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Exercise, Transfers & Ambulation Nursing 125
Mobility ,[object Object],[object Object],[object Object],[object Object],[object Object]
Ability to Move ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Medical Conditions that can Alter Mobility ,[object Object],[object Object],[object Object]
Nursing Measures ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]
Range of Motion Exercise (ROM) ,[object Object]
ROM(cont.) ,[object Object]
ROM (cont.) ,[object Object],[object Object],[object Object],[object Object],[object Object]
Two Purposes of ROM ,[object Object],[object Object],[object Object]
Contraindications to ROM ,[object Object]
Perform Exercises in Head to Toe Format ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Start at the Neck  P&P p. 830 Flexion – raise arm forward & overhead Extension – return arm to side of body Abduction – raise arm to side to position above head with palm away from head. Adduction – return arm & bring across chest Internal rotation – elbow flexed, rotate the shoulder by moving arm til thumb is turned inward & toward the back (fingers to the floor) External rotation – elbow flexed, move arm until thumb is upward & lateral to head. (fingers point up) Circumduction – move arm in full circle (arm straight out, move hand as if to draw a circle.  Shoulder  Flexion – look @ the toes Extension – look straight ahead Hyperextension – look up @ ceiling  Lateral flexion – look straight ahead, tilt head to shoulder Neck
Elbow  Flexion – bend wrist forward Extension – straighten wrist (fingers, wrist & arm in same plane) Hyperextension – bring dorsal surface of hand as far back as possible Abduction (radial flexion) – bring wrist medially towards the thumb Adduction (ulnar flexion) – bend wrist laterally towards 5 th  finger Wrist  Supination – turn lower hand so palm is up Pronation - turn lower hand so palm is down Forearm Flexion – bend elbow Extension – straighten elbow Hyperextension – bend lower arm back as far as possible Elbow
Fingers & Thumb Flexion – bend fingers & thumb into palm make a fist Extension – straighten fingers & thumb Hyperextension – bend fingers as far back as possible Abduction – spread fingers apart / extend thumb laterally Adduction – bring fingers together/ thumb back to hand Circumduction – move finger/thumb in circular motion Opposition – touch thumb to each finger of same hand Fingers & thumb
Hip Flexion – bring heel toward back of thigh (120-130 deg) Extension – return leg to floor Knee Flexion – move leg forward  (ROM 90-120 deg) Extension – move leg back beside other leg Hyperextension – move leg backwards (ROM 30-50 deg) Abduction – move leg laterally away from body (ROM 30-50 deg) Adduction – move leg back to medial position & beyond if possible (ROM 30-50 deg) Hip
Ankle Inversion – turn sole of foot medially (ROM 10 deg) Eversion – turn sole of foot laterally (ROM 10 deg) Flexion – curl toes downward (ROM 30-60 deg) Extension – straighten toes (ROM 30-60 deg) Abduction – spread toes apart Adduction – bring toes together Foot Dorsiflexion – move foot so toes are pointed upward Plantarflexion – move foot so toes are pointed downward Ankle
Spine Flexion – when standing – bend forward from the waist Extension – straighten up Hyperextension – bend backward Lateral flexion – bend to the side Rotation – twist from the waist Spine
Types of ROM exercises ,[object Object],[object Object],[object Object]
Isometric/Isotonic Exercises ,[object Object],[object Object],[object Object],[object Object]
Applying Antiembolism Stockings (Elastic)  P&P p. 842 ,[object Object],[object Object],[object Object],[object Object],[object Object]
Antiembolism stockings  ,[object Object],[object Object],[object Object]
Orthostatic hypotension ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Therapeutic Positions ,[object Object],[object Object],[object Object],[object Object],[object Object]
Therapeutic positions cont. ,[object Object],[object Object],[object Object],[object Object]
Benefits of Proper Positioning ,[object Object],[object Object],[object Object],[object Object]
Transfers ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Transfers - Safety ,[object Object],[object Object],[object Object],[object Object]
Nursing Process - Transfers Wash hands Position chair 45 deg angle to bed on clients stronger side Lock bed brakes, lower bed, raise HOB as high as patient tolerates Lower side rail Assist to sitting (lift upper body & swing legs around) Assist with robe & slippers Position feet on floor Take wide stance, bend knees, grasp patient β€œ 1 2 3 stand” Pivot to chair Implementation Decide appropriate transfer technique Explain procedure to the patient Planning Activity orders Client capabilities Assessment
