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BNS Exam 1- Ch8\PPT Body Mechanics & PT Mobility

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icorojo's version from 2018-04-14 23:20

Key Terms

Question Answer
Abductiona type of movement which draws a limb AWAY from the median plane of the body
Adductiona type of movement which draws a limb TO the median plane of the body
Alignmentbody parts in relation to one another
Ambulationthe act of walking
Atrophydecrease in size or wasting away of body tissue usually due to lack of use
Body Mechanicsfield of physiology that studies muscular action and the function of muscles in maintaining the posture of the body (p161)
Contracturethickening and gardening of tissue that prevents normal mobility of tissue or joint (p173)
Crutch Palsyweakness of the hand, wrist and the forearm. Induced by prolonged pressure from the under arm bar of a crutch on the radial nerves
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Key Terms Cont'd

Question Answer
Extensionmovement of certain joints that INCREASES ANGLE between two adjoining bones
Flexionmovement of certain joints that DECREASES ANGLE between two adjoining bones
Hyperextensionextreme or abnormal extension
Dorsiflexionmove FOOT so that toes are pointed UPWARD
Plantar flexionmove FOOT so that toes are pointed DOWNWARD
Eversionturn sole of foot MEDIALLY
Inversionturn sole of foot LATERALLY
Rotationturn head as far as possible right AND left
Pronationturn lower arm so that palm is DOWN
Supinationturn lower arm so that palm is UP
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Key Terms Cont'd

Question Answer
Flaccidlacking firmness, resilience, or muscle tone
Fracturea broken bone
Gaitthe way a person walks
Immobilityunable to move
Paralysisthe loss of ability to move all or part of the body, and often includes loss of feeling in the affected area
Jointan articulation. The point of juncture between two bones
Mobilityability to move (p166)
Range of Motionmovement of the body that involves the muscles and joints in natural directional movements (p169)
Active ROMperformed by PT
Passive ROMperformed by caregivers
Body Mechanicsbody mechanics is moving and positioning the body in ways that PREVENT INJURY to oneself and to others
Posturethe way a person holds and positions his body
Leversomething that moves an object by resting on a base of support
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Types of ROM Exercises

Question Answer
Activeperformed by PT independently
Active assistiveperformed by PT with some assistance
Passiveperformed for the client by caregivers
Passive assistednurse may assist client to move his limb if weak or paralyzed
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Older Adults/ROM Exercises

Question Answer
Skinis fragile and susceptible to injury (body produces less collagen after age 40)
Supportunder the joints when moving them in bed to avoid stress on the joint
Assessfor signs of weakness, hypotension, orthostatic hypotension
Discouragefrom sitting for a prolonged period without stretching and moving
Encourageparticipation in regular exercise
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ROM Exercises

Question Answer
Forearmsupination, pronation
Wristflexion, extension, hyperextension, radial and ulnar flexion
Fingersflexion, abduction, adduction
Ankledorsiflexion, plantar flexion
Footinversion, eversion
Toesflexion, extension, abduction, adduction
Thumbflexion, extension, abduction, adduction, opposition
Hipflexion, extension, hyperextension, abduction, adduction, internal and external rotation, circumduction
Kneeflexion, extension
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Nursing Action

Question Answer
#1Check medical record or care plan for special intervention (provides basis for care)
#2Assemble equipment (organizes procedure)
#3Introduce self (decreases PT anxiety)
#4Identify PT (ensures procedure is performed with correct PT)
#5Explain procedure (enlists cooperation and decreases PT anxiety)
#6Perform hand hygiene and don clean gloves (reduces spread of microorganisms)
#7Prepare PT for intervention: close door to room or pull curtains (provides privacy); drape PT for procedure if appropriate (prevents unnecessary exposure of PT); raise bed to comfortable working level; assist PT to comfortable position (ensures PT comfort)
#8Remove and dispose of gloves and wash hands
#9Document
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Principles of Body Mechanics

