1. IMMOBILITY
RISKS AND PREVENTION

2. Question:
Which major body systems are impacted by immobility?

3. Answer:
ALL OF THEM!!!!!

4. Factors impacting effects of immobility:
Extent & duration of immobilization
Age of individual
Physical condition
Nutritional intake

5. Metabolic changes with immobility
Decrease in metabolic rate
Alteration of nutrient metabolism
Electrolyte imbalance
Nitrogen imbalance
Calcium loss

6. Gastrointestinal system
Decreased GI motility
Anorexia
Constipation
Fecal impaction

7. Respiratory system
Atelectasis
Hypostatic pneumonia

8. Cardiovascular system
Orthostatic hypotension
Increased cardiac workload
Thrombus formation (DVT)

9. Musculoskeletal system
Osteoporosis
Contractures
Disuse atrophy (occurs at a rate of 3%/day in healthy people)

10. Genitourinary system Renal calculi (stones)
Urinary tract infection (UTI)

11. Integumentary system Diminished healing capacity
Decubitus ulcer formation

12. Psychosocial effects:
Emotional & behavioral changes
Sensory alterations
Sleep disturbances

13. ASSESSMENT Joint problems
Assess for stiffness, swelling, limitations,& inequality

14. Prevention of joint problems
Range of motion exercises
Ambulation: ASAP!!!

15. Assessment Respiratory problems Auscultate lung sounds
Inspect color and viscosity of mucus
Observe respiratory effort

16. Prevention of respiratory problems
Cough and deep breathe
Incentive spiromater
Fluid intake
Ambulate ASAP!

17. Assessment Cardiovascular problems
Heart rate and quality of heart sounds
Exercise tolerance
Blood pressure: sitting and standing
Calf circumference
Homan’s sign

18. Prevention of cardiovascular problems
Dangling
Transfer to chair
TED hose/Sequential stockings
Leg exercises (ankle pumps, foot circles,etc.)
Fluid intake
Medication if ordered (Heparin/Coumadin)
Ambulate ASAP!!!

19. Assessment Skin integrity Color (inflammation, pallor)
Temperature (warmth, cold)
Hydration
Excoriation
any break in integrity

20. Prevention of skin problems
Turn or reposition FREQUENTLY
Hydration (2000cc daily)
Hygiene
Circulation
Diet: high protein, high calorie, high fiber

21. Prevention of Psychosocial Problems
Listen well
Respond to feelings
Educate patient and family
Limit noise & overstimulation
Promote sleep and rest
Allow choices and control