Term
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Definition
| Meeting basic needs;coordinated body movement of musculoskeleton and Nervous system |
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Term
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Definition
Reduction in movement in an attempt to decrease painful stimuli
Refusal to participate in rehabilitative activities |
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Term
| Muskuloskeletal Impairment; Trauma |
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Definition
| Fracture or other type of injury |
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Term
| Musculoskeletal impairment; diseases |
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Definition
| Osteomyelitis, Tumors, Osteosporosis, Scoliosis |
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Term
| What is functional Impairment? |
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Definition
| Chronic conditions that limit available supply of oxygen and nutrients to the body resulting in activity intolerance |
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Term
| What are 4 examples of functional impairment? |
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Definition
| COPD, CHF, Diabetes, Obesity |
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Term
| What are signs of Psychological problems; Depression? |
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Definition
| Lethargy, low energy, fatigue |
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Term
| What aresigns of psychological problems; anxiety? |
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Definition
| Stress, Obsessive compulsive disorder, PTSD |
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Term
| What are psychological problems related to fear? |
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Definition
| Agoraphobia, Panic Disorder |
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Term
| What would be two causes of Medically-Induced Immobility? |
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Definition
| Physician ordered bedrest, Immobilization devices |
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Term
| The ______ the extent and the _____ duration of immobility, the more pronounce the _______. |
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Definition
| greater, longer, consequences |
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Term
| What are the 3 Major complications from immobility and the Musculoskeletal system? |
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Definition
| Disuse atrophy, disuse osteoporosis, joint contractures |
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Term
| Disuse Atrophy leads to... |
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Definition
| Loss of muscle tissue, reduced muscle mass, increased fatigue, muscle weakness ALWAYS occurs with prolonged mobility |
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Term
| Disuse Osteoporosis leads to imobility by? |
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Definition
| Without stress of weight bearing activities, bones demineralize due to decreased rate of bone resorption, whuch depletes Ca+, and then bones become spongy,, which gradually deform and fracture easily |
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Term
| What happens with the muscles in joint contractures? |
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Definition
| The muscle fibers are not able to shorten and lengthen, a permanent shortening of the muscle develops limiting joint mobility |
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Term
| What is the most common cause of immobilization or inactivity? |
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Definition
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Term
| Where do joint contractures normally occur? |
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Definition
| Primarily in the skin, underlying tissues, muscle, tendons, and joint areas |
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Term
| How do joint contractures develop? |
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Definition
| When the normally elastic connective tissues are replaced by inelastic fibrous tissue. |
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Term
| What is a classic example of joint contractures? |
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Definition
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Term
| What is the difference in venous vasodialation and stasis in a mobile and immoble person? |
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Definition
| A mobile persons skeletal muscles contract and help the blood get back to the heart, valves in the leg veins prevent backflow and pooling. In an immobile person, skeletal muscles do not contract sufficiently and can no longer assist in pumping, as well as blood pools in the legs and cause greater volume and venous BP. |
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Term
| What happens with Dependent Edema? |
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Definition
| When venous pressure is increased, serous fluid is forced out of the vessel and seeps into the interstitial space surrounding the vessl, which causes edema |
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Term
| what does edema impede on? |
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Definition
| Venous return leading to more pooling, hence more edema. |
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Term
| What is Orthostatic hypotension? |
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Definition
| A decrease of 20+mmHg systolic or 10+ mmHg diastolic when rising from a lying or sitting position. |
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Term
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Definition
| A blood clot that is attached to a vessel wall? |
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Term
| What is the threat of a Thrombus? |
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Definition
| It may occlude vessel lumen. |
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Term
| What are 3 conditions favorable to thrombus formation? |
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Definition
| slow blood flow, injury to vessel wall, change in coagulation |
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Term
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Definition
| A blood clot that has moved from its place of origin causeing obstruction to circulation elsewhere. |
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Term
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Definition
| An embolus entering the pulmonary circulation from the legs may occlude vessels that nourish the lung. |
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Term
| What does decreased respiratory movement do to ventilation? |
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Definition
| It is passively altered by the bed (chest movement curtailed), and abdominal organs push against diaphragm restricting lung movement? |
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Term
| What does decreased respiratory movement do to respirations and O2 sats? |
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Definition
| Overall muscle atrophy affects respiratory by causing shallow respirations , which leads to decrease oxygenation and increase co2 retention by shallow breathing. |
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Term
| What can pooling of respirations secretions lead to? |
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Definition
| Respiratory acidosis, by inadequate oxygenation and retention of CO2. |
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Term
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Definition
| When pooled secretions accumulate in dependent areas of bronchioles and create a blockage of mucous. |
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Term
| What does immobility decrease which causes atelectasis? |
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Definition
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Term
| What does a combination of decreased surfactant and blocked bronchioles result in? |
