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Mobility

Mobility. Let’s Get Going! E. Heim. RANC Objectives. Describe the functions of the musculoskeletal and nervous systems in the regulation of movement. Discuss physiological and pathological influences on body alignment and joint mobility.

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Mobility

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  1. Mobility Let’s Get Going! E. Heim

  2. RANC Objectives • Describe the functions of the musculoskeletal and nervous systems in the regulation of movement. • Discuss physiological and pathological influences on body alignment and joint mobility. • Assess for correct and impaired body alignment and mobility. • Discuss the importance of “no-lift” policies for the client and health care provider. • Describe equipment needed for safe client handling and movement. • Compare and contrast active and passive range-of-motion exercises. • Evaluate the nursing plan for maintaining body alignment and mobility.

  3. Scientific Knowledge Base:Nature of Movement

  4. Physiology and Regulation of Movements • Skeletal system • Provides attachments for muscles and ligaments • Provides leverage for movement • Skeletal muscles • Help movement of bones and joints • Nervous system • Regulates movement and posture

  5. Muscle Contraction • Mobility requires an interaction of the musculoskeletal & nervous systems • Bones, muscles, & nerves must be healthy • Nerve pathways and spinal nerves must be intact to transmit impulses to the muscle • Chemical reactions occur • Acetylcholine • Electrolytes • Calcium • Sodium • Potassium • http://faculty.etsu.edu/forsman/Histologyofmuscleforweb.htm

  6. Types of Muscle Contractions • Isotonic • Building bulk or “tone” • Shortening of muscle but no  flexion • Isometric • Building strength • Length remains same but force is 

  7. Pathological Influences on Mobility

  8. Mobility and Immobility • Mobility • The ability to move about freely • Immobility • Inability to move about freely • Bed rest • An intervention that restricts clients for therapeutic reasons •  pain •  oxygen demand of body • Allows rest periods

  9. Systemic Effects

  10. Psychosocial Effects • Emotional and behavioral responses • Hostility, giddiness, fear, anxiety • Sensory alterations • Sleep-wake alterations • Changes in coping • Depression, sadness, dejection

  11. Developmental Changes

  12. Assessment • Mobility • ROM • Gait • Exercise & Activity Tolerance • Body alignment • Standing • Sitting • Lying http://moveintohealth.com/learn_about_restore

  13. Assessment • Immobility • Metabolic • Respiratory • Cardiovascular • Musculoskeletal • Integumentary • Elimination • Psychosocial • Developmental

  14. Nursing Diagnosis & Planning • Select the applicable NANDA nursing diagnosis: • Impaired physical mobility • Risk for disuse syndrome • Risk for injury • Impaired skin integrity • Social isolation …etc. • The planning phase will establish client goals and outcomes: • Realistic, time-framed, and measurable See the NCPlan on pp1242-1243

  15. ImplementationAcute Care • Metabolic • Provide high-protein, high-caloric diet with vitamin B and C supplements • Respiratory • Cough & deep breathe every 1 to 2 hours (q1-2h) • Chest physiotherapy (CPT) • Incentive spirometer (IS) • Cardiovascular • Progress from bed to chair to ambulation • SCDs, TED hose, and leg exercises

  16. Implementation • Musculoskeletal • Passive ROM • Con’t passive motion (CPM) equipment • Active ROM • Integumentary system • Reposition every 1 to 2 hours • Skin care • Elimination system • Adequate hydration • Diet rich in fluids, fruits, vegetables, and fiber http://www.coastalortho.com/articles/acl.htm

  17. Implementation • Positioning techniques • Fowler’s • Supine • Prone • Side lying • Sims • Transfer

  18. Evaluation • Gauges the effectiveness of specific interventions designed to promote body alignment, improve mobility, and protect the client from hazards of immobility

  19. THE END • Moving on….! http://www.wheelessonline.com/ortho/trauma_fractures_index

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