Mobility - The ability to move freely, easily, rhythmically and purposefully.
Range of Motion - Range of motion (ROM) exercises are ones in which a nurse or patient move each joint through as full a range as is possible without causing pain.
Exercise - A type of physical activity defined as a planned, structure and repetitive bodily movement done to improve or maintain one or more components of physical fitness
TYPES OF EXERCISE:
ISOTONIC - Dynamic exercise in which the muscle shortens to produce contraction and movement. Example: Running, walking, swimming, cycling
ISOMETRIC - Are those in which there is a change in muscle tension but NO CHANGE in muscle length. Example: Tensing, extending and pressing exercises
ISOKINETIC - Involves muscle contraction or tension against a resistance
Aerobic exercise - activity during which the amount of oxygen taken into the body is greater than that used to perform the activity
Benefits Of Exercise:
- Increases joint flexibility, tone and ROM
- Bone density is maintained
- Increases cardiac output and perfusion
- Prevents pooling of secretions in the lungs
- Improves appetite and facilitate peristalsis
- Elevates the metabolic rate
- Prevents stasis of urine
- Produces a sense of well-being
EFFECTS OF IMMOBILITY
Cardiovascular System
Venous stasis caused by prolonged inactivity that restricts or slows venous circulation. Muscular activity, especially in the legs, helps move blood toward the central circulatory system. Increased cardiac workload due to increased viscosity from dehydration and decreased venous return. The heart works more when the body is resting.
Thrombus and embolus formation caused by slow flowing blood, which may begin clotting within hours, and an increased rate in the coagulation of blood. During periods of immobility, calcium leaves bones and enters the blood, where it has an influence on blood coagulation.
Orthostatic hypotension probably due to a decrease in the neurovascular reflexes, which normally causes vasoconstriction, and to a loss of muscle tone. The result is that blood pools and does not squeeze from veins in the lower part of the body to the central circulatory system. The immobile person is more susceptible to developing orthostatic hypotension. The person tends to feel weak and faint when the condition occurs.
Respiratory System
Hypostatic pneumonia - The depth and rate of respirations and the movement of secretions in the respiratory tract is decreased when a person is immobile. The pooling secretions and congestion predispose to respiratory tract infections. Atelectasis - When areas of lung tissue are not used over a period of time, incomplete expansion or collapse of lung tissue may occur. Impaired coughing - Impairment of coughing mechanism may be due to the patient's position in bed decreasing chest cage expansion.
Musculoskeletal System.
Muscle atrophy - Disuse leads to decreased muscle size, tone, and strength. Contracture - Decreased joint movement leads to permanent shortening of muscle tissue, resistant to stretching. The strong flexor muscles pull tight, causing a contraction of the extremity or a permanent position of flexion. Ankylosis - Consolidation and immobility of a joint in a particular position due to contracture. Osteoporosis - Lack of stress on the bone causes an increase in calcium absorption, weakening the bone.
Nervous System
Altered sensation caused by prolonged pressure and continual stimulation of nerves. Usually pain is felt at first and then sensation is altered, and the patient no longer senses the pain. It also may cause peripheral nerve palsy.
Gastrointestinal System
Altered digestion and utilization of nutrients resulting in constipation. Disturbance in appetite caused by the slowing of gastrointestinal tract, secondary immobility, and decreased activity resulting in anorexia.
Integumentary System.
Risk of skin breakdown, which leads to necrosis and ulceration of tissues, especially on bony areas.
Urinary System
Urinary tract infections caused by urinary stasis that favors the growth of bacteria. Decreased bladder muscle tone resulting in urinary retention. Renal calculi (kidney stones) caused by stagnation of urine in the renal pelvis and the high levels of urinary calcium.
Metabolism
Altered exchange of nutrients and gases. Increased risk of electrolyte imbalance. An absence of weight on the skeleton and immobility causes protein to be broken down faster than it is made, resulting in a negative nitrogen balance. Decreased metabolic rate.
Psychosocial Functioning
Decreased social interaction that may result to poor self-concept and increase in sense of powerlessness due to inability to move purposefully and dependence on someone for assistance with simple self-care activities. Decrease in sensory stimulation due to lack of activity, and altered sleep-wake pattern. Increased risk of depression, which may cause the patient to become apathetic, or the patient may exhibit altered thought processes.
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NURSING INTERVENTIONS for patient with mobility problem
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