The Immobile Client
Who is our immobile client?
~ People with chronic conditions that affect overall health
~
Most
Healthy Compromised
A – Infant with hip spica cast on for 4 weeks
B – Adult client with Covid on ventilator – sedated and intubated
C – Chronic Obstructive Pulmonary Disease (COPD) with activity intolerance
D – Triathlon Athlete with casted fractured ankle
E – Mother delivered full term baby via C-section
F – Your client in LTC
G – young adult quadriplegic – severed spinal cord
H – Car accident with head injury – unconscious with increased intracranial
pressure
Factors Affecting the Severity of Problems of Immobility
1. Overall health
2. Time (Temporary or chronic)
3. Age
4. Severity/Seriousness of Injury
5. Activity (Actively Participates?)
6. Elective
, Effects of Immobility (Body System)
( Taylor’s Fundamentals… Table 34-4 p 1250 and Narrative pp. 1253 – 1255)
Cardiovascular System
Increases cardiac workload - R/T decreased skeletal muscle contractions
(legs) with pooling of blood in veins causing a decrease in blood returned to the
right side of the heart and entering circulation.
~ Increased heart rate
~ Increase stroke volume - preload - pressure of RV is less restrictive
during diastole (rest period) so blood can more easily enter.
~ Increase cardiac output (CO = stroke volume x heart rate)
Thrombi (Blood clot) formation R/T venous stasis in the legs
Blood pools in the legs with a decrease in core circulation AND
Calcium leaves the bones enhancing blood coagulation with blood clots.
Orthostatic Hypotension (Decreased blood pressure based on parameters for
positional changes) R/T vasoconstriction cause the neurovascular adjustments
that maintain BP not to work correctly.
Actions (Nursing and Collaborative)
~ Compression stockings ~ Protein (Accommodating diet)
~ Anti-coagulant therapy ~ Dietary consult
~ SCD’s (Sequential Compression Device) ~ Adequate calcium
~ Q2h Repositioning to promote veinous return & prevent orthostatic hypotension
~ Exercise/Ambulate according to mobility level ~ PT Consult
~ Active or Passive ROM activities ~ Isometric exercise
~ Abnormal heart sounds
Who is our immobile client?
~ People with chronic conditions that affect overall health
~
Most
Healthy Compromised
A – Infant with hip spica cast on for 4 weeks
B – Adult client with Covid on ventilator – sedated and intubated
C – Chronic Obstructive Pulmonary Disease (COPD) with activity intolerance
D – Triathlon Athlete with casted fractured ankle
E – Mother delivered full term baby via C-section
F – Your client in LTC
G – young adult quadriplegic – severed spinal cord
H – Car accident with head injury – unconscious with increased intracranial
pressure
Factors Affecting the Severity of Problems of Immobility
1. Overall health
2. Time (Temporary or chronic)
3. Age
4. Severity/Seriousness of Injury
5. Activity (Actively Participates?)
6. Elective
, Effects of Immobility (Body System)
( Taylor’s Fundamentals… Table 34-4 p 1250 and Narrative pp. 1253 – 1255)
Cardiovascular System
Increases cardiac workload - R/T decreased skeletal muscle contractions
(legs) with pooling of blood in veins causing a decrease in blood returned to the
right side of the heart and entering circulation.
~ Increased heart rate
~ Increase stroke volume - preload - pressure of RV is less restrictive
during diastole (rest period) so blood can more easily enter.
~ Increase cardiac output (CO = stroke volume x heart rate)
Thrombi (Blood clot) formation R/T venous stasis in the legs
Blood pools in the legs with a decrease in core circulation AND
Calcium leaves the bones enhancing blood coagulation with blood clots.
Orthostatic Hypotension (Decreased blood pressure based on parameters for
positional changes) R/T vasoconstriction cause the neurovascular adjustments
that maintain BP not to work correctly.
Actions (Nursing and Collaborative)
~ Compression stockings ~ Protein (Accommodating diet)
~ Anti-coagulant therapy ~ Dietary consult
~ SCD’s (Sequential Compression Device) ~ Adequate calcium
~ Q2h Repositioning to promote veinous return & prevent orthostatic hypotension
~ Exercise/Ambulate according to mobility level ~ PT Consult
~ Active or Passive ROM activities ~ Isometric exercise
~ Abnormal heart sounds
