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Excerise & Safety Ch. 26, 27

Body alignment Relationship of one body part to another
Body balance Achieved by low center of gravity; enhanced by posture (optimal body position)
Friction Effect of rubbing or resistance when a moving body meets a surface
Skeletal system Bones provide support, protection, movement, mineral storage, blood cell formation
Joints Connection of bones
Ligaments Bind joints and connect bones and cartilage
Tendons Connect muscle to bones
Cartilage Nonvascular, supportive tissue that acts as a shock-absorber pad between articulating bones
Neurotransmitters Chemicals that transfer electric impulses from nerves to the muscles; stimulating muscles
Proprioception The awareness of body position and body parts
Balance Cerebellum coordinates movement; inner ear contains fluid-filled canals which aid in balance
Pathological Influences Congenital defects, Disorders of bones, joints and muscles, CNS damage, Injury or CVA, Damage to component that regulates voluntary movement, Musculoskeletal trauma
Standing Head erect and midline; body symmetrical; spine straight; abdomen tucked; knees straight; hips and ankles flexed; feet flat
Sitting Head erect; neck straight; weight on buttocks and thighs; feet on the floor; forearms supported
Recumbent Lateral position; vertebrae straight without curves
Range of motion Used to determine limitation/injury to a joint
Gait Manner or style of walking including rhythm, cadence, and speed
Nursing Knowledge to Assist with Mobility Physical sciences, Growth & development, Hazards of immobility, Behavior change, Culture and individual’s history/choices, Assessment skills, Factors of activity tolerance (Box 26-7), Realistic goal setting
Effects of Exercise Cardiovascular, Respiratory, Metabolic, Musculoskeletal, Activity tolerance, Psychosocial
Fowler’s HOB elevated; support/ align hips & spine
Supine Back lying; support w/ pillows, trochanter rolls, splints; >risk of aspiration; prevent foot drop w/ support
Prone Face down
Lateral Side lying w/ proper spine alignment
Sims’ Position Side-lying with upper knee bent
Devices for Proper Positioning Pillows, Foot boots, Trochanter rolls, Sandbags, Hand rolls, Hand-wrist splints, Trapeze bar, Side rails, Bed boards, Wedge pillow, chair ottoman
Lifting Techniques Tighten stomach muscles, tuck pelvis, Bend at the knees, Keep weight lifted close to the body, Maintain trunk erect and knees bent, Avoid twisting, Maintain a low center of gravity
Transfer Techniques: Immobilized client Use of proper body mechanics moves clients safely and protects nurse from injury
Dependent client Assists client to regain optimal independence, joint movement, increases strength, promotes circulation, relieves pressure on skin, improves respiratory and urinary function
Vulnerable groups Infants, children, older adults; the ill, mentally & physically disabled, illiterate, and poor often require help to achieve a safe environment.
Basic Human Needs at Risk: Oxygen Risk: Carbon monoxide poisoning
Basic Human Needs at Risk: Nutrition Proper refrigeration, food storage, and food preparation are needed: avoid feed poisoning
Basic Human Needs at Risk: Temperature Comfort: 65° - 75° F. Risks: Hypothermia, hyperthermia, heat exhaustion
Basic Human Needs at Risk: Humidity Comfortable: 60% - 70%. Respiratory clients: helps liquefy secretions & improve breathing
Physical Hazards in the home Inadequate lighting, barrier to walkways, bathroom fixtures, lack of safety devices, stairs
House fires Major causes of death/injury between 11:00 pm and 8:00 am due to smoking and falling asleep
Pathogen Any microorganism capable of producing an illness.
Pathogen Transmission Inadequate hand washing, Insects, rodents, and parasites, Inadequate disposal of human waste, Improper disposal of biohazardous waste
Common Safety Hazards by Developmental Levels: Infant, toddler, preschooler Prone to accidents (many are preventable). Accident prevention requires parent education
Common Safety Hazards by Developmental Levels: School-age child Require education about safe play; should use protective safety equipment for sports
Common Safety Hazards by Developmental Levels: Adolescent Drug abuse, MVA, drowning, alcohol use
Common Safety Hazards by Developmental Levels: Adult Safety issues related to lifestyle habits such as alcohol, drug use, and stress
Common Safety Hazards by Developmental Levels: Older Adult Age-related physiological changes, effects of medications, psychological factors, illness and accidents (e.g., falls, environmental hazards, burns)
Other Risk Factors Lifestyle, Impaired mobility, Sensory impairments, Cognitive impairments, Safety awareness
Joint Commission: Patient Safety Goals for 2009 Improve patient identification. Effective communication among caregivers. Reconcile meds cross continuum of care.
Joint Commission: Patient Safety Goals for 2009 Encourage active pt. participation in own health care for safety. Reduce falls and pressure ulcers incidence. Recognition and response to change in patient condition
Side rails Safety. Keep clients from falling out of bed. When raised, keep bed in lowest position
Physical restraint Device client can’t remove. Restrict client’s physical mobility. Can cause serious complications
Why use restraints? Reduce risk of client injury from falls. Prevent interruption of therapy. IV infusions/ Endotracheal (ET) tubes. NG tubes for feedings. Foley catheter.
Why use restraints? Prevent confused/combative client from removing life support equipment. Reduce risk of injury to self or others
Restraints Patients have the right to be free from seclusion and from physical and medical restraints except to ensure pt’s safety in an emergency situation
Nursing Process Assessment. Nursing Dx. Risk for falls. Impaired home maintenance. Disturbed sensory perception. Planning. Implementation. Evaluation
Restraints IN LTC Regulated by JCAHO and HCFA. Goal: a restraint-free environment. Option: use AMBULARM. Monitor client for complications and document per facility policy
Fatal Mistakes Not to: Keep the doctor informed. Perform safety checks. Consider SAFETY FIRST. Follow policy and procedure. Follow SOC. Be sure and notify the family. Document routinely
Facility Fires: RACE R: remove pt. from immediate harm. A: activate the alarm. C: close doors to prevent spread. E: extinguish
Created by: maggardba