Nursing Care of Immobility Patients

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Questions and Answers

Which of the following correctly defines immobility?

  • Restricting movement of a body part or the entire body. (correct)
  • The ability to move freely and easily.
  • The condition where the body remains in constant movement.
  • A state of increased physical activity.

What is a potential benefit of bed rest for patients?

  • Increased risk of pressure ulcers.
  • Development of cardiovascular complications.
  • Decreased metabolism.
  • Facilitation of recovery from certain medical conditions. (correct)

Which body system is least likely to be affected by immobility?

  • Musculoskeletal system.
  • Cognitive system. (correct)
  • Urinary system.
  • Cardiovascular system.

What change occurs in metabolic rate due to immobility?

<p>Decrease in metabolic rate. (B)</p> Signup and view all the answers

Which factor is NOT a contributor to pressure ulcers in immobilized patients?

<p>Adequate nutrition and hydration. (B)</p> Signup and view all the answers

Which of the following consequences can result from immobility?

<p>Decrease in pulmonary function. (B)</p> Signup and view all the answers

What is a common nursing intervention for patients experiencing immobility?

<p>Promoting frequent repositioning. (B)</p> Signup and view all the answers

Which psychological effect is most likely associated with immobility?

<p>Feelings of isolation and depression. (B)</p> Signup and view all the answers

What is a key characteristic of immobility?

<p>Unavoidable restriction of movement (A)</p> Signup and view all the answers

Which factor does NOT affect body alignment and mobility?

<p>Personality traits (D)</p> Signup and view all the answers

What is a therapeutic reason for client immobility?

<p>Following injury to a limb (D)</p> Signup and view all the answers

Which of the following describes a client who is completely immobile?

<p>An unconscious patient (A)</p> Signup and view all the answers

What is one purpose of movement?

<p>Expressing emotions nonverbally (B)</p> Signup and view all the answers

Which level of immobility describes a person who requires help to move?

<p>Needs assistance or help (B)</p> Signup and view all the answers

Which scenario illustrates voluntary immobility?

<p>Individual choosing to limit activity due to health reasons (A)</p> Signup and view all the answers

What is a potential consequence of prolonged immobilization?

<p>Development of physical disabilities (A)</p> Signup and view all the answers

What is a significant cardiovascular effect of prolonged immobility?

<p>Thrombus formation (D)</p> Signup and view all the answers

What causes orthostatic hypotension in immobilized patients?

<p>Loss of general muscle tone (C)</p> Signup and view all the answers

How much harder does the heart work when a person is in a recumbent position compared to a sitting position?

<p>30% harder (A)</p> Signup and view all the answers

What effect does decreased cardiovascular function have on blood perfusion?

<p>Decreased blood perfusion (D)</p> Signup and view all the answers

What is a consequence of venous blood pooling in the lower parts of the body for immobilized clients?

<p>Increased dependent edema (D)</p> Signup and view all the answers

What physiological change occurs in the blood due to increased viscosity?

<p>Increased clotting predisposition (D)</p> Signup and view all the answers

Which factor contributed to the increased work load on the heart during immobility?

<p>Increased stroke volume (A)</p> Signup and view all the answers

What condition can arise due to decreased efficiency of the orthostatic neurovascular reflexes?

<p>Orthostatic hypotension (C)</p> Signup and view all the answers

What is a consequence of decreased respiratory movement during immobility?

<p>Pooling of respiratory secretions (D)</p> Signup and view all the answers

What increases due to prolonged immobility affecting the cardiovascular system?

<p>Vascular resistance (B)</p> Signup and view all the answers

What effect does immobility have on the respiratory system's oxygen and carbon dioxide levels?

<p>Oxygen-carbon dioxide imbalance (C)</p> Signup and view all the answers

Which factor contributes to decreased lung expansion in immobile individuals?

<p>Counter resistance of bed or chair (A)</p> Signup and view all the answers

How does decreased muscular power affect respiratory function in immobile individuals?

