NSE12 Week 7 Objectives
1. Describe the principles of body movement/mechanics.
Good body mechanics is the use of correct muscles to complete activities safely and efficiently,
without unnecessary strain on any muscle or joint.
• The wider the base of support, the greater the stability
• The lower the centre of gravity, the greater the stability.
The equilibrium of an object is maintained as long as the line of gravity passes through its base
• Facing the direction of movement prevents abnormal twisting of the spine
• Dividing balanced activity between arms and legs reduces the risk of back injury.
• Leverage, rolling, turning, or pivoting requires less work than lifting
When friction is reduced between the object to be moved and the surface over which it is
moved, less force is required to move it.
• Reducing the force of work reduces the risk of injury
• Maintaing good body mechanics reduces fatigue of muscle groups
• Alternating periods of rest and activity helps reduce fatigue
2. Understand and use ergonomic strategies to reduce injury.
Manual lifting should be the last resort, and is only used when it does not involve lifting most or
all of the client's weight. Before lifting, assess the weight to be lifted and determine the assis-
tance needed and the resources available. Follow the these lifting techniques:
1. Tighten your gluteal, abdominal, pelvic, and leg muscles.
2. Bend at your knees
3. Keep the person’s weight as close to your body as possible.
4. Keep your trunk erect and knees bent, so that multiple muscle groups work together
5. Avoid twisting.
Mobility and Immobility
3. Describe the functions of the musculoskeletal and nervous systems in the regulation of move-
- skeletal system provides attachment sites for muscles and ligaments and the leverage
necessary for movement. Bones are characterized by firmness, rigidity, and elasticity.
- Joints, ligaments, tendons and cartilage permits strength and flexibility of the skeleton
muscles contractions provide movement and posture
Nervous System - regulates movement and posture, and generates awareness of the position of the body
and its parts
4. Discuss the effect that pathological influences can have on mobility.
· Postural abnormalities: can either start at birth or can be acquired later in life.
o Affects the musculoskeletal system and usually accompanied with pain and im-
o May limit ROM (range of motion).
· Impaired muscle development: usually caused by either injury or disease.
o Caused by dystrophies which are a group of familiar disorders that cause degener-
ation in skeletal muscles.
o Increases disability and deformity
· Damage to the central nervous system: any parts that regulates voluntary
movement results in impairment.
o This can happen by from a trauma (head injury), stroke, brain attacks…
o Can impair mobility and result in bilateral loss of voluntary motor
· Direct trauma to the musculoskeletal system: such as fractures.
o Treatment after a fracture or a broken bone includes positioning of the bone in
proper alignment and immobilizing it.
o This can lead to muscle astrophy( loss on tone) and joint stiff-
5. Identify the physiological and psychosocial effects of immobility.
o Metabolic system:
Increased edema or dehydration which increase chances of skin breakdown.
Decreased food intake which leads to slower wound healing/ abnormal lab results.
Can also lead to muscle astrophy and decreased amounts of subcutaneous fat.
Loss of calcium, constipation, mechanical bowel obstruction.
o Respiratory system:
Asymmetrical chest wall movement, dyspnea, atelectasis (collapse of alveoli), hypo-
static pneumonia (inflammation of lungs) increased respiratory rate decreased o2,
Crackles, wheezes, decreased air entry
Orthostatic hypotension (usually happens when you change position quickly and feel
a bit dizzy)
Increased heart rate, third heart sound (a form of heart failure), weak peripheral pulse
and peripheral edema( when the heart can not compensate for the entire body, your
hands/feet will get cold because blood is not being pumped hard enough to reach the
areas) and DVT ( deep vein thrombosis which can lead to a stroke after forming in the
vein and travelling).
o Musculoskeletal Mass astrphy (weakness and loss of mass in bone), activity intolerance, decreased
ROM, erythema (redness of skin), joint contracture (shortening or hardening) and dis-
Lower urine output which can lead to dehydration and then infections/kidney failure,
lower bowel movement, distended bladder and abdomen and decreased bowel sounds.
Urinary stasis ( a kind of infection that happens because the urine is staying in the
ureters longer than usual/ no gravity/ the patient is supine)
Break downs in skin integrity.
o Confusion especially in older adults.
o Boredom, feeling of isolation, depression and anger.
o Changes in sleep/wake cycles.
o Becoming less cooperative/ more demanding.
6. Discuss the risk factors that contribute to pressure ulcer formation
Pressure ulcers are impairment to the skin as a result of a prolonged ischemia (decreased
blood supply to an area) in tissue.
o Impaired sensory perception: clients with impaired sensory perceptions are not
able to feel pain that’s why they are at a higher risk of ulcers.
o Impaired mobility: such as clients with spinal injury that cannot move.
o Alternation in level of consciousness: such as clients who are confused or
disoriented. They can feel the pressure but can’t relieve it or communicate their dis-
o Shear: it results from both gravity pushing down on the body and resistance (fric-
tion) between the client and the