👩‍⚕️Foundations of Nursing Practice Unit 9 – Mobility and Activity

What's This Unit About?

• Focuses on the importance of mobility and activity in maintaining overall health and well-being
• Explores the nurse's role in assessing, promoting, and maintaining patient mobility
• Covers common mobility issues and their impact on patient outcomes
  • Includes conditions such as arthritis, stroke, and spinal cord injuries
• Discusses nursing interventions and techniques to support patient mobility
  • Includes range of motion exercises, positioning, and assistive devices
• Emphasizes the importance of patient education and support in promoting mobility and preventing complications

Key Concepts and Definitions

• Mobility: the ability to move freely and easily, including changing positions and transferring from one surface to another
• Activity: the level of physical exertion and participation in daily tasks and exercises
• Range of motion (ROM): the extent to which a joint can move through its full range of motion
  • Includes active ROM (patient-initiated) and passive ROM (nurse-assisted)
• Assistive devices: equipment used to support mobility and independence (walkers, canes, wheelchairs)
• Immobility: the inability to move freely or easily, often due to physical limitations or medical conditions
• Pressure ulcers: skin breakdown caused by prolonged pressure on bony prominences, often associated with immobility

Why Mobility Matters

• Maintains muscle strength, flexibility, and joint function, reducing the risk of contractures and atrophy
• Promotes circulation, reducing the risk of blood clots and improving wound healing
• Supports respiratory function, reducing the risk of pneumonia and other respiratory complications
• Enhances digestion and bowel function, reducing the risk of constipation and impaction
• Improves mental health and cognitive function, reducing the risk of depression and delirium
• Promotes independence and self-care abilities, improving overall quality of life

Assessing Mobility and Activity

• Observe patient's ability to move, transfer, and perform daily activities
• Assess muscle strength, tone, and coordination using manual muscle testing and observation
• Evaluate joint range of motion using goniometry and visual assessment
• Identify any pain, discomfort, or limitations that may impact mobility
• Assess skin integrity, particularly over bony prominences, to detect early signs of pressure ulcers
• Consider patient's cognitive function, sensory abilities, and motivation in relation to mobility
• Document findings and communicate with the healthcare team to develop an individualized care plan

Common Mobility Issues

• Arthritis: inflammation of the joints, causing pain, stiffness, and reduced range of motion
  • Osteoarthritis: wear-and-tear arthritis, common in older adults
  • Rheumatoid arthritis: autoimmune disorder causing joint inflammation and deformity
• Stroke: brain injury resulting in weakness, paralysis, and impaired coordination on one side of the body
• Spinal cord injuries: damage to the spinal cord, causing paralysis and sensory loss below the level of injury
• Parkinson's disease: progressive neurological disorder affecting movement, balance, and coordination
• Fractures: broken bones that may require immobilization and rehabilitation to restore mobility
• Muscular dystrophy: group of genetic disorders causing progressive muscle weakness and wasting

Nursing Interventions and Techniques

• Encourage early mobilization and activity as tolerated, following medical orders and safety guidelines
• Assist with range of motion exercises, both active and passive, to maintain joint flexibility
• Use proper body mechanics and assistive devices when transferring or positioning patients
  • Includes techniques such as the pivot transfer and the use of slide boards and mechanical lifts
• Implement pressure relief strategies, such as turning and repositioning, to prevent pressure ulcers
• Collaborate with physical and occupational therapists to develop and implement mobility plans
• Monitor patient's response to interventions and adjust the care plan as needed

Patient Education and Support

• Teach patients and caregivers about the importance of mobility and activity for overall health
• Provide instruction on safe transfer techniques, use of assistive devices, and fall prevention strategies
• Encourage patients to participate in their care and set realistic mobility goals
• Educate patients about the signs and symptoms of complications, such as blood clots or pressure ulcers
• Offer emotional support and encouragement to help patients cope with mobility challenges
• Connect patients and families with community resources and support groups as needed

Risks and Complications

• Falls: increased risk of falls due to weakness, impaired balance, or environmental hazards
  • Can result in fractures, head injuries, and other serious complications
• Pressure ulcers: skin breakdown caused by prolonged pressure, particularly in immobile patients
  • Can lead to infection, sepsis, and prolonged hospital stays if left untreated
• Contractures: shortening and tightening of muscles and tendons due to prolonged immobility
  • Can cause permanent joint deformities and limit future mobility
• Blood clots: increased risk of deep vein thrombosis (DVT) and pulmonary embolism (PE) due to reduced circulation
• Respiratory complications: increased risk of pneumonia and atelectasis due to shallow breathing and reduced lung expansion
• Urinary tract infections (UTIs): increased risk due to urinary stasis and catheter use in immobile patients

Putting It All Together

• Mobility and activity are essential components of overall health and well-being
• Nurses play a crucial role in assessing, promoting, and maintaining patient mobility
• Common mobility issues, such as arthritis, stroke, and spinal cord injuries, can significantly impact patient outcomes
• Nursing interventions, including range of motion exercises, positioning, and assistive devices, can help support patient mobility
• Patient education and support are key to promoting mobility, preventing complications, and improving quality of life
• Recognizing and addressing the risks and complications associated with immobility is essential for providing comprehensive patient care
• By understanding the importance of mobility and implementing evidence-based strategies, nurses can help patients achieve optimal outcomes and maintain their independence