for bsc. nursing 1st yr

1. VIDYAKIRANA COLLEGE OF NURSING BANGALORE
SUBJECT-
NUTRITION BSC
1SR YR.
TOPIC-
MOBILITY AND
IMMOBILITY
PRESENTED BY –
MRS. SULEKHA
DESHMUKH

2. **
• =

3. Body mechanics
Body mechanics is a term used to describe the
ways we move as we go about our daily lives. It
includes how we hold our bodies when we sit
stand, lift, carry, bend, and sleep. Poor body
mechanics are often the cause of back problems.

5. Purpose
•To avoid stress and strain[pressure] on the
musculoskeletal system
•It promote proper physiological function of the
body .
•It minimize the expenditure of the energy.

6. •it help in maintaining balance of the body
without strain.
•To prevent kyphosis, lordosis, and other
deformities.
•It contributes to one”s beauty.

7. Kyphosis
•Abnormal
curved spine, it
most common
in older women

8. •Lordosis is the natural curve of the lower back
(lumbar) area of the spine.

9. Principles of body mechanics
•maintain good posture in all activity by avoiding
twisting the body ,turn your whole body ,face
the area in which you are working.
•It is easier to slide, pull or roll an object than to
lift it help to reduce the energy needed to raise
the weight .

10. •Movement should be smooth and co-ordinate
rather than jerky to prevent injury.
•Use strongest and longest muscles to perform
tasks which require physical effort.
•Keep the objective as close as possible to your
body when lifting ,moving, or carrying them

11. /
•keep the work at a comfortable height to avoid
excessive bending at the waist.
•Keep the body in good physical condition to
reduce the chance of injury.
•Get help if the object feel too heavy to lift.
•Flex the joint [ knee and hips] to come close to
the object instead of bending back

12. •Use the weight of the body to pull or push an
object by keeping the body above the object

13. GENERAL INSTRUCTION IN MOVING AND
LIFTING PATIENT

14. •Plan the movement of the patient ahead of time
and be sure the path is clear.
•Face the direction in which the movement will
be made to avoid twisting of the vertebral
column.
•Place the feet comfortably apart to provide a
wide base of support

15. •Flex the knee and hip joint but keep the trunk as
vertical [ straight 90 de.] as possible .
•Keep the patient as close to the body as
possible.
•Avoiding jerking and twisting during the lift.
•Heavy patient should be moved in bed by sliding
rather than lifting them.

16. •Assistance should be requested when lifting or
moving heavy patient.
•When moving a patient by more than one
person each worker assume the responsibility
for supporting one of the patients body section
the area to be supported are

17. •1 – head, shoulders, and chest
•2- hips
•3- thighs and ankles
•Observe the patient for symptoms of orthostatic
hypotension such as fainting,[to lose of
consciousness] dizziness, sweating

18. •Do not support the patient under his armpits,
since injury to major nerve and blood vessels
may occur.
•Always lock the wheels of bed and stretcher
prior to transferring a patient to increase static
friction between the wheels and the floor

19. position used for comfort

20. The pt. lies
on his back
with his head
and shoulder
are slightly
elevated

21. • Position in which the patient lies
on the abdomen with the head
turned to one side with one small
pillow under the ankle

22. the pt lies
on the
side with
weight on
hip and
shoulder

24. •It is the siting position in which the head is
elevated at 45 to 60 degree .

25. POSITION USED FOR
PHYSICAL EXAMINATION

26. Dorsal recumbent position
•Used for vulval, vaginal and rectal examination
and for the operative procedures on the vulval
area and for such procedures as catheterization
of the bladder.

28. Erect position
•This is normal standing position with both feet
on the floor
•Used for orthopedic and neurological disorder

30. Sims lateral
•The patient lies on his left side or right side
•One pillow placed under the head, the left arm is
behind the back and right arm may be in any
position comfortable for the patient ,the right
thigh is flexed against the abdomen.

31. •Used mainly for the vaginal and rectal
examination

33. Lithotomy position
•the patient lies on his back with one pillow
under the head
•The legs are well separated and the thighs are
well fixed on the abdomen and the legs on the
thighs.
•The patient buttocks are brought to the extreme
edge of the table and legs are the supported on
the stirrups.

34. •used for the gynaecological examination and
treatments, surgical procedure involving the
genitourinary system.

36. Knee chest position
•The pt. rest on the knee and the chest
•mainly used for the examination of rectum and
vagina
•Also as an exercise for the post partum patient

38. Trendelenburg position

39. •The patient lies on his back the foot on the bed
is elevated at a 45 degree angle.
•This position is used during the examination or
operation on the pelvic cavity into the upper
abdomen

40. •also used to treat shock and decreased blood
pressure.

