FUNDAMENTAL NURSING

1. EXERCISE

2.  Exercise is any physical activity involving muscles that
elevates the heart rate above resting levels.
 Exercise reduces joint pain and stiffness, and increases
flexibility, muscle strength, and endurance.
EXERCISE

3.  Normalizes glucose tolerance
 Improves gait and balance
 Improves cardiovascular function
 Increases energy Promotes bone density
BENEFITS/IMPORTANCE OF EXERCISE

4.  Improves mobility
 Promotes weight loss
 Reduces blood pressure
 Lowers cholesterol
 Promotes rest and relaxation Improves sleep
BENEFITS/IMPORTANCE OF EXERCISE

5. 1. Aerobic Exercise: Improve cardiovascular fitness, assist
with weight control and improve general functional
ability.
2. Strengthening Exercise: Maintain or increase muscle
strength.
3. Isometric Exercise: Maintain muscle tone and strength.
TYPES OF EXERCISE
There are several types of exercise that promote physical and
psychologic health;

6. 4. Isotonic Exercise: Increase and maintain muscle
tone and strength, shape muscles, maintain joint
mobility and improve cardiovascular fitness.
5. Isokinetic Exercise: Condition muscle groups.
6. Range of Motion (ROM) Exercise: Maintain joint
movement and maintain or increase flexibility.
TYPES OF EXERCISE

7. Clients with restricted mobility are unable to perform some
or all range of joint motion exercises independently. The
easiest intervention to maintain or improve joint mobility for
client is the use of ROM exercises. If joints are not moved
periodically, joint may become fixed in one position and
client loses normal use of the joint. So, ROM exercises are
very important.
RANGE OF MOTION EXERCISES
Introduction:

8.  Range of motion (ROM) is the range, measured in
degrees of a circle, through which the bones of a joint
can be moved.
 Range of motion is the maximum amount of movement
available at a joint in one of the three planes of the body,
sagittal, frontal or transverse.
RANGE OF MOTION EXERCISES
Definition:

9.  Sagittal plane - It is a line that passes through the body
from front to back, dividing the body from side to side
and dividing the body into left and right side.
 Frontal plane - Plane that passes through body into front
and back.
 Transverse plane - It is a horizontal line that divides the
body into upper and lower portion.
RANGE OF MOTION EXERCISES
Definition:

10.  Active ROM Exercises-
Used for the client who are able to move his or her joints
independently.
 Passive ROM Exercises-
Used for clients who does not have voluntary motor control,
passive ROM exercises are of choice.
RANGE OF MOTION EXERCISES
Types of ROM Exercise

11.  While assessing ROM, nurse should physically examine
the client for stiffness, swelling, pain, limited movements
and unequal movements.
 Nurse should schedule them at specific times perhaps
along with another nursing activity.
 With a weak client, the nurse merely provides support
while the client performs most of the movement.
Points to be remembered while performing ROM exercises

12.  Exercises should be as active as health and mobility allow.
 Unless contraindicated, plan should include moving
extremities through as nearly full range of joint motion as
possible.
 Movements are carried out slowly and smoothly and
should not cause pain.
 Never force a joint beyond its capacity.
Points to be remembered while performing ROM exercises

13.  Each movement should be repeated 5 times during the
exercises.
 While performing passive range of motion exercises, the
nurse stands at the side the bed closest to the joint being
exercised.
Points to be remembered while performing ROM exercises

14.  Congenital problems- They usually affect normal
musculoskeletal or neurological development such as
congenital hip dysplasia, spina bifida.
 Neuromuscular deficits- Any disease that impairs the
ability of nervous system to control muscular movements
and coordinated hindered functional mobility.Eg. Muscular
dystrophy etc.
Causes for Altered Mobility

15.  Musculoskeletal deficits- includes osteoporosis etc.
 Chronic health problems- Such disorders limit the oxygen
and nutrients delivered to the muscles.
 Trauma- Trauma often results in accidental injury to joints,
tendons, ligaments, muscles or bones
Causes for Altered Mobility

16.  Affective disorders- Depression and catatonic states
results in limited mobility because of physical
impairments.
 Therapeutic modalities- Sometimes, movement is limited
to treat a medical problem. Restrictive devices such as
casts, braces & splints may be used to immobilize certain
areas to promote healing.
Causes for Altered Mobility

17.  Flexion:- Decrease in the angle between circulating bones.
Bending motion that decreases the angle of the joint
bringing the 2 bones closer together.
Example-
=Bending of head towards chest.
=Movement of palm toward inner aspect of forearm.
=Making a fist.
=Curling toes downward.
TYPES OF MOVEMENTS AT VARIOUS JOINTS