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Definition
| Collapse of alveoli distal to the mucous blockage. |
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Term
| What causes hypostatic pneumonia? |
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Definition
| Pooled secretions provide excellent medium for bacterial growth. |
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Term
| What is the common cause of death among weakened, immobile persons? |
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Definition
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Term
| What does the infection in Hypostatic Pneumonia do? (physiology) |
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Definition
| Impairs O2-CO2 exchange in alveoli |
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Term
| How does immobility cause a Negative Nitrogen Balance? |
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Definition
| Immobility creates an inbalance between anabolism and catabolism, catabolic processes exceed anabolic processes, catabolized muscle mass releases nitrogen, over time more nitrogen is excreted than ingested. |
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Term
| How does immobility cause Anorexia? |
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Definition
| Loss of appetite because of decreased metabolic rate, reduced calorie intake on response to the decreased energy requirements, if proetin intake id decreased, negative Nitrogen will be exacerbated causing malnutrition. |
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Term
| How does Immobility cause a negative Calcium Balance? |
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Definition
| Greater amounts of calcium is extracted from bone that can be replaced, absence of weight-bearing is a direct cause of calcium loss from bones, and weight bearing MUST be present for calcium to be replaced in bone. |
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Term
| How does immobility cause Urinary Stasis? |
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Definition
| The body is in a horizontal position, which impedes on gravity emptying the kidneys and bladder, which results in incomplete emptying. |
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Term
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Definition
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Term
| How are renal calculis formed? |
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Definition
| By elevated level of calcium in the blood from bone mineralization. |
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Term
| How can immobility cause renal calculi? |
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Definition
| It can lead to a decline in fluid intake which leads to concentrated urine which increases the risk of stone formation. |
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Term
| Elevated levels of Calcium in the urine ________ the pH. |
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Definition
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Term
| What is urinary retention? |
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Definition
| Accumualtion of urine in the bladder. |
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Term
| What can Urinary Retention cause? |
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Definition
| It can cause bladder distention, the detrusor muscle is atrophied which inhibits the bladder to empty completely which can cause a bladder infection. |
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Term
| What does urinary retention cause? |
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Definition
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Term
| What does stagnant urine provide? |
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Definition
| An excellent medium for bacterial growth. (Stagnant urine is from reflux, or the backward flow of urine from bladder distention into the ureters and kidneys.) |
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Term
| How can distention traumatize the bladder? |
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Definition
| By stretching the bladder mucosa causing minute tears. |
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Term
| What does an elevated level of Ca+ support in the urine? |
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Definition
| It increases the alkalinity which supports bacterial growth. |
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Term
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Definition
| Where skin atrophies due to prolonged immobolity. |
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Term
| What can body fluids do to cause Skin Turgors? |
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Definition
| Shifts in body fluids can affect the consistency of the dermis and subcutaneous tissue in the dependent parts of the body (edema), which causes gradual loss of skin elasticity. |
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Term
| What is the major risk for pressure ulcers? |
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Definition
| Skin breakdown, which is caused by direct effect of pressure on the skin due to immobility and is combined with changes in metabolism. |
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Term
| What are the indicators of stage 1 PU? |
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Definition
| an observable pressure related alteration of intact skin when compared to the opposite side of the body. |
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Term
| What are 3 signs of a stage 1 PU? |
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Definition
1. Skin temperature, warmth or coolness
2. Tissue consistency, firm or boggy feel (and/or)
3. Change of sensation, pain itching |
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Term
| What does a Stage 2 PU involve? |
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Definition
| Partial-thickness skin loss involving the epidermis, dermis, or both. Ulcer is superficial and presents clinically as an abrasion, blister, or shallow crater. |
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Term
| What does a stage 3 PU look like? |
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Definition
| Ulcer presents itself as a deep crater with or whithout undermining of adjacent tissue. |
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Term
| With a stage 3 PU, how far down does the ulcer extend to? |
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Definition
| Down to, but not through the underlying fascia. |
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Term
| What type of tissue is completely damaged in a stage 3 PU? |
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Definition
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Term
| What does a stage 4 pressure ulcer damage? |
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Definition
| Skin loss, tissue necrosis, damage to muscle, bone or supporting structure (tendons, joint capsules) |
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Term
| What is the major complication from immobility in the GI system? |
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Definition
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Term
| How does immobility cause constipation? |
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Definition
| By decreasing peristalsis and overall muscle atrophy which hinders the abdominal and perineal muscles used for defacation. |
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Term
| Why do bedpans inder elimination? |
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Definition
| They are unnatural and an uncomfortable position which does not facilitate elimination. |
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Term
| How does immobilization facilitate depression? |
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Definition
| It creates more time to worry about present and future. Also, it exafferates feeling of sadness, worthlessness, helplessness, hopelessness. |
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Term
| What are 5 behavioral changes due to immobility? |
