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Basic Human Needs Mobility & the Hazards of Immobility

Basic Human Needs Mobility & the Hazards of Immobility. 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. Principles of Body Mechanics.

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Basic Human Needs Mobility & the Hazards of Immobility

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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 VTE/DVT (Calf circumference)

  19. Prevent Thrombus Formation • Anticoagulants (Lovenox, Heparin) • 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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