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Questions and Answers
What is one critical aspect that can be assessed through a patient's gait analysis?
Which of the following is NOT a recommended safety guideline when assessing patient mobility?
What is the recommended frequency for repositioning a patient to prevent complications?
Which consequence can result from worsening movement issues in individuals with IDD?
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Which type of contractures often develop in individuals due to inadequate movement?
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What is a key aspect of activity tolerance in patients?
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What is an effective way to address pressure injuries in patients using wheelchairs?
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What does the Range of Motion (ROM) assessment help to prevent?
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What is a common health risk associated with being underweight?
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Which measurement is often used to assess risk status related to weight?
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What should caregivers of individuals with IDD counsel regarding diet?
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Which of the following is a modifiable risk factor for obesity?
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What type of resources should be referred for patients not meeting diet and activity targets?
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What is the primary physiological change associated with immobility related to muscle?
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Which of the following is NOT a consequence of urinary elimination changes due to immobility?
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What is a critical change in the integumentary system associated with immobility?
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Which factor is essential for assessing a patient's range of motion (ROM) accurately?
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Which guideline is important for ensuring patient safety in those with reduced mobility?
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What are the two main respiratory complications associated with immobility?
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What is the most likely metabolic change resulting from immobility?
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What should be prioritized when assessing a patient's mobility condition?
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Study Notes
Mobility Assessment
- A physical evaluation of a patient's ability to move, including range of motion (ROM) and gait assessment.
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Range of Motion (ROM): Helps determine the degree of joint movement passively or actively.
- Contractures: Limited joint movement can occur due to lack of regular exercise.
- Gait: The way a patient walks provides insights into balance, posture, safety, and their ability to walk without assistance.
- Activity Tolerance: Refers to the capacity of a person to engage in physical activity and exertion.
- Body Alignment: Refers to posture and how the body is positioned, either sitting, standing, or lying down.
- Balance: Achieved when a wide base of support is established, the center of gravity is within the base of support, and a vertical line extends from the center of gravity to the base of support.
Safety Guidelines
- Clear communication is essential when performing any assessments or tasks.
- A thorough review of transfer steps should be conducted mentally before proceeding.
- Mobility and strength of the patient need to be evaluated to determine the assistance needed.
- Equipment requirements should be assessed & prepared.
- Body alignment should be properly evaluated.
- Familiarity with equipment usage is imperative.
- Patient education is paramount in ensuring their understanding and cooperation.
Spasticity in Individuals with Intellectual and Developmental Disabilities (IDD)
- Spasticity, especially in extremities, neck, and torso, is common in individuals with cerebral palsy, brain injuries, and neuromuscular disorders.
- It can hinder mobility, speech, eating, dressing, and hygiene activities.
- Contractures, which are often permanent, can develop with prolonged spasticity, highlighting the importance of addressing this issue.
- Treating the underlying spasticity can reduce pain and help prevent contractures.
Therapeutic Basics for IDD with Abnormal Movement Patterns
- Frequent repositioning: At least every two hours, to alleviate pressure and prevent injury.
- Pressure redistribution: Essential to minimize pressure points from assistive devices like wheelchairs, orthotics, and braces.
- Maintaining body alignment: As much as possible to promote comfortable positioning and optimal function.
- Monitoring for new or worsened movement issues: Medication side effects may be the root cause, requiring further investigation.
Physical Inactivity and Obesity in Individuals with IDD
- Physical inactivity and obesity are significant health concerns among individuals with IDD.
- These factors increase their risk of cardiovascular disease, diabetes, constipation, osteoporosis, premature death, and other health risks.
Mobility and Immobility: Nursing Implications
- Nurses play a critical role in managing and addressing mobility and immobility challenges in patients.
- Understanding the physiological and pathological factors affecting mobility is important.
- The psychosocial impact of immobility on patients must be recognized and addressed.
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Key objectives for nurses include:
- Assessing and interpreting mobility limitations.
