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42 Cards in this Set

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Range of Motion: Critical Criteria
Critical Criteria-ROM
• Supports dependent joints
• Moves body parts smoothly, slowly, and
rhythmically
• Stops at point of pain, resistance, or fatigue
• Identifies and demonstrates exercises
appropriate for specific body joints
– flexion, extension, hyperextension, abduction,
adduction, circumduction, opposition, internal rotation,
external rotation
Define Range of Motion
Complete extent of movement
of which the joint is normally capable
• Active
• Active
– Client performs independently.
– Improves/maintains strength,
cardiovascular, respiratory function
• Active-assisted
• Active-assisted
– Nurse provides minimal assist
•Passive
•Passive
– Nurse moves joint through ROM
Joint Movements
•Flexion
•Flexion
– Decreasing the angle of the joint
Joint Movements
• Extension
• Extension
– Increasing the angle of the joint
Joint Movements
• Hyperextension
• Hyperextension
– Further extension or straightening of a joint
– Not done on the neck for passive ROM
Joint Movements
• Abduction
• Abduction
– Movement of the bone away from the midline
of the body
Joint Movements
• Adduction
• Adduction
– Movement of the bone toward the midline of
the body
Joint movements
• Rotation-Internal & External
• Rotation-Internal & External
– Movement of the bone around its central axis
Joint movements
• Circumduction
• Circumduction
– Movement of the distal part of the bone in a circle
while the proximal end remains fixed
Joint movements
•Eversion
•Eversion
– Turning the sole of the foot outward by moving the
ankle joint
Joint movements
• Inversion
• Inversion
– Turning the sole of the foot inward by moving the
ankle joint
Joint Movement
• Pronation
• Pronation
– Moving the bones of the forearm so that the palm of
the hand faces downward when held in front of the
body
Joint Movement
• Supination
• Supination
– Moving the bones of the forearm so that the palm of
the hand faces downward when held in front of the
body
Joint Movement
• Opposition
• Opposition
– Thumb movement to touch other fingers only
Patient Limitations
Patient Limitations
• Joint mobility
• Swelling, tenderness at joint, redness
• Deformities
• Pain
• Muscle atrophy, contractures
• Asymmetrical movement
Nursing Procedure
Nursing Procedure
• Explain procedure to client. Wash hands
• Raise bed to waist level, lower HOB as
tolerated
• Begin ROM at client head, move down body one
side at a time
• Perform each exercise 2-5 times
• Protect joint
– Use cupped hand to support joint
– Cradle distal portion of extremity
– Support joint by holding distal and proximal areas
next to joint
-Documentation
Goal
Keep patient in best possible physical
state when bed rest is necessary
• Physician Order:
• Physician Order: Physical therapy designs
and implements program
• Document
• Document: What was done, how, when,
patient education, limb(s), exercise,
repetitions, patient response
MOBILITY
GROWTH AND DEVELOPMENT
ADOLSCENTS (12-18yrs.)
ADOLSCENTS (12-18yrs.)
1 Tremendous uneven growth spurts
2 Awkward
3 Uncoordinated
4 Postural problems
MOBILITY
GROWTH AND DEVELOPMENT
ADULT (18yrs. >)
ADOLSCENTS (12-18yrs.)
1 Tremendous uneven growth spurts
2 Awkward
3 Uncoordinated
4 Postural problems
MOBILITY
GROWTH AND DEVELOPMENT
20-40
Midlife 40-65
- Older 65>
20-40 – generally have few physical changes
affecting mobility with the exception of pregnant
women
- Midlife 40-65 – coordination and musculoskeletal
development determined upon lifestyle
- Older 65> -decreased ROM, decreased muscle,
bone mass, and strength, slower gait
( not all elderly )
JOINTS
- Functional unit of the Musculoskeletal System
- Bones connect at joints
- Muscles attach to bones at / near joints
- Muscles are classified according to joint
action ( flexors,extensors )
TYPES OF JOINTS
Synarthrosis
Synarthrosis – immovable
TYPES OF JOINTS
Amphiarthrosis
Amphiarthrosis – slightly movable
TYPES OF JOINTS
Diarthrosis / Synovial
Diarthrosis / Synovial – freely movable
SYNOVIAL JOINTS
SYNOVIAL JOINTS
1) Freely movable
2) Characteristically has a cavity enclosed by a
capsule
3) Lubricated with synovial fluid
4) Primary function:
-Bear weight
-Movement
TYPES OF SYNOVIAL JOINTS (6)
TYPES OF SYNOVIAL JOINTS (6)
1) Ball and Socket
2) Hinge
3) Pivot
4) Condyloid
5) Saddle
6) Gliding
BALL AND SOCKET
BALL AND SOCKET
- Movement
-flexion,
-extension,
-hyperextension
-abduction
-adduction
-circumduction
*Examples – hip, shoulder
HINGE JOINT
HINGE JOINT
- Movement
– flexion
-extension
*Examples – finger, toe,
knee, elbow, ankle
joints
PIVOT JOINT
- Movement – rotation
* Examples – joints
between the proximal
ends of the radius and
ulna. Some joints of
the vertebral column.
CONDYLOID JOINT
CONDYLOID JOINT
-Movement
– flexion
-extension
-abduction
-adduction
* Example – wrist joints
SADDLE JOINT
SADDLE JOINT
- Movement
– flexion
-extension
-abduction
-adduction
* Example – base of the thumb only
GLIDING JOINT
GLIDING JOINT
- Movement – gliding
* Examples – carpal
bones, tarsal bones,
ribs w/ vertebrae, sacrum
and iliac, fibula w/ tibia
BODY MECHANICS
BODY MECHANICS
- The ability to maintain balance, body
alignment, and coordinated body movements
- Correct use of body mechanics is a phase of
illness prevention and health promotion.
- Nurses responsibility is to use ( be an
example) and teach correct body mechanics.
BODY MECHANICS
- Proper
- Proper – safe and effective movement
conservation of muscle energy
increased mobility
BODY MECHANICS
- Improper
- Improper – unsafe movement
increased energy output
strains, falls, decreased mobility
FACTORS THAT INFLUENCE BODY
MECHANICS
- General health status
- Nutrition
- Emotions
- Habits
- Situational factors
- Life style
- Personal values
- Knowledge
- Disease/injury
- Postural abnormalities
THERAPEUTIC BEDREST
- Decreased physical activity
- Decreased pain
- Increased rest
- Bed rest vs. bed rest with bathroom
privileges
(Familiarize yourself with the meaning of bed
rest in each practice setting)