Question Answer
Useboth arms and hands to lift, push, or carry objects
Holdobjects close to you when lifting/carrying
Pushor slide objects, rather than lifting them
Avoidbending and reaching as much as possible
If making an adjustable bedadjust the height to a safe working level, usually waist high
When a task requires bendinguse a good stance. Bend your knees to lower yourself, rather than bending from the waist
Avoid twisting at the waistwhen you are lifting or moving something. Instead turn your whole body, pivoting with your feet instead of twisting at the waist
Get help from coworkerswhen possible for lifting or helping residents
Talkto residents BEFORE moving them. Agree on a signal
Nevertry to catch a falling resident. If the resident begins to fall, assist her/him to the floor. Report to the nurse any task you feel that you cannot safely do
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Positioning

Question Answer
Anteriorfront portion
Dorsal (supine)lying flat on back
Dorsal Recumbentsupine lying on back, head, and shoulder
Fowler'sHOB is raised 45-60 degrees (can be high or low) -position to feed PT
Semi-Fowler'sHOB raised 30 degrees
Orthopneicsitting up in bed at 90 degree angle or sometimes resting in forward tilt while supported by pillow on overbed table
Simslying on side with knee and thigh drawn toward chest
Pronelying face down horizontal position
Knee-chest (genupectoral)kneels so weight of body is supported by knees and chest, abdomen raised, head turned to one side and arms flexed
Trendelenburg'shead is low, body and legs are on inclined plane (victim in shock position) ***utilize when BP is low, PT usually in shock***
Lateralside-lying. can also be 30 degree. best position for prevention of pressure ulcer when immobility is constant pillows are often used for lateral alignment
Lithotomylying supine with hips and knees flexed and thighs abducted and rotated externally
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*Class Notes

Question Answer
Turn PTq2hr
Body Mechanics main objectiveprevent injury for PT and nurse
Attending call lightbuilds trust
ROM exercise requiredoctor's order
ROM exercise: repeateach full sequence 5 times minimum
Before initiating ROM exerciseask PT if they are in PAIN; if in pain relay info to head nurse/Supv. to obtain meds to alleviate pain
PT has the rightto refuse exercise; honor refusal and document attempt
PT may have mobility restrictionshonor limitations, do not cause pain or injury to PT
If PT cannot get out of bedencourage PT to move while in bed; both mobilized and immobilized PT need exercise to prevent muscle atrophy
Minimum # of hrs of daily activity2hrs is recommended daily to prevent contractures
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*Class Notes cont'd

Question Answer
Care of the eyesuse clean water to wash face and eyes; moisten folded guaze with water and clean closed eyes in one motion from inner to outer canthus
#1introduce yourself SMILE
#2get PERMISSION from the PT to do any care activity
#3provide PRIVACY by drawing curtains or shutting the door --except when feeding
*4FL constitution recognizes a right to individual privacy
#5All info related to the PT is CONFIDENTIAL
#6Each PT is asked personal PREFERENCE
#7Document
Personal preferenceif PT wants something different/new, honor it IF it is WNL, otherwise consent is needed from Supv/MD for requested change
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*Class Notes cont'd

Question Answer
Supinefacing upward; lying on back
Proneface down; lying on abdomen
Semi Fowler30 degree angle HOB; favorite position for nursing homes; if lying flat resident may aspirate (choke)
Sims Left Lateral Positionbefore giving enema due to position of rectum (bed ridden residents have issues with constipation)
Feedingraise HOB up to 90 degrees
Cannot restrain anyonewithout doctors order
SRDused for safety; prevents falls; PT care still provided as usual
Resident clothingstreet clothing at all times to include top, bottoms, socks, and shoes *gowns are for hospitals**
Liftsanyone above 35-40 pounds OSHA recommends mechanical lift to move PT
Trapeze Barcan be used for exercise for heavy PT's
Gait Beltsprovides additional safety from falls; can be used to transport resident from chair
PT needs to do 2 things before transferresident Face nurse and both feet flat on the floor **resident may fall if not flat**
Unconscious PTdocument PT is unconscious; put call light within reach; turn every 2 hrs
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PPT Questions 1-4
Question Answer
A PT was admitted to the hospital with a fractured hip. Which are complications of immobility?Embolus (blot clot) & Pressure Ulcer (from not moving)
A PT has a NG tube and is receiving feedings. While in bed, the PT is to be kept in what position?Semi-Fowler's ***take into account PT comfort, semi-fowler is usually most comfortable***
When performing ROM wrist exercises, the nurse can put the wrist through all movements exceptadduction
An implementation a nurse may use to improve safety in transferring a PT isusing a gait belt
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