Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Chapter 36 Mobility.

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Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Chapter 36

Mobility

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Overview of Mobility

• Body alignment– Position of body parts in relation to each other

• Body mechanics– Purposeful and coordinated positions

– ROM reflects extent to which joint can move

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Physiology of Mobility

• Musculoskeletal system

• Neurological system– Proprioception

– Postural reflexes

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Exercise

• Types of exercises:– ROM exercise

– Aerobic

– Strengthening

– Isometric

– Isotonic

– Isokinetic

(continued)

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Exercise

• Physical fitness– Endurance and strength

– Joint flexibility

– Cardiorespiratory fitness

– Body composition

– Fitness in older adults

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Factors Affecting Mobility

• Health status• Developmental

stage– Children

– Adolescents

– Adults

• Environment• Attitudes and

beliefs• Lifestyle

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Physiological Effects of Mobility and Immobility

• Neurological effects and mental status

• Cardiovascular effects

• Respiratory effects

• Musculoskeletal effects

• Digestive effects

• Elimination effects

• Integumentary effects

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Mobility and the Nursing Process

• Assessment– Health history

– Physical examination• Musculoskeletal assessment

• Movement and gait

• Body alignment

• Endurance

(continued)

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Mobility and the Nursing Process

• Assessment– Physical examination

• Pathological alterations– Muscle impairments

– Contractures

(continued)

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Mobility and the Nursing Process

• Assessment– Physical examination

• Musculoskeletal trauma– Fracture

– Amputation

• Central nervous system damage– Spinal cord injury

(continued)

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Mobility and the Nursing Process

• Assessment– Neurological assessment

• Cranial nerves

• Motor system

• Sensory system

• Reflexes

– Functional assessment

(continued)

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Mobility and the Nursing Process

• Diagnosis– NANDA statements

• Activity intolerance

• Impaired physical mobility

• Risk of disuse syndrome

• Self-care deficits

• Ineffective health maintenance

• Risk for falls

(continued)

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Mobility and the Nursing Process

• Planning and outcome identification– Collaboration

– Bed rest

– Restorative care

– Health promotion and fitness

(continued)

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Mobility and the Nursing Process

• Implementation– Meeting psychosocial needs

– Applying principles of body mechanics

– Maintaining body alignment• Positioning

– Performing ROM exercises

(continued)

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Mobility and the Nursing Process

• Implementation– Employing transfer techniques

• Moving clients– Logrolling

• Transferring from bed to chair

• Transferring from bed to stretcher

• Using assistive devices

(continued)

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Mobility and the Nursing Process

• Implementation– Assisting with ambulation

• Preparing client to walk– Client education

– Preambulatory exercise

(continued)

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Mobility and the Nursing Process

• Implementation– Assisting with ambulation

• Using assistive devices– Canes

– Walkers

– Crutches

(continued)

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Mobility and the Nursing Process

• Implementation– Promoting wellness

• Health status

• Physical condition

• Age

• Client preferences

– Employing complementary and alternative treatment modalities

(continued)

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Mobility and the Nursing Process

• Evaluation– Balance dependence and independence

– Perform ongoing assessment• Physical assessment

• Functional assessment

• Performance of ADLs

(continued)

Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Mobility and the Nursing Process

• Evaluation– Observe in client’s environment

• Home exercise programs

• Compliance