Immobilisation PDF

# Immobility Dr/ Heba Elfeky ## Outlines: - Definition of mobility - Definition of immobility - Causes of immobility - Common effects and complications of immobility - Nursing process for immobilized patient ## Mobility: - Mobility is a person's ability to move around freely in the environment...

# Immobility Dr/ Heba Elfeky ## Outlines: - Definition of mobility - Definition of immobility - Causes of immobility - Common effects and complications of immobility - Nursing process for immobilized patient ## Mobility: - Mobility is a person's ability to move around freely in the environment. - It assists in maintaining the body's normal physiological activities, and attaining basic needs as performing activities of daily living (ADLs) such as bathing, dressing and eating. ## Immobility: - Immobility is an impaired physical mobility. It is a state in which the individual experiences a limitation of activities caused by physical problems or by necessary therapeutic measures. - **N.B:** Bed rest is an intervention prescribed when the client is restricted to bed for therapeutic reasons. - **For example:** Reducing physical activity and the oxygen need of the body, allowing ill clients to rest and regain strength. ## Causes of immobility: - **Physical:** - Musculoskeletal disorders: Arthritis, Osteoporosis, Fractures - Neurological disorders: Stroke, Parkinson's disease - Cardiovascular disease: Myocardial infarction, angina - Pulmonary disease: Chronic obstructive lung disease - Acute and chronic pain - Sensory factors: Impairment of vision - **Psychological:** - Fear, depression - **Environmental:** - Forced immobility (in hospitals), inadequate aids for mobility, poor lightening. ## Effects and complications of immobility ➤ Factors affecting the severity of physical impairment due to immobility: - Degree of immobility experienced. - Length of time of immobilization. - Overall health status - Age. ## IMMOBILITY ### Common effects on body systems | Body System | Common Effects | |---|---| | **Urinary System** | Reduced kidney function | | **Urinary System** | Incontinence | | **Urinary System** | Urinary tract infections | | **Urinary System** | Urinary retention | | **Musculoskeletal System** | Brittle bones | | **Musculoskeletal System** | Contractures | | **Musculoskeletal System** | Muscle weakness and atrophy | | **Musculoskeletal System** | Footdrop | | **Nervous System** | Lack of stimulation | | **Nervous System** | Feelings of anxiety | | **Nervous System** | Feelings of isolation | | **Nervous System** | Confusion | | **Nervous System** | Depression | | **Respiratory System** | Pneumonia | | **Respiratory System** | Decreased respiratory effort | | **Respiratory System** | Decreased oxygenation of blood | | **Cardiovascular System** | Blood clots | | **Cardiovascular System** | Reduced blood flow | | **Integumentary System** | Decreased blood flow | | **Integumentary System** | Pressure ulcers | | **Integumentary System** | Infections | | **Integumentary System** | Skin breakdown and pressure ulcers | | **Digestive System** | Decreased appetite and low fluid intake | | **Digestive System** | Constipation and/or bowel obstruction | | **Digestive System** | Incontinence | | **Digestive System** | Electrolyte imbalances | ## Problem or complication associated with the effects of immobility: | Body part or system | Effect of immobility | Problem or complication | |---|---|---| | Cardiovascular system | Venous stasis | Thrombus formation | | Cardiovascular system | Increased cardiac workload | Thrombophlebitis | | Cardiovascular system | Blood pressure alterations | Pulmonary embolus | | Cardiovascular system | | Orthostatic hypotension | | Cardiovascular system | | Increased pulse rate | | Respiratory system | Stasis of secretions | Hypostatic pneumonia | | Respiratory system | Decreased elastic recoil | Bacterial pneumonia | | Respiratory system | Decreased vital capacity | Atelectasis | | Respiratory system | | Decreased gas exchange | | Gastrointestinal tract | Anorexia | Weight loss | | Gastrointestinal tract | Metabolic change to catabolism and negative nitrogen balance | Protein deficiency | | Gastrointestinal tract | Decreased peristalsis | Abdominal distention | | Gastrointestinal tract | | Constipation | | Musculoskeletal system | Decreased muscle mass and muscle tension | Fibrosis of connective tissue | | Musculoskeletal system | | Atrophy | | Musculoskeletal system | Shortening of muscle | Weakness | | Musculoskeletal system | | Joint contracture | | Musculoskeletal system | Loss of calcium from bone matrix | Osteoporosis | | Musculoskeletal system | Decrease in bone weight | Bone pain | | Urinary system | Stasis of urine | Precipitation of calcium salts | | Urinary system | Urinary tract infection | Frequency | | Urinary system | | Dysuria | | Urinary system | Renal stones | | | Skin | Decreased circulation from pressure | Skin breakdown | | Skin | Ischemia and necrosis of tissue | Pressure ulcers | | Brain/psychological | Decreased mental activity | Disorientation | | Brain/psychological | | Confusion | | Brain/psychological | Decreased sensory input | Boredom | | Brain/psychological | Decreased socialization | Anxiety | | Brain/psychological | Decreased | Depression | ## Assessment of immobilized patient: - **Integumentary system:** - Presence of skin irritation: friction, shear - Presence of pressure ulcers - **Cardiovascular system:** - Vital signs - Peripheral edema - Auscultate heart sounds - Orthostatic vital signs - Lower leg assessment - **Gastrointestinal system:** - Usual dietary intake - Food and fluid intake - Weight gain& loss - Bowel pattern - Bowel sound - **Respiratory system:** - Respiratory rate, depth, rhythm - Breath sounds - Oxygen saturation - Skin color and mucous membrane - **Urinary system:** - Ability to empty bladder - Volume of voiding - 24-h intake and output - Urine inspection for odor, cloudiness, and color - Bladder distention - Symptoms associated with UTI(flank pain, burning, frequency) - **Musculoskeletal system:** - Usual activity level - Ability to perform activities of daily living - Gait - Posture - Joint range of motion - Measure muscle mass - Observe muscle tone - Test muscle strength - Use of assistive devices - **Psychosensory system:** - Signs of withdrawal, depression, or anxiety - Life roles - Neurologic status assessment ## Nursing diagnosis and intervention: