1. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Chapter 36 Mobility

2. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Overview of Mobility Body alignment –Position of body parts in relation to each other Body mechanics –Purposeful and coordinated positions –ROM reflects extent to which joint can move

3. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Physiology of Mobility Musculoskeletal system Neurological system –Proprioception –Postural reflexes

4. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Exercise Types of exercises: –ROM exercise –Aerobic –Strengthening –Isometric –Isotonic –Isokinetic (continued)

5. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Exercise Physical fitness –Endurance and strength –Joint flexibility –Cardiorespiratory fitness –Body composition –Fitness in older adults

6. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Factors Affecting Mobility Health status Developmental stage –Children –Adolescents –Adults Environment Attitudes and beliefs Lifestyle

7. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Physiological Effects of Mobility and Immobility Neurological effects and mental status Cardiovascular effects Respiratory effects Musculoskeletal effects Digestive effects Elimination effects Integumentary effects

8. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Mobility and the Nursing Process Assessment –Health history –Physical examination Musculoskeletal assessment Movement and gait Body alignment Endurance (continued)

9. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Mobility and the Nursing Process Assessment –Physical examination Pathological alterations –Muscle impairments –Contractures (continued)

10. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Mobility and the Nursing Process Assessment –Physical examination Musculoskeletal trauma –Fracture –Amputation Central nervous system damage –Spinal cord injury (continued)

11. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Mobility and the Nursing Process Assessment –Neurological assessment Cranial nerves Motor system Sensory system Reflexes –Functional assessment (continued)

12. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Mobility and the Nursing Process Diagnosis –NANDA statements Activity intolerance Impaired physical mobility Risk of disuse syndrome Self-care deficits Ineffective health maintenance Risk for falls (continued)

13. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Mobility and the Nursing Process Planning and outcome identification –Collaboration –Bed rest –Restorative care –Health promotion and fitness (continued)

14. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Mobility and the Nursing Process Implementation –Meeting psychosocial needs –Applying principles of body mechanics –Maintaining body alignment Positioning –Performing ROM exercises (continued)

15. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Mobility and the Nursing Process Implementation –Employing transfer techniques Moving clients –Logrolling Transferring from bed to chair Transferring from bed to stretcher Using assistive devices (continued)

16. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Mobility and the Nursing Process Implementation –Assisting with ambulation Preparing client to walk –Client education –Preambulatory exercise (continued)

17. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Mobility and the Nursing Process Implementation –Assisting with ambulation Using assistive devices –Canes –Walkers –Crutches (continued)

18. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Mobility and the Nursing Process Implementation –Promoting wellness Health status Physical condition Age Client preferences –Employing complementary and alternative treatment modalities (continued)

19. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Mobility and the Nursing Process Evaluation –Balance dependence and independence –Perform ongoing assessment Physical assessment Functional assessment Performance of ADLs (continued)

20. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Mobility and the Nursing Process Evaluation –Observe in client’s environment Home exercise programs Compliance