Activity and mobility

• What are the effects of exercise on the musculoskeletal system?

  • Increased muscle efficiency (strength) and flexibility
  • Increased coordination
  • Reduced bone loss
  • Prevents contractions
  • helps efficiency of nerve input transmission
• What are the effects of immobility on the musculoskeletal system?

  • Decrease muscle size, tone, and strength
  • Decrease in joint mobility and flexibility
  • Bone demineralization
  • Increased risk for contractions
• What are the effects of exercise on the cardiovascular system?

  • Increased efficiency of the heart
  • Decreased heart rate and blood pressure
  • Increased blood flow to all body parts
  • Improved venous return
• What are the effects of immobility on the cardiovascular system?

  • Increased cardiac workload
  • Increased risk for orthostatic hypotension
  • Increased risk for venous thrombosis, edema DVT, pooling
• What are the effects of exercise on the Respiratory system?

  increased depth, rate, gas exchange at alveolar level

  Carbon dioxide excretion increased.  

  Regular exercise leads to improved alveolar ventilation, 

  decreased work of breathing
• What are the effects of immobility on the respiratory system?

  decreased depth and rate respiration (cells don’t need as much)

  Poor gas exchange may lead to acid-base imbalance

  Pooling of secretions 

  increase risk for respiratory infection 

  Loss of tone of muscles involved w/ respiration
• What are the effects of exercise on the gastrointestinal system?

  • Increase in appetite
  • Increase in intestinal tone 
  • Aides in digestion and elimination
• What are the effects of immobility on the gastrointestinal system?

  • Disturbance in appetite
  • Decrease in peristalsis
  • Increased risk for constipation
• What are the effects of exercise on the urinary system?

  • Increased blood flow to kidneys
  • Aides in fluid and acid-bases balance
  • Increase efficiency in excreting body waste
• What are the effects of immobility on the urinary system?

  • Increase urinary stasis
  • Increase risk for renal calculi
  • Decreased bladder tone
• What are the effects of exercise on the integumentary system

  • Improves circulation
  • Increased tone, color, and turgor
• What are the effects of immobility on the integumentary system?

  • Increased risk for skin breakdown and pressure injuries
• What are the effects of exercise on the psychosocial?

  • Increased energy
  • Improved sleep
  • Positive health behaviors
• What are the effects of immobility on the psychosocial?

  • Altered sleep - wake pattern
  • Increased risk for depression
  • Decrease in social interaction
• What are the physiologic conditions that may result in immobility?

  Which in turn may affect Activities of daily living

  Think of feeding themselves

  Moving & transferring

  Scoliosis, kyphosis

  Osteogenesis (brittle bones)

  Inflammation or arthritis

  Trauma 

  Stroke
• What are other factors that can affect movement?

  COPD – tired, SOB

  Cancers > muscle wasting

  Arthritis > pain 

  life style
• What are the psychosocial conditions that may result in immobility?

  depressed patients may slump & have a flat affect

  not depressed may be more erect & animated facial features
• what are the ways cultural conditions may result in immobility?

  Identifying culturally acceptable physical activities is an important step in planning a program of physical activity.
• What are the environmental conditions that may result in immobility?

  The weather 

  Support from others

  The neighborhood
• What are the interventions for maintaining proper alignment with positioning?

  Q 2 hours – either on own or someone else does

  Watch for reddened areas – do not massage

  Move extremities
• What are the interventions for maintaining proper alignment with ROM exercise?

  Active (does on own) & Passive (do for/to patient)
• What are the interventions for maintaining proper alignment with orthotic device?

  have a patient wear boots to high - tops, trochanter tools,hand splint
• Describe nursing interventions for reducing the risks of injury to hospitalized and/or immobilized clients: bed-level

  Bed level on the lowest positioning to prevent the patient from falling
• Describe nursing interventions for reducing the risks of injury to hospitalized and/or immobilized clients by using the call bell

  call bell within patients' reach, if they need assistance with getting up
• Describe nursing interventions for reducing the risks of injury to hospitalized and/or immobilized clients by using side rails

  used to help patients to get up and reposition themselves
• Describe nursing interventions for reducing the risks of injury to hospitalized and/or immobilized clients by using restraints

  used a last resort
• Describe nursing interventions for reducing the risks of injury to hospitalized and/or immobilized clients by using pneumatic compression devices (SCDs)

  Used to enhance blood flow and venous return BY STIMULATING the normal muscle pumping action in the legs. 

  They prevent pooling of blood and increase venous return.
• Identify self-care and nursing activities to prevent or reduce the effects of immobility

  promote activities of daily living (ADLs) and instrumental activities of daily living (IADLs) or self-care activities, and maintain their quality of life (functional health)