The effects of Immobility
a) Interventions that improve flexibility
P.R.E.P.(Perform passive ROM, Reposition Q2HR, Encourage independent activity
... [Show More] as
much as possible even in bedrest, Provide assistive devices)
Know examples of exercises for flexibility
b) Assessment/ Findings of a patient with DVT
Assessment
(1) Compare distal pulses for pulse quality, observe the color and temp. of
extremities, evaluate sensation and motion, and determine speed of capillary
refill. Compare calf circumferences.
Findings
(1) Redness, warmth, tenderness, swelling (Thrombus formation), Peripheral and
sacral edema.
c) Identify patients at risk for skin breakdown
Older adults, immobile, cognitive impairments, incontinence, poor nutrition/
malnutrition. Medications may also cause vasoconstriction and result in poor tissue
perfusion.
2. Benefits of Exercise
a) Rationale for weight bearing exercise
Promotes bone reformation and growth (Makes bones stronger)
At least 3-5 times a week
Identify benefits of exercise
Bone reformation and growth
Cardiovascular health promotion
Promotes balance and stability
Reduce stress and increase energy levels
b) Identify benefits of exercise
Bone reformation and growth
Cardiovascular health promotion
Promotes balance and stability
Reduce stress and increase energy levels
Improves pulmonary circulation, skeletal development, skin tone
Reduces systemic inflammation
c) Identify negative effects of immobility on musculoskeletal system
Osteoarthritis
Rheumatoid Arthritis
Loss of muscle strength
Impaired balance
Altered join mobility
Decreased stability
Osteoporosis
Depression, isolation, anxiety, and mood change
Can cause decreased peristalsis
d) Explain ways to maintain proper posture for a client
Place the spine in a neutral position(Resting)
This allows the bones to be aligned, reduce stress and fatigue & muscle joints, and
ligament can work efficiently
Avoid standing in 1 position for a long period of time
Do not lock your knees when standing
Keep core tight and don’t bend at the waist or neck
No slumping when sitting
Sit close to your work and use back support
Sit with feet flat on floor
Sleep on firm mattress
Do not wear high heels for a prolonged time, do not slump, and use a chair that
supports your back.
e) Identify interventions in minimizing contractures (which is a negative effect of
immobility)
Gently straighten out contracted extremity, fingers. Etc
Mobility-encouraging interventions such as passive ROM, and rotation. Flexion and
extension exercises
These interventions should be performed about every 2hrs and as needed if the
contractures are present
3. Identify bed positions
Semi-fowlers: Patient is on their back with the head raised between 15 and 45 degrees.
High-fowlers: Patient is on their back with the head of the bed raised between 60 and 90
degrees.
Prone: Lying on the abdomen with the head turned to one side
Supine: Lying on the back
Sims: Patient lies on their side with the left thigh slightly flexed and the right thigh
acutely flexed on the abdomen.
Trendelenburg's Position: Patient is on their back whose lower section is inclined 15-30
degrees so that the head is lower than the body.
Reverse Trendelenburg's Position: Patient is in the supine position with the feet facing
downward and head is inclined 15-30 degrees.
Lateral Position: Side lying position, and a pillow is often placed between the legs for
patient comfort
4. Identify proper body mechanics for moving the patients in bed
Transfer board
Mechanical lift
Transfer belt
What are the proper ways to move patients in bed?
5. Explain how to use walkers to the elderly
Push or lift your walker 6-12 inches forward
Make sure all 4 tips or wheels of your walker are touching the ground before taking a
step
Step forward with your weak leg first
Then step forward with your other leg placing it in front of the weaker leg
6. Be able to assess client with diabetic neuropathy
Monofilament test: touch foot at the same time and have patient which time they were
touched
Vibration perception: use a 128 hz tuning fork and ask the patient if they are able to feel
vibrations
Look for ulceration or inspection of the feet [Show Less]