Nursing 105

Essentials of Nursing Study Guide

©2018 Achieve Page 109 of 160 • Negative nitrogen balance: This is the development of a state of catabolism (protein breakdown). Greater anabolism (protein synthesis) in an immobile client is related to lack of ingestion of adequate nitrogen and breakdown of muscle mass. • Anorexia: The development of a loss of appetite in an immobile client related to decreased metabolic rate and need for energy. • Negative calcium balance: The development of a state of more calcium being extracted from the bone than can be replaced. Occurs in an immobile client due to the absence of the stress of weight-bearing. The Urinary System • Urinary stasis : This is the development of residual urine in an immobile client related to gravity impeding complete emptying of urine from the urinary bladder in the horizontal position. • Renal calculi: These are caused by the increased amounts of calcium and phosphate inthe urine. The urine becomes more alkaline and calcium salts precipitate out as crystals to form renal calculi. Calculi are formed when a person remains in one position and the renal pelvis does not completelyempty. • Urinary retention: This is the development of bladder distention in an immobile client related to detrusor muscle weakness, inability to relax the perineal muscles, discomfort, lack of privacy and/or embarrassment when using a bedpan or urinal, and the assumption of an unnatural position when attempting to void. • Urinary infection: This is the development of a urinary tract infection in an immobile client due to static, retained urine which is an excellent medium for bacterial growth. The Gastrointestinal System • Constipation: This is caused by decreased peristalsis and colon motility. Unnatural and uncomfortable position of the bedpan does not facilitate elimination. Excessive use of the Valsalva maneuver dangerously increases intra-abdominal and intra-thoracic pressures. This places undue stress on the heart and circulatory system. The Integumentary System • Skin breakdown: This is caused by immobility, which impedes circulation and diminishes the supply of nutrients to specific areas, resulting in skin breakdown. Skin breakdown is most significant over bony prominences. • Reduced skin turgor: This causes skin to atrophy with prolonged immobility. The Psychoneurologic System • Self-esteem: Frustration and decreased self-esteemprovoke exaggerated emotional reactions (apathy, withdrawn, regression, anger, aggressiveness). A client’s narrow participation in life and decreased variety of stimuli result in deterioration of time perception. Deterioration of

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