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115 Cards in this Set

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Coordinated movement involves integrated functioning of what systems?
-Skeletal system
-skeletal muscle
-nervous system
Postural abnormalities can cause?
-pain
-impair alignment or mobility
Impaired muscle development is caused by?
-injury
-diseases
Name a disorder that causes degeneration of skeletal muscle fibers?
Muscular distrophies
What are the characteristics of muscular dystrophies?
-progressive
-symmetrical weakness
-wasting of skeletal muscles
-increasing disability & deformity
What injury can damage the motor strip in the cerebral cortex?
-trauma from head injury
-CVA(ischemia from a stroke or brain attack)
-bacterial infection (meningitis)
A person with a right-sided cerebral hemorrhage with complete necrosis,what body part will be affected?
-destruction of right motor strip
-left-sided hemiplegia
What results from direct trauma to the musculoskeletal system?
-bruises
-contusions
-sprains
-fractures
Disruption of bone tissue continuity?
Fracture
what can cause fractures?
-direct external trauma
-deformities of the bone
(osteoporosis, pagets disease
What is the treatment for fractures?
-proper alignment
-immobilization
(promotes healing and restores function?
loss of tone and joint stiffness?
muscle atrophy
the inability to move about freely?
immobility
terms frequently used when discussing clients on the mobility immobility continuum are?
-bed rest
-impaired physical mobility
an intervention that restricts clients to bed for therapeutic reasons?
Bed rest
a state in which the individual experiences or is at risk of experiencing limitation of physical movement?
Impaired physical mobility
Name some prescribed restrictions of movement that can alter the level of physical mobility?
-Bed rest
-Physical restriction(cast)
-voluntary restriction
-impairment fo motor or skeletal function
the pathological reduction in normal size of muscle fibers after prolonged inactivity from bed rest, trauma, casting, or local nerve damage?
disuse atrophy
immobility disrupts normal metabolic function, name 3 changes?
-altered endocrine metabolism
-calcium resorption (loss of bones)
-disrupt GI system
What is the function of the endocrine system?
maintains and regulate vital functions
-response to stress and injury
-growth and development
-reproduction
-ionic homeostasis
-energy metabolism
How does the endocrine system maintain homeostasis in the body?
through maintaince of Na,K,water and acid-base balance
How does the endocrine system regulate energy metabolism?
-BMR in increased by thyroid Hormone
-energy made available to cells through GI and Pancreatic Hormones
What results from the disruption of normal metabolic function due to immobility?
-decrease metabolic rate
-alters metabolism of carbs,fats, proteins
-F/E and calcium imbalances
-GI disturbance(low appetite)
If an immobilized client experiencing an infectious process such as fever, or is in the process of wound healing what will happen to his BMR and Why?
-Increases, due to increase in cellular oxygen requirement.
Clients with decrease appetite secondary to immobility have what defiency
-calories
-protein
When more nitrogen is excreted than is ingested in protein the body is said to have?
Negative nitrogen balance
What causes tissue breakdown (catabolism)?
-weight loss
-decreased muscle mass
-weakness
-protein loss
What is a common symptom seen due to impairment of GI function?
constipation
Most common respiratory complication seen in post-operative and immobile clients are?
-Atelectasis(collapse of alveoli)
-hypostatic pneumonia (inflammation of lung from stasis or pooling of secretions)
Immobilization causes what 3 major cardiovascular changes?
-orthostatic hypotension
-increase cardiac workload
-thrombus formation
Name 3 factors that contribute to venous thrombus formation?
-loss of integrity of the vessel wall(injury)
-abnormalities of blood flow
-change in clotting factors
Name an effect of the muscles due to immobilization?
-Protein breakdown
-muscle weakness
What puts a client at risk for falls related to muscle effects?
-loss of endurance
-decreased muscle mass and strenght
-joint instability
Name 2 skeletal effects immobilization cause?
-impaired calcium resorption(bone resorption,
tissue less dense,
atrophied(osteoporosis)
What is the client with disuse osteoporosis at risk for ?
Pathological Fractures
An abnormal and possibly permanent condition characterized by fixation of the joint?
joint contracture
What causes joint contractures?
disuse atrophy
shortening of muscle fibers
Name a common contracture where the foot is permanently fixed in the plantar flexion, ambulation is difficult due to inability to dorsiflex the foot?
Foot Drop
What clients are susceptible to footdrop?
-Hx CVA or brain attacks
-left or right sided hemiplegia
The clients urinary elimination is altered by immobility, when a patient is in a recumbent or flat position, insufficient peristalltic contractions cannot overcome gravity therefor the renal pelvis may fill before urine enters the ureters this condition is known as?
Urinary stasis
Calcium stones that lodge in the renal pelvis and pass through the ureters cause hypercalcemia?
