fund: chap 15.txt

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  1. Which profession has the highest worker�s compensation claims?
    Nurses
  2. Which system must be protected to minimize injury to the nurse and to the patient?
    Musculoskeletal
  3. Reason for body mechanics?
    Protect large muscles groups of injury and provides safety for patients when assisting with ambulation
  4. MSD
    • Musculoskeletal disorder
    • Abbrev?
  5. Injuries are most likely when ?
    • This occurs when you are performing a task that requires you to exert yourself forcefully, perform repetitive movements, or maintain an awkward or static posture
    • What occurs?
  6. Most serious injuries occur when?
    • This occurs when you twist and lift at the same time or move a pt without help from other personnel or an assistive device
    • What occurs?
  7. Safe pt transfer requires?
    • This requires adequate staffing, right mix of personnel, and appropriate, readily available, well maintained patient lifting equiptment
    • What does?
  8. Body mechanics are used daily in what activities?
    Making beds, assisting pt to ambulate, carrying supplies, lifting/carrying equipment, provide pt care, and carrying out other procedures
  9. Why are body mechanics important?
    Helps minimized pain/injuries to musculoskeletal system
  10. Injury to the spine causes?
    • Loss of feeling, movement, and strength
    • What kind of injury causes this?
  11. what is the most common back injury?
    Lumbar muscle group strain (lower back) injury
  12. Injury of lower back affects?
    • It affects ability to bend forward, backward, and side to side as well as rotate hips and lower back
    • What affects this?
  13. Body mechanics
    • Field of physiology that studies muscular actions and the functions of muscles in maintaining the posture of the body
    • Term?
  14. Body mechanics refers to?
    • Refers to the way we move our body � using good posture; maintain appropriate body alignment
    • What refers to this?
  15. Alignment
    • Refers to the relationship of various body parts to each other
    • What refers to this?
  16. What is the key factor in proper body mechanics?
    • Maintaining appropriate body alignment is the key factor for this
    • For what?
  17. Alignment helps?
    • Helps balance and helps coordinate movements smoothly and effectively
    • What does?
  18. Good postures generally means?
    • Spine is in a �neutral� or �resting� position
    • What means this?
  19. How are vertebrae, facet joints and discs placed and do what?
    • They are vertically stacked, held together by a system of muscles and ligaments. They support alignment, allow movement, and protects the spinal cord and nerves
    • What are?
  20. Discs purpose?
    • Absorb shock from the changing weight loads applied to the spine
    • What does?
  21. What are risk factors for back injury?
    • Risk factors: Lifting with your back bowed out, behind and reaching with your back bowed out, slouched sitting, and jerking or twisting, lack of proper rest, obesity, loss of strength and flexibility, stressful living and working habits, smoking, and poor nutrition
    • Risk factors for what?
  22. what is the good position for body mechanics?
    • Position: chin is high and parallel to the floor, abdomen is tightened (internal girdle) in and up with gluteal muscles tuck in, and feet are spread apart for a broad base of support
    • Position of what?
  23. Base of support
    • Stance with feet slightly apart
    • Term?
  24. What helps provide better stability?
    • Base of support provides this
    • Provides what?
  25. What is the distance of the base that should be maintained?
    • should be about 1.5 times the length of ones shoes
    • What should be?
  26. What maintains equilibrium, or balance, which facilitates appropriate body alignment when lifting, bending, moving, and doing other activates?
    • Skeletal muscles and the nervous system maintains this
    • Maintains this?
  27. Why should one avoid bending from the waist?
    • Avoid this so that there is no strain in the lower back
    • Avoid what?
  28. What helps prevent undue stress and strain on your back?
    • Working at a height or level that is comfortable and easy helps this
    • Helps what?
  29. Hyperextension
    • Extreme or abnormal stretching
    • Term?
  30. What can one do to require less effort to carry out an activity?
    • Widen your base of support in the direction of movement does this
    • Does what?
  31. When using correct use of body mechanics how should the gluteal muscles be?
    • These muscles need to be contracted in and down
    • What muscles?
  32. When using correct use of body mechanics how should the abdominal muscles be?
    • These muscles need to be contracted in and up
    • Which muscles?
  33. What are ways to protect you and the patient from injury?
    • Carry objects close to the midline of your body, avoid reaching too far, avoid lifting when other means of movement are available, use devices instead of or in combination with lifting, and use alternating periods of rest and activity
    • Why do all this?
  34. Dorsal position
    • Lying flat on the back
    • What position?
  35. Dorsal position is also known as?
    • Supine position
    • Also known as?
  36. Dorsal recumbent position
    • Supine position with pt lying on back, head, and shoulder with extremities moderately flexed; legs are sometimes extended
    • What position?
  37. Fowlers position
    • Posture assumed by pt when head of bed is raised 45 to 60 degrees
    • What position?
  38. Semi-fowlers position
    • Posture assumed by pt when head of bed is raised approximately 30 degrees
    • What position?
