Transcript Chapter_26 - Educators Learn

Chapter 26
Exercise and Activity
Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc.
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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
• Mental well-being
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Nurses use the nursing process to promote
exercise and activity in all persons to the extent
possible.
 To help promote exercise and activity, you need
to understand:
• Bedrest
• How to prevent complications from bedrest
• How to help with exercise
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BEDREST
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Generally bedrest is ordered to:
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Reduce physical activity
Reduce pain
Encourage rest
Regain strength
Promote healing
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These types of bedrest are common:
• Strict bedrest
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Bedrest
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Everything is done for the person.
Some activities of daily living (ADL) are allowed.
Bedrest with commode privileges
Bedrest with bathroom privileges (bedrest with BRP)
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Complications of bedrest include:
• Pressure ulcers
• Constipation and fecal impaction
• Urinary tract infections and renal calculi (kidney
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stones)
Blood clots (thrombi)
Pneumonia (inflammation and infection of the lung)
Contractures
Muscle atrophy
Orthostatic hypotension (postural hypotension)
Syncope (fainting)
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Good nursing care prevents complications from
bedrest.
• Good alignment
• Range-of-motion exercises
• Frequent position changes
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These are part of the care plan.
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Supportive devices are often used.
• Bed boards prevent the mattress from sagging.
• Foot boards prevent plantar flexion and serve as bed
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cradles.
Trochanter rolls prevent the hips and legs from external
rotation.
Hip abduction wedges keep the hips abducted.
Handrolls or handgrips prevent contractures of the
thumb, fingers, and wrist.
Splints keep the elbows, wrists, thumbs, fingers,
ankles, and knees in normal position.
Bed cradles keep the weight of top linens off the feet
and toes.
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Exercise helps prevent:
• Contractures
• Muscle atrophy
• Other complications of bedrest
 Some exercise occurs:
• With ADL
• When turning and moving in bed without help
 A trapeze is used:
• For exercises to strengthen arm muscles
• To move up and turn in bed
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RANGE-OF-MOTION EXERCISES
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Range-of-motion exercises involve moving the
joints through their complete range of motion.
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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.
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AMBULATION
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Ambulation is the act of walking.
After bedrest, activity increases slowly and in
steps.
To achieve the goal of walking:
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Contractures and muscle atrophy must be prevented.
Proper positioning and exercises are needed during
bedrest.
Walking regularly helps prevent deconditioning.
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Walking aids
• Walking aids support the body.
• The type ordered depends on:
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The person’s condition
The amount of support needed
The type of disability
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Crutches are used when the person cannot use
one leg or when one or both legs need to gain
strength.
Follow these safety measures:
• Check the crutch tips.
• Check crutches for flaws.
• Tighten all bolts.
• Make sure the person wears street shoes with flat,
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non-skid soles.
Make sure clothes fit well.
Practice safety rules to prevent falls.
Keep crutches within the person’s reach.
Know which crutch gait the person uses.
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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.
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Braces support weak body parts.
• They also prevent or correct deformities or prevent joint
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movement.
A brace is applied over the ankle, knee, or back.
An ankle-foot orthosis (AFO) is placed in the shoe.
You need to:
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Keep skin and bony points under braces clean and dry.
Report redness or signs of skin breakdown at once.
Report complaints of pain or discomfort.
The care plan tells you when to apply or remove a
brace.
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RECREATIONAL ACTIVITIES
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OBRA requires activity programs for residents.
Recreational activities:
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Are important for a person’s physical and mental wellbeing
Exercise joints and muscles
Stimulate circulation
Are social events
Are mentally stimulating
A good activity program improves a person’s
quality of life.
Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc.
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