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Basic Human Needs Mobility & the Hazards of Immobility

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Presentation on theme: "Basic Human Needs Mobility & the Hazards of Immobility"— Presentation transcript:

1 Basic Human Needs Mobility & the Hazards of Immobility

2 Mobility serves many purposes
Performance of ADL Satisfaction of basic needs Self-defense Expression of emotion Recreational activities Need intact & functioning M/S & nervous system to achieve mobility

3 Principles of Body Mechanics
Body Mechanics-coordinated efforts of M/S & nervous systems to maintain balance, posture & body alignment during lifting, bending, moving, & performing ADL’s Proper use of body mechanics reduces risk for injury and ensures safe care

4 Principles of Body Mechanics
Alignment Balance Gravity Friction


6 Regulation of Movement
Skeletal system Skeletal system functions Characteristics of bone, joints,ligaments, tendons, cartilage Skeletal muscle Muscle tone Nervous system


8 Pathological Influences of Mobility
Postural Abnormalities Impaired Muscle Development Damage to CNS Direct Trauma to M/S System




12 Systemic Changes Associated With Immobility
Metabolic changes: Endocrine metabolism affected (decrease in BMR) Disrupts metabolic functioning Fluid & Lyte Imbalances Decreased calories & protein Negative Nitrogen Balance Calcium Resorption affected Functioning of GI tract


14 Respiratory Changes Lack of exercise & movement put client at risk for: Atelectasis-Collapse of alveoli leading to partial collapse of lung Hypostatic Pneumonia- Inflammation of lung tissue from stasis or pooling of secretions Both decrease oxygenation, prolong recovery, & add to discomfort




18 Cardiovascular Changes
Orthostatic hypotension Increased workload of heart due to decrease in venous return to the heart Risk for thrombus (Virchow’s Triad)




22 Musculoskeletal Changes
Muscle effects (muscle atrophy) Skeletal effects- Disuse osteoporosis, contractures and foot drop



25 Urinary Elimination Changes
Stasis and pooling of urine in renal pelvis leads to increased risk for infection and renal calculi Risk for dehydration and decreased urine output UTI’s due to foley catheter

26 Other Changes Integumentary changes (Risk assessment tool for skin breakdown, proper skin hygiene) Psychosocial effects (Depression from immobility) Developmental Changes

27 Nursing Process & Immobility
Assessment Assess immobilized client for hazards of immobility ROM exercises (P&P pgs )

28 Nursing Process: Nursing Diagnosis
You tell me!!!

29 Implementation Health Promotion Acute Care: Metabolic system
Respiratory system Cardiovascular system Musculoskeletal system Elimination system

30 Metabolic System Evaluate muscle atrophy I&O
Monitor lab data (BUN, albumin, protein, electrolytes) Assess wound healing Assess edema Assess for dehydration (Skin turgor, mucous membranes) Assess nutritional status (protein and vitamin supplements, enteral feedings, TPN)

31 Respiratory System Frequent respiratory assessment
Ascultate lung sounds Inspect chest wall movement Promote lung expansion and stasis of pulmonary secrections Deep breathing and coughing exercises Incentive spirometer Chest physiotherapy Suctioning Hydration Positioning every 2 hours

32 Cardiovascular System
Vital sign monitoring Assess for orthostatic changes (Baseline BP) Reduce workload of heart Peripheral pulse assessment Assessment of edema (hearts inability to handle increased work load) Prevent thrombus formation Assessment of DVT (Calf circumference)

33 Prevent Thrombus Formation
Anticoagulants (Heparin, Lovenox) TED Stockings Calf pumping exercises Sequential compression stockings





38 Musculoskeletal System
Assessment of muscle tone, strength, loss of muscle mass, contractures Assess for risk of disuse osteoporosis Assessment of ROM Passive ROM for all immobilized joints Physical therapy consult Prevent foot drop and contractures





43 Elimination System I&O each shift
Assess for fluid & electrolyte imbalances Bowel assessment Adequate hydration Incontinent considerations Assess bladder distention

44 Positioning techniques
Footboard Trocanter roll Trapeze bar Pillows Splints Abductor pillow ROM exercises






50 Practice Scenario A 72 year old client is recovering following abdominal surgery for colon cancer. Which hazards of immobility is this client at risk for and why? How would you as the nurse prevent post-operative complications associated with this client’s condition?

51 Practice Question Which nursing assessment of the immobilized client would prompt the nurse to take further action? A. Client complaining of fatique B. Urinary output of 50 ml/hr C. White blood cell count of 9.5 D. Absence of bowel sounds

52 Practice Question During an exercise session, the nurse assists the client to dorsiflex and plantarflex the foot, explaining the client needs to exercise the foot to maintain function. The nurse recognizes this type of exercise activity as: A. Active range of motion B. Passive range of motion C. Isometric exercise D. Isotonic exercise

53 Practice Question Which of the following clients is most at risk for thrombus formation? A. Client with renal failure B. Client with severe abdominal pain C. Client with a total hip replacement D. Client with right sided heart failure

54 Practice Question Which of the following is true concerning the physiologic effects of immobility? A. Serum calcium levels decrease. B. Hypertension develops because of increased cardiac workload. C. Caloric intake often increases. D. Secretions may block bronchioles.

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