  39. Orthopneic position
    • The posture assumed by the pt sitting up in the bed at 90 degree angle, or sometimes resting in forward tilt while supported by pillow on overbed table
    • What position?
  40. Sims� position
    • Position in which the pt lies on side with knee and thigh drawn upward toward chest
    • What position?
  41. The left sims�s position is appropriate positioning for what?
    • This position is appropriate for enema procedure and administering a rectal suppository
    • Term?
  42. Prone position
    • Position: lying face down in horizontal position
    • What position?
  43. Knee chest position is also known as?
    • Genupectoral position
    • Also known as?
  44. Genupectoral position
    • Knee chest position where pt kneels so that weight of body is supported by knees and chest, with abdomen raised, head turned to one side, and arms flexed
    • Position?
  45. Lithotomy position
    • Position: pt lies supine with hips and knees flexed and thighs abducted and roatted externally (sometimes feet are positioned in stirrups)
    • What position?
  46. What is the distance of position of feet apart?
    • Should be 6-8 inches apart
    • What should be?
  47. How should knees be when standing?
    • Flex them when standing
    • Flex what?
  48. Lift with what?
    Lift with legs
  49. Keep objects where when carrying them?
    • Keep them close to body of midline
    • Keep what? And when?
  50. What does lift twice mean?
    • Twice: Once mentally than physically
    • For what?
  51. Never attempt to life more than?
    • Don�t do: More than 35 % of your own body weight or more than 50 lbs
    • What is that?
  52. Trendelenburg position
    • Pts head is low and the body and legs are on inclined plane
    • Position?
  53. Which postion is no longer widely used?
    • Trendelenburg position
    • What is different about this position?
  54. Principles of good body mechanics?
    • Principles: Do not lift higher than chest level, arrange for adequate help, encourage pt to assist as much as possible, flex knee, keep feet wide apart, position self close to object lifting, slide pt toward yourself using a pull sheet, set abdominal and gluteal muscles in preparation for move, person with heaviest load coordinates efforts of team by counting to 3
    • Principles of what?
  55. How to put pt in supine position?
    • Place pt on back with head of bed flat, plc small rolled towel under lumbar area of back, place pillow under upper shoulder, neck and head, place trochanter rolls or sandbags parallel to lateral surface of lights, place small pillow or roll under ankle to elevate heels, support feet in dorsiflexion with firm pillow, footboard, or high top sneakers, place pillows under forearms to keep pts parallel to body, and place hand rolls in pts hands
    • This puts pt in what position?
  56. Mobility is necessary for?
    • Necessary for body�s nervous, muscular and skeletal systems to be intact, and used regularly
    • What is necessary ?
  57. Complications of immobility?
    • Muscle/bone atrophy/ contractures, pressure ulcers, constipation, UTI, disuse osteoporosis, and insomnia, renal calculi, deep vein thrombosis, pulmonary embolism, postural hypotension, pneumonia
    • Complications of what?
  58. Immobilization can result from?
    Decline in medical or physical status due to illness, injury, or surgery or can be used therapeutically to limit movement of body or part, or restrict ambulation
  59. Postural hypotension
    • When laying down or sitting up and when one gets up BP drops
    • Term?
  60. What to do to prevent complications from immobility
    • Do: Reposition at least Q 2 hrs, provide adequate intake and encourage fluids unless contraindicated, encourage well balanced diet, prevent deformities (use assistive devices), handle/transfer pts carefully, position lower extremities properly, encourage ambulation ASAP, anti-embolism measures, coughing and deep breathing exercises or incentive spirometry, away of side effects of meds, diversional activities, and meticulous skin care, ROM exercises, reality therapy, use gait belt and follow fall safety guidelines, pt family/ education
    • Helps in what?
  61. What needs to happen to put pt in dorsal recumbent position?
    • Move pt and mattress to head of bed, turn pt onto back, assist pt to raise legs, bend knees and allow legs to relax, pt will sometimes need a small lumbar pillow
    • This puts pt in what position?
  62. What needs to happen to put pt in fowler�s position?
    • Move pt and mattress to head of bed, raise head of bed to 45 to 60 degress. Replace pillow, use footboard, use pillows to support arms and hand, place small pill or roll under ankles
    • This puts pt in what position?
  63. What needs to happen to put pt in semi-fowlers position?
    • Move pt and mattress to head of bed, raise head of bed about 30 degrees, replace pillow
    • This puts pt in what position?
  64. What to do for progressive ambulation?
    • Elevate HOB, dangle at side of bed, stand, take a few steps then sit in chair, advance from chair to bathroom, then about the room, then to the hallway, then ad lib
    • Do this when?
  65. When should pt be in semi-fowlers position?
    • Thyroidectomy, GT feedings, cataract surgery, stroke, laryngectomy, NGT insertions, mastectomy, bronchoscopy post procedure
    • For these procedures pt should be in what position?
