BC VNRS B1 - Chapter 47 - Mobility and Immobility

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LICENSED VOCATIONAL NURSING PROGRAM1ST SEMESTER FUNDAMENTALSCLIENTS WITH SPECIAL NEEDSCHAPTER 47 - MOBILITY AND IMMOBILITYINTR7ODUCTIONImmobilization can adversely affect a client’s total well-being, including the physiological, psychosocial and developmental dimensions. Immobilization may result from illness, a therapeutic intervention essential to facilitate wound healing, proper alignment of skeletal trauma, or rest following an illness and it involves many hazards and risks. A nurse must plan appropriate interventions to prevent these hazards or to minimize them when they do occur.OBJECTIVESUpon completion of this unit, the student will be able to:A. Theory1. Define immobility, bed rest, with BRP, decubitus ulcer, pressure sore, ischemia, renal calculus, thrombus, emboli, P.E.2. Discuss benefits and hazards of bed rest.3. Describe alternations in respiratory function associated with immobility.4. Discuss the mechanism of orthostatic hypertension.5. Define the Valsalva maneuver.6. Describe how immobilization increases cardiac workload.7. Describe the mechanism of thrombus formation.8. Identify musculoskeletal changes associated with immobility.9. List the alterations in gastrointestinal functioning associated with immobility.10. List the alterations in genitourinary functioning associated with immobility.11. Describe the psychosocial effects of immobilization and the nursing interventions used to minimize those effects.ASSIGNMENTA. Read Chapter 47- Potter & Perry – Critical Thinking Exercises # 1, 4, and Review Questions B. Study Guide for Chapter 47- Chapter 47Mobility and Immobility- Scientific Knowledge Base:Nature of Movement- Physiology and Regulation of Movements- Skeletal systemo Provides attachments for muscles and ligaments o Provides leverage for movement- Skeletal muscleso Help movement of bones and joints- Nervous systemo Regulates movement and posture- Pathological Influences on Mobility- Mobility and Immobility- Mobilityo The ability to move about freely- Immobilityo Inability to move about freely- Bed resto An intervention that restricts clients for therapeutic reasons- Systemic Effects- Psychosocial Effects- Emotional and behavioral responseso Hostility, giddiness, fear, anxiety- Sensory alterationso Sleep-wake alterations- Changes in copingo Depression, sadness, dejection- Developmental Changes Assessment- Mobilityo ROMo Exercise and activity toleranceo Body alignmento Standingo Sittingo Lyingo Assessment- Immobilityo Metabolico Respiratoryo Cardiovascularo Musculoskeletalo Integumentaryo Eliminationo Psychosocialo Developmental- Nursing Diagnosis and Planning- A nursing diagnosis will be selected from the NANDA-I list after the assessment has been made.- The planning phase will establish client goals and outcomes.- ImplementationAcute Care- Metabolico Provide high-protein, high-caloric diet with vitamin B and C supplements- Respiratoryo Cough and deep breathe every 1 to 2 hourso Chest physiotherapy- Implementation- Cardiovascularo Progress from bed to chair to ambulationo SCDs, TED hose, and leg exercises- Musculoskeletalo Passive ROMo CPMo Active ROM- Implementation- Integumentary systemo Reposition every 1 to 2 hourso Skin care- Elimination systemo Adequate hydrationo Diet rich in fluids, fruits, vegetables, and fiber- Implementation- Positioning techniqueso Fowler’so Supineo Proneo Side lyingo Sims- Transfer - Evaluation- Needed to gauge the effectiveness of specific interventions designed to promote body alignment, improve mobility, and protect the client from hazards of


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BC VNRS B1 - Chapter 47 - Mobility and Immobility

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