IMMOBILITY

Potter & Perry
Chapter 34

 

 

Developed by:

June Mair, RN, MSN

Revised by Susan Stone

Conditions which may result in Immobility

    Physical inactivity

Prescribed bed rest

    Physical inactivity

Response to severe pain

    Physical restriction or limitation

Cast or traction

    Cognitive- emotional changes

Depression

 

 

 

 

 

 

 

 

 

 

 

Physiological Effects of Immobility

     Respiratory changes

     Changes in Metabolic Rate/Metabolism

     Fluid & Electrolyte Balance

     Gastrointestinal changes

     Cardiovascular changes

     Musculoskeletal changes

     Integumentary (Skin) changes

     Urinary Elimination changes

     Psychosocial Effects

     Developmental Effects

 

 

Respiratory Changes

   Respiratory changes

Atelectasis and hypostatic pneumonia

    Decreased lung expansion

    Weakened respiratory muscles

    Decreased ability to cough productively

 

Changes in
Metabolic Rate & Metabolism

    Decreased response to energy requirements of body cells

    Negative nitrogen balance

    Loss of lean body mass

 

 

 

 

Fluid and Electrolyte Balance

    Increased blood flow to kidneys and increased circulating blood volume, cause excessive excretion of urine and losses in sodium, potassium, and calcium.

 

Gastrointestinal Changes

    Depressed peristalsis results in constipation

    Fecal impaction may occur if constipation is untreated

    Complete bowel obstruction is a severe consequence

 

Cardiovascular Changes

    Orthostatic hypotension

    Increased cardiac workload

Heart rate increased (4-15 beats per minute)

    Dependent edema

    Risk for thrombus formation

 

Musculoskeletal Changes

    Loss of strength and endurance

    Loss of muscle mass

    Decreased stability or balance

    Joint contracture formation

    Disuse osteoporosis from impaired calcium imbalance

 

Integumentary Changes

    Risk for pressure ulcer formation

    Decreased wound healing

    Weight of body on bony prominences result in ischemia and risk for impaired skin integrity

Urinary Elimination Changes

    Urinary stasis

    Urinary tract infection

    Renal calculi caused by calcium lodged in renal pelvis

 

Psychosocial Effects

   Psychosocial

Depression (most common)

   Behavioral changes

   Changes in sleep- wake cycles

   Decreased coping abilities

   Anger

 

 

 

 

 

 

 

 

 

 

Developmental Effects

    Infants,toddler, preschool:

Delayed development of intellectual and motor skills

    Older adult:

Increased rate of physical dependence

Increased rate of loss of system functions

 

Assessments

    Mobility

    Respiratory system

    Metabolic system

    Fluid & Electrolyte Balance

    Gastrointestinal system

    Cardiovascular system

    Musculoskeletal system

    Integumentary (Skin) system

    Urinary Elimination system

    Psychosocial Effects

    Developmental Effects

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Nursing Interventions

    Mobility

    Respiratory system

    Metabolic system

    Fluid & Electrolyte Balance

    Gastrointestinal system

    Cardiovascular system

    Musculoskeletal system

    Integumentary (Skin) system

    Urinary Elimination system

    Psychosocial Effects

    Developmental Effects

 

Restorative/Continuing Care

Goal:

to maximize independence, increase endurance and prevent injury

QUESTIONS????