Nursing Process (cont.) Body in alignment, patient comfortable, no injuries Nurse maintains good body alignment Two person lift (same as above) except one nurse is on each side of the patient Never lift under the axilla – can damage nerves Mechanical lifts – enables you to lift heavy patients, or those unable to help.  (Use 2 people) Evaluation Of note:
Ambulation  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Assisting the patient ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cane ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Walker ,[object Object],[object Object],[object Object],[object Object]
Walker (cont.) ,[object Object],[object Object],[object Object]
Crutches  ,[object Object],[object Object]
Crutches (cont.)  P&P p.859 ,[object Object],[object Object]

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NurseReview.Org - Exercise Transfers & Ambulation

  • 1. Exercise, Transfers & Ambulation Nursing 125
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  • 13. Start at the Neck P&P p. 830 Flexion – raise arm forward & overhead Extension – return arm to side of body Abduction – raise arm to side to position above head with palm away from head. Adduction – return arm & bring across chest Internal rotation – elbow flexed, rotate the shoulder by moving arm til thumb is turned inward & toward the back (fingers to the floor) External rotation – elbow flexed, move arm until thumb is upward & lateral to head. (fingers point up) Circumduction – move arm in full circle (arm straight out, move hand as if to draw a circle. Shoulder Flexion – look @ the toes Extension – look straight ahead Hyperextension – look up @ ceiling Lateral flexion – look straight ahead, tilt head to shoulder Neck
  • 14. Elbow Flexion – bend wrist forward Extension – straighten wrist (fingers, wrist & arm in same plane) Hyperextension – bring dorsal surface of hand as far back as possible Abduction (radial flexion) – bring wrist medially towards the thumb Adduction (ulnar flexion) – bend wrist laterally towards 5 th finger Wrist Supination – turn lower hand so palm is up Pronation - turn lower hand so palm is down Forearm Flexion – bend elbow Extension – straighten elbow Hyperextension – bend lower arm back as far as possible Elbow
  • 15. Fingers & Thumb Flexion – bend fingers & thumb into palm make a fist Extension – straighten fingers & thumb Hyperextension – bend fingers as far back as possible Abduction – spread fingers apart / extend thumb laterally Adduction – bring fingers together/ thumb back to hand Circumduction – move finger/thumb in circular motion Opposition – touch thumb to each finger of same hand Fingers & thumb
  • 16. Hip Flexion – bring heel toward back of thigh (120-130 deg) Extension – return leg to floor Knee Flexion – move leg forward (ROM 90-120 deg) Extension – move leg back beside other leg Hyperextension – move leg backwards (ROM 30-50 deg) Abduction – move leg laterally away from body (ROM 30-50 deg) Adduction – move leg back to medial position & beyond if possible (ROM 30-50 deg) Hip
  • 17. Ankle Inversion – turn sole of foot medially (ROM 10 deg) Eversion – turn sole of foot laterally (ROM 10 deg) Flexion – curl toes downward (ROM 30-60 deg) Extension – straighten toes (ROM 30-60 deg) Abduction – spread toes apart Adduction – bring toes together Foot Dorsiflexion – move foot so toes are pointed upward Plantarflexion – move foot so toes are pointed downward Ankle
  • 18. Spine Flexion – when standing – bend forward from the waist Extension – straighten up Hyperextension – bend backward Lateral flexion – bend to the side Rotation – twist from the waist Spine
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  • 29. Nursing Process - Transfers Wash hands Position chair 45 deg angle to bed on clients stronger side Lock bed brakes, lower bed, raise HOB as high as patient tolerates Lower side rail Assist to sitting (lift upper body & swing legs around) Assist with robe & slippers Position feet on floor Take wide stance, bend knees, grasp patient β€œ 1 2 3 stand” Pivot to chair Implementation Decide appropriate transfer technique Explain procedure to the patient Planning Activity orders Client capabilities Assessment
  • 30. Nursing Process (cont.) Body in alignment, patient comfortable, no injuries Nurse maintains good body alignment Two person lift (same as above) except one nurse is on each side of the patient Never lift under the axilla – can damage nerves Mechanical lifts – enables you to lift heavy patients, or those unable to help. (Use 2 people) Evaluation Of note:
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