Foundations of Nursing - Topic 3: Chapter 39 - Immobility

Importance of Mobility

• Optimal Mobility is crucial for positive client outcomes.
• Essential for:
  • Daily activities
  • Self-defense
  • Communication (verbal & non-verbal)
  • Recreational and leisure activities
• Dependent on intact musculoskeletal and nervous systems.

Body Mechanics

• Body Mechanics: Coordinated effort of musculoskeletal and nervous systems.
• Correct body alignment reduces strain and promotes balance and energy conservation.
• Balance can be affected by disease, injury, and life changes such as aging and pregnancy.
• Friction: Opposes movement, greater with larger objects.
• Shear: Force exerted against the skin while the skin remains stationary.

The Skeletal System

• Provides support and protection for vital organs.
• Bone changes due to aging or disease affect mobility.
• Contains bone marrow for red blood cell production.
• Joints: Regions where bones attach, essential for movement.
• Ligaments, tendons, cartilage: Support and facilitate joint movement.

Muscular and Nervous Systems

• Skeletal muscles: Contract and relax for movement.
• Nervous system: Regulates movement and posture.
• Disorders affecting neurotransmitter production can impair movement.

Impact of Immobility

• Affects metabolic processes, causing issues with metabolism and GI disturbances.
• Respiratory risks: Atelectasis, pneumonia.
• Cardiovascular risks: Orthostatic hypotension, increased cardiac workload, thrombus formation.
• Musculoskeletal effects: Muscle atrophy, joint contractures.
• Urinary & Skin effects: Urinary stasis, pressure injuries.

Psychosocial Effects

• Leads to emotional responses, sensory alterations, changes in coping.
• Can cause social isolation and depression.

Age-Related Considerations

• Development delays in children.
• Adolescents face social isolation if immobilized.
• Older adults: Bone mass loss, risk for falls, functional status changes.

Nursing Process and Critical Thinking

• Anticipate potential and actual risks of immobility.
• Collaborate with other health professionals.
• Develop individualized care plans to improve function and psychological well-being.

Assessment

• Consider client’s perception of mobility limitations.
• Assess movement, gait, exercise history, body alignment.

Nursing Diagnoses

• Impaired Mobility: Some limitation but not completely immobile.
• Risk for Disuse Syndrome: Immobile and at risk for multi-system problems.

Planning and Implementation

• Set priorities for immediate needs.
• Involve clients in planning care.
• Health promotion: Education, prevention, early detection.
• Exercise programs to enhance well-being.

Interventions for Immobility

• Promote lung expansion, reduce respiratory complications.
• Minimize cardiovascular risks.
• Maintain musculoskeletal function: Active ROM, positioning aids.
• Prevent skin breakdown: Positioning, therapeutic support surfaces.

Case Study: Ms. Eileen Thomas

• Risks: Bone loss, cardiovascular issues, skin breakdown, mobility and social needs.
• Interventions: Deep breathing, coughing, repositioning, incentive spirometry.

Safety Guidelines

• Safe transfer techniques.
• Use of mechanical lifting equipment to prevent injury.

Conclusion

• Application of nursing process and collaboration are key in managing immobility.
• Contact course instructor for queries.