Activity & Exercise + Immobility

Question 1

what is SO IMPORTANT ABOUT PHYSICAL ACTIVITY & EXERCISE?

Answer 1

• contribute greatly to one’s own physical & emotional well-being
• allows one to keep fit & elevate one’s mood
  
  • stress management
  • better sleep quality
  • improves confidence & self-image
• patients need the MOTIVATION to engage in regular exercise

Question 2

definition of DECONDITIONING

Answer 2

• based upon INACTIVITY OF PHYSICAL ACTIVITY
• indication of physical, emotional decline due to inactivity

Question 3

what are some ACTIVITIES SEEN IN HEALTH CARE SETTINGS?

Answer 3

• WALKING
• TURNING/POSITIONING
• LIFTING
• CARRYING

**often see nurse undergo injuries–such as on the BACK due to overexertion from lifting or moving patients

Question 4

definition of MOVEMENT

Answer 4

complex process that requires COORDINATION between the musculoskeletal & nervous systems

Question 5

defintiion of BODY MECHANICS

Answer 5

a term that describes the COORDINATED EFFORTS of the MUSCULOSKELETAL SYSTEM & NERVOUS SYSTEM

Question 6

definition of BODY ALIGNMENT

Answer 6

• or aka POSTURE; allows for the positioning of the joints, tendons, ligaments, & muscles while in standing, sitting, or lying positions
• indicates a person’s center of gravity is STABLE

Question 7

how does GRAVITY & FRICTION PLAY A PART?

Answer 7

if we have an UNSTEADY PATIENT; this means their CENTER OF GRAVITY IS UNBALANCED & WEAK

• friction is where we have a FORCE THAT IS OPPOSITE TO THE MOVEMENT
• the GREATER SURFACE AREA = GREATER FRICTION
• the LARGER THE OBJECT = GREATER RESISTANCE to MOVEMENT

Question 8

what is the TYPICAL CORRECT BODY ALIGNMENT?

Answer 8

• RELAXED and FACE FORWARD POSITIONING
• minimization of HUNCHING

Question 9

definition of SHEAR

Answer 9

• the force exerted against the skin while the skin remains stationary & bony structures move
  
  • ex. moving HOB - patient pulled by gravity on underlying sheets
• causes damage to UNDERLYING TISSUE & impedes blood flow

Question 10

what is the SKELETAL SYSTEM and what is it composed of?

Answer 10

• composed of ATTACHMENTS for MUSCLES & LIGAMENTS that forms the FRAMEWORK for the body
  -contains our joints, ligaments, tendons, and cartilage

Question 11

what about our SKElETAL MUSCLES?

Answer 11

muscules that are concerned with MOVEMENT OR POSTURE
- they can either EXTEND OR CONTRACT

Question 12

definition of PROPRIOCEPTION

Answer 12

where we have the ACTUAL AWARENESS of the POSITION OF THE BODY and all its PARTS

Question 13

what do we use to help ease pain within the MUSCLES?

Answer 13

can use HEAT THERAPY
- allows for VASODILATION & RELAXING OF THE MUSCLES

Question 14

definition of PHYSICAL ACTIVITY

Answer 14

any movement produced by the SKELETAL MUSCLES that results in ENERGY EXPENDITURE

Question 15

definition of PHYSICAL EXERCISE

Answer 15

type of SUBSET OF PA; more of a PLANNED, STRUCTURED, and REPETITIVE movements that has a more FINAL OR INTERMEDIATE OBJECTIVE OR GOAL
- goal; improvement or maintenance

Question 16

definition of ISOTONIC/DYNAMIC CONTRACTION/EXERCISES

Answer 16

mobilizing; causes the body to move
- have CONTRACTION OF THE MUSCLE

Question 17

definition of ISOMETRIC EXERCISES

Answer 17

• stabilizing; causes the body to hold a stable position
• has an INCREASE IN MUSCLE TENSION — has NO SHORTENING OR ACTIVE MOVEMENT OF MUSCLE
• still has ENERGY EXPENDITURE
  
  • ex. having car in neutral

Question 18

what are PATHOLOGICAL INFLUENCES that must be considered during ACTIVITY?

Answer 18

• CONGENITAL DEFECTS (scoliosis, OI - brittle bone disease)
• DISORDERS pertaining to the BONES, JOINTS, or MUSCLES (osteoporosis)
• CNS DAMAGE
• MSK TRAUMA (fractures etc..)
• OBESITY (increased SOB, risk of disorders, low back pain)

Question 19

definition of SPHM

Answer 19

involves the SAFE PATIENT HANDLING & MOBILITY
- where we have TECHNIQUES and improved assessments of equipment and procedures to allow SAFE MOVING, HANDLING, and TRANSFERING OF PATIENTS

Question 20

infants - developmental changes in MSK?

Answer 20

have more of a SPINE THAT IS FLEXED
- continued DEVELOPMENT OF MOVEMENT–just starting to lift their head, sit up, and stand

Question 21

toddlers - MSK developmental changes?

Answer 21

• has more of a SWAYBACK SPINE and PROTRUDING ABDOMEN

Question 22

adolescents - MSK developmental changes

Answer 22

greater amount of ACTIVITY - more sports and more sporadic growth

Question 23

older adults - MSK changes?

