Transcript legs and stockings

Activity/Exercise FHP
Elola Maberry, MSN, RN
Range-of-Motion Exercises
• The movement of a joint to the extent possible
without causing pain.
• Active ROM- done by the person.
• Passive ROM- done by another person.
• Active-assistive ROM- the person does some of
the movement with help form another person.
Purpose of Range of Motion
exercises
• Improve joint mobility.
• Increase circulation to the affected part.
Joint Movements
• Abduction- moving a body part away from the midline of the body
• Adduction- moving a body part toward the midline of the body
• Extension-straightening a body part
• Flexion – bending a body part
• Rotation- turning the joint
• Internal rotation
• External rotation
• Plantar flexion
• Pronation
• Supination
Heat & Cold Therapy
• Heat and cold are applied to bring about a
local or systemic change in body temperature
for various therapeutic purposes.
• Heat causes “vasodilation”
• Cold causes “vasoconstriction”
Effects of Applying Heat
• Dilates peripheral blood vessels
• Vasodilation increases local blood flow.
• Increases tissue metabolism
• Reduces blood viscosity
Effects of Applying Heat
• Increases capillary permeability
• Reduces muscle tension
• Helps relieve pain
• Heat reduces muscle tension to promote
relaxation and helps to relieve muscle spasm
Uses of Heat Therapy
• Treat infections
• Surgical wounds
• Arthritis
• Joint and muscle pain
• Dysmenorrhea
• Chronic pain
Effects of Applying Cold
• Constricts peripheral blood vessels
• Reduces blood flow to tissues
• Decreases the local release of pain-producing
substances (promotes comfort)
• Decreases tissue metabolism
• Reduces edema formation
• Reduces muscle spasm
• Alters tissue sensitivity (producing numbness)
Uses of Cold Therapy
• After direct trauma
• Dental pain
• Muscle spasm
• Sprains
• To treat some chronic pain syndromes.
Physiological
Considerations
• Rebound phenomena is important to the therapeutic
value of heat and cold.
• Heat produces maximum vasodilation in 20 to 30
minutes; then vasoconstriction occurs.
• With cold, vasoconstriction occurs when the skin reaches
15 degrees Celsius; then vasodilation begins.
Do not apply Heat!
• Open wound immediately after trauma
• During hemorrhage
• A localized malignant tumor
• The testes
• The abdomen of a pregnant women
• Over metallic implants
Do not apply Cold!!!
• Open wounds
• Clients with impaired peripheral circulation
• Clients who have an allergy to cold
Nursing Diagnosis
• Ineffective Thermoregulation
• Ineffective Tissue Perfusion
• Acute Pain
• Chronic Pain
• Risk for Injury
• Risk for Trauma
Applying Heat
• Hot water bags
• Electric heating pads
• Aquathermia Pads
• Hot packs
• Warm moist compresses
• Sitz baths
• Warm soaks
• Heat lamp/cradle
Applying Cold
• Ice bags/collar
• Cold packs
• Cold compresses
Ace Bandage
• A stretchable band used to create localized pressure.
• Used to treat muscle sprains and strains by reducing
blood flow to the area which can reduce swelling
• Mobilize the affected joint
Anti-Embolic
Stockings
• Used for patients at risk for deep vein thrombosis,
pulmonary embolism and to help prevent phlebitis.
• Elastic material available in either knee-high or thighhigh length.
• Pressure increases the velocity of blood flow in the
superficial and deep veins and improve venous vale
function in the legs promoting venous return to the
heart.
Anti-Embolism Stockings
• Measure the client’s leg to determine the proper size of
the stocking.
• Assess the skin and the neurovascular status of the
legs.
• Apply the stockings in the morning before the client is
out of bed and while the client is supine.
• Do not massage the leg.
• Assess the leg for redness, blistering, swelling and pain.
Compression Devices
• May be used in conjunction with antiembolism stocking.
• High-risk surgery clients, decreased mobility, chronic venous
disease, and client’s at risk for deep-vein disorders.
• Apply intermittent or sequential pressure to the leg to enhance
blood flow and venous return, simulating the normal muscle
pumping action in the legs.