1. Chapter 23 Body Mechanics, Positioning, and Moving

2. Introduction to Dangers of Inactivity
Inactivity leads to deterioration of health
Disuse syndrome: signs and symptoms resulting from inactivity in as little as 24 hours

3. Dangers of Inactivity

4. Maintaining Good Posture
Good posture affects a person’s appearance, stamina, and ability to use the musculoskeletal system efficiently
Poor posture often results in muscle spasms

5. Maintaining Good Posture (cont’d)

6. Maintaining Good posture
Posture: is the position of the body, or the way in which it is held. Good posture is important for both clients and midwives to avoid muscle spasm (sudden, forceful, and involuntary muscle contraction).
Standing: To keep good posture in standing:
Keep the feet parallel (10-20 cm wide)
Distribute weight equally on both feet
Bend knees slightly
Hold the chest up & slightly forward
Keep the spin properly aligned
Old the head erect

7. Sitting:
Both feet rest on the floor
Knees are free from the edge of the chair
Lying down:
The same as standing; the person is horizontal

8. Standing Posture

9. (Refer to Figure 23-4 in the textbook.)
Lying-Down Posture
Good lying-down posture
Head, neck centered between shoulders
Shoulders level; arms, hips, knees slightly flexed
Trunk straight; hips level; legs parallel; feet at right angles to legs
(Refer to Figure 23-4 in the textbook.)

10. Body Mechanics Proper body mechanics Increase muscle effectiveness
Reduce fatigue
Avoids repetitive strain injuries

11. Body mechanics Nursing guidelines 23-1, p. 497
Use the longest & strongest muscles of the arm & legs
When lifting a heavy load, center it on the feet
Hold objects close to the body
Bend the knees
Pull, push, or roll objects rather than lifting them
Keep wide base of support

12. Positioning Clients General principles for positioning
Change the inactive client’s position at least every 2 hours
Enlist the assistance of at least one other caregiver
Remove pillows and positioning devices

13. Positioning Clients (cont’d)
Common positions
Supine position
Foot drop: permanent dysfunctional position caused by shortening of the calf muscles and lengthening of the opposing muscles on the anterior leg

14. Foot Drop

15. Positioning Clients (cont’d)
Common positions (cont’d)
Lateral
Lateral oblique
Prone
Sims’ and Fowler’s

16. Common Positions

17. Positioning Clients (cont’d)
Turning and moving clients
Assistive devices and additional caregivers are needed when turning or moving a client who cannot change from one position to another independently

18. Transferring Clients Examples of transferring aids Transfer handle
Transfer belt
Transfer boards
Mechanical lift

19. Nursing Implications Nursing diagnoses for inactive clients
Impaired physical mobility
Risk for injury
Risk for disuse syndrome
Risk for perioperative-positioning injury
Impaired bed mobility

20. Chapter 24 Therapeutic Exercise

21. Exercise Beneficial to all age groups
Sedentary lifestyle is a health risk
Individualized
Nurses assess fitness level before initiating exercise program

22. Types of Exercise Fitness exercise
Develops and maintains cardiorespiratory function, muscular strength, endurance
2 categories
Isotonic
Isometric

23. Types of Exercise (cont’d)
Isotonic exercise
Involves movement and work
Increases cardiorespiratory function
Aerobic exercise

24. Types of Exercise (cont’d)
Isometric exercise
Stationary exercise, usually against resistance
Increases circulation but does NOT promote cardiorespiratory function
Weight lifting
Body building

25. Types of Exercise (cont’d)
Therapeutic exercise
Activity performed by people with health risks that prevents complications and restores lost function
Isotonic or isometric
Active exercise is performed independently by client after instruction
Passive exercise is performed by client with assistance when client is unable to move body parts

26. Types of Exercise (cont’d)
Range-of-motion exercises
Therapeutic activities to move joints
Performed to assess joint flexibility; maintain joint mobility and flexibility in inactive clients; prevent ankylosis; stretch joints for strenuous activities; and evaluate response to therapeutic exercise program
Performed for care of inactive client

27. Nursing Implications
Nursing diagnoses to be treated with activity or exercise regimen
Impaired physical mobility
Disuse syndrome
Unilateral neglect
Delayed surgical recovery
Activity intolerance