Question | Answer |
What are some properties of goals/outcomes? | Should be valued by the client - pick something you can fix (can't fix hopelessness or ineffective coping)
Time frame - short-term goal would be what you could accomplish on your shift |
How does immobility affect the psychosocial aspects of a person? | Sleep-wake disturbances - hospital
Isolation from significant others
Sensory deprivation
Change in body image
Depression and disorientation
Lack of productivity and freedom
Ineffective coping |
How does immobility affect nutritional status? | Decrease in metabolic rate
Anorexia - TPN (total parenteral nutrition)via IV - sometimes necessary
Negative nitrogen balance - elevated BUN
Calcium loss
Need good nutrition to heal |
How does immobility affect the musculoskeletal system? | Disuse osteoporosis
Muscle atrophy
Joint contractures - ligaments/tendons
Decrease endurance
Decreased stability and balance
Altered calcium metabolism |
How does immobility affect the integumentary system? | Decreased circulation and sensation to peripheral areas
Increased tissue pressure
Shearing forces |
How does immobility affect the GI system? | Decreased intestinal motility - slow or hypoactive bowel sounds
Increased constipation and fecal impaction
Gastric stress ulcer - acid build-up occurs |
How does immobility affect the genitourinary system? | Stasis of urine in kidney
Stasis of urine in bladder
Renal calculi formation - calcium clumps together in kidneys
Increased UTI |
How does immobility affect the cardiovascular system? | Status of blood in the legs - blood pools
Increased risk of thrombus formation
Increased cardiac workload - no gravity to help heart work
Orthostatic hypotension - drop in BP through changing positions |
How does immobility affect respiration? | Limited chest expansion (ventilation)
Decreased cough response - secretion build-up, dehydration causes sticky secretions
Stasis of pulmonary secretions - hypostatic pneumonia
Alteration in pulmonary perfusion - less surface area lead to less perfusion |
What types of immobility are there? | Temporary - post-operative
Permanent - skeletal/neurological (stroke)
Acute - injury or accident; pregnancy bed rest
Chronic - skeletal/neurologic deficit - get less and less mobile as other disease processes take hold |