NURS 101 LIBERTY UNIVERSITY SLO_s_muscle ASSIGNMENT 2023.pdf

Concept #25 Mobility

Student Learning Outcomes for this concept:

Describe the concept of mobility.

oPurposeful physical movement, including gross simple movements, fine complex

movements, and coordination.

oDependent on the synchronized efforts of the musculoskeletal and nervous

systems as well as adequate oxygenation, perfusion, and cognition.

oRequires adequate energy, adequate muscle strength, underlying skeletal stability,

joint function, and neuromuscular coordination to carry out the desired

movement.

oDefined as a “state or quality of being mobile or moveable”.

Identify risk factors for impaired mobility.

oCardiac

Reduced cardiac capacity

Decreased cardiac output

Orthostatic hypotension

Venous stasis

Deep vein thrombosis

oRespiratory

Recued lung expansion

Atelectasis

Pooling of respiratory secretions

oMusculoskeletal

Reduction in muscle mass and atrophy

Contracture of joints

Bone demineralization

oIntegumentary

Skin breakdown

oGastrointestinal

Reduced peristaltic motility.

Constipation

oUrinary

Renal calculi

Urinary stasis

Infection

Determine when an individual has impaired mobility

oAcute and chronic conditions

oChronic pain

oInjury/trauma

oOrthopedic injury

oCongenital deformities

oNeurologic disorders

oStrokes

oHead injury

oSpinal injury or deformities

oNutritional deficiencies

oCardiopulmonary conditions

oEnd-stage cancer

oSide effects and adverse effects of medications

oMedical treatments

oSubstance use disorder

Summarize potential complications of impaired mobility across the lifespan.

Changes to the musculoskeletal system occur throughout infancy and

childhood as a function of growth and development.

In infancy, childhood, and adolescence, bones change in composition,

grow in length and diameter, and undergo changes in rotation and

alignment. Size and composition of muscles undergo changes as a result of

physical growth and development throughout childhood.

Musculoskeletal changes occur with aging. Thinning of vertebral disks,

shortening of the spinal column, and onset of kyphosis. Bone density

decreases and become brittle. Cartilage becomes rigid and fragile. Muscle

mass and tone reduce significantly.

Reduced range of motion and pain in joints, reduced muscle strength and

increased risk for bone fracture.

Identify appropriate nursing and collaborative interventions to optimize mobility and

minimize complications of immobility.

oPrimary Prevention

Regular physical activity

Optimal nutrition

Keeping an ideal body weight

Adequate rest

Measures to prevent injury and trauma.

Fall prevention.

Safe environment

Optimizing vision

oSecondary Prevention (Screenings)

Screenings for:

Osteoporosis

Mobility

Fall risk

Bone density

oTertiary/Collaborative Interventions

Exercise therapy

Pharmacological agents

Surgical interventions

Immobilization

Assistive devices

Identify interrelated concepts to mobility

oPain

oNutrition

oIntracranial regulation

oGas exchange

oPerfusion

Student Learning Outcomes for the exemplar:

Developmental dysplasia of the hip (DDH) /Muscular Dystrophy (MD)/Clubfoot

Describe the manifestations, diagnostic evaluation, and therapeutic management of the

following mobility alterations:

oMuscular dystrophy

Progressive muscle weakness/wasting

Contractures with the loss of independent ambulation by 9-12

years old

Inherited

Duchenne’s (most common)

oSex-linked recessive - Occurs only in makes

Ultimately affects the muscles of respiration.

Death usually occurs about age 20 d/t respiratory or heart failure.

Manifestations

Waddling

Wide-based gait

Lordosis, scoliosis

Difficulty climbing stairs, running or peddling bike

Gower’s sign

Need to use wheelchair by 9 to 12 years old

Diagnostic evaluation

EMG- decreased electrical impulses in muscles

Serum creatine kinase: if elevated indicative of early MD

Nerve conduction velocity: Abnormal nerve response to electrical

stimulus

Muscle biopsy- identifies degenerative muscle fibers

oDevelopmental dysplasia of the hip

oClub foot

State appropriate nursing diagnoses for the child with the above alterations in mobility

Summarize the treatment modalities used to manage the child with the listed mobility

alterations.

oMuscular Dystrophy

NO CURE

Goal: to keep child as active as possible

Prevent obesity.

Physical and occupational therapy

Treat complications

Possible surgery

Design appropriate nursing interventions for the child with the above alterations in

mobility.

Identify nursing considerations for cast care.

NURS 101 LIBERTY UNIVERSITY SLO_s_muscle ASSIGNMENT 2023.pdf

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