Fundamentals Of Nursing Chapter 39 Immobility Quizlet

Fundamentals of Nursing: Chapter 39 Immobility - A Comprehensive Guide

This article delves into the complexities of immobility as discussed in Fundamentals of Nursing Chapter 39, providing a detailed overview exceeding the typical quizlet summary. We'll explore the multifaceted implications of immobility across various physiological systems, highlighting preventative measures and nursing interventions. This in-depth analysis aims to provide a thorough understanding of this crucial nursing concept.

What is Immobility?

Immobility, in a nursing context, refers to the inability to move freely and independently. This can range from temporary restrictions, like post-surgical recovery, to long-term limitations caused by chronic conditions. It’s crucial to understand that immobility is not simply a lack of movement; it's a complex condition with cascading effects on multiple body systems.

The Physiological Consequences of Immobility:

Immobility significantly impacts virtually every system in the body. Understanding these effects is critical for effective nursing care.

1. Musculoskeletal System:

• Muscle Atrophy: Reduced muscle use leads to a decrease in muscle mass, strength, and tone. This is particularly noticeable in the extremities and can significantly impair mobility and function.
• Contractures: Prolonged immobility can result in the shortening and tightening of muscles, tendons, and ligaments, leading to joint stiffness and limited range of motion. This can cause permanent deformities if not addressed.
• Bone Demineralization (Osteoporosis): Reduced weight-bearing activity leads to decreased bone density, increasing the risk of fractures. This is particularly concerning for older adults.
• Joint Stiffness: Limited movement can lead to joint stiffness, pain, and decreased flexibility.

2. Cardiovascular System:

• Orthostatic Hypotension: A sudden drop in blood pressure upon standing, often caused by a decrease in blood volume and impaired venous return due to immobility.
• Deep Vein Thrombosis (DVT): Stagnant blood flow increases the risk of clot formation in the deep veins of the legs, which can be life-threatening if it embolizes (travels) to the lungs.
• Increased Cardiac Workload: The heart has to work harder to pump blood against increased peripheral vascular resistance.
• Reduced Cardiac Output: Reduced activity leads to decreased venous return, impacting the heart's efficiency.

3. Respiratory System:

• Atelectasis: Collapse of the alveoli in the lungs, leading to decreased gas exchange and hypoxemia (low blood oxygen levels).
• Pneumonia: Immobility increases the risk of pneumonia due to decreased lung expansion and mucus clearance.
• Decreased Lung Capacity: Reduced deep breathing and coughing can result in a decreased vital capacity.
• Hypoventilation: Shallow breathing can lead to inadequate ventilation and respiratory acidosis.

4. Integumentary System:

• Pressure Ulcers: Prolonged pressure on the skin, particularly over bony prominences, can lead to pressure ulcers (bedsores), which can range from superficial to deep and life-threatening.
• Skin Breakdown: Reduced circulation and moisture can weaken the skin, making it more susceptible to breakdown and infection.
• Dry Skin: Immobility can contribute to dry, cracked skin, increasing susceptibility to infection.

5. Gastrointestinal System:

• Constipation: Decreased physical activity and changes in diet can lead to constipation.
• Anorexia: Loss of appetite, often due to decreased physical activity and discomfort.
• Gastrointestinal Issues: Impaired peristalsis due to inactivity.

6. Urinary System:

• Urinary Tract Infections (UTIs): Immobility can lead to urinary retention, which increases the risk of UTIs.
• Renal Calculi (Kidney Stones): Immobility can increase the risk of kidney stone formation due to changes in calcium metabolism.
• Urinary Retention: Impaired bladder emptying and urinary stasis.

7. Neurological System:

• Depression: Immobility can lead to feelings of isolation, helplessness, and depression.
• Cognitive Impairment: Decreased sensory input and lack of stimulation can contribute to cognitive decline.
• Sensory Deprivation: Lack of environmental stimuli.

8. Metabolic System:

• Negative Nitrogen Balance: The body breaks down more protein than it builds up, leading to muscle loss and decreased immunity.
• Electrolyte Imbalances: Changes in fluid balance can cause electrolyte imbalances.
• Impaired Glucose Tolerance: Reduced metabolism and reduced physical activity.

Nursing Interventions and Preventative Measures:

Nursing interventions focus on minimizing the negative effects of immobility and promoting patient comfort and well-being.

1. Promoting Mobility:

• Passive Range of Motion (PROM): The nurse moves the patient's joints through their full range of motion.
• Active Range of Motion (AROM): The patient moves their own joints through their full range of motion.
• Ambulation Assistance: Helping the patient walk, using assistive devices as needed.
• Therapeutic Exercises: Prescribed exercises to improve strength and flexibility.

2. Preventing Complications:

• Positioning: Frequent repositioning to prevent pressure ulcers and promote comfort.
• Deep Breathing Exercises: To prevent atelectasis and pneumonia.
• Incentive Spirometry: To encourage deep breathing and lung expansion.
• Coughing and Sputum Production: Techniques to clear the airways.
• Compression Stockings: To improve venous return and reduce the risk of DVT.
• Anticoagulant Therapy: Medication to prevent blood clot formation.
• Adequate Hydration: To maintain fluid balance and prevent constipation.
• Bowel and Bladder Programs: To promote regular elimination.
• Nutritional Support: To maintain adequate protein intake and prevent muscle loss.
• Skin Care: Regular skin assessment and care to prevent pressure ulcers.
• Pain Management: To alleviate pain and discomfort.
• Emotional Support: To address psychological aspects of immobility, including depression and anxiety.
• Fall Prevention: Assess fall risk and implement appropriate measures.

3. Patient Education:

• Instruct patients and their families about the importance of mobility and the risks of immobility.
• Teach patients how to perform ROM exercises and other preventative measures.
• Encourage patients to participate actively in their care.

Assessment and Monitoring:

Regular assessment is crucial to identify and address potential problems early.

• Monitor vital signs: Regularly check blood pressure, heart rate, respiratory rate, and temperature.
• Assess skin integrity: Regularly inspect skin for signs of pressure ulcers or breakdown.
• Monitor bowel and bladder function: Assess for constipation, urinary retention, or incontinence.
• Assess respiratory status: Listen to lung sounds and monitor for signs of atelectasis or pneumonia.
• Monitor muscle strength and range of motion: Assess for muscle atrophy, contractures, or joint stiffness.
• Assess pain levels: Regularly assess for pain and administer pain medication as needed.
• Monitor nutritional status: Assess for signs of malnutrition or dehydration.
• Assess psychological status: Assess for signs of depression or anxiety.

Conclusion:

Immobility presents a significant challenge in nursing care. Understanding the physiological consequences, implementing appropriate interventions, and providing comprehensive patient education are vital for minimizing complications and promoting optimal patient outcomes. This detailed exploration of Fundamentals of Nursing Chapter 39 on immobility offers a comprehensive understanding beyond a simple quizlet summary, providing nurses with a solid foundation for effective patient care. Regular assessment and proactive interventions are key to managing the effects of immobility and enhancing the quality of life for immobile patients. Remember to always consult relevant medical texts and guidelines for the most up-to-date information and best practices.