Transcript Wk 3 Mobility. Student copyx

Concept: Mobility
Concept: Mobility
Mobility, the ability to move freely, easily,
rhythmically, and purposefully in the
environment, is an essential part of living.
Systemic Effects of
Immobility
Mindmap
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Metabolic changes
Psychosocial Effects: Depression
Respiratory Changes
Cardiovascular Changes
Musculoskeletal changes
Integumentary changes
Urinary elimination
Bowel elimination
Gas Exchange
Respiratory Changes
• Atelectasis (collapse of alveoli)
• Hypostatic pneumonia (inflammation of the lung
from stasis or pooling of secretions)
Perfusion
Orthostatic hypotension
When you stand up, gravity causes blood to pool in your legs.
This decreases blood pressure because there's less blood
circulating back to your heart to pump.
Orthostatic or postural hypotension occurs when something
interrupts the body's natural process of counteracting low
blood pressure.
Perfusion
Thrombus
• Thrombus is an accumulation of platelets,
fibrin, clotting factors, and the cellular
elements of the blood attached to the interior
wall of a vein or artery, which sometimes
occludes the lumen of the vessels.
Skeletal Effects
osteoporosis, joint contracture, footdrop
• Muscle Effects:
– Lose of lean body mass
– Decreased muscle mass strength
– Atrophy
Skeletal Effects
Disuse osteoporosis
• Disuse osteoporosis: Immobilization results in bone
resorption
– These patients are at risk for pathological fractures
Skeletal Effects
Joint Contracture
• Joint contracture is an abnormal and possible
permanent condition characterized by fixation
of the joint.
Urinary Elimination
Urinary status & renal calculi
• Urinary stasis:
– Risk for UTI
– Risk for Renal Calculi: calcium stones that lodge
in the renal pelvis or pass through the ureters
Bowel elimination
Constipation
• Constipation is due to stasis of fecal material in the
rectum and sympathetic nervous system activity.
• May present as ribbon-like diarrhea and fecal
smearing
Integumentary
Pressure ulcers
• A pressure ulcer is a
specific tissue injury
caused by unrelieved
pressure that results in
ischemia and damage to
the underlying tissue
• Pressure ulcers occur
most commonly over
bony prominences.
Metabolic changes
• ↓ Appetite → Negative Nitrogen Balance
– Wt loss, ↓muscle mass, and weakness
• Hypercalcemia
– Pathological fractures
• ↓GI mobility
– Constipation
– Fecal impactions
Psychosocial Effects
Depression
Immobilization often leads to emotional and
behavioral responses, sensory alterations, and changes
in coping.
Sensory deprivation: altered sleep patterns and
significant increases in anxiety, hostility, and
depression.
Depression: feelings of sadness, melancholy, dejection,
worthlessness, emptiness, and hopelessness
VTE: Mortality and Morbidity
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300,000 to 650,000 with VTE per year
100,000 to > 200,000 deaths per year
Most are hospital related.
VTE is primary cause of fatality in half
– More than HIV, MVAs, Breast Ca combined
– Equals 1 jumbo jet crash/day
• 10% of hospital deaths
• Huge costs and morbidity
Perfusion
Pulmonary embolism
Pulmonary embolism
A blockage of a pulmonary artery by foreign
matter. The obstruction may be fat, air,
tumor tissue or a thrombus