215 mobility

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elevatedsound7
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203283
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215 mobility
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2013-02-25 14:45:44
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215 mobility
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215 mobility
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  1. mobility =
     the ability to move freely
  2. body mechanics =
    the efficient use of the body as a machine as a means of locomotion
  3. recommend amount of weight to lift
    no more than 35 pounds
  4. if body alignment and posture is correct
     there is no undue strain on joints, muscles, tendons, ligaments
  5. TABLE 44-1 in book
  6. what should you use to pull a pt up in the bed
    maxi slide
  7. postural =
    pertaining to the posture or body postitions
  8. mobility affects the cardiovascular sys
    • increasing efficiency
    • increase blood flow to body
    • decrease HR
  9. immobility effects on cardiovascular system
    • increased cardiac workload
    • increased HR
    • orthostatic hypotension
    • dependent edema (whatever area lowest on body)
    • DVT
    • embolus
  10. how often should you assess respiratory system status of immobile client
    every 2 hours
  11. mobility affects respiratory system by
    increasing pulmonary function
  12. no pitting edema =
    swelling but no pitting
  13. 2mm pitting =
    1+
  14. pitting 4mm =
    2+
  15. 6mm pitting =
    3+
  16. 8mm pitting =
    4+
  17. to control edema you can elevate leg how much
    6 inches above the heart
  18. monitor edema by
    measure circumference of leg daily
  19. if you have a pt. without ted hose, and cannot get out of bed what should you have them do
    exercise legs in bed
  20. immobility effects on pulmonary system
    • decreased ventilation
    • increased secretions - hypostatic pneumonia
    • decreased depth and rate
    • atelectasis
  21. pulled secretions in lungs can casue
    hydrostatic pneumonia
  22. atelectasis =
    alveoli collapse due to build up of secretion
  23. supine position affects diameter of airway how
    narrows it due to mucus
  24. mobility effects of musculoskeletal sys
    • increased mucle strength
    • increased flexibility
    • icreased tone
    • increased joint mobility
    • increased coordination
  25. immonbility effects on musculoskeletal sys
    • decreased size, tone, strength
    • decreased mobility and flexibility (contrctures, footdrop)
    • bone demineralization
    • limited endurance
    • footdrop
  26. footdrop =
    plantar flexion
  27. what happens to calcium in bone when persons are immobile for too long
    moves from bone to blood stream
  28. effects mobility to metabolic system
    • increased efficiency whcih leds to increased function
    • increased body heat
    • increased elimination of waste products
  29. immobility effects on metabolic system
    • decreased metabolic rate
    • altered metabolism of carbs, fats and proteins
    • fluid and electrolyte imbalances
    •  GI disturbances
  30. mobility effects GI
    • increased appetite
    • increased intestinal tone ---> improved digestion and elimination
  31. immobility effects on GI
    • changes in apptite
    • poor digestion
    • poor utilization of food
    • constipation
    • impaction
  32. mobility effects on urinary system
    • increase circulation to kidney
    • increased excretion of body wates
    • increased efficiency of aicd/base balance
    • improved urinary flow from bladder
  33. immobility effects of urinary system
    • • increased risk of UTI
    • • increased risk of renal calculi
    • • decreased bladder tone
    • • Hypercalcemia
  34. mobility assessment =
    • general ease of movement
    • gait and posture
    • alignment
    • joint structures and function
    • muscle mass, tone, strength
    • endurance
  35. mobility effects on skin
    healthy skin
  36. immobility effects on skin =
    pressure ulcers
  37. immobility diagnosis for Cardio
    • Activity Intolerance: Increased cardiac workload 
    • Altered Tissue Perfusion: Thrombus formation
    • Risk for Injury: Orthostatic Hypotension
  38. repiratory system mobility diagnosis =
    • ineffective breathing pattern
    • ineffective airway clearance
  39. immobility musculoskeletal diagnosis
    • self care deficit r/t
    • impaired physical mobility r/t
    • risk for injury r/t
  40. mobility diagnosis metabolic =
    • Activity Intolerance: Increased cardiac workload
    • Altered Tissue Perfusion: Thrombus formation
    • Risk for Injury: Orthostatic Hypotension
  41. GI immobility diagnosis
    constipation
  42. diagnosis immobility urinary system
    risk for infection
  43. implementation of metabolic system outcomes
    • encourage high calorie high protin diet
    • vitamins
  44. implementation for respiratory mobility
    • cough and deep breath
    • incentive spirometer
    • chest physiotherapy
    • encourage fluids
  45. chest physiotherapy
    cupping hands and breaking up secretions
  46. implementation cardiovascular mobility
    • prevention of orthostatic hypotension - early mobility, dangle legs
    • discourage valsalva manuver - bearing down
    • prevent thrombus
  47. prevent a thrombus =
    • leg exercises
    • heparin
    • compression devices OOB when possible
    • TED hose
  48. implementation musculoskeletal mobility
    • active and passive ROM
    • proper transfers
    • proper use of assistive devices
  49. implementation integumentry system
    prevent ulcers -position changes, good skin care, pressure relieving devices
  50. turning schedule =
    every two hours
  51. prevent uti and kidney stones =
    2-3 liters of fluid daily
  52. how can the nurse effect pt psychosocial in regards to mobility
    • involve in care
    • provide socialization
  53. restraint is
    any device that limits a pt movement
  54. some dangers of restraints =
    • suffocation
    • impaired circulation
    • altered skin integrity
    • decreased muscle and bone mass
    • fractures
    • altered nutrtion and hydration
    • aspiration
    • incontinence
    • pneumonia
  55. alternatives to restraints
    • •      Assess  for Pain
    • •      Involve family in care
    • •      Decrease noise
    • •      Use night light
    • •      Decrease hazards
    • •      Disoriented clients near station
    • •      Allow to walk
    • •      Orient family
    • •      Maintain bed in low position
    • •      Toilet frequently
    • •      Encourage exercise
  56. what do you ahve to document in regards to using restraints
    • document why pt restrained
    • document alternatives to restraints
    • observation Q 60 minutes
    • release restraint Q 2 hours
  57. to use restrints must have physcian order every
    24 hours
  58. appropriate to restrain when
    you or pt in danger

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