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Questions and Answers
What is a primary consequence of immobility in the respiratory system?
What is a primary consequence of immobility in the respiratory system?
Which intervention can help reduce the hazards associated with immobility?
Which intervention can help reduce the hazards associated with immobility?
Which condition is characterized by a permanent tightening of muscles and tissues, potentially due to immobility?
Which condition is characterized by a permanent tightening of muscles and tissues, potentially due to immobility?
What is the main risk factor for falls in immobile patients?
What is the main risk factor for falls in immobile patients?
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What is ischemia in the context of skin pressure injuries?
What is ischemia in the context of skin pressure injuries?
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What should a nurse do after feeding a patient to ensure safety?
What should a nurse do after feeding a patient to ensure safety?
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Which of the following is not an intervention for promoting nutrition?
Which of the following is not an intervention for promoting nutrition?
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What type of liquid diet is appropriate for patients who cannot safely swallow thin fluids?
What type of liquid diet is appropriate for patients who cannot safely swallow thin fluids?
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Which of the following foods is included in a puréed diet?
Which of the following foods is included in a puréed diet?
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Which type of diet is appropriate for patients needing a low fiber intake?
Which type of diet is appropriate for patients needing a low fiber intake?
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Which type of pain arises from damage to the nerves or nervous system?
Which type of pain arises from damage to the nerves or nervous system?
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What is a common description of neuropathic pain?
What is a common description of neuropathic pain?
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What distinguishes acute pain from chronic pain?
What distinguishes acute pain from chronic pain?
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What term describes pain that is felt in a different area from where it originated?
What term describes pain that is felt in a different area from where it originated?
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Which symptom is NOT a physiological response to pain?
Which symptom is NOT a physiological response to pain?
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How does nociceptive pain develop?
How does nociceptive pain develop?
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What type of pain might be classified as malignant?
What type of pain might be classified as malignant?
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What characteristic is associated with poorly localized pain?
What characteristic is associated with poorly localized pain?
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What percentage of patients may show risk of malnutrition at admission?
What percentage of patients may show risk of malnutrition at admission?
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Which of the following is NOT a factor affecting nutrition?
Which of the following is NOT a factor affecting nutrition?
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Which clinical observation indicates a risk for aspiration during feeding?
Which clinical observation indicates a risk for aspiration during feeding?
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When assessing for dysphagia, which sign is an indicator of difficulty swallowing?
When assessing for dysphagia, which sign is an indicator of difficulty swallowing?
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Which dietary practice is characterized by the inclusion of fish in the diet but excludes meat?
Which dietary practice is characterized by the inclusion of fish in the diet but excludes meat?
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During feeding, which practice should be avoided to reduce the risk of aspiration?
During feeding, which practice should be avoided to reduce the risk of aspiration?
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What should be the position of a patient to minimize aspiration risk before feeding?
What should be the position of a patient to minimize aspiration risk before feeding?
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Which aspect of nutritional assessment involves examining food practices and allergies?
Which aspect of nutritional assessment involves examining food practices and allergies?
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What is one of the primary reasons for reducing physical activity in patients?
What is one of the primary reasons for reducing physical activity in patients?
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Which of the following is a potential consequence of immobility affecting the musculoskeletal system?
Which of the following is a potential consequence of immobility affecting the musculoskeletal system?
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How does immobility primarily affect metabolic functioning?
How does immobility primarily affect metabolic functioning?
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What cardiovascular issue can result from prolonged immobility?
What cardiovascular issue can result from prolonged immobility?
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Which gastrointestinal issue is commonly associated with immobility?
Which gastrointestinal issue is commonly associated with immobility?
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Which of the following describes a respiratory complication due to immobility?
Which of the following describes a respiratory complication due to immobility?
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What is a common urinary complication caused by immobility?
What is a common urinary complication caused by immobility?
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What is the effect of immobility on muscle and joint function?
What is the effect of immobility on muscle and joint function?
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Study Notes
Consequences of Immobility
- Musculoskeletal: Muscle atrophy, decreased strength and endurance, osteoporosis, joint contractures, foot drop.
- Cardiovascular: Deep vein thrombosis (DVT), orthostatic hypotension, increased cardiac workload.
- Respiratory: Atelectasis (collapsed alveoli), hypostatic pneumonia.
- Gastrointestinal: Decreased peristalsis, constipation, fecal impaction, decreased appetite.
- Urinary: Urinary stasis, increased risk of urinary tract infections.
- Integumentary: Pressure injuries.
- Metabolic: Decreased metabolic rate, calcium loss from bones, fluid and electrolyte imbalances.
- Psychological: Depression, anxiety, social isolation, loss of independence.
Interventions to Reduce Hazards of Immobility
- Passive Range of Motion (ROM) Exercises: Performed by a caregiver to maintain joint mobility and flexibility.
