1. Effects of 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 Brainabd contents on Fatiguediaphragm Kidneys Dec gas exchange Dec urine output Stasis of respiratory Skin Decubitussecretions Impairlungexpansion Obstruct airway Infection 4. Pressure Ulcers Ischemic or necrotic lesions rt decreasedblood flow Causes External pressure > capillary pressure Low O2 & nutrients to skin Friction Shearing forces 5. ConstipationPoor healing Muscle inactivity Inactivity, GI fullness decreasesperistalsis Anorexia increases fluid Negative nitrogenabsorptionbalance Weak muscles Low hemoglobin dec ability to defecate (globin is protein!) Low albumin(malnutrition) Fatigue 6. Immobility & Musculoskeletal Decreased wt bearing Demineralization DecreasedOsteoblastic- bone forming Increased Osteoclastic- bone resorbed Bone breakdown Increased serum Ca++ > 11 mg/dl muscle flaccidity Muscle breakdown Increased creatinine 7. Osteoporosis occurs when rate of bone resorption >bone formation Etiology Hormone deficiencies estrogen, androgen Poor Ca intake Disuse of muscles 8. 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 9. Paget Disease Genetic or viral infection Affects osteoclastic function leading to aberrant bone remodeling Painful bone deformities or bone fractures Skull deformation- HA