41. Range of motion
•Range of motion is used when doing routine
activities such as bathing eating, dressing,
walking, sleeping, siting and standing,

42. Range of motion
•Abduction: The movement of a limb away from
the midline of the body. The opposite of
abduction is adduction.

44. flexion and extension
•Flexion describes a
bending movement
and extension
describing a
straightening
movement

45. Supination and pronation
•When your palm or forearm faces up, it's
supinated. When your palm or forearm faces
down, it's pronated.

47. Range of motion exercise

48. •Range of motion exercises refers to activity
aimed at improving movement of a specific joint.
0r
Range of motion exercise are used to keep the
muscles and joint strong and flexible ,this exercise
can be done by the patient himself or with a
physical therapist.

49. Types
•ACTIVE RANGE OF MOTION -
Performed by the patient without help.
•PASIVE RANGE OF MOTION –
Not performed by the patient and the health care
worker moves each joint .

50. ACTIVE
EXERCISES

51. PASSIVE
EXCERCISES

52. •ACTIVE ASSISTIVE RANGE OF MOTION –
the patient does the exercises with some
assistance from another person or equipment

54. General rules for ROM
•use good body mechanics
•Expose only the body part being exercised
•Explain the patient what you are going to do .
•Support the extremity being exercised
•Move each joint slowly
•Return the joint to a natural position after the
movement

55. •Repeat the exercise 3-5 times
•Ideally these exercise should be done once per
day
•Expect the patient heart rate to increases during
exercise
•Some exercise may need to be delayed until the
patient condition improves.

56. ROM EXERCISE FOR NECK

57. ROM EXERCISE FOR SHOLDER

59. ROM
EXERCISE
FOR HIP

61. Immobility
•Immobility refers
to the persons”s
inability to move
about freely

62. Types of immobility
Social immobility- withdrawal from normal
pattern of social interaction .

63. Emotional immobility
•it can occur when
stressors exceed the
coping ability of an
individual.

64. Intellectual immobility
•It can occur in persons who lack the ability to
acquire needed knowledge

65. Physical immobility
•Can be caused by physical
problem or by necessary
therapeutic measures
blind, dumb, deaf, one
eyed

66. Effects of immobility
•Musculoskeletal system
•Prolonged bed rest and immobilization lead to
complications. Such complications are much
easier to prevent than to treat. Musculoskeletal
complications include loss of muscle strength
contractures and soft tissue changes, disuse
osteoporosis, and degenerative joint disease.-

67. Cardiovascular system
•Cardiovascular complications include an
increased heart rate, decreased cardiac reserve,
orthostatic hypotension, and venous
thromboembolism.[blood clots in the veins]

68. Respiration system
•The depth and rate of respiration and movement
of secretion in the respiration tract is decreased
when a person is immobile ,signs and system
include—
•Increased temperature
•Cough
•Increased pulse

69. •sharp chest pain
•Dyspnea

70. Nervous system
•Due to prolonged pressure and continual
stimulation of nerves, sensation in the nervous
system is altered ,the patient in the initial phase
may experience pain and then the sensation is
altered . But in cases of peripheral nerve palsy
the patient may no longer sense the pain

71. Gastrointestinal system
•Immobility may affect the gastrointestinal
system by slowing down the gastrointestinal
tract and decreased activity resulting in anorexia
bowel movements are also disturbed resulting in
constipation, and difficulty to evacuate feces

72. Integumentary system
•Prolong pressure on the skin especially on bony
areas due to immobility marks, the client at
likelihood for skin breakdown[damage to the
skin surface] pressure ulcers and poor skin
turgor which leads to necrosis and ulceration of
tissues.

73. Urinary system
•Immobility can affect the urinary system
adversely, condition may include urinary stasis
retention, calculi, continence, urinary tract
infection.

74. Psychological changes
•Decreased self concept
•Altered thought process
•Coping difficulties
•Disturbed sleep pattern

75. care of patient with immobility
• =

76. •Assess the client for mobility, gait, strength, and
motor skills
•Identify complication of immobility e.g. skin
breakdown
•Perform skin assessment and implement
measures to maintain skin integrity and prevent
skin breakdown

77. Skin breakdown

78. •E.g. – turning, repositioning, pressure –relieving
support

79. •Maintain the
client correct
body alignment

80. •Apply and
maintain or
remove
orthopedic device

81. •Apply knowledge of nursing procedures and skill
when providing care of client with immobility
•Educate the clients regarding proper methods
used when repositioning an immobilized client
•Evaluate the client”s response to intervention to
prevent complication from immobility