Chapter 39: Immobility and Body Mechanics

Importance of Body Mechanics

• Coordinated efforts between musculoskeletal and nervous systems.
• Proper lifting and positioning techniques crucial in nursing to prevent injuries.
• Correct body alignment reduces strain and conserves energy.
• Weight as gravitational force; friction opposes movement.

Skeletal System

• Provides muscle and ligament attachment and mobility leverage.
• Bones firm, rigid, and elastic; elasticity changes with age, nutrition, disease.

Nervous System

• Regulates movement and posture.
• Postural abnormalities affect musculoskeletal efficacy, balance, and mobility.
• Damage to nervous system impacts movement and alignment.

Effects of Immobility

• Muscular Deconditioning: Observed in days, 3% muscle strength loss per day.
• Metabolic Changes: Decreases rate, causes imbalances.
• Respiratory Complications: Risk of atelectasis and hypostatic pneumonia.
• Cardiovascular System: Orthostatic hypotension, increased workload, thrombus formation.
• Musculoskeletal Effects: Protein breakdown, muscle mass loss.
• Urinary System: Urinary stasis, risk of infections and renal calculi.
• Skin and Emotional Impact: Pressure injuries, emotional changes, isolation.

Nursing Interventions and Care Plan

• Regular assessment of mobility status.
• Develop individualized care plans.
• Encourage range of motion exercises to prevent joint issues.
• Promote high-protein, high-calorie diet with necessary vitamins.
• Implement lung expansion and secretion removal exercises.
• Focus on health promotion and education.

Common Nursing Diagnoses

• Impaired mobility and risk for disuse syndrome.
• Include patient and family in setting realistic, measurable goals.

Restorative Care

• Maximize functional mobility and independence.
• Focus on activities of daily living and instrumental activities.
• Evaluate patient feedback and adjust care plans accordingly.

Safety and Prevention

• Assess patient's mobility and gather necessary equipment.
• Interventions to prevent pressure injuries: repositioning, support surfaces.
• Exercise programs enhance well-being, reduce health risks.

Special Considerations

• Older Adults: More prone to bone loss and coordination issues.
• Developmental Changes in the Young: Immobility affects growth and social integration.

Critical Thinking in Nursing

• Analyze findings for patient-centered decisions.
• Evaluate the impact of interventions on patient outcomes.