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Immobility

Immobility. Degrees of mobility. Complete immobility e.g. unconscious patient Partial mobility e.g. patient with fracture. Physiological responses of immobility. Musculoskeletal system Cardiovascular system Respiratory system Metabolic and nutrition Urinary system Fecal elimination

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Immobility

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  1. Immobility

  2. Degrees of mobility • Complete immobility e.g. unconscious patient • Partial mobility e.g. patient with fracture

  3. Physiological responses of immobility • Musculoskeletal system • Cardiovascular system • Respiratory system • Metabolic and nutrition • Urinary system • Fecal elimination • Neurosensory system • Integumentry system

  4. Musculoskeletal system • Decrease in muscle strength • Decrease in physical stability • Muscle atrophy • Osteoporosis • Stiff painful joints • Muscle contracture

  5. Interventions • Body repositioning • Weight beering activities • Independence in activities of daily living • Active and passive range of motion

  6. Cardiovascular system • Weakness of cardiovascular system • Postural hypotension • Thromophlebitis e.g, DVT

  7. Interventions • Movement and exercise • Use vertical positions • Encourage normal breathing pattern • Elastic stocking

  8. Respiratory system • Reduced gaseous exchange • Respiratory acidosis • Accumulation of secretion • Atelectasis • Upper respiratory tract infections • Pneumonia

  9. Interventions • Deep breathing and coughing exercise • Diaphragmatic abdominal exercise • Changing position and exercise

  10. Metabolic and nutrition • Decreased basal metabolic rate • Reduced gastrointestinal motility • Imbalance in protein synthesis • Anorexia • Hypoproteinemia • Negative calcium balance

  11. Interventions • High protein, calories and fibre diet • Vitamin and minerals supplements • Weight bearing exercises • Enteral and Parenteral supplements

  12. Urinary system • Urinary stasis • Renal calculi formation • Urinary incontinence • Urinary retention • Urinary tract infection

  13. Interventions • Turning, positioning and exercise • Improving hydration • Perianal hygiene • Position and relaxation of urination

  14. Fecal elimination • Constipation • Fecal impaction

  15. Interventions • Well hydration • Ambulate as much as possible • High fibre diet

  16. Neurosensory system • Decreased motor activity • Hyperactive sympathetic stimulation • Increased heart rate • Restlessness • Drowsiness • Irritability • Confusion • Unrealistic perception

  17. Integumentry system • Loss of skin turger and elasticity • Decubitus ulcer formation

  18. Psychological responses of immobility • Social, emotional and intellectual changes • Self concept changes • Feeling of worthlessness and hopelessness • Impaired decision making and problem solving abilities

  19. Pressure Ulcer • Is impaired in skin integrity resulting from decrease mobility and direct pressure occurring most frequently over bony prominence • It is a wound with a localized area if tissue necrosis • Other names: Docubitus ulcer, bed sores • Pressure is the most prominent cause

  20. Predisposing factors increase the possibility of pressure sores: • Immobility and lack of normal movement • Friction and moisture • Poor personal hygiene • Decrease level of consciousness • Advance Age • Malnutrition • Immunosuppression • Edema

  21. Principles of Pressure Management • Maximize the surface area • Redistribute body weight • Training for pressure relief • Dietary instruction • Instruction for lifting/ transferring • Personal hygiene and skin care

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