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Mobility and Immobility: Impact on Human Health

Understand the importance of mobility for basic needs satisfaction and the hazards of immobility on various body systems. Learn about body mechanics, regulation of movement, and pathological influences, and systemic changes of immobility. Discover how immobility affects respiratory, cardiovascular, musculoskeletal, urinary, and other body systems. Explore nursing interventions to prevent complications associated with immobility.

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Mobility and Immobility: Impact on Human Health

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  1. Basic Human NeedsMobility & the Hazards of Immobility

  2. Mobility serves many purposes • Performance of ADL • Satisfaction of basic needs • Self-defense • Expression of emotion • Recreational activities • Need intact & functioning M/S & nervous system to achieve mobility

  3. Principles of Body Mechanics • Body Mechanics-coordinated efforts of M/S & nervous systems to maintain balance, posture & body alignment during lifting, bending, moving, & performing ADL’s • Proper use of body mechanics reduces risk for injury and ensures safe care

  4. Principles of Body Mechanics • Alignment • Balance • Gravity • Friction

  5. Regulation of Movement • Skeletal system • Skeletal system functions • Characteristics of bone, joints,ligaments, tendons, cartilage • Skeletal muscle • Muscle tone • Nervous system

  6. Pathological Influences of Mobility • Postural Abnormalities • Impaired Muscle Development • Damage to CNS • Direct Trauma to M/S System

  7. Systemic Changes Associated With Immobility • Metabolic changes: • Endocrine metabolism affected • (decrease in BMR) • Disrupts metabolic functioning • Fluid & Lyte Imbalances • Decreased calories & protein • Negative Nitrogen Balance • Calcium Resorption affected • Functioning of GI tract

  8. Respiratory Changes • Lack of exercise & movement put client at risk for: • Atelectasis-Collapse of alveoli leading to partial collapse of lung • Hypostatic Pneumonia- Inflammation of lung tissue from stasis or pooling of secretions • Both decrease oxygenation, prolong recovery, & add to discomfort

  9. Cardiovascular Changes • Orthostatic hypotension • Increased workload of heart due to decrease in venous return to the heart • Risk for thrombus (Virchow’s Triad)

  10. Musculoskeletal Changes • Muscle effects (muscle atrophy) • Skeletal effects- Disuse osteoporosis, contractures and foot drop

  11. Urinary Elimination Changes • Stasis and pooling of urine in renal pelvis leads to increased risk for infection and renal calculi • Risk for dehydration and decreased urine output • UTI’s due to foley catheter

  12. Other Changes • Integumentary changes (Risk assessment tool for skin breakdown, proper skin hygiene) • Psychosocial effects (Depression from immobility) • Developmental Changes

  13. Nursing Process & Immobility • Assessment • Assess immobilized client for hazards of immobility • ROM exercises (P&P pgs. 1435-1439)

  14. Nursing Process: Nursing Diagnosis • You tell me!!!

  15. Implementation • Health Promotion • Acute Care: • Metabolic system • Respiratory system • Cardiovascular system • Musculoskeletal system • Elimination system

  16. Metabolic System • Evaluate muscle atrophy • I&O • Monitor lab data (BUN, albumin, protein, electrolytes) • Assess wound healing • Assess edema • Assess for dehydration (Skin turgor, mucous membranes) • Assess nutritional status (protein and vitamin supplements, enteral feedings, TPN)

  17. Respiratory System • Frequent respiratory assessment • Ascultate lung sounds • Inspect chest wall movement • Promote lung expansion and stasis of pulmonary secrections • Deep breathing and coughing exercises • Incentive spirometer • Chest physiotherapy • Suctioning • Hydration • Positioning every 2 hours

  18. Cardiovascular System • Vital sign monitoring • Assess for orthostatic changes (Baseline BP) • Reduce workload of heart • Peripheral pulse assessment • Assessment of edema (hearts inability to handle increased work load) • Prevent thrombus formation • Assessment of DVT (Calf circumference)

  19. Prevent Thrombus Formation • Anticoagulants (Heparin, Lovenox) • TED Stockings • Calf pumping exercises • Sequential compression stockings

  20. Musculoskeletal System • Assessment of muscle tone, strength, loss of muscle mass, contractures • Assess for risk of disuse osteoporosis • Assessment of ROM • Passive ROM for all immobilized joints • Physical therapy consult • Prevent foot drop and contractures

  21. Elimination System • I&O each shift • Assess for fluid & electrolyte imbalances • Bowel assessment • Adequate hydration • Incontinent considerations • Assess bladder distention

  22. Positioning techniques • Footboard • Trocanter roll • Trapeze bar • Pillows • Splints • Abductor pillow • ROM exercises

  23. Practice Scenario • A 72 year old client is recovering following abdominal surgery for colon cancer. Which hazards of immobility is this client at risk for and why? • How would you as the nurse prevent post-operative complications associated with this client’s condition?

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