Natcep day 28


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Natcep day 28

  1. 1. Preventing the Complications of Immobility NATCEP Day Twenty-Eight
  2. 2. Objectives List the negative effects of immobility on the body Describe activities that promote selfcare Define range of motion (ROM) Describe ROM exercises for all joints including safety measures Identify measures that help prevent complications of immobility Slide 2
  3. 3. Nurses use the nursing process to promote exercise and activity in all persons to the extent possible. To help promote exercise and activity, you need to understand: Bedrest How to prevent complications from bedrest How to help with exercise Slide 3
  4. 4. Bedrest Generally bedrest is ordered to: Reduce physical activity Reduce pain Encourage rest Regain strength Promote healing Slide 4
  5. 5. Types of Bedrest Strict bedrest Everything is done for the person Bedrest Some activities of daily living (ADL) are allowed. Bedrest with commode privileges Bedrest with bathroom privileges (bedrest with BRP) Slide 5
  6. 6. Complications of Bedrest and/or Immobility Skin: Pressure ulcers Muscles: Atrophy Joints: Contractures Bones: Lose Calcium = become brittle & weak Kidneys: stones (calcium) Bladder: stagnant urine = infections Bowel Function: Constipation and fecal impaction Lungs: Fluid collects = Pneumonia (inflammation and infection of the lung) Circulation: sluggish = blood clots, especially in the lower legs Slide 6
  7. 7. Good nursing care prevents complications from bedrest. Encourage self care Frequent position changes These are part of the care plan. Good alignment Range-of-motion exercises Slide 7
  8. 8. What You Can Do – Prevention Change a resident’s position every 2 hours or more frequently based on the resident’s plan of care Sitting in chair? Change position every hour in chair Slide 8
  9. 9. Promote Activity through Self Care Encourage to feed self Encourage to groom and/or dress self Encourage to independently performs ADLs Promote use assistive devices as needed Assist with bladder and bowel training Slide 9
  10. 10. Exercise – encourage the resident to be active! Exercise helps prevent: Contractures Muscle atrophy Other complications of bedrest Some exercise occurs: With ADL Planned Activities When turning and moving in bed without help Hydration! Slide 10
  11. 11. Elastic Stockings Used to exert pressure on the veins, promoting the return of venous blood to the heart – check plan of care Slide 11
  12. 12. Elastic Stockings Information you need from the care plan and nurse before apply: Size Length When to remove and for how long Typically on for 8 hours and off for 30 minutes What observations to report and record When applied and/ or removed Skin color and temperature Leg and foot swelling Signs of skin breakdown Complaints of numbness and/or tingling When you washed stockings Slide 12
  13. 13. Devices for support or maintaining position Splints: Keep joints in a normal position Slide 13
  14. 14. Trapeze Used for exercises to strengthen arm muscles To move up and turn in bed Slide 14
  15. 15. Bed Cradles Keep the weight of top linens off the feet and toes Slide 15
  16. 16. Foot Boards Placed at the foot of the mattress to prevent plantar flexion that leads to foot drop (foot falls at ankle permanently) Slide 16
  17. 17. Trochanter Rolls Prevent the hip and legs from turning outward Slide 17
  18. 18. Hip Abduction Wedge A wedge to keep the hips abducted – away from the midline Slide 18
  19. 19. RANGE-OF-MOTION EXERCISES Range-of-motion exercises involve moving the joints through their complete range of motion. Active range-of-motion exercises are done by the person. With passive range-of-motion exercises, someone moves the joints through their range of motion. With active-assistive range-of-motion exercises, the person does the exercises with some help. Slide 19
  20. 20. Key Terms Abduction Move body part away from the midline of the body Adduction Move body part toward the midline of the body Extension Straightening a body part Flexion Bending a body part Hyperextension Excessive straightening of a body part Dorsiflexon Bending the toes and foot at the ankle Slide 20
  21. 21. More Key Terms Rotation Turning the joint Internal Rotation Turning the joint inward External Rotation Turning the joint outward Plantar Flexion Bending the foot down at the ankle Pronation Turning the joint downward Supination Turning the joint upward Slide 21
  22. 22. Joints to be Exercised Neck Shoulder Elbow Wrist Fingers Hip Knee Ankle Toes Slide 22
  23. 23. Safety Considerations NEVER FORCE A JOINT TO MOVE; only exercise to the point of pain NEVER perform therapies unless you have been trained and approved by your facility Slide 23