Term
| Gordon's Activity-Exercise Health Pattern |
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Definition
- Patterns of exercise, activity, leisure and recreation
- Affected by musculoskeletal, neurological, cardiovascular, and respiratory status
- Looks at activities of daily living, hobbies
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Term
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Definition
- Is the freedom and independence in purposeful movement
- Refers to adapting to and having self-awareness of the environment
- Depends on the successful interaction between the Musculoskeletal System and the Nervous System
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Term
| Nurse Activities and Mobility |
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Definition
- Promote safety when mobility is impaired
- Encourage increased mobility
- Recognize and treat risk factors associated with immobility
- Promote independence in performing activities of daily living
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Term
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Definition
- Bones
- Cartilage
- Ligaments
- Tendons
- Muscles
- Joints
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Term
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Definition
- 206 bones in the body
- Long, short, flat, and irregularly shaped
- 5 functions:
-Support
-Protection
-Movement
-Mineral Storage and Homeostasis
-Hematopoiesis (blood cell production)
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Term
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Definition
- Span a joint and attach by tendons to two different bones, causing one to move at the joint
- Function
-Motion
-Maintenance of posture
-Heat production
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Term
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Definition
- An articulation or connection between bones
- Classified based on the amount of movement they permit
-Fixed, Slightly Moveable, Freely Moveable (Synovial)
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Term
| Joint Movement - Abduction |
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Definition
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Term
| Joint Movement - Adduction |
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Definition
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Term
| Joint Movement - Circumduction |
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Definition
| moving in a circular fashion - revolving around an axis |
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Term
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Definition
| bending, decreasing joint angle |
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Term
| Joint Movement - Extension |
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Definition
| straightening, increasing joint angle |
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Term
| Joint Movement - Hyperextension |
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Definition
| extreme extension, bending backwards, joint angle more than 180° |
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Term
| Joint Movement -Lateral Flexion |
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Definition
| tilting the neck laterally from midline towards the shoulder |
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Term
| Joint Movement - Rotation |
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Definition
| the process of turning on an axis |
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Term
| Joint Movement - Inversion |
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Definition
| Turning the sole of the foot medially |
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Term
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Definition
| Turning the sole of the foot laterally |
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Term
| Joint Movement - Opposition |
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Definition
| touching the thumb to the top of each finger of the same hand |
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Term
| Joint Movements - Internal Rotation |
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Definition
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Term
| Joint Movements - External Rotation |
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Definition
| turning away from midline |
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Term
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Definition
- Ball and Socket (shoulder, hip)
- Condyloid (wrist)
- Gliding (intervertebral joints)
- Hinge (knee, elbow)
- Pivot (neck)
- Saddle (thumb)
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Term
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Definition
- Body Alignment
- Body Balance
- Coordination
- Joint Mobility
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Term
| Body Mechanics: Body Alignment |
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Definition
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Term
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Definition
- Line of Gravity - An imaginary vertical drawn from the top of the head through the center of gravity
- Center of Gravity - The point around which mass is distributed below
- Base of Support - Holds the body up
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Term
| Body Mechanics: Coordination and Joint Mobility |
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Definition
- Coordination
-Exists between the Nervous and Musculoskeletal systems
-The Cerebellum coordinates movement by controlling posture, movement and a sense of position
- Joint Mobility - Range of Motion
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Term
| American Culture and Immobility |
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Definition
- Growth & Development
- Nutrition
- Lifestyle/Occupation
- External factors
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Term
| Effects of Aging on Mobility |
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Definition
- Lean muscle mass is replaced by fat deposits
- Impaired Balance (wider stance, cognition)
- Altered Calcium Metabolism (fragility of bones, changes in height and posture)
- Degenerative Alterations in Joints (limited range of motion - pain)
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Term
| Diseases Affecting Physical Activity |
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Definition
- Arthritis (osteo & rheumatoid)
- Osteoporosis (more bone breakdown than buildup)
- Disorders of the Central Nervous System (stroke, Parkinson's)
- Impaired Oxygenation
- Psychological
- Trauma
- Illnesses requiring Bedrest
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Term
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Definition
- Atrophy
- Joint Stiffness/Contractures
- Calcium Loss/Renal Calculi/Fracture
- Pooling of Secretions/Infection
- Increase Workload on the Heart/Venous Stasis and Edema
- Risk for Clotting/DVT
- Orthostatic Hypotension
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Term
| Immobility Hazards Continued..... |
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Definition
- Integument (skin breakdown)
- Gastrointestinal (constipation, malnutrition)
- Genitourinary (urinary tract infection)
- Psychological (isolation, dependence, loss of dignity)
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Term
| Activity Exercise & The Nursing Process: Assessment |
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Definition
- History & Physical
- Do a special needs assessment on all patients admitted to the hospital (Braden Scale-risk for skin breakdown, Fall Risk, Risk for thromboembolus-done by physician for blood clotting)
- Do a focused assessment on any patient who has musculoskeletal concerns, is obese, has limited mobility or is confined to bed or home (ask more questions about specific issue)
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Term
| Mobility Assessment: History |
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Definition
- Medical and Surgial History
- History of Falls
- Sensory Impairment
- Pain, Weakness, Numbness, Tremors, Tingling
- Ability to perform activities of daily living
- Exercise status
- Fitness goals
- External Factors (environment, use of assitive devices)
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Term
| Mobility Assessment: Physical |
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Definition
- Use Inspection, Palpation, Percussion, Ausculation
- Activity Tolerance (vital signs before, during, after)
- Neurological Status
- Nutritional Status
- Diagnostics (lab work, MRI, Xray, etc.)