19.  Extension: Straightening a joint. There is increase in angle
between circulating bones often to restore a part of the
body to the anatomical position after it has been flexed.
Example-
=Head in erect position.
=Aim to position at side of the body.
=Straighten toes.
TYPES OF MOVEMENTS AT VARIOUS JOINTS

22.  Hyperextension - Moving a joint part normal, extension or
continuation of extension beyond the anatomical position
is called hyperextension.
TYPES OF MOVEMENTS AT VARIOUS JOINTS

24.  Abduction: Moving a joint or extremity away from midline
of the body.
Example-
=Moving the femur laterally at the hip joint.
TYPES OF MOVEMENTS AT VARIOUS JOINTS

26.  Adduction: Moving a joint or extremity towards the
midline of the body.
Example-
=Bringing finger together.
TYPES OF MOVEMENTS AT VARIOUS JOINTS

27.  Circumduction: Moving a body part in widening circles. It
occurs as a result of continuous sequence of flexion,
abduction, extension and adduction.
Example-
=Moving the humerous in circle at the shoulder joint
TYPES OF MOVEMENTS AT VARIOUS JOINTS

29.  Rotation: In rotation, a bone revolve around its own
longitudinal axis.
Example-
=Turning head from side to side.
TYPES OF MOVEMENTS AT VARIOUS JOINTS

31. Internal rotation - Turning a joint or an extremity on its axis
towards body's midline.
Example- Turning foot and leg toward other leg.
External rotation - Turning a joint or an extremity on its axis
away from the body's midline.
Example- Turn foot and leg away from other leg.
TYPES OF MOVEMENTS AT VARIOUS JOINTS
Two types rotation

32.  Supination:- Turning the body or a body part to face
upward. Supination is a position of either the forearm or
foot. Supination of the forearm occurs when the forearm
or palm face to the front (anteriorly) of the body.
Supination of the foot occurs when the foot rolls outwards,
placing most of the weight onto the outside of the foot
and raising the arch.
TYPES OF MOVEMENTS AT VARIOUS JOINTS

34.  Pronation- Turning the body or a body part to face
downward pronation is a rotational movement of the
forearm at the radioulnar joint, or of the foot at the
subtalar and talocalcaneo-navicular joints.
TYPES OF MOVEMENTS AT VARIOUS JOINTS

35.  Inversion- Turning the feet inward, so toes are pointing
toward the midline Inversion is the movement of the sole
and the num plane (as when an ankle is bested).
TYPES OF MOVEMENTS AT VARIOUS JOINTS

37.  Eversion:- Eversion is the movement of the sole of the foot
away from the median plane Turning the feet outward so
toes are pointing away from the midline or movement of
soles laterally at the intertarsal joints so that the soles face
away from each other.
TYPES OF MOVEMENTS AT VARIOUS JOINTS

38.  Dorsi flexion - Bending of the foot at the ankle in the
direction of the dorsum (superior surface). e.g Standing on
heels.
TYPES OF MOVEMENTS AT VARIOUS JOINTS

40.  Palmer flexion: Bending of the foot at the ankle joint in the
direction of the planter (inferior surface).
Example- Standing on toes.
TYPES OF MOVEMENTS AT VARIOUS JOINTS

41.  Opposition: It is movement of thumb across the palm to
touch finger tips on the same hand as touch thumb to each
finger.
TYPES OF MOVEMENTS AT VARIOUS JOINTS

43.  Lateral flexion- It occurs in frontal plane Movement of
trunk is frontal plane. It involves Intervertebral joints.
Example- Tilting of head as far as possible towards each
shoulder.
TYPES OF MOVEMENTS AT VARIOUS JOINTS

45.  NECK:- Flexion, Extension, Hyperextension, Lateral flexion,
Rotation.
 SHOULDER:-Flexion, Extension, Hyperextension,
Abduction, Adduction, Internal rotation, External rotation,
Circumduction.
 ELBOW:- Flexion, Extension.
 FOREARM:- Supination, Pronation.
TYPES OF MOVEMENTS IN DIFFERENT BODY PARTS

46.  WRIST:- Flexion, Extension, Hyperextension, Abduction.
 FINGERS:- Flexion, Extension, Hyperextension, Adduction,
Abduction, Adduction.
 THUMB:- Flexion, Extension, Abduction, Adduction,
Opposition.
 HIP:- Flexion, Extension, Hyperextension, Adduction,
Abduction, Internal rotation, External rotation,
Circumduction.
TYPES OF MOVEMENTS IN DIFFERENT BODY PARTS

47.  KNEE:- Flexion, Extension.
 ANKLE:- Dorsal flexion, Plantar flexion.
 FOOT:- Inversion, Eversion.
 TOES:- Flexion, Extension, Abduction, Adduction.
TYPES OF MOVEMENTS IN DIFFERENT BODY PARTS