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Activity and Exercise

front 1 Four basic elements of normal movement	back 1 body alignment joint mobility balance coordinated movement
front 2 alignment and posture	back 2 brings body parts into position that promotes optimal balance and body fxn person maintains balance and balance as long as line of gravity passes through center of gravity and base of support.
front 3 Joint Mobility	back 3 ROM is maximum movement possible for joint ROM varies and determined by: -genetic makeup -developmental patterns -presence or absence of disease -physical activity
front 4 Balance	back 4 complex mechanisms proprioception -awareness of posture, movement, changes in equilibrium -knowledge of position, weight, resistance of objects in relation to body.

front 5 coordinated movement	back 5 Balanced, smooth, purposeful movement result of proper functioning of -Cerebral cortex-initiates voluntary movement -Cerebellum-coordinates motor activity -Basal ganglia-maintains posture
front 6 Isotonic (dynamic) exercise	back 6 muscle shortens to produce muscle contraction and active movement increase muscle tone, mass, and strength maintain joint flexibility and circulation HR and CO quicken increase
front 7 Isometric (static or setting) exercise	back 7 muscle contraction without moving the joint(muscle length does not change) involve exerting pressure against a solid object produce a mild increase in HR and CO no apparent increase in blood flow to other parts of the body
front 8 Isokinetic (Resistive) Exercise	back 8 muscle contraction or tension against resistance can either be isotonic or isometric person moves(isotonic) or tenses(isometric) against resistance an increase in blood pressure and blood flow to muscles occurs

front 9 Aeboric exercise	back 9 activity during which the amount of oxygen taken in the body is greater than that used to perform the activity improve cardiovascular conditioning and physical fitness
front 10 anaerobic exercise	back 10 activity in which the muscles cannot draw enough oxygen from the bloodstream anaerobic pathways are used to provide additional energy for a short time used in endurance training for athletes
front 11 musculoskeletal system	back 11 exercise -maintain size, shape, tone, and strength of muscles(including the heart muscle) -nourish joints -increase flexibility, stability, and ROM -maintain bone density and strength
front 12 musculoskeletal immobility	back 12 disuse osteroporosis disuse atrophy contractures stiffness and pain in joints

front 13 cardiovascular system exercise	back 13 increases HR, strength of contraction, and blood supply to the heart and muscles mediates harmful effects of stress
front 14 cardiovascular system immobility	back 14 diminished cardiac reserve increased use of the Valsalva maneuver orthostatic hypotension venous
front 15 Respiratory system exercise	back 15 increase ventilation and oxygen intake improving gas exchange prevents pooling of secretions in the bronchi and bronchioles
front 16 respiratory system immobility	back 16 decreased respiratory movement pooling of secretions atelectasis hypostatic pneumonia

front 17 metabolic system exercise	back 17 elevates the metabolic rate decreases serum triglycerides and cholesterol stabilizes blood sugar and makes cells more responsive to insulin
front 18 metabolic system immobility	back 18 decreased metabolic rate negative nitrogen balance anorexia negative calcium balance
front 19 urinary system exercise	back 19 promotes blood flow to the kidneys causing body wastes to be excreted more effectively prevents stasis(stagnation) of urine in the bladder
front 20 Urinary system immobility	back 20 urinary stasis renal calculi urinary retention urinary infection

front 21 GI system exercise/immobility	back 21 exercis -improves the appetite -increases GI tract tone -facilitates peristalsis immobility-constipation
front 22 immune system exercise	back 22 pumps lymph fluid from tissues into lymph capillaries and vessels increases circulation through lymph nodes strenuous exercise may reduce immune function -leaving window open of opportunity for infection during recovery phase.
front 23 psychoneurological system exercise	back 23 elevates mood relieves stress and anxiety improves quality of sleep for most individuals
front 24 psychoneurological system immobility	back 24 decline in mood elevating substances perception of time intervals deteriorates problem-solving and decision making ability may deteriorate loss of control over events can cause anxiety

front 25 cognitive function exercise	back 25 positive effects on decision-making and problem solving processes, planning, and paying attention induces cells in brain to strengthen and build neuronal connections
front 26 spiritual health	back 26 yoga-style exercise improves mind-body-spirit connection, relationship with god and physical well-being.
front 27 Integumentary system immobility	back 27 reduced skin turgor skin breakdown
front 28 factors affecting body alignment and activity	back 28 growth and development nutrition personal values and attitudes external factors -i.g. temperature, humidity, availability of recreational activities, safety of the neighborhood prescribed limitations -casts, braces, traction, activity restrictions including bed rest