Renal calculi
As immobility continues how is urinary elimination effected?
-fluid intake diminish
-fever,causes dehydration
-high concentration of urine cause calculi formation and infectin
-high risk of e.coli in women
Major risk of the integumentary system seen with immobility?
pressure ulcers
Tissue metabolism depends on the body's receipt of ?
-oxygen,nutrients, blood and elimination of wastes
Common emotional changes seen with immobility
-depression
-behavioral changes
-sleep-wake disturbances
-impaired coping
Prolong immobility can delay gross motor skills, intellectual and musculoskeletal development this is mostly seen in what age group?
infants, toddler preschoolers
Alter growth spurt, decrease independence and increase isolation in what age group?
Adolescent
Immobility affects self-confidence and affects adult role regarding family or social structure?
Adults
Immobility increases physical dependence and accelerate functional losses, cna be gradual or sudden?
Older Adults
Assessment of client mobility focuse on 5 factors?
-ROM
-Gait
-Exercise-
-Activity intolerance
-Body alignment
The maximum amount of movement available at a joint?
ROM
Aline that passes through the body from front to back?
Sagittal plane
(divides the body into left and right side)
Passes through the body from side to side and divides the body in front and back?
Frontal plane
a horizontal line that divides the body into upper and lower portions?
transverse plane
Name the joint movements in the sagittal plane?
-flexion and extension(fingers and elbows)
-dorsiflexion and plantar flexion (feet)
-extension ( hip)
Name the joint movements in the frontal plane?
-abduction and adduction(arms and legs)
-eversion, inversion (feet)
Name the joint movements in the transverse plane?
-pronation and supination (hands)
-internal and external rotation(hips)
When assessing ROM, physical examination consist of ?
-stiffness
-swelling
-pain
-limited/unequal movement
The client is able to move all joints through their ROM unassisted?
Active ROM
The client is unable to move independently and nurse moves each joint through its ROM?
Passive ROM
A particular manner or style of walking?
gait
Assessment of gait allow the nurse to draw conclusions about?
-balance
-posture
-safety
-ability to walk w/o assist
How does the gait cycle begin?
-with the heel strike of one lef and continues to the heel strike of the other leg
Physical activity for conditioning the body, improving healt and maintaining fitness?
exercise
The type and amount of exercise or work that a person is able to perform?
activiy tolerance
Assement for activity tolerance is necessary when planning what kind of activities/
-walking
-ROM exercises
-ADL's
The nurse should monitor pt during activity for what symptoms?
-dyspnea
-fatigue
-chest pain
-change of vital signs
The assessment of body alignment has what objective?
-determines normal physiological changes
-Id deviation in body cause by posture
-Learning for clients to maintain alignment
-id trauma,muscle damage,or nerve dysfuntio
What position do you assess body alignment?
-standin
-sitting
-lying
What mesurement is used when assessing metabolic system?
-Ht, Wt, skinfold thickness
-I & O
-Dehydration,edema
-lab data
-lytes,serim protein(albumin),total protein levels, BUN, wound healing
Metabolic system: Interventions for the immobilized client involves:
-High protein,high-calorie diet
-May require Parenteral or enteral feedings
TPN, a central line or IV site is Known as what type of feeding?
-Parenteral
NGT, GT, jejunostomy tube with high protein feeding is known as what type of feeding?
-Enteral
Respiratory system: Name hazards of immobility?
-Assess full insp and exp cycle.
-chest movement may be aymmetrical
-Assess for crackles or wheezez
Interventions for a immobile pt at risk for respiratory disfunction?
-change position every 2hrs
-deep breath and cough q 2hrs
-min.2000ml of fluid/day
-CPT if needed
-Suction PRN
Cardiovascular system: What are some hazards due to immobility?
-edema, poor wound healing
-DVT, Thrombus....Homan signs
-Embolus
-Recumbant position,increases cardiac workload, increases HR
Cardiovascular system: Name NSG Interventions?
-Prevent orthostatic BP:pedangle
-Increase mobility to decrease cardiac workload
-avoid valsalva maneuvar(encourage pt to breath out while moving or positioning
-Prevent DVT(IPC/SCDs,Meds,TED,ROM)
Name interventions to reduce orthostatic hypotension?
-dangling at bedside(to increase venous return)
Name interventions to reduce cardiac workload?
-avoid valsalva maneuvar
-teach client breathing exercises when moving or repositioning
Define valsalva maneuvar?
-used during straining of defecation or moving up in bed
-decreases venous return,C.O
-when strain is release, increase in BP due to increase in venous return
-produces reflex bradycardia, low BP
Name interventions to prevent thrombus formation?
