NUR2356: Multidimensional Care I / MDC 1 Exam 2 Review
1. The effects of Immobility
a) Interventions that improve flexibility
• P.R.E.P.(Perform passive ROM, Reposition Q2HR, Encourage independent activity
as much as possible even in bedrest, Provide assistive devices)
• Know examples of exercises for flexibility
b) Assessment/ Findings of a patient with DVT
• Assessment
(1) Compare distal pulses for pulse quality, observe the color and temp. of
extremities, evaluate sensation and motion, and determine speed of capillary
refill. Compare calf circumferences.
• Findings
(1) Redness, warmth, tenderness, swelling (Thrombus formation), Peripheral and
sacral edema.
c) Identify patients at risk for skin breakdown
• Older adults, immobile, cognitive impairments, incontinence, poor nutrition/
malnutrition. Medications may also cause vasoconstriction and result in poor tissue
perfusion.
2. Benefits of Exercise
a) Rationale for weight bearing exercise
• Promotes bone reformation and growth (Makes bones stronger)
• At least 3-5 times a week
Identify benefits of exercise
• Bone reformation and growth
• Cardiovascular health promotion
• Promotes balance and stability
• Reduce stress and increase energy levels
b) Identify benefits of exercise
• Bone reformation and growth
• Cardiovascular health promotion
• Promotes balance and stability
• Reduce stress and increase energy levels
• Improves pulmonary circulation, skeletal development, skin tone
• Reduces systemic inflammation
c) Identify negative effects of immobility on musculoskeletal system
• Osteoarthritis
• Rheumatoid Arthritis
• Loss of muscle strength
• Impaired balance
• Altered join mobility
• Decreased stability
• Osteoporosis
• Depression, isolation, anxiety, and mood change
• Can cause decreased peristalsis
d) Explain ways to maintain proper posture for a client
, • Place the spine in a neutral position(Resting)
• This allows the bones to be aligned, reduce stress and fatigue & muscle joints, and
ligament can work efficiently
• Avoid standing in 1 position for a long period of time
• Do not lock your knees when standing
• Keep core tight and don’t bend at the waist or neck
• No slumping when sitting
• Sit close to your work and use back support
• Sit with feet flat on floor
• Sleep on firm mattress
• Do not wear high heels for a prolonged time, do not slump, and use a chair that
supports your back.
e) Identify interventions in minimizing contractures (which is a negative effect of
immobility)
• Gently straighten out contracted extremity, fingers. Etc
• Mobility-encouraging interventions such as passive ROM, and rotation. Flexion and
extension exercises
• These interventions should be performed about every 2hrs and as needed if the
contractures are present
3. Identify bed positions
• Semi-fowlers: Patient is on their back with the head raised between 15 and 45 degrees.
• High-fowlers: Patient is on their back with the head of the bed raised between 60 and 90
degrees.
• Prone: Lying on the abdomen with the head turned to one side
• Supine: Lying on the back
• Sims: Patient lies on their side with the left thigh slightly flexed and the right thigh
acutely flexed on the abdomen.
• Trendelenburg's Position: Patient is on their back whose lower section is inclined 15-30
degrees so that the head is lower than the body.
• Reverse Trendelenburg's Position: Patient is in the supine position with the feet facing
downward and head is inclined 15-30 degrees.
• Lateral Position: Side lying position, and a pillow is often placed between the legs for
patient comfort
4. Identify proper body mechanics for moving the patients in bed
• Transfer board
• Mechanical lift
• Transfer belt
• What are the proper ways to move patients in bed?
5. Explain how to use walkers to the elderly
• Push or lift your walker 6-12 inches forward
• Make sure all 4 tips or wheels of your walker are touching the ground before taking a
step
• Step forward with your weak leg first
• Then step forward with your other leg placing it in front of the weaker leg
6. Be able to assess client with diabetic neuropathy
1. The effects of Immobility
a) Interventions that improve flexibility
• P.R.E.P.(Perform passive ROM, Reposition Q2HR, Encourage independent activity
as much as possible even in bedrest, Provide assistive devices)
• Know examples of exercises for flexibility
b) Assessment/ Findings of a patient with DVT
• Assessment
(1) Compare distal pulses for pulse quality, observe the color and temp. of
extremities, evaluate sensation and motion, and determine speed of capillary
refill. Compare calf circumferences.
• Findings
(1) Redness, warmth, tenderness, swelling (Thrombus formation), Peripheral and
sacral edema.
c) Identify patients at risk for skin breakdown
• Older adults, immobile, cognitive impairments, incontinence, poor nutrition/
malnutrition. Medications may also cause vasoconstriction and result in poor tissue
perfusion.
2. Benefits of Exercise
a) Rationale for weight bearing exercise
• Promotes bone reformation and growth (Makes bones stronger)
• At least 3-5 times a week
Identify benefits of exercise
• Bone reformation and growth
• Cardiovascular health promotion
• Promotes balance and stability
• Reduce stress and increase energy levels
b) Identify benefits of exercise
• Bone reformation and growth
• Cardiovascular health promotion
• Promotes balance and stability
• Reduce stress and increase energy levels
• Improves pulmonary circulation, skeletal development, skin tone
• Reduces systemic inflammation
c) Identify negative effects of immobility on musculoskeletal system
• Osteoarthritis
• Rheumatoid Arthritis
• Loss of muscle strength
• Impaired balance
• Altered join mobility
• Decreased stability
• Osteoporosis
• Depression, isolation, anxiety, and mood change
• Can cause decreased peristalsis
d) Explain ways to maintain proper posture for a client
, • Place the spine in a neutral position(Resting)
• This allows the bones to be aligned, reduce stress and fatigue & muscle joints, and
ligament can work efficiently
• Avoid standing in 1 position for a long period of time
• Do not lock your knees when standing
• Keep core tight and don’t bend at the waist or neck
• No slumping when sitting
• Sit close to your work and use back support
• Sit with feet flat on floor
• Sleep on firm mattress
• Do not wear high heels for a prolonged time, do not slump, and use a chair that
supports your back.
e) Identify interventions in minimizing contractures (which is a negative effect of
immobility)
• Gently straighten out contracted extremity, fingers. Etc
• Mobility-encouraging interventions such as passive ROM, and rotation. Flexion and
extension exercises
• These interventions should be performed about every 2hrs and as needed if the
contractures are present
3. Identify bed positions
• Semi-fowlers: Patient is on their back with the head raised between 15 and 45 degrees.
• High-fowlers: Patient is on their back with the head of the bed raised between 60 and 90
degrees.
• Prone: Lying on the abdomen with the head turned to one side
• Supine: Lying on the back
• Sims: Patient lies on their side with the left thigh slightly flexed and the right thigh
acutely flexed on the abdomen.
• Trendelenburg's Position: Patient is on their back whose lower section is inclined 15-30
degrees so that the head is lower than the body.
• Reverse Trendelenburg's Position: Patient is in the supine position with the feet facing
downward and head is inclined 15-30 degrees.
• Lateral Position: Side lying position, and a pillow is often placed between the legs for
patient comfort
4. Identify proper body mechanics for moving the patients in bed
• Transfer board
• Mechanical lift
• Transfer belt
• What are the proper ways to move patients in bed?
5. Explain how to use walkers to the elderly
• Push or lift your walker 6-12 inches forward
• Make sure all 4 tips or wheels of your walker are touching the ground before taking a
step
• Step forward with your weak leg first
• Then step forward with your other leg placing it in front of the weaker leg
6. Be able to assess client with diabetic neuropathy
