Transcript Slide 1
Chapter 24 Exercise and Activity Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc. Being active is important for physical and mental well-being. Illness, surgery, injury, pain, and aging cause weakness and some activity limits. Inactivity, whether mild or severe: • Affects every body system • Affects mental well-being Deconditioning is the loss of muscle strength from inactivity. Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 2 To help promote exercise and activity, you need to understand: • Bedrest • How to prevent complications from bedrest • How to help with exercise Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 3 BEDREST Generally bedrest is ordered to: • Reduce physical activity • Reduce pain • Encourage rest • Regain strength • Promote healing These types of bedrest are common: • Strict bedrest • Bedrest • Bedrest with commode privileges • Bedrest with bathroom privileges (bedrest with BRP) Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 4 The person’s care plan and your assignment sheet tell you the activities allowed. Complications of bedrest involve every system and include: • Pressure ulcers • Constipation and fecal impaction • Urinary tract infections and renal calculi • Blood clots (thrombi) • Pneumonia • Contractures • Muscle atrophy • Orthostatic hypotension (postural hypotension) Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 5 Good nursing care prevents complications from bedrest. • The care plan includes: Good alignment Range-of-motion exercises Frequent position changes Supportive devices are often used. • Bed boards • Foot boards • Trochanter rolls • Hip abduction wedges • Hand rolls or handgrips • Splints • Bed cradles Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 8 Exercise helps prevent: • Contractures • Muscle atrophy • Other complications of bedrest A trapeze is used for exercises to strengthen arm muscles. • The trapeze is also used to move up and turn in bed. Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 15 RANGE-OF-MOTION EXERCISES Active range-of-motion exercises are done by the person. With passive range-of-motion exercises, someone moves the joints through their range of motion. With active-assistive range-of-motion exercises, the person does the exercises with some help. OBRA requires an assessment and care planning process to prevent unnecessary loss in a person’s range of motion. Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 17 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 18 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 19 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 20 AMBULATION Some people need help walking. • Some become strong enough to walk alone. • Others will always need help. After bedrest, activity increases slowly and in steps. To achieve the goal of walking: • Contractures and muscle atrophy must be prevented. • Proper positioning and exercises are needed during bedrest. Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 22 When helping the person to walk: • Follow the care plan. • Use a gait (transfer) belt if the person is weak or unsteady. • The person uses hand rails along the wall. • Check the person for orthostatic hypotension. Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 23 Walking aids support the body. • The need may be temporary or permanent. • The type ordered depends on: The person’s condition The amount of support needed The type of disability • Crutches are used when the person cannot use one leg or when one or both legs need to gain strength. Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 27 • Follow these safety measures when crutches are used: Check the crutch tips. Check crutches for flaws. Tighten all bolts. Street shoes are worn. Clothes must fit well. Practice safety rules to prevent falls. Keep crutches within the person’s reach. Know which crutch gait the person uses. Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 28 • Canes are used for weakness on one side of the body. They help provide balance and support. Single-tip and four-point (quad) canes are common. A cane is held on the strong side of the body. • A walker is a four-point walking aid. It gives more support than a cane. There are many kinds of walkers. Baskets, pouches, and trays attach to the walker. • Braces support weak body parts. They prevent or correct deformities or prevent joint movement. They are applied over the ankle, knee, or back. You need to keep the skin and bony points under braces clean and dry. You need to report redness, signs of skin breakdown, and complaints of pain or discomfort at once. Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 29 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 30 RECREATIONAL ACTIVITIES OBRA requires activity programs for residents. A good activity program improves a person’s quality of life. Activities must meet each person’s interests and physical, mental, and psychosocial needs. Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 34 QUALITY OF LIFE You assist residents with exercise and activity. You must protect the rights to privacy and personal choice. • The person’s body is not exposed. • Choices are allowed whenever safe and possible. Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 35