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Exam 4 - Immobility.docx - Med Surg – MOBILITY EXAM 4...

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Med Surg – MOBILITY EXAM 4Assessment of ImmobilityHx of injury, progression of symptomsTHE SIX P’s1.Pain2.Paresthesia3.Pallor4.Paralysis5.Pulselessness6.PoikilothermicSystem Specific AssessmentsMusculoskeletalMentationOxygenationBone DemineralizationIntakeLack or decrease in Cardio OutputEliminationPriority Interventions for Immobile PatientsAlignmentCough and Deep BreatheTransfer out of BedIncrease Fluids = 2000 – 3000 per day (NO KIDNEY DISEASE OR HF)Devices for ImmobilizationExercise in BedComplications if we do not InterveneThrombus formation (risk)Elimination (fluid and electrolyte imbalance)Risk for atelectasisReduced cardiac outputIntegumentary compromiseBone lossLoss of muscle enduranceEmotional status changesHOW DO WE PREVENT COMPLICATIONS?????Move the clients within their abilityoAssist to ambulate, sit, turn, ROMO2xygenateoO2Sat, RR, Cough/Deep breathe, Incentive Spirometry
Vital SignsoEvaluate trends for signs of altered oxygenation and interveneEliminate PainoIf they are in pain they will not move or cough/deep breatheTRAUMATIC INJURIESSPRAINS/STRAINSSprain = injury to ligaments surrounding joint, usually through stretching/twisting1st, 2nd, 3rddegree,Painful,Avulsion fractureStrain = excessive stretching of muscle, fascial sheath or tendonMost common in large muscle groupsManifestations of BOTHPain, edema, contusion, reduced functionWhat do we do??RICERestIceCompressionElevationFRACTURESComminuted: shattered into piecesCompression: bone is crushedImpacted: ends of jammed togetherSpiral: bone twists and have jagged breaksGreenstick: incomplete breakTransverse: complete break to right angle of long axis of boneAssessment FindingsLocalized pain, decreased function, inability to bear weight/use, guard against movement, mayor may not have deformityIMMOBILIZE IF SUSPECTED FRACTUREPriority Interventions

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Term
Spring
Professor
BrendaS.Dyal
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