Ch.44 Activity and Exercise
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Normal movement and stability are the result of what?
- Intact musculoskeletal system
- Intact nervous system
- Intact inner-ear structures responsible for equilibrium
What are the four basic elements of normal movement?
- Alignment and Posture
- Joint Mobility
- Coordinated Movement
What is range of motion (ROM)?
- The maximum movement that is possible for that joint
- (FYI it varies from person to person)
The term proprioception is used to describe what?
Awareness of posture, movement, and changes in equilibrium and knowledge of position, weight, resistance of objects in relation to the body.
Coordinated movement are the result of what three parts in the brain?
- Cerebral Cortex = initiates voluntary movement (does not operate muscles)
- Cerebellum = coordinates motor activity (translates instructions)
- Basal Ganglia = maintains posture
What kind of movements will you see in a client that has an injured cerebellum?
Clumsy, unsure, and uncoordinated
What are isotonic (dynamic) exercises?
- exercises in which the muscle shortens to produce muscle contraction and active movement.
- (FYI: ADL's and active ROM exercises, increase muscle tone, mass, strength ad maintain joint flexibility and circulation)
What is the purpose of isotonic (dynamic) exercises?
to increase muscle tone, mass and strength and maintain joint flexibility and circulation.
Why does the heart rate and cardiac output quicken during isotonic (dynamic) exercises?
To increase blood flow to all parts of the body
What are Isometric (static or setting) exercises?
- Muscle contraction without moving the joint
- (mild increase in cardiac output and heart rate)
What are isokinetic (resistive) exercises?
- Muscle contraction or tension against resistance.
- (build up certain muscle groups)
- (↑ B/P, ↑ blood flow to muscles)
What is aerobic exercise?
Activity during which the amount of oxygen taken in in the body is greater than that used to perform the activity.
What does aerobic exercises improve?
Cardiovascular conditioning and physical fitness
What are anaerobic exercises?
- Involves activity in which the muscles cannot draw out enough oxygen from the bloodstream
- (used for endurance training)
A clot that is loosely attached to an inflamed vein wall
An object that has moved from its place of origin, causing obstruction to circulation elsewhere
What is vital capacity?
The maximum amount of air that can be exhaled after a maximum inhalation.
What is metabolism?
Sum of all the physical and chemical processes by which living substance is formed and maintained, and by which energy is made available for use by the body
Body mechanics is the term used to describe what?
The efficient, coordinated, and safe use of the body to move objects and carry out ADL’s
What is the maximum client weight a nurse should attempt?
- 35 pounds
- (NO MANUAL or SOLO LIFT)
What are two ways a nurse can greatly enhance body balance
- Widening the base of support
- Lowering the center of gravity, bringing it closer to the base of support
What are two movements to avoid because of their potential for causing back injures?
Twisting (rotation) and stooping
- Semisitting position: 45° - 60° elevation of head and trunk.
- (knees may or may not be flexed)
- Low Fowler's position: Head and trunk are elevated 15° - 45°
High Fowler Position
Sitting upright: 60° - 90°
Fowler's position is ideal for what type of patient?
A patient who is having difficulty breathing and for some with heart problems
Define orthopneic position
- Client sits either in bed or on the side of the bed with an over bed table across the lap
Dorsal recumbent position
- Back lying position, head and shoulder slightly elevated on a small pillow
Head and shoulders are not elevated
- Client lies on the abdomen with head turned to one side
Lying on back; dorsal recumbent
- Body is turned to side, both arms in front of body
- Semiprone position; halfway between lateral and prone position
In order to prevent spinal twisting when moving or lifting a client the nurse should do what?
Face in the direction of the movement.
When moving or lifting a client the nurse should assume broad stance in order to what?
Increase stability and provide balance
When pulling a patient the nurse should rock from leg to leg
Front leg to back leg
When moving (pushing) a patient the nurse should rock from leg to leg
Back leg to front leg
What does the nurse need to determine and document after moving a client?
Clients comfort, body alignment, tolerance of the activity, ability to assist, use of supportive devices, and safety precautions required.
What are active ROM exercises?
- Isotonic exercises in which the client moves each joint in the body through its complete range of movement.
- (FYI: maintain or increase muscle strength and endurance and helps maintain cardiorespiratory function in an immobilized patient)
Passive ROM exercises
- Another person moves each of the client's joints through its complete range of movement
- (FYI: it is useful for maintaining joint flexibility, but has no value in maintaining muscle strength)
What is food drop?
Plantar flexion contracture; occurs when a stronger muscle dominates the opposite muscle
Permanent shortening of the muscle
What is an ankylosed joint?
A permanently immobile joint
How should a nurse provide passive ROM to a patient with contractures?
By applying slow firm pressure, without causing pain, to stretch the muscle fibers.
Define basal metabolic rate
The minimal energy expended for maintenance of physical and chemical processes of the body
too much muscle tone
Without muscle tone
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