<p>It leads to poor coordination of respiratory muscles (B)</p> Signup and view all the answers

What is a common risk associated with prolonged immobility in terms of respiratory health?

<p>Development of pneumonia (A)</p> Signup and view all the answers

Which condition is NOT directly related to the effects of immobility on the respiratory system?

<p>Increased secretion production (C)</p> Signup and view all the answers

Which muscle is primarily affected by poor coordination due to immobility?

<p>Diaphragm (B)</p> Signup and view all the answers

What is a primary consequence of depressed respiratory movement?

<p>Stasis of bronchial secretions (B)</p> Signup and view all the answers

Which of the following is a potential result of infection in the breathing passages?

<p>Narrowing of the bronchi and bronchioles (D)</p> Signup and view all the answers

What leads to hypostatic pneumonia?

<p>Infection resulting from stasis of secretions (A)</p> Signup and view all the answers

How does immobility affect the gastrointestinal system?

<p>Suppresses the defecation reflex (C)</p> Signup and view all the answers

What effect do secretions have on the growth of microorganisms?

<p>They provide a good media for microorganisms (C)</p> Signup and view all the answers

What is one of the nervous manifestations associated with impaired respiratory function?

<p>Impaired memory (C)</p> Signup and view all the answers

What role do abdominal and diaphragm muscles play in the gastrointestinal system?

<p>They aid in the expulsion of fecal material. (C)</p> Signup and view all the answers

What condition may result from an obstruction of the airway?

<p>Atelectasis (B)</p> Signup and view all the answers

What is the primary consequence of sustained pressure due to immobility on the integumentary system?

<p>Tissue hypoxia and necrosis (D)</p> Signup and view all the answers

What is the initial sign of pressure ulcers caused by immobility?

<p>Reddish areas on the skin (D)</p> Signup and view all the answers

Which psychosocial effect is commonly associated with immobility?

<p>Feelings of dependency (B)</p> Signup and view all the answers

Which neurological effect is a result of immobility?

<p>Decreased self-esteem (C)</p> Signup and view all the answers

Which of the following conditions results from immobility affecting muscle and joint function?

<p>Atrophy (C)</p> Signup and view all the answers

Which of the following may a patient experience due to immobility?

<p>Anxiety due to reduced control (C)</p> Signup and view all the answers

How does immobility typically affect a person's mental state?

<p>Exaggerated emotional responses (A)</p> Signup and view all the answers

What physiological change occurs as a result of immobility impacting muscle activity?

<p>Decreased blood circulation (B)</p> Signup and view all the answers

Flashcards

Mobility

The ability to move freely and independently, involving the coordinated function of the nervous, muscular, and skeletal systems.

Immobility

The state of being unable to move freely or independently. Can be partial or complete.

Why Movement Matters

The purpose of movement is essential for overall health and well-being. It encompasses physiological, psychological, and developmental aspects.

What Impacts Mobility?

Factors like age, body weight, muscle strength, and neurological conditions can influence how well someone moves.

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Causes of Immobility

Immobility can be caused by injuries, illnesses, surgeries, neurological disorders, and many other factors.

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Levels of Immobility

The extent of immobility can vary, ranging from limited movement to total bed rest.

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Benefits of Bed Rest

Benefits of bed rest include reducing physical activity, promoting healing, and preventing further injury.

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Conditions Requiring Bed Rest

Conditions requiring bed rest can involve injuries, infections, and surgeries, requiring limited movement for recovery.

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Inactivity

Reduced physical activity that can be temporary or long-term, often due to medical reasons.

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Bed Rest

A medical intervention where a patient is confined to bed for therapeutic purposes.

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Immobility and Disability

The degree of immobility and its duration directly impact the risk of developing disabilities.

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Factors Affecting Mobility

Factors like age, health, mental state, nutrition, lifestyle, and external influences can affect a person's ability to move.

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Therapeutic Immobility

Immobility that occurs due to medical reasons, such as after surgery or injury.

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Unavoidable Immobility

Immobility that results from a primary disability, such as muscle paralysis.

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Respiratory Center

The area in the brain that controls breathing rate and depth.