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Definition
1. Hostility
2. Belligerence
3. Fear
4. Anxiety
5. Recognize grieving process |
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Term
| Why does the hospital environment create Sleep-wake alterations? |
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Definition
| Disruptions of normal sleeping patterns, i.e. turning patients every 2 hours, vitals and assessments during the night, and meds administered around the clock |
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Term
| What signs may a patient present when they are exhibiting impaired coping mechanisms? |
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Definition
| Withdrawn, passive, and loss of desire for independence. |
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Term
| Why is it important to assess the patient's strength before attempting to move? |
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Definition
| If assistance is needed, it lowers the risk of muscle strain and injury. |
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Term
| What are the maximum amounts of movement available at a joint in one of 3 planes of the body? |
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Definition
| Sagittal, frontal, transvers |
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Term
| What do you need to obtain to compare and evaluate whether loss in joint mobility has occured? |
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Definition
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Term
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Definition
| The client is able to move all joints through their ROM unassisted. |
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Term
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Definition
| The patient is unable to move independently and the nurse moves each joint through its ROM. |
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Term
| Why is it important to determine activity levels of patients? |
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Definition
| To prevent unnecessary expenditure of energy, such as bathing or walking. |
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Term
| What are the measures for predicting activity tolerance? |
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Definition
-Heart rate, strength, rythm
-Respiratory rate, depth
-Blood pressure |
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Term
| When does the nurse need to assess for activity tolerance? |
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Definition
| Before, during,and 3 minutes after activity to determine if the patient is able to tolerate activity. |
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Term
| When do you need to stop an activity or mobility of a patient? |
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Definition
| When there is any physiological change indicating that the activity is too strenuous. (sudden facial pallor, dizziness, change of level of consciousness, Vitals significantly exceed baseline, dyspnea, chest pain) |
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Term
| When is an activity tolerable considered tolerable to a patient? |
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Definition
| If the heart rate returns to baseline within 5 minutes after the activity ceases, it is considered safe. |
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Term
| What can a tolerable activity serve for the patient? |
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Definition
| A standart for predictiong the client's tolerance to similar activities. |
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Term
| When crutch walking, what does the patient do with the injured extremity? |
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Definition
| Keeps body weight off of it. |
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Term
| When crutch walking, what angle is appropriate for their elbows? |
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Definition
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Term
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Definition
| Move the head from the upright midline position forward, so that the chin rests on the chest, 45 degrees from midline, example; nodding "yes" |
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Term
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Definition
| Move the head from the flexed position to the upright position, 45 degrees from midline, example; nodding "yes" |
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Term
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Definition
| Move the head from the upright position, back far as possible |
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Term
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Definition
| Move the head laterally to the right and left shoulders |
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Term
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Definition
| Turn the face as far as possible from the right to the left. |
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Term
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Definition
| Raise each arm from a position by the side forward and upward to a position beside head, 180 degrees from side, example; reaching to turn on an overhead light |
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Term
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Definition
| Move each arm from a vertical position beside the head forward and down to a resting position at the side of the body. |
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Term
| Hyperextension of the arm: |
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Definition
| Move each arm from a resting postion to behind the body. |
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Term
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Definition
| Move each arm laterally from a resting position at the sides to a side position above the head, palm of hand away from the head. Example: Reaching to a bedside stand as the same side as the arm. |
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Term
| Adduction of the shoulder: |
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Definition
| Move each arm from a position at the sides across the front of the body as far as possible, the elbow may be straight or bent. Example: reaching across the body to get something on the opposite side of the bed |
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Term
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Definition
| Move each arm forward, up, back and down in a full circle. |
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Term
| External Rotationof the shoulder: |
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Definition
| With each arm held out to the side at shoulder level and the elbow bent to a right angle, finders pointing down, move the arm upward so that the fingers point up. |
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Term
| External Rotationof the shoulder: |
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Definition
| With each arm held out to the side at shoulder level and the elbow bent to a right angle, finders pointing down, move the arm upward so that the fingers point up. |
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Term
| External Rotation of the shoulder: |
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Definition
| With each arm held out to the side at shoulder level and the elbow bent to a right angle, finders pointing down, move the arm upward so that the fingers point up. |
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Term
| External Rotation of the shoulder: |
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Definition
| With each arm held out to the side at shoulder level and the elbow bent to a right angle, finders pointing down, move the arm upward so that the fingers point up. |
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Term
| External Rotation of the shoulder: |
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Definition
| With each arm held out to the side at shoulder level and the elbow bent to a right angle, finders pointing down, move the arm upward so that the fingers point up. |
