ECPI : NUR 164: CHAPTER 33: ACTIVITY QUESTIONS
WITH COMPLETE SOLUTIONS
Trapeze Bar:
A trapeze bar is a handgrip suspended from a frame near the
head of the bed. A patient can grasp the bar with one or both
hands and raise one's trunk from the bed. The trapeze makes
moving and turning considerably easier for many patients and
facilitates transfers into and out of bed. It can also be used when
a patient needs to perform exercises that strengthen some
muscles of the upper extremities (e.g., biceps).
Fowler's Position:
The semi-sitting position calls for the head of the bed to be
elevated 45 to 60 degrees.
- This position is often used to promote cardiac and respiratory
functioning because abdominal organs drop in this position,
providing maximal space in the thoracic cavity. This is also the
position of choice for eating, conversation, and urinary and
intestinal elimination.
- Variations of Fowler's position include high-Fowler's and low-
Fowler's, or semi-Fowler's position. In the high-Fowler's
position, the head of the bed is elevated 90 degrees. When a
bedside table with a pillow on top of it is placed in front of the
patient in high-Fowler's position, the patient can lean forward
and rest the arms on the pillow, assuming a posture that allows
for maximal lung expansion.
- In low-Fowler's or semi-Fowler's position, the head of the bed
,is elevated only 30 degrees.
- In Fowler's position, the buttocks bear the main weight of the
body. In this position, the heels, sacrum, and scapulae are at risk
for skin breakdown and require frequent assessment.
Supine Or Dorsal Recumbent Position:
In the supine position, the patient lies flat on the back with the
head and shoulders slightly elevated with a pillow unless
contraindicated, such as spinal anesthesia or surgery on the
spinal vertebrae.
Side-lying Or Lateral Position:
In the side-lying position, the patient lies on the side and the
main weight of the body is borne by the lateral aspect of the
lower scapula and the lateral aspect of the lower ilium. Because
many people routinely fall asleep in the side-lying position, this
is a comfortable alternative to the supine position for the patient
on bed rest. Although it relieves pressure on the scapulae,
sacrum, and heels and allows the legs and feet to be comfortably
flexed, support pillows are needed for correct positioning
Prone Position:
In the prone position, the person lies on the abdomen with the
head turned to the side. The body is straight in the prone
position because the shoulders, head, and neck are in an erect
position, the arms are easily placed in correct alignment with the
shoulder girdle, the hips are extended, and the knees can be
prevented from flexing or hyperextending. When patients on bed
rest use this position periodically, it helps to prevent flexion
,contractures of the hips and knees. However, the pull of gravity
on the trunk when the patient lies prone produces a marked
lordosis or forward curvature of the lumbar spine. The position
is thus contraindicated for people with spinal problems.
Using Graduated Compression Stockings and Pneumatic
Compression Devices:
Venous stasis and the development of venous thrombosis are
potential complications of immobility. Graduated compression
stockings and pneumatic compression devices are passive
interventions prescribed to aid in the prevention of these
complications.
Graduated Compression Stockings:
Often used for patients at risk for deep vein thrombosis and
pulmonary embolism and to help prevent phlebitis
- By applying pressure, graduated compression stockings
increase the velocity of blood flow in the superficial and deep
veins and improve venous valve function in the legs, promoting
venous return to the heart.
- By preventing pooling of the blood, clot formation is less
likely. An order is required from the patient's health care
provider for their use.
How To Put On Graduated Compression Stockings:
- Measure the patient's legs to determine the proper size of
stocking. Each leg should have a correct fitting stocking; if
measurements are different, then two different sizes of stocking
need to be ordered to ensure correct fitting on each legThe
, manufacturer whose stockings are being used gives directions
for measuring. Some stockings fit either leg; others are
designated right or left. An improperly fitting stocking is
uncomfortable and ineffective and possibly even harmful
- Assess the skin condition and neurovascular status of the legs.
Report abnormalities before continuing with the application of
the stockings.
- Be prepared to apply the stockings in the morning before the
patient is out of bed and while the patient is supine. If the patient
is sitting or has been up and about, have the patient lie down
with legs and feet elevated for at least 15 minutes before
applying the stockings. Otherwise, the leg vessels are congested
with blood, reducing the effectiveness of the stockings.
- Do not massage the legs. If a clot is present, it may break away
from the vessel wall and circulate in the bloodstream.
- Check the legs regularly for redness, blistering, swelling, and
pain. Some recommend checking the legs at least once every 8
hours; others recommend twice a day. Remove the stockings
completely once a day to bathe the legs and feet.
- Launder the stockings as necessary, but at least every 3 days.