- Joints (ROM for each joint, crepitus)
- Muscle Tone, Strength, Mass
- Deformity, Redness, Warmth, Swelling
- Balance, Coordination
- Body Alignment (standing, sitting, lying)
- Gait (steady or abnormal)
- Use of Assistive Devices (ambulation, transfer, reposition)
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Term
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Definition
- Activity and Exercise Problems
-Imparied Physical Mobility
-Risk for Disuse Syndrome
-Activity Intolerance
- Mobility Problems as Etiology
-Risk for Injury
-Self-Care Deficit
-Risk for Impaired Skin Integrity
-Pain
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Term
| Nursing Diagnoses for Mobility Dysfunction |
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Definition
- Impaired Physical Mobility r/t pain and limited ROM to hip secondary to surgery
- Risk for Disuse Syndrome r/t prolonged bed rest
- Activity Intolerance r/t shortness of breath on exertion
- Risk for Injury r/t unsteady gait
- Self-Care Deficit r/t limited ROM in right (dominant) arm
- Risk for Skin Breakdown r/t inability to reposition self in bed
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Term
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Definition
- Nursing interventions are designed to maintain mobility and prevent or minimize complications of immobility
- The best intervention is prevention!
- Interventions to Promote Mobility/Exercise
- Interventions to Prevent Complications of Immobility
- Interventions to Prevent Injury to Client and Self
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Term
| Interventions to promote mobility |
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Definition
- Assist client with ADL's whenever appropriate and encourage independence when possible
- Encourage and assist with transfer from bed to chair, ambulation
- Healthy diet to build muscle and bone mass or nutritional status
- Assist in developing an exercise regimen
- Set attainable goals to motivate
- Medicate prior to activity as needed
- Collaborate with Physician and PT or OT
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Term
| Interventions to promote safety |
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Definition
- To prevent orthostatic hypotension, have patient dangle at side of bed before rising
- Assist with ambulation (use gait belt, have someone follow, have patient wear skid free socks)
- Teach patient proper use of cane, rolling walker, wheelchair, etc.
- Teach hip precautions after surgery (to prevent hip joint from popping out)
- Support affected side when transferring or ambulating
- If patient starts to fall while ambulating, gently assist in lowering to floor
- Okay to delgate ambulation when cleared by physical therapy
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Term
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Definition
- Decreased risk of cardiovascular disease
- Increased muscle tone and flexibility
- In some cases Resting Energy Expenditure (REE) increases up for to 48 hours after exercise
- Decreased risk of diseases associated with obesity
- Possible decrease in appetite
- Beta-endorphin released for improved mood
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Term
| Exercise Benefits for the Older Adult |
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Definition
- Decreased
-Bone and Muscle Loss
-Functional Decline
-Fall-Related Injuries
-Pressure Ulcers
- Improved
-Bone Strength
-Self-Esteem
-Independence
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Term
| Risk Associated with Exercise |
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Definition
- Cardiac Injury
- Musculoskeletal Injury
- Dehydration
- Hyper/Hypothermia and Heat Exhaustion
- Attention people with eating distorders
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Term
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Definition
- Isotonic (moving joint during muscle contraction-weight training with free weights)
- Isometric (muscle contraction without movement-low risk for injury, can be used when on bedrest)
- Isokinetic (machines that control resistance and move joints through full ROM)
- Aerobic (acquires energy from metabolic pathways that use oxygen-jogging, biking, brisk walking, swimming)
- Anaerobic (when amount of oxygen taken in does not meet the needs required by the body)
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Term
| Encourage, Motivate, Promote Dignity, Facilitate Coping |
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Definition
- Planning should involve the patient
- Goals should be set together
- Offer choices about care
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Term
| Interventions to prevent complications of immobility |
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Definition
- Reposition patient every 2 hours (Log Rolling if necessary)
- Position for optimal lung expansion
- Teach Deep Breathing and Coughing
- Skin Assessment and Care
- Use of pillows, air mattress, trochanter rolls
- Use of pull sheets
- Use of mechanical lifts and transfer boards
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Term
| Range of Motion as Interventions |
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Definition
- Assist or perform ROM to all of client's extremities
- Teach client's family to perform ROM and have them demonstrate skill
- Can be done while performing bed bath or other care
- Perform 2x daily
- Can be delegated
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Term
| Performing Active Assist or Passive Range of Motion |
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Definition
- Support extremity or limb, above and below the joint
- Slow, smooth rhythmic motion
- Move until resistance is felt, NOT pain
- Move each joint through ROM 3-5 times and return to neutral position (in good alignment)
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Term
| Prevent Complications of Bedrest: Proper Alignment: Positioning |
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Definition
- Fowler's (sitting position at different degrees)
- Lateral (lying on side)
- Supine (on back)
- Dorsal Recumbent (on back with knees bent)
- Prone (on belly)
- Sims' (on side with upper leg bent and in front of bottom leg - used for enemas)
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Term
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Definition
- Use a gait belt when ambulating
- Use assistive devices when transferring
- Ask for help from staff
- Refer to physical therapy as ordered
- Know proper body mechanics
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Term
| Principles of Body Mechanics |
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Definition
- Stand with body in alignment and erect posture
- Use wide base of support
- Keep items close to your body
- Avoid bending and twisting
- Use the muscles of your legs as the power for lifting
- Face the direction of movement
- Raise or lower height of bed to maintain good posture
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