Post on 18-Jan-2015
description
BedrestWhy?
Decrease activity Decrease pain Encourage rest Regain strength Promote healing
Types of Bedrest1. Bedrest- can do ADL's (bath) 2. Strict Bedrest-not up at all 3. Bedrest with bathroom privileges 4. Bedrest with commode privileges
What body systems are affected by immobility?
Systems affectedSkin-decrease
circulation bedsores decubitus ulcersMuscles- atrophy contracturesMental – depressionSkeletal: brittle bones stiffnessUrinary- UTI’s kidney stones stagnant urine
GI- constipation fecal impaction decrease motilityRespiratory-
pneumonia atelectasisPoor
ventilationCardiovascular-
blood clotsPoor circulationOrthostatic hypotension (postural hypotension)Syncope
Think about it?They dr. has ordered bed rest for a resident.
What must you do to prevent complications of immobility?
Body System Complication Care/prevention
Integumentary (skin)
Muscles
Joints
Bones
Gastrointestinal
Respiratory
Cardiovascular
Body System Complication Care/prevention
Integumentary (skin) Pressure Ulcers (decubitus ulcers) Turning q 2 hr.Skin care
Muscles Atrophy- muscle wastes away ROM
Joints Contracture-muscle shortens over joint, fixed & can’t move
ROM
Bones Brittle ROMAmbulation
Gastrointestinal ConstipationFecal impaction
Respiratory PneumoniaAtelectasis
Cough & Deep breathingTurning q 2 hr.
Cardiovascular ThrombiOrthostatic /postural HypotensionSyncope –pass out
TED hose, ROM, AmbulationChange position slowlyMonitor VS
Urinary UTIRenal calculi
Increase fluid intakeToilet q 2 hr.
Think about it?A pt. has been on bed rest for 3 days. The RN
asks you to assist the pt. with ambulation. You know orthostatic hypotension can occur when the pt. moves from lying to sitting to standing. The pt. is at risk for syncope. What questions can you ask the pt., to check for orthostatic hypotension?
Devices to prevent complicationsa. Bed board- prevent sagging
b. Footboard- prevent plantar flexion/foot drop
c. Trocanter roll: prevent hip abduction
d. Hip abduction wedge: prevent adduction
Bed cradles: prevents foot drop & touching wounds
Purpose of ROM:
Allows for movement of joints to prevent complications such as atrophy and contractures.
Required by OBRA
Types of ROM1. Active ROM- do by self2. Passive ROM-someone does for the pt. 3.Active/Passive ROM-someone assists pt.
Rules of ROM:
Done 2 times/day RN will direct you on joints to do ROM Expose part being exercised Good body mechanics-pt. & you Support above & below joint being exercised Move slowly and smoothly Do not force joint Stop if pain
Movements Abduction-move away from body Adduction-move towards body Extension-straighten a body part Flexion-bend a body part Hyperextension-excessive straightening Dorsiflexsion-bending backwards Rotation-turning joint Internal rotation-turning joint inward External rotation-turning joint outward Plantar Flexion-planting foot down Pronation-turning downward Supination-turning upwardDO NOT do Neck ROM without permission!
Think about it?The dr. orders passive ROM for your pt’s
right knee. What safety rules do you need to follow when performing Passive ROM to the pt’s right knee?
Prosthesis
Replacement of a missing part by an artificial substitute
Care of the prosthesis
Label CleanStorage