Excerise & Safety Ch. 26, 27
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| Body alignment | Relationship of one body part to another
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| Body balance | Achieved by low center of gravity; enhanced by posture (optimal body position)
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| Friction | Effect of rubbing or resistance when a moving body meets a surface
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| Skeletal system | Bones provide support, protection, movement, mineral storage, blood cell formation
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| Joints | Connection of bones
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| Ligaments | Bind joints and connect bones and cartilage
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| Tendons | Connect muscle to bones
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| Cartilage | Nonvascular, supportive tissue that acts as a shock-absorber pad between articulating bones
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| Neurotransmitters | Chemicals that transfer electric impulses from nerves to the muscles; stimulating muscles
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| Proprioception | The awareness of body position and body parts
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| Balance | Cerebellum coordinates movement; inner ear contains fluid-filled canals which aid in balance
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| Pathological Influences | Congenital defects, Disorders of bones, joints and muscles, CNS damage, Injury or CVA, Damage to component that regulates voluntary movement, Musculoskeletal trauma
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| Standing | Head erect and midline; body symmetrical; spine straight; abdomen tucked; knees straight; hips and ankles flexed; feet flat
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| Sitting | Head erect; neck straight; weight on buttocks and thighs; feet on the floor; forearms supported
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| Recumbent | Lateral position; vertebrae straight without curves
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| Range of motion | Used to determine limitation/injury to a joint
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| Gait | Manner or style of walking including rhythm, cadence, and speed
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| 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
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| Effects of Exercise | Cardiovascular, Respiratory, Metabolic, Musculoskeletal, Activity tolerance, Psychosocial
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| Fowler’s | HOB elevated; support/ align hips & spine
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| Supine | Back lying; support w/ pillows, trochanter rolls, splints; >risk of aspiration; prevent foot drop w/ support
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| Prone | Face down
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| Lateral | Side lying w/ proper spine alignment
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| Sims’ Position | Side-lying with upper knee bent
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| 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
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| 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
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| Transfer Techniques: Immobilized client | Use of proper body mechanics moves clients safely and protects nurse from injury
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| Dependent client | Assists client to regain optimal independence, joint movement, increases strength, promotes circulation, relieves pressure on skin, improves respiratory and urinary function
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| Vulnerable groups | Infants, children, older adults; the ill, mentally & physically disabled, illiterate, and poor often require help to achieve a safe environment.
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| Basic Human Needs at Risk: Oxygen | Risk: Carbon monoxide poisoning
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| Basic Human Needs at Risk: Nutrition | Proper refrigeration, food storage, and food preparation are needed: avoid feed poisoning
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| Basic Human Needs at Risk: Temperature | Comfort: 65° - 75° F. Risks: Hypothermia, hyperthermia, heat exhaustion
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| Basic Human Needs at Risk: Humidity | Comfortable: 60% - 70%. Respiratory clients: helps liquefy secretions & improve breathing
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| Physical Hazards in the home | Inadequate lighting, barrier to walkways, bathroom fixtures, lack of safety devices, stairs
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| House fires | Major causes of death/injury between 11:00 pm and 8:00 am due to smoking and falling asleep
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| Pathogen | Any microorganism capable of producing an illness.
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| Pathogen Transmission | Inadequate hand washing, Insects, rodents, and parasites, Inadequate disposal of human waste, Improper disposal of biohazardous waste
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| Common Safety Hazards by Developmental Levels: Infant, toddler, preschooler | Prone to accidents (many are preventable). Accident prevention requires parent education
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| Common Safety Hazards by Developmental Levels: School-age child | Require education about safe play; should use protective safety equipment for sports
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| Common Safety Hazards by Developmental Levels: Adolescent | Drug abuse, MVA, drowning, alcohol use
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| Common Safety Hazards by Developmental Levels: Adult | Safety issues related to lifestyle habits such as alcohol, drug use, and stress
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| 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)
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| Other Risk Factors | Lifestyle, Impaired mobility, Sensory impairments, Cognitive impairments, Safety awareness
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| Joint Commission: Patient Safety Goals for 2009 | Improve patient identification. Effective communication among caregivers. Reconcile meds cross continuum of care.
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| 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
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| Side rails | Safety. Keep clients from falling out of bed. When raised, keep bed in lowest position
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| Physical restraint | Device client can’t remove. Restrict client’s physical mobility. Can cause serious complications
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| 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.
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| Why use restraints? | Prevent confused/combative client from removing life support equipment. Reduce risk of injury to self or others
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| 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
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| Nursing Process | Assessment. Nursing Dx. Risk for falls. Impaired home maintenance. Disturbed sensory perception. Planning. Implementation. Evaluation
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| 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
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| 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
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| Facility Fires: RACE | R: remove pt. from immediate harm. A: activate the alarm. C: close doors to prevent spread. E: extinguish
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