front 29 Assessment	back 29 nursing history physcial exam-body alignment, gait, appearance and movement of joints, capabilities and limitations for movement muscle mass and strength activity intolerance problems related to immobility physical fitness
front 30 NANDA nursing diagnoses	back 30 for activity and exercise -activity intolerance -risk for activity intolerance -impaired physical immobility -sedentary lifestyle -Risk for disuse syndrome
front 31 Impaired physical mobility becomes the etiology	back 31 fear of falling ineffective coping low self-esteem powerlessness risk for falls self-care deficit
front 32 prolonged immobility	back 32 ineffective airway clearance risk for infection risk for injury risk for disturbed sleep pattern risk for situational low self-esteem

front 33 planning	back 33 activity tolerance body positioning bowel elimination fall prevention behavior immobility consequences both physiological and psychocognitive joint movement mobility
front 34 planniing cont	back 34 respiratory status ventilation and gas exchange self care sleep stress level weight control
front 35 Planning cont	back 35 increased tolerance for physical activity restored or improved capability to ambulate and/or participate in ADLs absence of injury from falling or improper use of body mechanics enhanced physical fitness absence of any complications assoc with immobility improved social, emotional, and intellectual well-being
front 36 implementing	back 36 maintain or promote body alignment and mobility positioning clients appropriately moving and turning clients in bed transferring clients providing ROM exercises

front 37 implementing cont	back 37 ambulating pt with/without mechanical aids strategies to prevent complications of immobility
front 38 body mechanics	back 38 used to describe the efficient, coordinated, and safe use of the body to move objects and carry out ADLs support "no mannual lift" and "no solo lift" body balance can be greatly enhanced by -widening the base of support -lowering the center of gravity, bringing it closer to the base of support
front 39 fowlers position	back 39 45-60 degrees
front 40 semi fowlers	back 40 15-45

front 41 high fowlers	back 41 60-90
front 42 moving and turning clients	back 42 before moving, assess if indicated use pain relief modalities prepare any needed assistive devices plan around encumberances be alert to the effects of any meds obtain required assistance explain the procedure to the client raise the height of the bed lock the wheels face the direction of the movement assume a broad stance
front 43 Determine and document moving and turning	back 43 clients comfort body alignment tolerance of activity ability to assist use of supportive devices safety precautions required
front 44 general guidelines for transferring a pt	back 44 plan what to do and how to do it obtain essential equipment before starting remove obstacles explain transfer to pt and assistive personnel support or hold pt rather than equipment explain what pt should do make written plan, including pts tolerance

front 45 active ROM exercises	back 45 isotonic exercises moves each joint in the body maximally stretching all muscle groups
front 46 passive ROM exercises	back 46 another person moves each joint maximally stretching all muscle groups useful in maintaining joint flexibility
front 47 practice guidelines proving passive ROM	back 47 cover body with a bath blanket use correct body mechanics position bed at appropriate height expose only the limb being exercised support pts limb above and below joint use a firm comfortable grip move body parts smoothly, slowly, and rhythmically avoid moving or forcing body part beyond the existing range of motion if muscle spasticity occurs, stop if contractures are present, apply slow firm pressure if rigidity occurs, press against rigidity
front 48 client teaching using canes	back 48 hold cane with the hand on the stronger side of the body position the tip of the cane about 15cm to the side and 15cm in front of the near foot so that the elbow is slightly flexed

front 49 maximum support canes	back 49 move the cane and leg forward at the same time move stronger leg forward move the unaffected(stronger) side forward ahead of time
front 50 cane teaching as you become stronger	back 50 move the cane and leg forward at the same time move stronger leg forward
front 51 walker max assistance	back 51 move the walker ahead -body wt is borne on both legs move the right foot up to the walker -body wt. is borne by left leg and both arms move the left foot up the right foot -body wt. is borne by right leg and both arms
front 52 crutch gaits	back 52 ability to take steps ability to bear wt. and keep balance ability to hold body erect ability to get into and out of chairs safely go up and down stairs safely