N105: Essentials of Nursing Care - Health Differences

Essentials of Nursing Study Guide

Chapter Five: Activity and Mobility 5.1 Normal Movement Alignment and Posture: Greater stability and balance are provided in a sitting or lying position than in a standing position. Strain on the joints, muscles, tendons, or the ligaments are minimized and internal structures and organs are supported when the body is well aligned. A person maintains balance as long as the line of gravity passes thru the center of gravity and the base of support. Proper alignment enhances lung expansion and promotes efficient circulatory, renal, and GI function. The line of gravity begins at the top of the head and falls between the shoulders down to the base of support (feet). The center of gravity is the point at which all the body’s mass is centered. Postural tonus is sustained contraction of the muscles supporting this upright position. Joint Mobility: Joints are the functional units of the musculoskeletal system. Flexor muscles are stronger than extensor muscles. Inactive persons get their muscles “pulled” into a flexed position. Range of motion (ROM) is the maximum movement that is possible for that joint. Balance is determined by labyrinth (inner ear), vision (vestibulocular input), and from stretch receptors of muscles and tendons (vestibulospinal input). The cochlea is concerned with hearing and the vestibule and the semicircular canals are concerned with equilibrium. Coordinated Movement: When a person moves, the center of gravity shifts continuously in the direction of the moving body parts. The center of gravity is lowered by squatting. People should avoid twisting (rotation) of the spine and acute flexion of the back with knees straight (stooping). It is suggested that objects are lifted close to the body to maintain the line of gravity and balance. Positioning the Client: The preferred method is to have two or more people move or turn the client. The mattress should be firm and level, and the bed clean and dry. Use supportive devices such as pillows, bed boards, chair beds, foot boots, and a footboard. Avoid placing one body part on top of another, especially bony prominences. Client should be repositioned every two hours. 5.2 Exercise Exercise is a type of physical activity defined as a planned, structured, and repetitive bodily movement done to improve or maintain one or more components of physical fitness. Physical activity is bodily movement produced by skeletal muscles that requires energy expenditure and produces progressive health benefits. Activity tolerance is the type and amount of exercise, or ADLs, an individual is able to perform.

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