropriate and comfortable working height.

    • 5.Adjust the head of the bed to a flat position or as low as the patient can tolerate. Place pillows, wedges, or any other supports to be used for positioning within
    • easy reach.

    6.Lower the side rail nearest you if it has been raised. If not already in place, position a friction-reducing sheet or drawsheet under the patient.

    • 7.Using the friction-reducing sheet or drawsheet, move the patient to the edge of the bed, opposite the side to which he or she will be turned. Raise side rail and move to the opposite side of the bed.
    • 8.Stand on the side of the bed toward which the patient is turning. Lower the side rail nearest you.

    • 9.Place the patient’s arms across his or her chest and cross
    • his or her far leg over the leg nearest you.

    10.Stand opposite the patient’s center with your feet spread about shoulder width and with one foot ahead of the other. Tighten your gluteal and abdominal muscles and flex your knees. Use your leg muscles to do the pulling.

    11.If available, activate the bed mechanism to inflate the side of the bed opposite from where you are standing.

    12.Position your hands on the patient’s far shoulder and hip, and roll the patient toward you, or you may use the friction-reducing sheet or drawsheet to gently pull the patient over on his or her side.

    13.Use a pillow or other support behind the patient’s back. Pull the shoulder blade forward and out from under the patient.

    14.Make the patient comfortable and position in proper alignment, using pillows or other supports under the leg and arm as needed. Readjust the pillow under the patient’s head. Elevate the head of the bed as needed for comfort.

    15.Place the bed in the lowest position, with the side rails up. Make sure the call bell and other necessary items are within easy reach.
  21. Moving a patient UP in bed (assisted):
    1.Identify the patient. Explain the procedure to the patient.

    2.Perform hand hygiene and put on gloves, if necessary.

    3.Close the room door or curtains. Place the bed at an appropriate and comfortable working height. Adjust the head of the bed to a flat position or as low as the patient can tolerate. Placing the bed in slight Trendelenburg position aids movement, if the patient is able to tolerate it.

    4.Remove all pillows from under the patient. Leave one at the head of the bed, leaning upright against the headboard.

    5.Position at least one nurse on either side of the bed, and lower both side rails.

    6.If a friction-reducing sheet or drawsheet is not in place under the patient, place one under the patient’s midsection.

    7.Ask the patient (if able) to bend his or her legs and put his or her feet flat on the bed to assist with the movement.

    • 8.Have the patient fold the arms across the chest. Have the
    • patient (if able) lift the head with chin on chest.
    • 9.Position yourself at the patient’s midsection with your feet spread shoulder width apart and one foot slightly in front of the other.

    10.If available on bed, engage mechanism to make the bed surface firmer for repositioning.

    11.Fold or bunch the drawsheet close to the patient before grasping it securely and preparing to move the patient.

    12.Flex your knees and hips. Tighten your abdominal and gluteal muscles and keep your back straight.

    • 13.Shift your weight back and forth from your back leg to your front leg and count to three. On the count of three, move the patient up in bed. If possible, the patient can assist with the move by pushing with the legs. Repeat the process if necessary to get the patient to
    • the right position.

    14. Assist the patient to a comfortable position and readjust the pillows and supports as needed. Return bed surface to normal position, if necessary. Raise the side rails. Place the bed in the lowest position.

    15. Remove gloves if used and perform hand hygiene.
  22. Log Roll
    žSpinal injuries, recovering from neck, back, or spinal surgery

    žKeep body in straight alignment

    žTwo or three nurses
  23. RESTRAINTS
    ž=Physical device used to limit a patient’s movement.

    žPhysical restraints

    ›Side rails

    ›Geriatric chairs with attached trays

    ›Appliances tied at the wrist, ankle, or waist

    ›Hand mitten

    žChemical restraints

    ›Drugs used to control behavior

    • (žLast resort
    • žFamily must be notified
    • Alternative methods first
    • Alert physician that restraint is needed
    • Order must include type, justification, and criteria removal, and duration of use.
    • Assess Q1-2 hours depends on hospital policy and patient need
    • Remove Q2 hours and perform ROM -also depends on hospital policy and patient need)
  24. Restraint Hazaards 
    žDanger of suffocation

    žImpaired circulation

    žAltered skin integrity

    žPressure ulcers and contractures

    žDecrease muscle and bone mass

    žFractures

    žAltered nutrition and hydration

    žAspiration and breathing difficulties

    žIncontinence

    žChange in mental status
  25. Alternatives to Restraints:
    ›Rule out causes for agitation

    ›Ask family to stay

    ›Use night light

    ›Assist with toileting

    ›Divisional activities

    ›Relocate patient’s room

    ›Use alternative restraints:

    –(Ambularm & Floor mats)
  26. When Applying Restraints....Remember to:
    žTwo fingers between restraint and skin

    žQuick release knot

    žSecure to bed frame, not side rails

    žAssess patient Q1 hour

    žRemove Q2 hours

    ›Perform ROM

    ›Assess skin

    ›Early release

    ›Offer bathroom

    ›Offer hydration and food

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