Activity and Mobility Quiz

Activity and Mobility

• Activity involves bones, joints, ligaments, tendons, muscles, and the nervous system.
• The autonomic nervous system controls involuntary actions like heart rate.
  • The sympathetic nervous system ("fight or flight") increases muscle tension and pupil dilation.
  • The parasympathetic nervous system ("rest and digest") speeds up digestion.
• The somatic nervous system controls voluntary skeletal muscles.

Body Mechanics

• Body mechanics describe how we move using muscles for balance, posture, and alignment during tasks.
• Body alignment (posture): Good posture maintains the spine's natural curves.
• Balance: Proper alignment and a center of gravity close to the base of support (e.g., wider stance increases balance) are crucial.
• Coordination requires an intact nervous system.

Range of Motion (ROM)

• Active range of motion (AROM): Patient moves their body actively.
• Passive range of motion (PROM): Healthcare professional moves the patient's body.

Activity and Exercise

• Baseline activity encompasses daily tasks (ADLs).
• Exercise enhances health beyond baseline activities.
• Exercise Goals: Adults should aim for 150-300 minutes of moderate-intensity exercise weekly (specific amounts vary by age).

Types of Exercise

• Isometric: Muscle contraction without movement.
• Isotonic: Joint movement with muscle contraction.
• Isokinetic: Movement with constant speed and resistance.
• Aerobic: Uses oxygen during rhythmic activity.
• Anaerobic: Requires less oxygen than the body can supply.

Patient Concerns and Assessments

• Patients' physical abilities vary significantly.
• Assess patients for limitations in ROM, pain, and gait abnormalities.

Patient Positioning

• Immobile patients need repositioning every 2 hours to prevent skin breakdown, muscle discomfort, and contractures.
• Adequate assistance is essential to prevent injury for both healthcare workers and patients.
• Positioning devices (e.g., adjustable beds, pillows, side rails, trapeze bars, boots, footboards) maintain alignment, prevent contractures, and enhance comfort.
  • Pillows help maintain position and relieve pressure points.
  • Side rails should be up only when requested by patient/family, unless documented as a restraint
  • Trapeze bars aid patient movement.

Positioning Devices for Specific Concerns

• Foot drop prevention devices include footboards, cradle boots, and foot cradles.
• Hand/wrist splints maintain a neutral position to prevent contractures.
• Trochanter rolls prevent hip external rotation.

Moving Patients in Bed

• Moving up/down in bed: Lock bed, appropriate elevation, friction reducing device (e.g., sheet), patient arm crossing, and head lift if ability.
• Turning in bed: Lock bed, use friction reduction device, align patient limbs and head with torso, rotate using knees/hips, assist the turn.
• Logrolling: Special turn for spine alignment: head/shoulder and knee/hip support, pillow between knees, move in a single smooth motion.

Patient Positions

• Fowler's/High Fowler's: Seated positions with varying degrees of elevation.
• Orthopneic: Sitting upright with arms supported to ease breathing.
• Lateral (side-lying): On the side.
• Prone: On the stomach.
• Sims: Lying on the side with the top knee bent.
• Supine: Lying on the back.
• Trendelenburg: Lying back with feet elevated.
• Reverse Trendelenburg: Lying back with head elevated.

Patient Transfers and Ambulation

• Assistive Devices:
  • Canes: Vary in support (single-ended, multi-pronged) for different needs. Follow proper use guidelines.
  • Crutches: Forearm or axillary, specific height and placement for support, learn proper use for up and down stairs.
  • Walkers: Lightweight frames providing support; with or without a seat for mobility challenges. Follow proper use guidelines.

Lifting and Transferring (Nursing Staff)

• Lifting: Bend knees, not back; engage abdominal muscles when lifting from the floor.
• Pushing/Pulling: Widen base of support, face direction of movement; maintain proper positioning for both lifting, pushing, and pulling.

Compression Stockings and Devices

• Compression stockings: Prevent blood clots and improve venous return. Tight but comfortable.
• Pneumatic compression devices (SCDs): Improve blood flow after surgery or other procedures and prevent thrombosis.

Knowledge Check Answers

• Orthopneic position: Option C (sitting upright with arm support).
• Preventing nursing injuries: Options A, B, D, and E—request assistance, avoid twisting, use smooth movements, and take breaks.