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Hypoxia

Reduced oxygen levels in the blood.

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Respiration

The process of air moving in and out of the lungs.

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Depressed Respiration

A decline in the rate and depth of breathing.

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Increased Viscosity of Secretions

Sticky mucus in the airways making it difficult to breathe.

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Tracheitis

Inflammation of the trachea.

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Bronchitis

Inflammation of the bronchi.

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Hypostatic Pneumonia

Inflammation of the lung tissue.

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Increased Blood Viscosity

The thickening of blood due to an increased concentration of blood cells, leading to an increased risk of clotting.

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Venous Stasis

A condition that occurs when the blood in the veins becomes stagnant, leading to a buildup of blood clots.

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Decreased Basal Metabolism Due to Immobility

A decrease in the metabolic rate of the body due to inactivity, resulting in a lower demand for oxygen and less carbon dioxide production. This can lead to slower and shallower breathing.

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Decreased Respiratory Volume

A decrease in the volume of air that a person can breathe in and out, often due to immobility. This can occur because of reduced muscle activity and restricted lung expansion.

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Pooling and Stasis of Respiratory Secretions

The accumulation of mucus and other secretions in the airways due to decreased respiratory movement and the lack of proper coughing, which can lead to infections.

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Pneumonia

An inflammation of the lungs caused by an infection, often occurring in immobile individuals due to the accumulation of secretions and weakened immune response.

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Oxygen - Carbon Dioxide Imbalance

A condition where the body is unable to maintain the correct balance of oxygen and carbon dioxide in the blood, often due to immobility and its effects on respiratory function.

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Decreased Respiratory Movement

A condition caused by limited or restricted movement, often due to factors like pain or muscle weakness, leads to a reduction in the depth of breaths and can contribute to respiratory complications.

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Increased Heart Workload in Recumbent Position

The heart works 30% harder when someone is lying down compared to sitting up. This is because the heart has to pump against gravity to move blood effectively.

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Orthostatic Hypotension

A condition where blood pressure drops suddenly when a person stands up from a sitting or lying position. It happens due to the heart having to work harder and the blood pooling in the legs.

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Thrombus Formation

A blood clot that forms in a vein, often in the legs of immobile people. It occurs due to slow blood flow, leading to a buildup of blood cells and other substances.

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Dependent Edema

Swelling in the lower extremities, especially the ankles and feet, caused by the accumulation of fluid in the tissues. This is due to heart struggles to push blood back up against gravity.

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Tissue Hypoxia

A state of reduced blood flow to tissues. This can happen in immobility because the heart has to work extra hard to pump blood against gravity.

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Decreased Blood Perfusion

Poor blood circulation caused by decreased activity. This leads to a higher workload on the heart to maintain blood flow throughout the body.

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Poorly Nourished

The condition of having poor nutrition due to various factors, including lack of appetite, decreased intake, or specific dietary requirements.

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Pressure Ulcers and Immobility

When a person's body is unable to move freely, it can significantly affect their skin health. Sustained pressure on the same areas of the body can lead to reduced blood flow and oxygen to those areas, leading to pressure ulcers or bedsores.

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Mental Effects: Immobility and Psychosocial Wellbeing

Immobility can drastically change a person's emotional well-being. They may experience feelings of helplessness, anxiety, and depression due to loss of independence and social interaction. These mental health impacts can worsen with time.

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Immobility and Neurological Impacts: Brain Function

Immobility disrupts the natural flow of information in the brain, leading to a decreased awareness of time, reduced intellectual stimulation, and difficulty with solving problems and making decisions.

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Immobility and Loss of Self-Esteem

Being unable to do daily activities can make a person feel more dependent on others, leading to reduced self-esteem and feelings of frustration due to a loss of control.

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Immobility and Bone Loss (Osteoporosis)

Osteoporosis is a condition where the bones become weak and brittle due to a decrease in bone density. This can be often caused by lack of physical activity, as the stress of movement helps maintain bone strength.

