Ch. 35
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| Factors that contribute to immobility | length/severity of illness, presence of pain, cognitive/emotional status (i.e. depression)
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| Respiratory changes due to immobility | decr lung expansion, stasis of secretions, lead to atelectasis (collapse of alveoli), hypostatic pneumonia
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| Metabolic changes b/c of immobility | BMR decr, decr ability to produce insulin or metabolize glucose, negative nitrogen balance (breakdown of protein)
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| Fluid/electrolyte changes | Diuresis(incr. urine excretion), affects CA levels leads to hypercalcemia(release of CA in circulation)
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| Gastro changes | risk for constipation
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| Cardio changes | Orthostatic hypotension, incr workload, need O2, incr resting HR 4-15 bpm, risk for DVT, peripheral edema
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| What is a thrombus? | accumulation of platelets, fibrin, to int. wall of vein/artery
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| What is Virchow's triad | loss of integrity of vessel wall(injury), slow blood flow from bedrest, change in clotting factors
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| Musculoskelatal changes | loss of strength and endurance, decr muscle mass, decr balance/stability, joint contractures(footdrop), disuse osteoporosis(bone reabsorption)
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| Integument Changes | risk for pressure ulcers, ischemia (decr. blood flow)
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| Urinary elimination changes | urinary stasis incr UTI's, renal calculi(CA stones)
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| Psychosocial Changes | depression, sleep wake disturbances, impaired coping
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| Two most common nursing diagnoses related to immobility | impaired physical mobility and risk for disuse syndrome (multisystem complications)
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| Nursing interventions for musculoskeletal immobility | managed excercise progs, ROJM exercises, pedal pulse, walking
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| Respiratory interventions | position changes q2h for lung expansion, fluid intake of 2000mL/day, coughing/deep breaths
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| Metabolic interventions | dietary plan (carbs,proteins, fats),
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| skin interventions | position changes q2h, dry/clean, balance nutrition, pressure relief devices
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| elimination interventions | good hydration, timely toileting, monitor I/O, stool softeners
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| Psychosocial interventions | socialization, keep pxt involved in care, stimuli for orientation
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| cardio interventions | sequential suppresion devices, isometric excercises (tighten, heparin therapy (anticoagulant)
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| What is the Valsalva maneuver? | pxt in defecation, holds breath, strains, incr intrathoracic pressure, decr venous return and CO, lead to death
Pxt must breathe out in moving
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| Goals of restorative and continuing care for immobilized pxts | maximize independence, incr endurance and prevent injury
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| IADL's | instrumental activities of daily living: shopping, preparing meals, banking, taking meds
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Created by:
palmerag
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