Soiled stockings irritate the skin. Dry the stockings on a flat
surface to prevent them from stretching. If using a clothes dryer,
set on low heat and remove as soon as the cycle is complete. The
WITH COMPLETE SOLUTIONS
Trapeze Bar:
A trapeze bar is a handgrip suspended from a frame near the
head of the bed. A patient can grasp the bar with one or both
hands and raise one's trunk from the bed. The trapeze makes
moving and turning considerably easier for many patients and
facilitates transfers into and out of bed. It can also be used when
a patient needs to perform exercises that strengthen some
muscles of the upper extremities (e.g., biceps).
Fowler's Position:
The semi-sitting position calls for the head of the bed to be
elevated 45 to 60 degrees.
- This position is often used to promote cardiac and respiratory
functioning because abdominal organs drop in this position,
providing maximal space in the thoracic cavity. This is also the
position of choice for eating, conversation, and urinary and
intestinal elimination.
- Variations of Fowler's position include high-Fowler's and low-
Fowler's, or semi-Fowler's position. In the high-Fowler's
position, the head of the bed is elevated 90 degrees. When a
bedside table with a pillow on top of it is placed in front of the
patient in high-Fowler's position, the patient can lean forward
and rest the arms on the pillow, assuming a posture that allows
for maximal lung expansion.
- In low-Fowler's or semi-Fowler's position, the head of the bed
,is elevated only 30 degrees.
- In Fowler's position, the buttocks bear the main weight of the
body. In this position, the heels, sacrum, and scapulae are at risk
for skin breakdown and require frequent assessment.
Supine Or Dorsal Recumbent Position:
In the supine position, the patient lies flat on the back with the
head and shoulders slightly elevated with a pillow unless
contraindicated, such as spinal anesthesia or surgery on the
spinal vertebrae.
Side-lying Or Lateral Position:
In the side-lying position, the patient lies on the side and the
main weight of the body is borne by the lateral aspect of the
lower scapula and the lateral aspect of the lower ilium. Because
many people routinely fall asleep in the side-lying position, this
is a comfortable alternative to the supine position for the patient
on bed rest. Although it relieves pressure on the scapulae,
sacrum, and heels and allows the legs and feet to be comfortably
flexed, support pillows are needed for correct positioning
Prone Position:
In the prone position, the person lies on the abdomen with the
head turned to the side. The body is straight in the prone
position because the shoulders, head, and neck are in an erect
position, the arms are easily placed in correct alignment with the
shoulder girdle, the hips are extended, and the knees can be
prevented from flexing or hyperextending. When patients on bed
rest use this position periodically, it helps to prevent flexion
,contractures of the hips and knees. However, the pull of gravity
on the trunk when the patient lies prone produces a marked
lordosis or forward curvature of the lumbar spine. The position
is thus contraindicated for people with spinal problems.
Using Graduated Compression Stockings and Pneumatic
Compression Devices:
Venous stasis and the development of venous thrombosis are
potential complications of immobility. Graduated compression
stockings and pneumatic compression devices are passive
interventions prescribed to aid in the prevention of these
complications.
Graduated Compression Stockings:
Often used for patients at risk for deep vein thrombosis and
pulmonary embolism and to help prevent phlebitis
- By applying pressure, graduated compression stockings
increase the velocity of blood flow in the superficial and deep
veins and improve venous valve function in the legs, promoting
venous return to the heart.
- By preventing pooling of the blood, clot formation is less
likely. An order is required from the patient's health care
provider for their use.
How To Put On Graduated Compression Stockings:
- Measure the patient's legs to determine the proper size of
stocking. Each leg should have a correct fitting stocking; if
measurements are different, then two different sizes of stocking
need to be ordered to ensure correct fitting on each legThe
, manufacturer whose stockings are being used gives directions
for measuring. Some stockings fit either leg; others are
designated right or left. An improperly fitting stocking is
uncomfortable and ineffective and possibly even harmful
- Assess the skin condition and neurovascular status of the legs.
Report abnormalities before continuing with the application of
the stockings.
- Be prepared to apply the stockings in the morning before the
patient is out of bed and while the patient is supine. If the patient
is sitting or has been up and about, have the patient lie down
with legs and feet elevated for at least 15 minutes before
applying the stockings. Otherwise, the leg vessels are congested
with blood, reducing the effectiveness of the stockings.
- Do not massage the legs. If a clot is present, it may break away
from the vessel wall and circulate in the bloodstream.
- Check the legs regularly for redness, blistering, swelling, and
pain. Some recommend checking the legs at least once every 8
hours; others recommend twice a day. Remove the stockings
completely once a day to bathe the legs and feet.
- Launder the stockings as necessary, but at least every 3 days.
Soiled stockings irritate the skin. Dry the stockings on a flat
surface to prevent them from stretching. If using a clothes dryer,
set on low heat and remove as soon as the cycle is complete. The
