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  1. 1. BedrestWhy?  Decrease activity  Decrease pain  Encourage rest  Regain strength  Promote healing
  2. 2. Types of Bedrest1. Bedrest- can do ADLs (bath)2. Strict Bedrest-not up at all3. Bedrest with bathroom privileges4. Bedrest with commode privileges
  3. 3. Systems affected Skin-decrease circulation  GI- constipation bedsores fecal impaction decubitus ulcers decrease motility Muscles- atrophy  Respiratory- pneumonia contractures  atelectasisMental – depression  Poor ventilationSkeletal: brittle bones Cardiovascular- stiffness  blood clotsUrinary- UTI’s  Poor circulation  Orthostatic hypotension kidney stones  (postural hypotension) stagnant urine  Syncope
  4. 4. Think about it? They dr. has ordered bed rest for a resident. What must you do to prevent complications of immobility?
  5. 5. Body System Complication Care/preventionIntegumentary (skin)MusclesJointsBonesGastrointestinalRespiratoryCardiovascular
  6. 6. Body System Complication Care/preventionIntegumentary (skin) Pressure Ulcers (decubitus ulcers) Turning q 2 hr. Skin careMuscles Atrophy- muscle wastes away ROMJoints Contracture-muscle shortens over joint, fixed & can’t ROM moveBones Brittle ROM AmbulationGastrointestinal Constipation Fecal impactionRespiratory Pneumonia Cough & Deep breathing Atelectasis Turning q 2 hr.Cardiovascular Thrombi TED hose, ROM, Ambulation Orthostatic /postural Hypotension Change position slowly Syncope –pass out Monitor VSUrinary UTI Increase fluid intake Renal calculi Toilet q 2 hr.
  7. 7. Think about it? A pt. has been on bed rest for 3 days. The RN asks you to assist the pt. with ambulation. You know orthostatic hypotension can occur when the pt. moves from lying to sitting to standing. The pt. is at risk for syncope. What questions can you ask the pt., to check for orthostatic hypotension?
  8. 8. Positioning Turn or reposition pt. every 2 hours  Bed  chair
  9. 9. Devices to prevent complicationsa. Bed board- prevent saggingb. Footboard- prevent plantar flexion/foot drop
  10. 10. c. Trocanter roll: prevent hip abductiond. Hip abduction wedge: prevent adduction
  11. 11. e. handrolls: prevent contracturesf. splints: prevent contractures
  12. 12. Bed cradles: prevents foot drop & touching wounds
  13. 13. Purpose of ROM:  Allows for movement of joints to prevent complications such as atrophy and contractures.  Required by OBRA
  14. 14. Types of ROM1. Active ROM- do by self2. Passive ROM-someone does for the pt.3.Active/Passive ROM-someone assists pt.
  15. 15. Rules of ROM:  Done 2 times/day  RN will direct you on joints to do ROM  Expose part being exercised  Good body mechanics-pt. & you  Support above & below joint being exercised  Move slowly and smoothly  Do not force joint  Stop if pain
  16. 16. Movements Abduction-move away from body Adduction-move towards body Extension-straighten a body part Flexion-bend a body part Hyperextension-excessive straightening Dorsiflexsion-bending backwards Rotation-turning joint Internal rotation-turning joint inward External rotation-turning joint outward Plantar Flexion-planting foot down Pronation-turning downward Supination-turning upwardDO NOT do Neck ROM without permission!
  17. 17. Think about it? The dr. orders passive ROM for your pt’s right knee. What safety rules do you need to follow when performing Passive ROM to the pt’s right knee?
  18. 18. Prosthesis Replacement of a missing part by an artificial substitute
  19. 19. Care of the prosthesisLabelCleanStorage