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Understanding Immobility and Its Effects | Coping Strategies and Prevention Tips

Learn about the terminology of immobility, musculoskeletal, cutaneous, cardiovascular, respiratory, gastrointestinal, urinary, and neural effects, along with tips to prevent complications. Discover how immobility impacts children’s growth and development.

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Understanding Immobility and Its Effects | Coping Strategies and Prevention Tips

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  1. Chapter 25 Immobility and Associated Problems

  2. Immobility: Terminology • Hemiplegia • Paralysis on one side of the body • Paraplegia • Paralysis of the lower body half • Quadriplegia • Paralysis of trunk and all four limbs • Diplegia • Symmetrical paralysis in any area of the body

  3. Musculoskeletal Effects • Inactive muscle • Loss of strength, endurance, and mass • Muscle atrophy • Prolonged bed rest may lead to loss of half of the muscle strength. • Correct positioning • Essential for inactive muscles and joints • Loss of bone mass • Lack of weight-bearing activity and muscle action • Reduces osteoblastic activity • Osteoclastic activity continues.

  4. Musculoskeletal Effects (Cont.) • Tendon and ligaments • Require movement to maintain structure and function • Days of immobility will shorten these connective tissue structures, and density increases. • Results in limited flexibility and range of motion

  5. Contracture of Feet: Patient with Muscular Dystrophy

  6. Cutaneous Effects • Factors that promote skin breakdown • Poor general circulation or anemia • Edema • Inadequate subcutaneous tissue in older adults or disabled persons • Loss of sensation • Mechanical irritation or friction • Excessive moisture from perspiration or urine • Inadequate personal hygiene • Inadequate nutrition or hydration • Trauma to the skin

  7. Cardiovascular Effects • Full immobilization—initially • Blood pools in trunk • Venous return may increase. • Prolonged immobility • Venous return and cardiac output reduced • Orthostatic hypotension—at change of position • Short periods of dizziness • Fainting • Pallor and sweating • Rapid pulse

  8. Cardiovascular Effects (Cont.) • Patient becomes mobile after long bed rest • May take weeks for cardiovascular reflex controls to return to normal • Blood pooling—stasis • Increased capillary pressure and edema • Promotes thrombus formation in veins • Particularly in deep leg veins • Blood clotting in patients with dehydration or cancer • May be encouraged by increased venous pressure or damage to blood vessels

  9. Cardiovascular Effects (Cont.) • Blood pooling—stasis • Thrombi may break away with movement or massage • Pulmonary embolus • Venous stasis, hypercoagulability, and blood vessel damage, increase the chance of deep vein thrombosis.

  10. Respiratory Effects • Decreased metabolism • Respiration slow and shallow • Deep breathing and coughing more difficult • Drugs • Sedatives and analgesics • Depress neuromuscular activity and respiratory control center • Increased secretions in the lungs • Pneumonia • Atelectasis

  11. Gastrointestinal Effects • Decreased dietary intake • Appetite reduced • Negative nitrogen imbalance • Protein deficit • Constipation • Caused by muscle inactivity and body position • Reduced food, fiber, fluid intake • Obesity • When prolonged immobility occurs and caloric intake exceeds energy need

  12. Urinary Effects • Stasis of urine • In kidneys or bladder • Normal drainage by gravity impeded • Infection • Stasis of urine and calculi are predisposing factors. • Renal calculi (stones) • More likely in people with hypercalcemia • Bladder infection • Common if catheters are used • Increase in diuresis, resulting in dehydration • Variety of causes

  13. Neural and Psychological Effects • Neural effects • Continuous pressure on skin and underlying tissue will stimulate mechanoreceptors, pain receptors and others. • Spasms may occur because of nerve damage, and therefore muscle innervation may ensue. • Psychological effects • Effects of pain and lack of control over the environment • May cause depression and health-related problems

  14. Effects of Immobility on Children • Immobilized for extended period of time • Normal growth and development often delayed • Contractures and loss of muscle tone may affect: • Hips • Spine • Hands and feet • Mobility returns. • Catch-up growth possible

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