12.12.

18

IMMOBILITY

1. SCIENTIFIC KNOWLEDGE BASE

A. Nature of Movement
i. Alignment and Balance
ii. Gravity and Friction
iii. Skeletal System
1. Joints
2. Ligaments, Tendons, and Cartilage
iv. Skeletal Muscle
v. Nervous System
B. Pathological Influences on Mobility
i. Postural Abnormalities
ii. Muscle Abnormalities
iii. Damage to the Central Nervous System
iv. Direct Trauma to the Musculoskeletal System

2. NURSING KNOWLEDGE BASE

A. Factors Influencing Mobility-Immobility
i. Systemic Effects
1. Metabolic Changes
2. Respiratory Changes
3. Musculoskeletal Changes
a. Muscle Effects
b. Skeletal Effects
4. Urinary Elimination Changes
5. Integumentary Changes
ii. Psychosocial Effects
B. Developmental Changes
i. Infants, Toddlers, and Preschoolers
ii. Adolescents
iii. Adults
 iv. Older Adults

3. NURSING PROCESS
A. Assessment
i. Through the Patient's Eyes
ii. Mobility
1. Range of Motion
a. Neck
b. Shoulder
c. Elbow
d. Forearm
e. Wrist
f. Fingers and Thumb
g. Hip
h. Knee
i. Ankle and Foot
j. Toes
2. Gait
3. Exercise and Activity Tolerance
4. Body Alignment
a. Standing
b. Sitting
c. Lying
iii. Immobility
1. Metabolic System
2. Respiratory System
3. Cardiovascular System
4. Musculoskeletal System
5. Integumentary System
6. Elimination System
7. Psychosocial Assessment
8. Developmental Assessment
B. Nursing Diagnosis
C. Planning
i. Goals and Outcomes
ii. Setting Priorities

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 iii. Teamwork and Collaboration
D. Implementation
i. Health Promotion
1. Prevention of Work-Related Musculoskeletal Injuries
2. Exercise
3. Bone Health in Patients with Osteoporosis
ii. Acute Care
1. Metabolic System
2. Respiratory System
3. Cardiovascular System
a. Reducing Orthostatic Hypotension
b. Reducing Cardiac Workload
c. Preventing Thrombus Formation
4. Musculoskeletal System
5. Integumentary System
6. Elimination System
7. Psychosocial Changes
8. Developmental Changes
9. Positioning Techniques
a. Supported Fowler's Position
b. Supine Position
c. Prone Position
d. Side-Lying Position
e. Sims' Position
iii. Restorative and Continuing Care
1. Range-of-Motion Exercises
2. Walking
E. Evaluation
i. Through the Patient's Eyes
ii. Patient Outcomes