Immobility
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Prolonged immobility can lead to several negative cardiovascular, respiratory, musculoskeletal, and other effects. It can cause blood to pool in the lungs and veins, leading to increased capillary pressure and edema. It also decreases arterial blood flow and nutrient exchange. Respiratory issues include decreased chest expansion and gas exchange. Prolonged immobility increases risks of pressure ulcers, constipation, poor healing, osteoporosis, and other bone diseases like rickets due to decreased mobility and nutrient deficiencies.
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Vitamin D deficiency rickets is a common nutritional disorder in children under 3 years old, characterized by a failure of bone mineralization. The key symptoms in the active stage include skeletal deformities such as bowed legs, skull abnormalities, and wrist/ankle swelling. Biochemically there are low serum calcium and phosphate levels. Treatment involves vitamin D supplementation either orally or via injections, along with calcium and other nutrient supplementation. Hypocalcemic tetany can occur due to vitamin D deficiency and presents with seizures, with emergency treatment focusing on stopping seizures and controlling laryngospasm through calcium supplementation.
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Immobility
- 2. Prolonged Recumbent position & CV Blood pools in lungs, veins lead to inc cap pressure-edema in interstitial space Reduced arterial flow & nutrient exchange Decreased skeletal muscle contraction Pooled venous blood Increased thrombus formation Decreased venous return Orthostatic hypotension
- 3. Respiratory Dec chest expansion Dec O2 to tissues Rt Inc pressure of Brain abd contents on Fatigue diaphragm Kidneys Dec gas exchange Dec urine output Stasis of respiratory Skin Decubitus secretions Impair lung expansion Obstruct airway Infection
- 4. Pressure Ulcers Ischemic or necrotic lesions rt decreased blood flow Causes External pressure > capillary pressure Low O2 & nutrients to skin Friction Shearing forces
- 6. Constipation Poor healing Muscle inactivity Inactivity, GI fullness decreases peristalsis Anorexia increases fluid Negative nitrogen absorption balance Weak muscles Low hemoglobin dec ability to defecate (globin is protein!) Low albumin (malnutrition) Fatigue
- 7. Immobility & Musculoskeletal Decreased wt bearing Demineralization Decreased Osteoblastic- bone forming Increased Osteoclastic- bone resorbed Bone breakdown Increased serum Ca++ > 11 mg/dl muscle flaccidity Muscle breakdown Increased creatinine
- 8. Osteoporosis occurs when rate of bone resorption > bone formation Etiology Hormone deficiencies estrogen, androgen Poor Ca intake Disuse of muscles
- 9. Rickets & Osteomalacia Disorders with soft, weak bones Etiology inadequate concentration of vitamin D, Ca++ or phosphorus poor vitamin D metabolism renal disease long term Phenobarbital use
- 10. Paget Disease Genetic or viral infection Affects osteoclastic function leading to aberrant bone remodeling Painful bone deformities or bone fractures Skull deformation- HA
Editor's Notes
- excitation of nerve & muscle cells, changes in personality, arrhythmia
- Renal osteodystrophy 1,25(OH)2 vitamin D-3 levels reduceddecreased Ca absorption from GI tractparesthesia, tetany Removes Ca from bones bone surface becomes hypocellular abn matrix density (bone marrow changes)fractures