IMMOBILITY : NURSING MANAGEMENT

MEETING PATIENT NEEDS: MOBILITY AND IMMOBILITY: HAZARDS: NURSING MANAGEMENT

1. MOBILITY AND IMMOBILITY

2. Mobility and immobility Mobility refers to a person’s ability to move about freely Immobility refers to the inability to do so

3. Hazards of immobility Respiratory system Cardiovascular system Musculoskeletal system Metabolic system Gastro intestinal system Urinary system Skin Psychosocial outlook

4. Respiratory changes Atelectasis (collapse of alveoli) Hypostatic pneumonia Decreased ventilatory effort Increased respiratory secretions Acid base imbalance Respiratory congestion

5. Cardiovascular changes Increased cardiac work load Orthostatic hypotension Venous stasis Venous thrombosis

6. Musculoskeletal changes Atrophy Decreased joint mobility and flexibility Bone de mineralization Osteoporosis Contractures and ankylosis

7. Metabolic changes Decreased metabolic rate Increased catabolism Negative nitrogen balance Anorexia Fluid and electrolyte imbalances

8. Gastrointestinal changes Decreased food intake Altered protein metabolism Poor digestion and utilization Weight gain Constipation

9. Urinary changes Urinary stasis UTI Poor perineal hygiene Incontinence Decreased fluid intake Indwelling urinary catheterization Renal calculi Alkaline urine

10. Skin changes Impaired circulation Pressure ulcer

11. Psychosocial changes Decreased self concept Feeling of worthlessness Diminished self esteem Apathetic Altered thought process Coping difficulties Disturbed sleep pattern

12. factors influencing body alignment and mobility Growth and development Physical health Mental health Nutritional status Life style practices Environment

13. Nursing management

14. Assessment History Daily activity level Exercise Fitness goals Mobility problems Physical and mental alternations Physical examination Movement and gait Alignment Joint structure and function Muscle mass and power ADL

15. Assessment Physical examination Ability to stand, walk, and sit Physical and mental alternations

16. Nursing diagnosis Activity intolerance Impaired physical mobility Impaired bed mobility Impaired comfort Impaired skin integrity Impaired wheel chair mobility Impaired sitting Impaired standing Impaired transfer ability

17. Nursing diagnosis Impaired walking Fatigue Risk for activity intolerance Risk for falls Risk for injury Risk for physical trauma Risk for pressure ulcer Risk for disuse syndrome Risk for impaired skin integrity

18. Interventions Goal Long term : Patient will maintain or regain normal body alignment, activity or mobility level. Short term: Demonstrate correct body alignment whenever observed Demonstrate full ROM Perform ADL with assistance Be free from skin breakdown

19. Planning/implementation Interventions are directed towards, Prevention of complication Depends on system effected To restore musculoskeletal function

20. Planning/implementation Position the patient to maintain normal body alignment Change position every 2 hourly Teach to use overhead trapeze Provide exercise Isometric Isotonic Passive ROM (Offer analgesics 30 mts prior to exercise)

21. Planning/implementation Airway clearance problem Deep breathing and coughing exercises Chestphysiotherapy Suctioning Monitor vital signs before and after activity Instruct to stop if he is unable to tolerate Renal problems Increase fluid intake Frequent position changes

22. Planning/implementation Risk for injury Keep side rails Do not leave the patient un attended Take all safety measures Nutrition Provide balance diet Sufficient proteins, CHO, vitamins and minerals. Increase fluid intake Encourages for ADL Assist for brushing, combing etc Ambulate the patient at the earliest

23. Planning/implementation Elimination High fiber diet Add more fruits, vegetables and fluids Changing position and exercises Keep the patient clean and tidy Prevent soiling linens Provide/assist sponge bath Observe skin integrity Take precautions to prevent the developments of bed sores

24. Thank you