Pulmonary and Metabolic Disorders Overview

Respiratory Conditions

• Atelectasis refers to the collapse of part or all of a lung, leading to decreased oxygen exchange.
• Hypostatic pneumonia is a chronic disorder that develops slowly due to prolonged immobility and can occur in a bedridden patient.

Metabolic System Effects

• Decreased metabolic rate can indicate impaired bodily functions and energy use.
• Negative nitrogen balance suggests muscle breakdown exceeds synthesis, leading to loss of muscle mass.
• Anorexia often refers to a loss of appetite affecting nutritional intake.
• Negative calcium balance occurs when calcium loss outpaces intake, risking bone health.

Urinary System Conditions

• Urinary stasis indicates a cessation in urine movement, although urination may still be possible.
• Renal calculi are commonly known as kidney stones, formed from mineral deposits.
• Urinary retention is the inability to fully empty the bladder, which can lead to overflow.
• "Dribbling" of urine describes uncontrolled leakage.
• Urinary infections can arise from various pathogens and lead to discomfort.
• Urinary reflux is when urine flows back from the bladder to the ureters and kidneys, increasing the risk of infections.

Gastrointestinal System Concerns

• Constipation is characterized by infrequent or uncomfortable bowel movements, impacting overall digestive health.

Integumentary System Issues

• Reduced skin turgor indicates dehydration or other health issues affecting skin elasticity.
• Skin breakdown is a risk in immobile patients, leading to pressure ulcers.

Psychoneurologic System Factors

• Decreased endorphin levels can negatively impact mood, causing increased stress and anxiety.

Nursing Management

• Comprehensive nursing history and physical examination are crucial for assessing activity and exercise capability.
• Assess personal values and lifestyles that can influence health, including sedentary habits, family, and external factors like climate and finance.
• Evaluating prescribed limitations such as rehabilitation and nursing recommendations is essential for patient care.

Exercise Concepts

• Functional strength pertains to the ability to perform tasks effectively.
• Activity tolerance is the capacity to engage in daily activities without adverse effects on health.
• Types of exercises:
  • Isotonic (dynamic) exercises involve muscle contraction with joint movement.
  • Isometric (static) exercises focus on muscle contraction without joint movement, targeting specific muscle groups.
  • Isokinetic (resistive) exercises require resistance and promote muscle tension.

Benefits of Exercise

• Musculoskeletal System: Regular exercise maintains muscle tone, joint health, and bone density.
• Cardiovascular System: Exercise lowers blood pressure, improves oxygen uptake, and enhances heart rate stability.
• Respiratory System: Exercise boosts gas exchange, improves toxin elimination, and strengthens immune response.
• Gastrointestinal System: Regular activity improves appetite, gastrointestinal tone, and helps manage digestive disorders.
• Metabolic/Endocrine System: Exercise increases heat production, waste elimination, and regulates blood sugar levels.
• Urinary System: Promotes effective waste excretion and helps prevent urinary stasis and infections.
• Immune System: Enhances immune function through improved lymphatic circulation.

Normal Movement Principles

• Key components include alignment, posture, line of gravity, center of gravity, and base of support.
• Understanding joint movement is essential for facilitating activities of daily living (ADLs).
• Nutritional status, including undernutrition and overnutrition, as well as vitamin deficiencies (e.g., Vitamin D), are critical in maintaining overall health.

Nursing Responsibilities

• Identify and assess factors influencing mobility, including alignment, gait, muscle strength, and any problems arising from immobility.
• Develop and apply nursing diagnoses and outcomes connected to activity, exercise, and mobility issues.
• Implement safe practices during patient handling and mobility, including assessments for range of motion (ROM).
• Educate clients regarding the use of mechanical aids for walking to enhance safety and independence.