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Term
| External Rotation of the shoulder: |
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Definition
| With each arm held out to the side at shoulder level and the elbow bent to a right angle, finders pointing down, move the arm upward so that the fingers point up. |
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Term
| External Rotation of the shoulder: |
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Definition
| With each arm held out to the side at shoulder level and the elbow bent to a right angle, finders pointing down, move the arm upward so that the fingers point up. |
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Term
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Definition
| With each arm held out to the side at shoulder level and the elbow bent to a right angle, fingers pointing up, bring the arm forward and down so that the fingers point down. |
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Term
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Definition
| Bring each arm forward and upward so that the hand is at the shoulder. Example: eating, shaving, bathing |
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Term
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Definition
| Bring each lower arm forward and downward, straightening the arm |
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Term
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Definition
| Turn each hand and forearm so that the palm is facing upward. |
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Term
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Definition
| Turn each hand and forearm so that the palm is facing downward. |
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Term
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Definition
| Bring the fingers of each hand toward the inner aspect of the forearm. |
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Term
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Definition
| Straighten each hand to the same plane as the arm |
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Term
| Hyperextension of the wrist: |
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Definition
| Bend the fingers of each hand back as far as possible. |
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Term
| Radial flexion (abduction): |
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Definition
| Bend each wrist laterally toward the thumb side with hand supinated. |
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Term
| Ulnar Flexion (adduction): |
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Definition
| Bend each wrist laterally toward the fifth finger with the hand supinated. |
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Term
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Definition
| Straighten. the fingers of each hand |
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Term
| Hand and finger hyperextension: |
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Definition
| Bend the fingers of each hand back as far as possible. |
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Term
| Abduction of the fingers: |
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Definition
| Spread the fingers of each hand apart. |
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Term
| Adduction of the fingers: |
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Definition
| Bring the fingers of each hand together. |
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Term
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Definition
| Move each thumb across the palmar surface of the hand toward the fifth finger. |
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Term
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Definition
| Move each thumb away from the hand. |
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Term
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Definition
| Extend each thumb laterally |
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Term
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Definition
| Move each thumb back to the hand (after abduction). |
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Term
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Definition
| Touch each thumb to the top of each finger of the same hand. The thumb joint movements involved are abduction, rotation, and flexion. |
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Term
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Definition
| Move each leg forward and upward. The knee may be extended or flexed. |
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Term
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Definition
| Move each leg back beside each other (after flexion, or hyperextension). |
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Term
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Definition
| Move each leg back behind the body. |
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Term
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Definition
| Move each leg out to the side. |
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Term
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Definition
| Move each leg back to the other leg and beyond in front of it. |
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Term
| Circumduction of the hip: |
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Definition
| Move each leg backward, up, to the side, and down in a circle. |
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Term
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Definition
| Turn each foot and leg inward so that the toes point as far as possible toward the other leg. |
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Term
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Definition
| Turn each foot and leg outward so that the toes point as far as possible away from the other leg. |
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Term
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Definition
| Bend each leg, bringing the heel toward the back of the thigh. |
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Term
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Definition
| Straighten each leg, returning the foot to its position beside the other foot (after flexion). |
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Term
| Ankle Extension (plantar flexion): |
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Definition
| Point the toes of each foot downward. |
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Term
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Definition
| Point the toes of each foot upward. |
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Term
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Definition
| Turn the sole of each foot laterally. |
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Term
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Definition
| Turn the sole of each foot medially. |
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Term
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Definition
| Curl the toe joints of each foot downward. |
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Term
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Definition
| Straighten the toes of each foot. (After flexion) |
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Term
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Definition
| Bend the trunk toward the toes. |
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Term
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Definition
| Straighten the trunk from a flexed position. |
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Term
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Definition
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Term
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Definition
| Bend the trunk to the right and to the left. |
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Term
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Definition
| Turn the upper part of the body from side to side. |
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