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Structures of the musculoskeletal system regulating movement Bones, muscles, joints, joint motion: adduction, abduction, rotation, flexion, extension, supination (up), pronation (down), inversion (towards body), eversion
Normal physiologic function Alignment, posture, Balance and gait, coordinated movement (controlled by cerebellum), body mechanics.
Types of Exercise Aerobic (requires O2), Anaerobic (exchange occurs without O2, Isotonic (muscle contraction with a change in muscle length ex. walking/biking). Isometric (tightening or tensing a muscle with moving muscle length ex. flexing, push, pull)
Benefits of exercise Increase venous return, blood flow, oxygen.
Factors affecting mobility Lifestyle and habits. Intact musculoskeletal system. Nervous control system. Circulation and oxygenation. Pain.
Manifestations of Altered mobility Decreased muscle strength and tone. Lack of coordination. Altered gait. falls. Decreased joint flexibility. Pain on movement.
Impact of Immobility on cardiovascular Increased cardiac workload. Orthostatic hypotension. Thrombus formation and embolism.
Impact of Immobility on Respiratory Decreased lung expansion. Retained secretions. pulmonary embolus.
Impact of Immobility on Musculoskeletal System Muscle atrophy and weakness. Contractures and joint pain. Disuse osteoporosis.
Impact of Immobility on Nutrition and metabolism Decreased metabolic rate and anorexia. Impaired immunity. Pressure ulcers.
Impact of Immobility on elimination Urinary stasis. UTI. Renal calculi (kidney stones). Constipation
Subjective Data Normal pattern identification relating to activity. Risk Identification: pts on bedrest, risk for falls. Dysfunction Identification- activity intolerance
Objective Data Physical assessment, cardiovascular, vital signs including postural BP, edema, presence of thrombus, resp, auscultate lungs, nutrition, elimination, bowel sounds, weight, I
Nursing Diagnosis Impaired physical mobility, ineffective tissue perfusion, ineffective breathing pattern, impaired wheelchair mobility, impaired walking, constipation, risk for injury
Planning Pt's lungs will be clear to auscultation by discharge. Pt will be able to sit in chair for 20 minutes with assist of one within 2 days.
Implementation Health promotion: Physical fitness, exercise programs. Osteoporosis prevention: bone density screenings, calcium and vit D. Injury prevention: Identify falls risk
Cardiopulmonary nursing interventions Cough and deep breath. Incentive spirometer. Increase fluids. Gradually increase activity,
DVT prevention Early ambulation. TEDs and SCDs
Positioning interventions for altered mobility Turning schedules and positioning aids, logrolling, care of pts with hip surgery, change positions gradually.
Joint mobility maintenance General principles of ROM exercises. Automatic ROM equipment. Types of ROM.
Created by: senmark