MDC EXAM 2 REVIEW 11-19-19

The effects of Immobility a) Interventions that improve flexibility  P.R.E.P.(Perform passive ROM, Reposition Q2HR, Encourage independent activity as much as possible even in bedrest, Provide assistive devices)  Know examples of exercises for flexibility b) Assessment/ Findings of a patient with DVT  Assessment (1) Compare distal pulses for pulse quality, observe the color and temp. of extremities, evaluate sensation and motion, and determine speed of capillary refill. Compare calf circumferences.  Findings (1) Redness, warmth, tenderness, swelling (Thrombus formation), Peripheral and sacral edema. c) Identify patients at risk for skin breakdown  Older adults, immobile, cognitive impairments, incontinence, poor nutrition/ malnutrition. Medications may also cause vasoconstriction and result in poor tissue perfusion. 2. Benefits of Exercise a) Rationale for weight bearing exercise  Promotes bone reformation and growth (Makes bones stronger)  At least 3-5 times a week Identify benefits of exercise  Bone reformation and growth  Cardiovascular health promotion  Promotes balance and stability  Reduce stress and increase energy levels b) Identify benefits of exercise  Bone reformation and growth  Cardiovascular health promotion  Promotes balance and stability  Reduce stress and increase energy levels  Improves pulmonary circulation, skeletal development, skin tone  Reduces systemic inflammation c) Identify negative effects of immobility on musculoskeletal system  Osteoarthritis  Rheumatoid Arthritis  Loss of muscle strength  Impaired balance  Altered join mobility  Decreased stability  Osteoporosis  Depression, isolation, anxiety, and mood change  Can cause decreased peristalsis d) Explain ways to maintain proper posture for a client  Place the spine in a neutral position(Resting)  This allows the bones to be aligned, reduce stress and fatigue & muscle joints, and ligament can work efficiently  Avoid standing in 1 position for a long period of time  Do not lock your knees when standing  Keep core tight and don’t bend at the waist or neck  No slumping when sitting  Sit close to your work and use back support  Sit with feet flat on floor  Sleep on firm mattress  Do not wear high heels for a prolonged time, do not slump, and use a chair that supports your back. e) Identify interventions in minimizing contractures (which is a negative effect of immobility)  Gently straighten out contracted extremity, fingers. Etc  Mobility-encouraging interventions such as passive ROM, and rotation. Flexion and extension exercises  These interventions should be performed about every 2hrs and as needed if the contractures are present 3. Identify bed positions  Semi-fowlers: Patient is on their back with the head raised between 15 and 45 degrees.  High-fowlers: Patient is on their back with the head of the bed raised between 60 and 90 degrees.  Prone: Lying on the abdomen with the head turned to one side  Supine: Lying on the back  Sims: Patient lies on their side with the left thigh slightly flexed and the right thigh acutely flexed on the abdomen.  Trendelenburg's Position: Patient is on their back whose lower section is inclined 15-30 degrees so that the head is lower than the body.  Reverse Trendelenburg's Position: Patient is in the supine position with the feet facing downward and head is inclined 15-30 degrees.  Lateral Position: Side lying position, and a pillow is often placed between the legs for patient comfort 4. Identify proper body mechanics for moving the patients in bed  Transfer board  Mechanical lift  Transfer belt  What are the proper ways to move patients in bed? 5. Explain how to use walkers to the elderly  Push or lift your walker 6-12 inches forward  Make sure all 4 tips or wheels of your walker are touching the ground before taking a step  Step forward with your weak leg first  Then step forward with your other leg placing it in front of the weaker leg 6. Be able to assess client with diabetic neuropathy  Monofilament test: touch foot at the same time and have patient which time they were touched  Vibration perception: use a 128 hz tuning fork and ask the patient if they are able to feel vibrations  Look for ulceration or inspection of the feet