Movement, activity, and mobility positively affect ones overall health. These hazards of immobility can be prevented with range of motion exercises and in bed exercises such as isotonic, isometric and isokinetic muscular exercises. Mobility can be assessed by using direct observation of the client's movements and mobility and using some standardized tests such as the Timed Get Up and Go Test with which the nurse assesses the client's ability to rise from a chair, walk, and then return to the chair and sit, the Assessment Tool for Safe Patient Handling and Movement, the Egress test which the nurse uses to assess the client's ability to sit and then stand, march in place and advance forward with each foot and return to the same position. In this section of the NCLEX-RN examination, you will be expected to demonstrate your knowledge and skills of mobility and immobility in order to: The hazards or complications of immobility, such as skin breakdown, pressure ulcers, contractures, muscular weakness, muscular atrophy, disuse osteoporosis, renal calculi, urinary stasis, urinary retention, urinary incontinence, urinary tract infections, atelectasis, pneumonia, decreased respiratory vital capacity, venous stasis, venous insufficiency, orthostatic hypotension, decreased cardiac reserve, edema, emboli, thrombophlebitis, constipation and the loss of calcium from the bones, are highly costly in terms of health care dollars and in terms of client suffering. The Applying Prosthetics and Orthotics section in Chapter 8 describes devices such as a foot split to prevent musculoskeletal contracture. When passive range of motion is applied, the joint of an individual receiving the exercise is completely relaxed while the outside force moves the body part. The purpose of skin traction is to decrease pain and muscular spasms after a fracture has been surgically repaired with internal fixation. The nurse should monitor these clients to insure that they are performing these active range of motion exercises in the correct manner and to the greatest possible extent of movement for all of the joints of the body. Alene Burke RN, MSN is a nationally recognized nursing educator. Protect the skin as needed to minimize the potential for breakdown, and advocate for devices to prevent contractures, as needed.[11],[12]. Active range of motion is movement of a joint by the individual with no outside force aiding in the movement. Assess for the presence of urinary tract abnormalities related to immobility, such as suprapubic distention or tenderness that can result from urinary retention. These bowel alterations are further confounded when the client is not getting adequate fluid intake. Hip Fracture Nursing Care Plan An example of segmenting ADLs would be assisting a person to bathe in bed as independently as possible, letting them rest after bathing, and then returning later to assist them with dressing and grooming to get them ready for the day.
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