  66. What needs to happen to put pt in orthopneic position?
    • Elevate head of bed to 90 degree angle, place pillow btwn patients back and mattress, place pillow on overbed table and assist pt to lean over, placing head on pillow
    • This puts pt in what position?
  67. Assistive devices for positioning?
    • Devices: Pillows, foot boots, trochanter roll, and sandbag, hand wrist splint, hand roll, side rail, bed board, wedge pillow, trapeze bar
    • What kind of devices and for what?
  68. What needs to happen to put pt in sim�s position?
    • Place pt in supine position, pt in lateral position, lying partially on the abdomen, draw knee and thigh up near abdomen and support with pillows, place pts lower arm along back, bring upper arm up, flex elbow, and support with pillow, allow pt to lean forward to rest on chest
    • Puts pt in what position?
  69. What needs to happen to put a pt in prones position?
    • Assist pt onto abdomen with face to one side. Flex arms toward the head. Position pillows for comfort. Place a pillow under lower leg to release �pull� on the lower back, or place a pillow under the head (or both)
    • Puts pt in what position?
  70. What needs to happen to put a pt in a genupectoral (knee � chest) position?
    • Turn pt onto abdomen. Assist patient into kneeling position; arms and head will rest on pillow while upper chest rests on bed
    • Puts pt in what position?
  71. What needs to happen to put pt in a lithotomy position?
    • Position pt to lie supine, request pt to slide buttocks to edge of examining table. Lift both legs; have pt bend knees and place feet in stirrups
    • Put pt in what position?
  72. CMS assessment
    • Circulation, movement, and sensation assessment
    • Abbrev?
  73. ROM
    • Defined as any body action involving the muscles and joints in naturally directional movements
    • What?
  74. Reason for ROM
    • Prevent excessive muscle atrophy and joint contracture (physical disuse syndrome)
    • Reason for what?
  75. What is the minimum activity level to prevent muscle atrophy?
    • Minimum of 2 hrs per day, divided into 20 min sessions throughout the day and each movement done 5 times
    • Do this to prevent?
  76. Mobility
    • Persons ability to move around freely in his or her environment
    • Term?
  77. Passive ROM
    • Exercise is performed by caregivers
    • Term?
  78. Active ROM
    • Exercise is performed by pt
    • Term?
  79. Active assisted ROM
    • pt uses strong arm to exercise the weaker or paralyzed arm
    • Term?
  80. Passive assisted ROM
    • Caregiver helps the pt finish the full ROM after pt moves limb partially through ROM
    • Term?
  81. To maintain normal physical mobility it is necessary for?
    • It is necessary for the body�s nervous, muscular, and skeletal system to be intact, functioning and used regularly
    • Necessary for what?
  82. Immobility
    • Inability to move around freely
    • Term?
  83. Mechanical devices for moving clients?
    • hydraulic lifts, roller boards, and gurney lifts
    • what are these?
  84. What are mechanical devices for?
    • Used for moving pts safely, protecting the nurse�s back, and full weight lifting of clients who cant assist.
    • What is used for this?
  85. What to look for when assessing neurovascular status or CMS assessment?
    • Look at: Skin color, skin temp, movement, sensation, pulses, capillary refill, and pain
    • When to look at all these?
  86. During late-stage compartment syndrome there are signs the pt shows such as?
    • Signs shown by pts: pain, not relieved, paresthesias, pallor, pulse absent, paralysis and palpated tense tissue
    • When are these signs shown?
  87. What are factors that are that affected when lifting due to age?
    • Shearing or tearing forces, support joints, decreased flexibility and mobility of joints, weakness and hypotension, use ambulatory aids and assistive devices, and fear of assistive equipment
    • Factors for what and due to what?
  88. When assessing during nursing process for mobility what to look for?
    • Focus on ROM, muscle strength, activity tolerance, gait, and posture
    • When to look for this?
  89. Compartment syndrome
    • Phenomenon occurs in extremities, especially the legs, where a sheath of inelastic fascia partitions blood vessel, nerve, and muscle tissue
    • Term?
  90. When pt is late stage compartment syndrome and damage is irreversible pt will demonstrate signs as referred to as the six Ps and they are?
    • Pain, not relieved, paresthesias, pallor, pulse absent (pulselessness), paralysis, and palpated tense tissue
    • Known as and due to?
  91. Joint
    • Any one of the connections between bones
    • Term?
  92. Continuous passive motion machines
    • Machine which flex and extend joints in order to passively mobilize them without the strain of active exercises
    • term?
  93. What joints can the CPM machine be used on?
    • Machine used on: knee, hip, shoulder, and ankle
    • What machine?
  94. Mobilizing the joint prevents what types of complications?
    • Prevents what types of complications: as joint contracture, atrophy of surrounding muscles and thromboembolism
    • What prevents these complications?
  95. What are the goals of CPM machine?
    Goals: increase or maintain physical mobility by improving joint ROM and to prevent skin breakdown at pressure pts

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