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Musculoskeletal System and CareMedical-Surgical Nursing-7th edition

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What 2 actions increase the risk of UTIs in an immobilized patient?
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Poor perineal care and the insertion/use of an indwelling catheter
Skin breakdown can occur in an elderly patient within _______ of immobilization.
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3 hours (this is a reason why patients are turned every 2 hours)
What are psychosocial changes that can occur due to immobility?
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Sensory alterations related to changes in sleep patterns, depression, hostility, anxiety, fear, giddiness, decreased self concept, or withdrawal.
Prolonged immobilization can impact a child's development of? (3)
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Gross motor skills, musculoskeletal development and intellectual development.
Prolonged immobilization can impact an adolescent's? (3)
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Growth, independence and socialization
Adults who are immobilized are at risk for? (3)
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Decreases in all physiological systems functioning, loss of their role (job), and decreases in self concept.
Assessment of a patient's mobility focuses on what 4 factors?
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Range of motion (ROM), gait, exercise/activity tolerance, and body alignment
When unsure of a client's mobility level, what order is an assessment performed?
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Client starts off lying down, then is placed in a sitting position, then transferred to a chair, then walking.
The sagittal plane divides the body?
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Into left and right sides
The frontal plane divides the body into?
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Front and back
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The transverse plane divides the body into?
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Upper and lower
Which plane is used for division of the body when assessing pronation, supination, internal and external rotation?
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Transverse
Which plane is used for division of the body when assessing abduction, adduction, eversion and inversion?
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Frontal
Which plane is used for division of the body when assessing flexion, extension, dorsiflexion, plantar flexion and hip extension?
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Sagittal
Assessment of ________ is an important baseline to evaluate whether joint immobility has occurred.
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Range of motion (ROM)
Altered body alignment, changes in the visual field and decreased levels of independent functioning can occur from a flexion contracture of the _________.
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Neck
What should you do to assess the body alignment of an immobilized or unconscious client?
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Remove their pillows and positioning supports, then place the patient supine. Perform the evaluation. Replace pillows and supports.
Alignment should be assessed when a client is sitting if they have? (3)
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Muscle weakness, muscle paralysis, or nerve damage
What are the contraindications for assessing a patient's alignment in the supine position?
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Impaired mobility (like with arthritis or traction), decreased sensation (as with a stroke), impaired circulation (as with diabetes), or a lack of voluntary muscle control.
How is the metabolic system assessed for changes due to immobility?
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Anthropometric measurements (height, weight, etc.), intake and output records, labs for electrolytes, serum protein and BUN, food intake and elimination records.
An immobilized patient gets a respiratory system assessment every ______.
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2 hours.
  
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