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Care of Immobilized Client

Care of Immobilized Client. Conditions Causing Immobility. Cardiovascular conditions Neurological conditions Musculoskeletal Conditions Respiratory Conditions Other conditions. Risk and Effects of Immobility. Muscle wasting/atrophy/contractures/muscular weakness Clot formation

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Care of Immobilized Client

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  1. Care of Immobilized Client

  2. Conditions Causing Immobility • Cardiovascular conditions • Neurological conditions • Musculoskeletal Conditions • Respiratory Conditions • Other conditions

  3. Risk and Effects of Immobility • Muscle wasting/atrophy/contractures/muscular weakness • Clot formation • Skin Breakdown • Risk of discomfort and complications related to immobility ( constipation, renal calculi, pneumonia) • Reduced respiratory effort/lung capacity • Impaired client’s recovery • Postural hypotension • Disorientation

  4. Nursing Diagnosis of the Immobilized Client Nursing Diagnosis - Analysis of Data Immobility – a state in which the individual experiences a limitation of ability for independent physical movement

  5. Related Factors • Intolerance to activity/decreased strength and endurance • Pain/discomfort • Neuromuscular/musculoskeletal impairment • Depression/severe anxiety • Restrictive therapies/safety precautions ( bedrest, limb immobilization)

  6. Goals for Immobilized Client • Promote optimum function • Prevention of disability and deformities • Increased Mobility • Increased circulation • Increased systemic function

  7. Nursing Interventions for the Immobilized Clients • Asses functional mobility: Assess degree of immobility Note movement when patient is unaware of observation Note emotional/behavioral responses to problems of immobility Note presence of complications related to immobility

  8. Nursing Interventions for the Immobilized Clients 2. Identify causative contributing factors • Determine diagnosis that contributes to immobility • Note situations such as surgery, fractures, amputation, tubings, that restrict movement • Assess degree of pain • Note decrease motor agility related to age

  9. Nursing Interventions for the Immobilized Clients 3. Promote return to optimal level of function and prevent complications • Position patient for optimum comfort • Monitor circulation • Instruct use of side rails,trapeze • Support affected body parts • Provide well balanced diet • Monitor elimination patterns • Active/passive ROM • Provide skin care • Encourage deep breathing exercises

  10. Nursing Interventions for the Immobilized Clients 4. Promote wellness • Encourage involvement of family • Assist patient to learn safety measures • Identify need of adjunctive devices • Consult PT/OT as indicated

  11. Nursing Care for Decubitus Ulcers • Pressure- relieving beds and mattresses • Stages of ulcer development • Body positioning • Universal precautions • Topical medications • Dressings • Special considerations for the elderly

  12. Stages of Pressure Sore

  13. Stage II Partial thickness skin loss involving epidermis, dermis, or both. The ulcer is superficial and presents clinically as an abrasion, blister, or shallow center.

  14. Stage III Full-thickness loss of the skin and necrosis of subcutaneous tissue.

  15. Stage IV Full thickness skin loss with extensive destruction, tissue necrosis, or damage to muscle, bone, or supporting structures (e.g, tendon, joint capsule). Undermining and sinus tracts also may be associated with Stage IV pressure ulcers.

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