mobilization

Question 1

physiological effects of mobilization as a therapeutic intervention

Answer 1

it enhances ventilation, circulation (both central and peripheral), increases alertness, and helps with muscle metabolism - it counteracts the deleterious effects of immobility

Question 2

what are you stressing everytime you mobilize a patient?

Answer 2

oxygen delivery, extraction, and reserve

Question 3

how does mobiliation affect the cardiovascular system?

Answer 3

it increases HR and SV, it improves vascular reflexes, it reduces postural hypotension, and results in a decreased risk for DVT

Question 4

how does mobilization affect the nervous system?

Answer 4

it improves balance responses, it improves consciousness and mental function, it reduces anxiety and depression, and it improves sleep patterns

Question 5

how does mobilization affect the GI system?

Answer 5

it improves digestion and reduces constipation

Question 6

how does mobilization affect the respiratory system?

Answer 6

it increased FRC, it increases lung ventilation, it increased lung perfusion, it improves gas exchange (V/Q), and it improves airway clearance

Question 7

how does mobilization affect the MSK system?

Answer 7

it improves skeletal muscle function, it maintains bone density, and it maintains muscle length

Question 8

how does mobilization affect the skin?

Answer 8

it reduces risk of pressure ulcers and increases perfusion

Question 9

what does AUNT stand for?

Answer 9

ambulate unless not tolerated

Question 10

what does medical population refer to?

Answer 10

those admitted for medical management or failure to thrive

Question 11

what to consider during mobilization of the srugical population?

Answer 11

incisions, pain, or medical lines

Question 12

how to manage pain during mobilization as a PT?

Answer 12

coordinate session with analgesia, use TENS, use pillow/baby during mobility and coughing, and promote relaxation

Question 13

considerations of lowering the bed with NG feeding

Answer 13

stop feeding if lower the bed <30 degrees

Question 14

what to consider regarding environment safety during mobilization

Answer 14

bed brakes on, chair locked, clutter removed, and non-slip footwear

Question 15

what to prepare prior to mobilization?

Answer 15

lines to one side, having portable O2 ready is needed, having mobility aid ready, having a chair ready, and having the room or hallway cleared

Question 16

how to perform an in bed assessment?

Answer 16

ROM: shoulder flex/abd, elbow flex/ext, hand open/close, and heel slide; strength: resisted isos of biceps, triceps, handgrip, and glute bridge; then bed mobility: roll and move up/down bed

Question 17

how to perform a sitting assessment?

Answer 17

asses quad strength (first against gravity, then resisted), then dynamic balance

Question 18

how to perform a standing assessment?

Answer 18

weight shifts, marched, then dynamic balance

Question 19

what systems do transfers assess?

Answer 19

MSK, cardiorespiratory, and hemodynamic stability

Question 20

what kind of exercises could you do to support mobilization?

Answer 20

bed mobility exercises, transfer retraining exercises, sitting retraining exercises, and ambulation exercises

Question 21

common side effects of immobilization

Answer 21

inadequate LE strength/ ROM, intolerable dyspnea, and inappropriate cardiorespiratory responses

Question 22

examples of bed mobility exercises

Answer 22

ROM and strength exercises, bridging exercises, side to side bed mobility, and rolling on bed

Question 23

examples of transfer and sitting retraining exercises

Answer 23

lie to sit, sitting retraining, and sit to stand

Question 24

how to focus on sitting retraining exercises?

Answer 24

try to facilitate anterior pelvic tilt and erect spinal curvature

Question 25

what to assess in patients chart before mobilization?

Answer 25

diagnosis, current medical status, comorbidities, medications, recent procedures, and lines/tubes/attachments

Question 26

what to assess regarding the patients cognitive status before mobilization?

Answer 26

not severely agitated, not deeply sedated, and their ability to follow simple commands

Question 27

what to assess regarding the patients cardiovascular stability prior to mobilization?

Answer 27

no active chest pain or unstable angina, no untreated arrhythmia, no decompensated heart failure, and stable BP

Question 28

what to assess regarding the patient's respiratory stability prior to mobilization?

Answer 28

SpO2 in acceptable range, RR within safe range, and O2 delivery is stable

Question 29

what to assess regarding the patient's functional readiness for mobilization?

Answer 29

is their strength sufficient, is their balance assessed, and what is their energy reserve for activity

Question 30

cardiovascular red flags for mobilization

Answer 30

SBP drop >20, severe HTN (>220/110), HR <40 or >130, new or unstable angina, untreated arrhythmia, and decompensated HF

Question 31

respiratory red flags for mobilization

Answer 31

SpO2 <88%, RR <5 or >40, FiO2 >60%, and severe respiratory distress

Question 32

neurological red flags for mobilization

Answer 32

severe agitation, cannot follow commands, ICP >20 mmHg, and unstable or uncleared spinal/head injury

Question 33

other red flags for mobilization

Answer 33

unstable fractures, excessive residual fatigue, active bleeding, and immediately following high-risk procedures

Question 34

symptoms to monitor during mobilization

Answer 34

dizziness, dyspnea, chest symptoms, nausea, and sudden fatigue

Question 35

what objective measures to monitor during mobilization

Answer 35

SpO2, HR, RR, and BP

Question 36

considerations for femoral attatchment

Answer 36

limited hip flexion and sitting may be contraindicated in some settings

Question 37

considerations with an epidural catheter

Answer 37

check LE strength before mobilization

Question 38

with what attachment should ROM exercises be done?

Answer 38

chest tube - encourage shoulder ROM exercises on the affected side