Answer 23

• have a GREATER LOSS OF BONE MASS
• slower walk and coordination
• increased risk of falls
• can have underlying conditions or weakness in the muscles
• greater MEDS and POLYPHARMACY

Question 24

how do BEHAVIORAL ASPECTS PLAY A ROLE?

Answer 24

the more SUPPORTIVE EFFORTS ARE AROUND PATIENTS–the more they will incorporate themselves into an exercise program

• allows to hold yourself accountable!

Question 25

what are FACTORS THAT CAN INFLEUNCE ACTIVITY & EXERCISE?

Answer 25

- CULTURAL BACKGROUND - different ENVIRONMENTAL ISSUES/ACCESS TO ACTIVITIES - FAMILY & SOCIAL SUPPORT

Question 26

important questions to ask during nursing assessment?

Answer 26

- any major surgeries? - any medications or symptoms? - how much does the patient exercise each day? - are they bedbound, in need of PT/OT, or necessity of assistive devices? - do they have access to locations to exercise? - how ready are they to develop this lifestyle change?

Question 27

what are the APPRORIATE NANDAS?

Answer 27

Activity intolerance  Risk for injury  Impaired mobility in bed  Impaired mobility  Acute or chronic pain

Question 28

what is our GOAL AND OUTCOME?

Answer 28

want to be able to IMPROVE AND MAINTAIN THE PATIENTS MOTOR FUNCTION AND INDEPENDENCE - taking into account the PRIORITY NEEDS - being able to COLLABORATE WITH OTHERS

Question 29

what are the TYPES OF RANGE OF MOTION EXERCISES?

Answer 29

- ACTIVE, PASSIVE, or ASSISTEd - FAROM; full active range of motion - PAROM; partial active range of motion - PROM; passive ROM

Question 30

what are some things to remember while helping a PATIENT WALK?

Answer 30

- always ASSESS FIRST IF THE PATIENT CAN WALK SAFELT - dangle legs first around 1 - 2 min before starting - use gait belt and extra support

Question 31

what are SOME OF OUR ASSISTIVE DEVICES TO WALK?

Answer 31

- walkers - canes - crutches

Question 32

what can occur with DECREASE OF EXERCISE?

Answer 32

- CAD - HT - COPD -DM

Question 33

definition of MOBILITY

Answer 33

refers to a person's ABILITY to MOVE FREELY

Question 34

definition of IMMOBILITY

Answer 34

refers to the inability to move freely

Question 35

what are SOME EFFECTS OF MUSCULAR DECONDITIONING?

Answer 35

- DISUSE ATROPHY - decreasing of muscle mass/shrinking of the muscle - PHYSIOLOGICAL/PSYCHOLOGICAL EFFECTS - SOCIAL EFFECTS (ex. bed rest- decreased socialization)

Question 36

what are some METABOLIC CHANGES that occur with IMMOBILITY?

Answer 36

- decrease of ENDOCRINE METABOLISM - decreased CALCIUM RESORPTION - decreased GI SYSTEM FUNCTIONS - DECREASED PERISTALSIS

Question 37

what are some RESPIRATORY CHANGES that can occur with IMMOBILITY?

Answer 37

- ATELECTASIS (collasped lung) - HYPOSTATIC PNEUMONIA

Question 38

what are other CHANGES THAT CAN OCCUR?

Answer 38

- cardiovascular; ex. orthostatic hypertension changes in BP and HR - msk changes; ex. increase of blood clots/atrophy - urinary changes; ex. decrease in output = increase in UTI/stasis - integumentary changes; risk of pressure ulcers

Question 39

what can occur during DEVELOPMENTAL CHANGES?

Answer 39

INFANTS: - can have delayed development - want to develop their weight-support skills *tummy time TODDLERS: - have a MORE WIDE STANCE; with their head and trunk more forward - if immobilized; can delay gross motor skills ADOLESCENTS; - growth increases ADULTS: - have more increased risk of immobility OLDER ADULTS - greater risk for falls and bone loss

Question 40

what to observe during NURSING ASSESSMENT?

Answer 40

- can the patient perform ROM? - how does the patient walk? - how much do they exercise? - how do they stand/sit/lay down?

Question 41

what are some aspects of HEALTH PROMOTION FOR IMMOBILITY?

Answer 41

- prevent any work related msk injuries - importance of exercise - patient teaching of proper bone health

Question 42

what are some METABOLIC INTERVENTIONS?

Answer 42

making sure patient has a HIGH PROTEIN HIGH CALORIE DIET with VITAMIN B AND C SUPPLEMENTS

Question 43

what are some RESPIRATORY INTERVENTIONS

Answer 43

allow patient to cough and deep breathe every 1 - 2 hours - use of chest physiotherapy

Question 44

what are OUR POSITIONING TECHNIQUES?

Answer 44

- SUPPORTED FOWLER's POSITION - SUPINE POSITION - PRONE POSITION - SIDE-LYING POSITION - SIMS POSITION

Question 45

definition of INSTRUMENTAL ACTIVITIES OF DAILY LIVING

Answer 45

specific INTENSIVE SPECIALIZED THERAPY such as OT or PT - ex. dressing yourself, grocery shopping etc...