determine appropriate techniques for safe client handling including care of an older adult experiencing impaired mobility
- body mechanics: a term that describes the coordinated efforts of the musculoskeletal and nervous system, knowing how patients initiate movement and understanding your own movements requires a basic understanding of the physics surrounding body mechanics
- body alignment: means that an individual’s center of gravity is stable
- gait: particular manner or style of walking
- Range of motion: hip is ball and socket, knee and ankle is a hinge, foot is gliding and toes are condyloid
assess the client care environment for safety hazards in order to reduce and eliminate risk
-safe environment: includes meeting basic needs, reducing physical hazards and transmissions of pathogens, controlling pollution, parasites is reduced, and sanitation is maintained
identify safety and mobility issues that commonly affect the older adult population
safety issues: motor vehicle accidents, poison, falls, fire, disasters, individual risk factors (lifestyle, impaired mobility, sensory or communication impairment, lack of safety awareness
mobility issues: postural abnormalities, muscle abnormalities, damage to the central nervous system, direct trauma to the musculoskeletal system (atrophy), systemic effects, psychosocial effects
discuss the consequences of impaired skin integrity and identify interventions to prevent complications
- older adults admitted to acute and long term facilities are a vulnerable population
- preventions of
Skin
2 layers consisting of the epidermis (superficial) an dermis (deep)
discuss the consequences of impaired skin integrity and identify interventions to prevent complications
Pressure ulcer : At risk patients
older adults who experienced trauma, spinal cord injuries, sustained a hip fracture, long term homes or community care, individuals with diabetes, patients in critical care settings
Blanching
occurs when the normal red tones of the light skinned patient are absent
nonblanchable
occurs when you apply pressure and doesn’t blanch, deep tissue damage is probable
risk factors of pressure ulcer development
impaired sensory perception, impaired mobility, alteration in LOC, shear force, friction, moisture, nutrition, tissue perfusion, infection, age increase the patient’s risk for pressure ulcer development
Classifications of pressure ulcers
Stage 1: nonblanchable redness, intact skin presents w. nonblanchable redness of localized area, usually over bony prominence
Stage 2:partial thickness- loss of dermis presents shallow, open ulcer with red pink wound bed w/o slough
Stage 3: full thickness skin loss- loss subcutaneous fat may be visible, but bone, tendon, and muscle are NOT exposed
Stage 4: fill thickness tissue loss- loss with exposed bone, tendon or muscle, subcutaneous fat may be visible, but bone, tendon or muscle are NOT exposed
Unstageable: full thickness skin or tissue loss- in which actual depth of an ulcer is completely obscured by slough and/or eschar in the wound bed is unstageable
Slough and eschar
slough- yellow, tan, gray, green, or brown
eschar- tan, brown or black
reduction of physical hazards
- environmental factors such as broken stairs, icy sidewalks, inadequate lighting, throw rugs, decreasing clutter and exposed electrical cords
- older adults who wander have special safety challenges
- decrease hazards in the home is effective
nursing interventions for promoting safety are…
individualized for patient’s developmental stage, lifestyle, and environment
