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Aktiviteti dhe Ushtrimet. Objectivat: Krahaso efektet e ushtrimeve dhe imobilitetit ne sistemet e trupit Identifikoni faktoret qe influencojne ne aktivitetet dhe pozicionin e trupit
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Aktiviteti dhe Ushtrimet • Objectivat: • Krahaso efektet e ushtrimeve dhe imobilitetit ne sistemet e trupit • Identifikoni faktoret qe influencojne ne aktivitetet dhe pozicionin e trupit • Vlereso zakonet e ushtrimit os eaktivitet te cilat ndikojne ne problemet potenciale ose te rrezikut te immobilitetit • Zhvillo diagnozen infermierore dhe pritshmerine
Aktivitetet dhe Ushtrimet • Qe te kryejme aktivitetet e nevojshme ditore kerkohet energji dhe aftesi • Ushtrimet- tipi, cilesia, sasia, qe pacienti kryen • Mobility- nje nevoje humane, jetesore per indipendencen dhe e lidhur me shkallen e mireqenies
Aktivitet dhe ushtrimet • Levizshmeria eshte esenciale per te ruajtur funksionin normal te trupit • Humbja e levizshmerise mund te shkaktoje depresion tek te rriturit • Shkalla e stabilitetit veret nga aftesite per te mbajtur peshen trupore brenda qendres se gravitetit
Activity and Exercise • Proper body alignment promotes healthy organ function • Reduces strain on muscles and joints • Posture may reflect state of general health or state of mind • Balance –requires normally functioning nervous system and equilibrium mechanism of inner ear
Activity and Exercise • Movement is controlled by cerebral cortex, cerebellum and basal ganglia –if signals “crossed” movements may not be balanced or coordinated • Types of exercise • Isotonic • Isometric • Isokinetic • Aerobic
Activity and Exercise • Benefits of exercise • Musculoskeletal--strength and tone, increased bone density, joint mobility • Cardiovascular – strengthen heart muscle • Respiratory – improved ventilation, decreased pooling of secretions • GI – increased peristalsis • Metabolic – burn calories, fats, enhance insulin effectiveness
Activity and Exercise • Psychological benefits of exercise – self-image, increased energy, improved sleep patterns, decreased stress • Changes associated with aging – decreased muscle tone and joint mobility, osteoporosis, osteoarthritis
Activity and Exercise • Factors affecting mobility • Physical problems may directly or indirectly affect mobility and activity tolerance • Medically prescribed limitations • Nutritional status • Mental health • Values about exercise • External factors –safety, facilities
Effects of Immobility • Nursing Diagnosis: Disuse Syndrome –the state in which an individual is experiencing or at risk for deterioration of body systems or altered functioning as a result of prescribed or unavoidable musculoskeletal inactiviity • (Carpenito, 2002)
Effects of Immobility • The diagnosis of disuse syndrome includes the presence of some of these related nursing diagnoses – (actual or risk for) • Impaired skin integrity • Activity intolerance • Impaired physical mobility • Constipation
Effects of Immobility • Impaired respiratory function • Infection • Risk for Injury • Disturbed body image • Powerlessness
Effects of Immobility • Musculoskeletal effects • Atrophy • Osteoporosis • Contractures • Joint stiffness
Effects of Immobility • Cardiovascular • Diminished cardiac reserves • Valsalva maneuver • Orthostatic hypotension • Venous stasis and edema • Thrombophlebitis
Effects of Immobility • Respiratory - Decreased ventilatory effort • Pooling of secretions • Atelectasis • Metabolic • Negative nitrogen balance • Anorexia • Loss of calcium
Effects of Immobility • Urinary system • Urinary stasis • Renal calculi • Retention and infection • Gastrointestinal system • constipation
Effects of Immobility • Integumentary system (skin) ---Skin breakdown • Poor skin turgor • Psychological effects • Powerlessness • Loss of self-esteem, body image disturbance • Disturbed sensory perception
Nursing Process • Assessment of activity/exercise patterns • Nursing history-includes ability to perform ADLs, activity tolerance, exercise patterns • When a problem exists, more detailed history of each symptom and effects of immobility
Nursing Process • Physical assessment • Posture • Gait • Joints – ROM • Muscle strength • Activity tolerance – observe effects like VS
Nursing Process • Environmental / individual factors • Equipment • Safety • Medication side effects • Need for pain relief • Amount of assistance required • Patient ability/willingness to cooperate • Lab results (e.g. decreased Hgb and Hct)
Nursing Process • Nursing Diagnosis (as previously noted) • Planning / Goals • Activity orders from physician • Critical pathways • Individualized plan for increasing activity and preventing effects of immobility
Nursing Process • Interventions • Skills learned in nursing lab • Patient teaching • Collaboration with other disciplines • Pre and post-assessment • Psychologic support • Nutrition