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Mobility

Clinical Judgement Model: Recognize Clues

Assessment of Mobility

Muscle strength

Ability to move

Activity tolerance ADLs

Mobility Assessment Tool (MAT)

Age considerations

Assistive devices

Positions

Range of Motion

Assistive Devices and Positioning

Passive versus active ROM

Exercise

Antiembolism stockings

SCDs

Walker, cane, crutches

slide or transfer board

Pivot disc

Prone, supine, lateral

Lateral semi-prone

Trendelenburg

Fowler: Semi and High

Interventions

Interventions & Medications

Ambulation, Hourly rounding

DVT- stockings and SCD

Atelectasis: IS, cough and deep breath

Active and Passive ROM, Isometric and Isotonic

Foot drop- plantar flexion contractures- footboard

Pneumonia- turn and reposition

Constipation- fluids

Medications Pearson 944-945

GERD- elevate HOB

Presure Injury- turn every 2 hours

Body Mechanics

  • Prevent injuries for example back injuries:
  • Bend at knees not waist
  • Use large muscles of legs not back
  • Keep client or object close to body
  • Bed comfortable level
  • Avoid leaning, reaching, or stretching over the client or bed
  • Avoid twisting, move entire body in direction you wish to face
  • Wide base (your feet)
  • Abdominal muscles tight, lower back in normal position
  • Push up from knees and use that momentum to lift the object

Ergonomics

Policies

Adjustable equipment ie IV pole

Modifiable work stations

Shower chairs

Keyboard with wrist support

Elimination of uneven floor surfaces

Complications of immobility

Complications

Bones- Osteoporosis

Muscles-atrophy

Joints-contractures

Foot-drop

Cardiac-Deconditioning, DVT, PE, MI, CVA

GU: Urinary retention, renal calculi

Skin: Pressure sores

Psychological: Depression, social isolation

Respiratory- Atelectasis, Pneumonia

Gastrointestinal- Constipation, Malnutrition, impaction, GERD

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