- Developing patient-centered care plans to improve mobility.
- Preventing complications related to immobility, like deep vein thrombosis (DVT).
- Evaluating the effectiveness of interventions for improving mobility.
Terminology
- Mobility: The ability to move freely.
- Immobility: The inability to move freely.
- Bed Rest: An intervention that limits patient movement for therapeutic reasons.
Systemic Effects of Immobility
- Immobility significantly impacts many bodily systems, leading to a range of adverse consequences.
- Metabolic: Immobility can influence endocrine function, calcium absorption, and gastrointestinal function, leading to imbalances in fluids, electrolytes, and calcium levels.
- Respiratory: Immobile individuals are at higher risk for pulmonary complications such as atelectasis (collapsed alveoli) and hypostatic pneumonia (inflammation of the lung caused by the accumulation of secretions).
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Cardiovascular:
- Orthostatic Hypotension: A decrease in blood pressure due to a sudden change in body position, such as standing up too quickly.
- Thrombus Formation: Blood clots, primarily in the lower extremities, can form due to immobility, increasing the risk of pulmonary embolism.
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Musculoskeletal Effects:
- Loss of Muscle Mass and Strength: Immobility can lead to muscle atrophy and weakness.
- Decreased Endurance and Stability: Patients experience reduced endurance and balance due to muscle degeneration and atrophy.
- Joint Abnormalities: Joint stiffness, contractures, and other musculoskeletal impairments can occur.
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Urinary Elimination:
- Urinary Stasis: Urine can accumulate in the bladder due to decreased mobility, increasing the risk of urinary tract infections.
- Renal Calculi (Kidney Stones): Increased calcium levels in the blood, coupled with urinary stasis, can lead to kidney stone formation.
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Integumentary:
- Pressure Ulcers: Prolonged pressure on the skin from immobility can lead to tissue breakdown and ulceration.
- Ischemia: Reduced blood flow to affected areas, due to pressure, can result in tissue damage.
Respiratory Changes
- Immobile patients are particularly susceptible to respiratory complications.
- Atelectasis: The collapse of alveoli, the tiny air sacs in the lungs, leading to decreased gas exchange.
- Hypostatic Pneumonia: Inflammation of the lung, caused by pooling of secretions and bacterial growth, due to immobility and poor lung expansion.
Metabolic Changes
- Immobility significantly affects metabolism, causing imbalances.
- Endocrine Metabolism: The metabolic rate decreases, affecting the metabolism of carbohydrates, fats, and proteins. This can lead to imbalances in fluids, electrolytes, and calcium.
- Calcium Resorption: Increased calcium levels in the blood, and if the kidneys cannot handle the excess, hypercalcemia (high blood calcium) can occur.
Physical Inactivity and Obesity in Individuals with IDD
- Physical inactivity and obesity are persistent issues for individuals with IDD.
- Underlying factors: Environmental factors, social influences, and various barriers often contribute to obesity and a lack of physical activity.
- Importance of Health Promotion Programs: Tailored programs that address the unique needs of individuals with IDD can improve attitudes towards physical activity and overall satisfaction with life.
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Strategies to manage weight and physical activity in IDD:
- Regular weight monitoring: Tracking weight trends is essential to identify changes and assess risk factors using Body Mass Index (BMI), waist circumference, or waist-hip ratio.
- Annual counseling: Recommending dietary and physical activity targets aligned with age-specific general population guidelines.
- Addressing Risk Factors: Recognizing modifiable factors, such as certain medications or environmental barriers, to promote healthy lifestyle choices.
- Referral to Interprofessional Resources: Referring to dietitians, support workers, and community programs adapted for individuals with IDD to maximize support and guidance.
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Description
This quiz evaluates key concepts related to mobility assessment, including range of motion, gait analysis, and the importance of body alignment and balance. Additionally, safety guidelines for performing assessments are highlighted, emphasizing the necessity of clear communication. Test your knowledge on how these factors contribute to patient care and mobility.