-leg exercises
-encourage fluids
-position changes
-teaching begins when client becomes immobile
Name NSG intervention to prevent thrombus formation that require a physicians order?
-Meds(heparin,LMWH(lovenox)
-Intermittent pneumatic compression(IPC)
-Sequential compression devices(SCDs)
What is common dosage for heparin therapy?
-5000 units subq 2hrs before surgery
-repeated every 8 to 12 hrs until client is fully mobile or discharged.
Clients on Heparin assess for ?
-bleeding
-increase bruising
-guaiac-positive stools
-bleeding gums
Common dosage or lovenox(lMWH)in the prophylaxics of DVT?
-30 to 40 mg subq 2hrs before surgery
-and continue throughout post-op period
What are SCD/IPCs? What's a typycal cycle?
-sleeves or stockings
-wrap around legs, secure with velcro
-sleeves connected to pump
-inflation 10-15 sec(40mmhg)
-deflation 45-60 sec
What's the purpose of the use of SCDs/IPCs?
-decreases venous stasis
-increases venous return through deep veins of legs
Define TED Hose?
-Thromboembolic device hose
-elastic stockings
Name position techniques to aid in reducing compression of the leg veins?
-prevent pressure on posterior knee and deep veins in lower extremities
-
What do you teach a client regarding position techniques to aid in reducing compression of the leg veins?
-avoid crossing legs
-avoid sitting for prolong period of time
-avoid wearing clothing that constricts the legs and waist
-avoid putting pillows under the knees
-avoid massaging the legs
Name specific exercises that help prevent thrombophlebitis?
--anle pumps(alternate plantar flexion and dorsiflexion)
-foot circles(rotate ankle,make letters with feet every 2hrs)
-knee flexion(extend and flex knee
Name hazards of immobility seen in the musculoskeletal system?
-decrease muscle tone and strength
-loss of muscle mass
-contractures
-muscle atrophy due to lack of weight bearing
-osteoporosis
Whose at greater risk for bone demineralization?
-Clients on prolonged bedrest
-postmenopausal women
-clients taking steroids
-clients with increase serum and urine calcium levels
NSG interventions for the immobilized client to improve musculoskeletal system?
-ROM, during hygiene care
-passive ROM or CPM
-commonly used in POst knee surgery
-may need pt consult
Hazard of immobility in the integumentary system?
-assess skin for pallor or redness
-assess every 2hrs
-assess during hygiene care
hazard or immobility seen in the elimination system?
-dehydration(increases risk for skin breakdown, thrombus formation,respiratory infections, constipation)
-inadequate I&O
NSG interventions for maintaining optimal elimation sytem function?
-hydrate(2000-3000ml fl/day
-prevent urinary stasis
-assess I & O
-assess bowels
Diet adequate to facilitate peristalsis movement?
-veggies -stool softener
-fluids -cathartics
-fruits -enemas
-fiber
Abrupt changes in personality may be due to what physiological causes?
-surgery
-medication reaction
-pulmonary embolus
-acute infection
Primary symptom seen in older adults when experiencing pulmonary emboli or an acute infection?
-confusion
Common reactions to immobilization include?
-boredom
-feelings of isolation
-depression
-anger
Name some possible NSG DX related to psychological assessment?
-social isolation
-disturbed sleep pattern
-ineffective individual coping
What's procedure to transfer from bed to chair?
-Chair is placed next to bed with chair back in the same direction as the head of bed
What's procedure to transfer from bed to strecher?
-place beds side to side
-client fold arms over chest
-three-person carry
-lift sheet or transfer pad
-back board if spinal injury
What does the nurse assess when a client is getting ready to walk?
-activity tolerance
-strength
-coordination
-balance
-orientation
Methods used when assisting a client to ambulate?
-place both hands on waist
-use of a gait belt
Name assistive devices for walking
-walkers
-canes
-crutches
Causes mucle contraction and change in muscle length
isotonic contraction
Walking,swimming,dance aerobics,jogging,bicycling,moving arms and legs with light resistance these exercises are called?
-Isotonic exercises
what are the benefits of doing isotonic exercises?
-increases,
circulation and respiratory function
osteoblastic activity(bone forming cells)
muscle tone, mass and strength
tightening or tensing of muscles without moving body parts
isometric contraction
quadriceps sets and contraction of gluteal muscles, for pts who are unable to tolerate an increase in activity expected during isotonic exercises.
Isometric exercises
What are the benefits of isometric exercises?
-increase muscle mass,tone,strengh
-decreases potential for muscle wasting
-increases circulation to involved body part
-increases osteoblastic activity
Name pathological influences on body mechanics?
-congenital defects
-disorders of bones,joints, muscles
-CNS damage
-musculoskeletal trauma
Congenital defects affect what on the body?
-body alignment
-balance
-appearance