NCLEX Basic Care & Comfort
Mobility
● posture
● Joint movements
● promote activity & exercise
● avoid injury
● transfers
○ move toward strong side
● ADLs- promote independence
Immobility
● Assessment of what they can do
● Therapeutic Exercise
• active ROM
• passive ROM
• Active resistive ROM
■ help develop muscle strength
■ uses weights
• isometric exercises
● Complications
• decubitus ulcer
■ use draw sheet
■ low flow air mattress
■ elbow / heel pads bony prominences
■ turn q2 hrs
■ balance diet
■ keep dry
■ disorientation may happen
• osteoporosis
■ dec in weight bearing
■ pathological fractures
■ Renal calculi- calcium leaves bone and travels throughout body being filtered by
kidneys
■ Neg Nitrogen Balance- more nitro is being excreted than consumed
■ muscle begin to break down and used as protein source
• Hypercalcemia- Ca CALMS nerves (rowsiness, confusion, constipation in
gut,hallucinations, stupor or coma) but contracts muscle.
• Ca blocks Na channels and inhibits depolarization of nerve and muscle fibers,
increased Ca
raises threshold for depolarization.
• Decrease in HR and increade in contractility (MI)
• Normal range 9-10.5mg/dL
• Causes- excessive skeletal calcium release, increased
intestinal calcium absorption or decreased renal calcium
excretion.
• Contractures
• Thrombus
• Orthostatic Hypotension
• Respiratory secretion stasis
• Urinary stasis
, Therapeutic Positions
● Supine
● Prone – on face
● Side lateral
● Fowlers
● Modified trendelenburg- leg raised 45degrees
Asst Devices
● Crutches
○ stairs up with the good down with the bad
● Cane
○ in strong hand. Walk with injured first with cane creating a triangle
● Hoyer lift
Herniated Intervertebral Disk “Slipped disk” - lower back and leg pain b/c pressure
on spinal nerves
● NSAIDS
● epidural
● Surgery is best for treatment
Pavlik harness
● used for degenerative hip dysplasia
● warn at all times for 3-6 mo
● ORIF (open reduction internal fixation)
● traction for 6-18 mo 6mos- 1 ½ year
functional Scoliosis- structurally normal spine that tends to have lateral curvature
• caused by difference in leg length, muscle spasm, inflammatory conditions
• correct the UNDERLYING problem the spine itself needs no treatment.
Can be corrected with exercise & stretching
structural scoliosis- fixed curve of the spine
need more work to be fixed & is usually hereditary
Rheumatoid
arthritis nodules
in joint
results in painful and deformed joints (ulnar deviation, swan neck deformity,
boutinere deformity systemic disease (all joints)
remission & exacerbation
Osteoarthri
tis Risk
factors :
• postmenopausal women
• Kyphosis
• Diet ^ in Ca,protein, Vit D
Mobility
● posture
● Joint movements
● promote activity & exercise
● avoid injury
● transfers
○ move toward strong side
● ADLs- promote independence
Immobility
● Assessment of what they can do
● Therapeutic Exercise
• active ROM
• passive ROM
• Active resistive ROM
■ help develop muscle strength
■ uses weights
• isometric exercises
● Complications
• decubitus ulcer
■ use draw sheet
■ low flow air mattress
■ elbow / heel pads bony prominences
■ turn q2 hrs
■ balance diet
■ keep dry
■ disorientation may happen
• osteoporosis
■ dec in weight bearing
■ pathological fractures
■ Renal calculi- calcium leaves bone and travels throughout body being filtered by
kidneys
■ Neg Nitrogen Balance- more nitro is being excreted than consumed
■ muscle begin to break down and used as protein source
• Hypercalcemia- Ca CALMS nerves (rowsiness, confusion, constipation in
gut,hallucinations, stupor or coma) but contracts muscle.
• Ca blocks Na channels and inhibits depolarization of nerve and muscle fibers,
increased Ca
raises threshold for depolarization.
• Decrease in HR and increade in contractility (MI)
• Normal range 9-10.5mg/dL
• Causes- excessive skeletal calcium release, increased
intestinal calcium absorption or decreased renal calcium
excretion.
• Contractures
• Thrombus
• Orthostatic Hypotension
• Respiratory secretion stasis
• Urinary stasis
, Therapeutic Positions
● Supine
● Prone – on face
● Side lateral
● Fowlers
● Modified trendelenburg- leg raised 45degrees
Asst Devices
● Crutches
○ stairs up with the good down with the bad
● Cane
○ in strong hand. Walk with injured first with cane creating a triangle
● Hoyer lift
Herniated Intervertebral Disk “Slipped disk” - lower back and leg pain b/c pressure
on spinal nerves
● NSAIDS
● epidural
● Surgery is best for treatment
Pavlik harness
● used for degenerative hip dysplasia
● warn at all times for 3-6 mo
● ORIF (open reduction internal fixation)
● traction for 6-18 mo 6mos- 1 ½ year
functional Scoliosis- structurally normal spine that tends to have lateral curvature
• caused by difference in leg length, muscle spasm, inflammatory conditions
• correct the UNDERLYING problem the spine itself needs no treatment.
Can be corrected with exercise & stretching
structural scoliosis- fixed curve of the spine
need more work to be fixed & is usually hereditary
Rheumatoid
arthritis nodules
in joint
results in painful and deformed joints (ulnar deviation, swan neck deformity,
boutinere deformity systemic disease (all joints)
remission & exacerbation
Osteoarthri
tis Risk
factors :
• postmenopausal women
• Kyphosis
• Diet ^ in Ca,protein, Vit D