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Immobility and Contractures

Contractures are the tightening of muscles and joints, restricting movement. Immobility can lead to this because muscles are not used and begin to shorten. This can cause pain and limited mobility.

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Immobility and Muscle Atrophy

Muscle atrophy is the wasting away of muscle tissue, caused by a lack of use. Bedrest can lead to muscle atrophy as muscles begin to break down over time.

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Immobility and Blood Circulation

Immobility can negatively affect circulation, leading to a higher risk of blood clots. This happens because the muscles, responsible for pumping blood back to the heart, are not actively used during prolonged inactivity.

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Study Notes

Immobility

  • Immobility is the restriction of movement in any part of a person's life. It can be complete or partial.
  • Immobility can be caused by various factors, including injury, surgery, disease, or life choices.
  • Complete immobility may occur in unconscious patients, or individuals with significant injuries or medical conditions.
  • Partial immobility can result from conditions like a broken leg or a recent surgery.
  • Immobility affects numerous systems in the body, creating several risks.

Objectives

  • Define mobility, immobility, and bed rest.
  • Recognize common causes and risk factors for immobility.
  • Discuss the benefits and risks of immobility.
  • Identify metabolic rate changes related to immobility.
  • Describe physical changes related to immobility.
  • Describe musculoskeletal changes associated with immobility.
  • Discuss pressure ulcer risk factors.
  • Discuss psychological impacts of immobility.
  • Outline nursing interventions for immobile clients.

Hazards of Immobility

  • Immobility can lead to complications across various body systems.
  • Cardiovascular issues may arise, such as increased workload on the heart, orthostatic hypotension, thrombus formation, and dependent edema.
  • Respiratory complications could include reduced respiratory movement, stasis of secretions, and oxygen-carbon dioxide imbalances resulting in pneumonia.
  • Gastrointestinal complications include decreased activity, anorexia, lessened food intake, and constipation.
  • Urinary system effects include urinary retention, urinary stasis, urinary tract infection, and renal calculi formation.
  • Musculoskeletal complications result in muscle wasting, fibrosis of joints, muscle atrophy, joint contractures, and loss of function due to disuse and reduced activity. Osteoporosis is a significant skeletal risk.
  • Integumentary complications involve pressure sores from decreased blood flow and prolonged pressure, resulting in tissue hypoxia and necrosis—ultimately, pressure ulcers.
  • Psychological complications may cause anxiety, feelings of helplessness, and disorientation as well as impacting mental attitude and motivation. Psychological concerns may also occur and include problems with sleep, emotional responses, and an inability to carry out usual activities which can also lead to decreasing self-esteem.

Purposes of Movement

  • Movement can express emotions nonverbally, as well as be used for self-defense.
  • Movement supports meeting basic needs, such as activities of daily living, and also supports recreational activities.

Factors Affecting Mobility

  • Age and physical health
  • Nutrition
  • Mental health
  • Lifestyle choices
  • Personal values
  • Fatigue and stress
  • External factors
  • Degree of immobility itself

Levels of Immobility

  • Completely independent
  • Needs assistance
  • Bed rest with bathroom privileges
  • Complete bed rest
  • Dependent (immobile)

Client Risk for Complications

  • Large areas of immobility
  • Prolonged periods of immobility
  • Elderly clients
  • Clients who experience pain or muscle spasms
  • Decreased sensitivity to pain, temperature, or pressure
  • Malnutrition
  • Immobility in one position for an extended period.

Definitions

  • Mobility: A person's ability to move freely.
  • Immobility: Unavoidable restriction of movement, which can include decreased activity or range of motion.
  • Inactivity: Alteration in a person's ability to walk independently.
  • Bed rest: A therapeutic intervention restricting a patient to bed to reduce movement to meet a treatment or recovery goal.

Nursing Care

  • Range-of-motion exercises
  • Progressive mobility activities
  • Chest physiotherapy
  • Back massage
  • Changing positions according to a schedule
  • Increasing fluid intake
  • Balanced diet (as outlined by the provided dietary pyramid)
  • Psychological and spiritual care

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