- Active ROM Exercises: Exercises performed by the patient to maintain joint mobility.
- Early Ambulation: Encouraging the patient to walk as soon as possible after surgery or illness.
- Anti-embolism Stockings: Prevent DVT by applying graduated compression to the legs.
- Pneumatic Compression Devices: Inflatable sleeves that promote venous return and reduce the risk of DVT.
- Positioning: Frequent turning to help prevent pressure injuries and atelectasis.
- Adequate Hydration: Ensure adequate fluid intake to prevent dehydration, constipation, and urinary tract infections.
- Nutrition: Provide a balanced diet to meet the patient's nutritional needs and promote healing.
- Skin Care: Regularly inspect the skin for signs of pressure injury development and provide appropriate skin care measures.
Risk Factors for Falls
- Age: Older adults are at increased risk due to changes in balance, gait, and sensory function.
- Medical Conditions: Conditions affecting balance, gait, vision, or cognition, or medications with side effects like dizziness or drowsiness.
- Environmental Factors: Unsafe home environment with obstacles, poor lighting, slippery surfaces, or loose rugs.
- Medications: Drugs that cause drowsiness, dizziness, or hypotension.
- Immobility: Reduced muscle strength and balance increase the risk of falls.
Interventions to Reduce Risk of Falls
- Fall Risk Assessment: Assess the patient's risk of falling using validated tools.
- Environmental Modifications: Remove obstacles, improve lighting, and address safety hazards in the home.
- Medication Review: Ensure appropriate medication use and minimize the risk of drowsiness or falls.
- Assistive Devices: Provide appropriate assistive devices such as canes, walkers, or wheelchairs to aid mobility and reduce fall risk.
- Fall Prevention Education: Educate patients and caregivers about fall prevention strategies.
- Regular Exercise: Promote exercise to improve balance, strength, and coordination.
- Regular Toileting and Hydration: Ensure adequate hydration and access to bathrooms to reduce the need for midnight trips and prevent falls.
- Non-skid Footwear: Ensure patients wear non-skid footwear to reduce the risk of slipping.
Types of Pain
- Acute Pain: Often caused by injury or surgery, lasts less than 3 months, follows a predictable path, and usually dissipates after the injury heals.
- Chronic Pain: Pain lasting beyond the normal time of healing. Can be malignant (cancer-related) or non-malignant (e.g., failed back syndrome, failed surgery).
Nutritional Status
- Factors Affecting Nutrition: Age-related changes in GI function, diseases and medication, poverty, lack of education, lack of transportation, social isolation.
Assessment for Dysphagia
- Signs of Dysphagia: Delayed swallowing, coughing, hoarse voice, abnormal tongue/lip movements, slow speech, leaking saliva or food, pocketing food, regurgitation.
Aspiration Risks
- Aspiration Risks: Dysphagia, decreased level of consciousness, decreased cough and gag reflexes, difficulty managing saliva.
Aspiration and Dysphagia Precautions
- Before Feeding: Assess risk of aspiration, patient should sit upright, head tilted slightly forward, glasses, hearing aids, and dentures should be in place.
- During Feeding: Patient should remain upright, use metal teaspoon, nurse observes swallowing, allow time for chewing, ensure the Adam's apple moves up and down with each swallow.
- After Feeding: Remain upright for 30 minutes, check for food pocketing in the mouth, document food intake, identify if any food was eaten more quickly or with difficulty.
Interventions for Promoting Nutrition
- Eliminate unpleasant odors.
- Oral Hygiene: Brush teeth before meals to promote appetite.
- Meals in a Chair: Encourage patients to eat in a chair rather than bed.
- Family Presence: Encourage family visits to make meals more pleasant and supportive.
Types of Diets
- Clear Liquid: Broth, bouillon, coffee, tea, clear juices, gelatin.
- Thickened Liquid: All liquids must be thickened to prevent aspiration.
- Full Liquid: Smooth dairy products, custards, refined cereals, pureed vegetables and fruits.
- Puréed: Scrambled eggs, pureed meats and vegetables, fruits (ripe bananas, mashed fruit), and potatoes.
- Mechanical Soft: Ground or finely diced meats, flaked fish, cottage cheese, rice, potatoes.
- Soft or Low Residue: Low fiber, easily digested foods.
- High Fiber: Fresh uncooked fruits, steamed vegetables, bran, oatmeal, dried fruits.
- Low Sodium: 4g, 2g, 1g, or 500 mg sodium restriction.
- Low Cholesterol: Restricted diet to manage cholesterol levels.
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Description
Explore the various consequences of immobility on the musculoskeletal, cardiovascular, respiratory, gastrointestinal, urinary, integumentary, metabolic, and psychological systems. Understand the significance of interventions like range of motion exercises and early ambulation to mitigate these effects.
