Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Chapter 26 Exercise and Activity Mosby items and derived items © 2008 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 • Mental well-being Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 2 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 Mosby items and derived items © 2008 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 Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 4 These types of bedrest are common: • Strict bedrest • Bedrest • • 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) Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 5 Complications of bedrest include: • Pressure ulcers • Constipation and fecal impaction • Urinary tract infections and renal calculi (kidney • • • • • • stones) Blood clots (thrombi) Pneumonia (inflammation and infection of the lung) Contractures Muscle atrophy Orthostatic hypotension (postural hypotension) Syncope (fainting) Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 6 Good nursing care prevents complications from bedrest. • Good alignment • Range-of-motion exercises • Frequent position changes These are part of the care plan. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 7 Supportive devices are often used. • Bed boards prevent the mattress from sagging. • Foot boards prevent plantar flexion and serve as bed • • • • • 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. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 8 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 Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 9 RANGE-OF-MOTION EXERCISES Range-of-motion exercises involve moving the joints through their complete range of motion. • • • 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. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 10 AMBULATION Ambulation is the act of walking. 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. Walking regularly helps prevent deconditioning. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 11 Walking aids • Walking aids support the body. • The type ordered depends on: The person’s condition The amount of support needed The type of disability Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 12 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, • • • • 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. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 13 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. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 14 Braces support weak body parts. • They also prevent or correct deformities or prevent joint • • • movement. A brace is applied over the ankle, knee, or back. An ankle-foot orthosis (AFO) is placed in the shoe. You need to: • 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. Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 15 RECREATIONAL ACTIVITIES OBRA requires activity programs for residents. Recreational activities: • • • • • 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. Slide 16