Chapter 23 Body Mechanics, Positioning, and Moving

1. Chapter 23 Body Mechanics, Positioning, and Moving

2. Introduction to Dangers of Inactivity • Inactivity leads to deterioration of health • Disuse syndrome: signs and symptoms resulting from inactivity in as little as 24 hours

3. Dangers of Inactivity

4. Maintaining Good Posture • Good posture affects a person’s appearance, stamina, and ability to use the musculoskeletal system efficiently • Poor posture often results in muscle spasms

5. Maintaining Good Posture (cont’d)

6. Maintaining Good posture • Posture: is the position of the body, or the way in which it is held. Good posture is important for both clients and midwives to avoid muscle spasm (sudden, forceful, and involuntary muscle contraction). • Standing: To keep good posture in standing: • Keep the feet parallel (10-20 cm wide) • Distribute weight equally on both feet • Bend knees slightly • Hold the chest up & slightly forward • Keep the spin properly aligned • Old the head erect

7. Sitting: • Both feet rest on the floor • Knees are free from the edge of the chair • Lying down: • The same as standing; the person is horizontal

8. Standing Posture

9. Lying-Down Posture • Good lying-down posture • Head, neck centered between shoulders • Shoulders level; arms, hips, knees slightly flexed • Trunk straight; hips level; legs parallel; feet at right angles to legs (Refer to Figure 23-4 in the textbook.)

10. Body Mechanics • Proper body mechanics • Increase muscle effectiveness • Reduce fatigue • Avoids repetitive strain injuries

11. Body mechanics • Nursing guidelines 23-1, p. 497 • Use the longest & strongest muscles of the arm & legs • When lifting a heavy load, center it on the feet • Hold objects close to the body • Bend the knees • Pull, push, or roll objects rather than lifting them • Keep wide base of support

12. Positioning Clients • General principles for positioning • Change the inactive client’s position at least every 2 hours • Enlist the assistance of at least one other caregiver • Remove pillows and positioning devices

13. Positioning Clients (cont’d) • Common positions • Supine position • Foot drop: permanent dysfunctional position caused by shortening of the calf muscles and lengthening of the opposing muscles on the anterior leg

14. Foot Drop

15. Positioning Clients (cont’d) • Common positions (cont’d) • Lateral • Lateral oblique • Prone • Sims’ and Fowler’s

16. Common Positions

17. Positioning Clients (cont’d) • Turning and moving clients • Assistive devices and additional caregivers are needed when turning or moving a client who cannot change from one position to another independently

18. Transferring Clients • Examples of transferring aids • Transfer handle • Transfer belt • Transfer boards • Mechanical lift

19. Nursing Implications • Nursing diagnoses for inactive clients • Impaired physical mobility • Risk for injury • Risk for disuse syndrome • Risk for perioperative-positioning injury • Impaired bed mobility

20. Chapter 24 Therapeutic Exercise

21. Exercise • Beneficial to all age groups • Sedentary lifestyle is a health risk • Individualized • Nurses assess fitness level before initiating exercise program

22. Types of Exercise • Fitness exercise • Develops and maintains cardiorespiratory function, muscular strength, endurance • 2 categories • Isotonic • Isometric

23. Types of Exercise (cont’d) • Isotonic exercise • Involves movement and work • Increases cardiorespiratory function • Aerobic exercise

24. Types of Exercise (cont’d) • Isometric exercise • Stationary exercise, usually against resistance • Increases circulation but does NOT promote cardiorespiratory function • Weight lifting • Body building

25. Types of Exercise (cont’d) • Therapeutic exercise • Activity performed by people with health risks that prevents complications and restores lost function • Isotonic or isometric • Active exercise is performed independently by client after instruction • Passive exercise is performed by client with assistance when client is unable to move body parts

26. Types of Exercise (cont’d) • Range-of-motion exercises • Therapeutic activities to move joints • Performed to assess joint flexibility; maintain joint mobility and flexibility in inactive clients; prevent ankylosis; stretch joints for strenuous activities; and evaluate response to therapeutic exercise program • Performed for care of inactive client

27. Nursing Implications • Nursing diagnoses to be treated with activity or exercise regimen • Impaired physical mobility • Disuse syndrome • Unilateral neglect • Delayed surgical recovery • Activity intolerance