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Fundamental Nursing Skills and Concepts

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Stress electrocardiogram- electrical conduction through the heart during maximal ... Ambulatory electrocardiogram- (aka Holter monitor), a continuous recording of ... – PowerPoint PPT presentation

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Title: Fundamental Nursing Skills and Concepts


1
Fundamental Nursing Skills and Concepts
  • Chapter 24
  • Page 506

2
Chapter 24
  • THERAPEUTIC EXERCISE
  • Page 506

3
Exercise
  • Purposeful physical activity
  • Box 24-1 benefits of physical exercise, pg. 507

4
Fitness
  • Capacity to exercise
  • Impairment to fitness sedentary lifestyle,
    health problems, compromised muscle and skeletal
    function, obesity, advanced age, smoking, and
    high blood pressure
  • Before a client begins an exercise program
    assess his or her fitness level
  • Assessment techniques Measure body composition,
    evaluate trends in vital signs, perform fitness
    tests

5
Assessment Techniques
  • BODY COMPOSITION-Amount of body tissue that is
    lean versus the amount of fat
  • Assessment of body composition height, weight,
    body-mass index, skin fold thickness, mid-arm
    circumference
  • Vital signs, reflect a persons physical status,
    elevations while resting are signs that the
    person may have life-threatening cardiovascular
    symptoms during exercise

6
Assessment Techniques
  • Assessment of vital signs temperature, pulse
    rate, respiratory rate, and blood pressure
  • Fitness tests Measure current level of fitness
    and safe exercise

7
Assessment Techniques
  • Assessment of fitness tests Electrocardiogram
    and Ambulatory electrocardiogram

8
Assessment Techniques
  • Stress electrocardiogram- electrical conduction
    through the heart during maximal activity and is
    performed in an acute care facility or outpatient
    clinic. 1st patient walks on a flat treadmill,
    progresses in speed and angle of incline,
    continually being monitored for heart rate and
    rhythum, B/P, breathing and symptoms of chest
    pain or dizziness.
  • Ambulatory electrocardiogram- (aka Holter
    monitor), a continuous recording of heart rate
    and rhythm during normal activity for 24 hour
    period. Client should not shower or swim.
    Monitor should not get wet. Avoid magnets, metal
    detectors, electric blankets and high-voltage
    areas.

9
TARGET HEART RATE
  • The goal of the heart rate during exercise.
  • It is determined by first calculating the
    persons maximum heart rate
  • Maximum heart rate is calculated by subtracting a
    persons age from 220.

10
TYPES OF EXERCISES
  • Fitness exercise physical activity performed by
    healthy adults
  • Fitness exercise develops and maintains
    cardiorespiratory function, muscular strength,
    and endurance
  • Two categories of fitness exercises ISOTONIC AND
    ISOMETRIC

11
ISOTONIC EXERCISE
  • Activity that involves movement and work
  • Example of isotonic exercise AEROBIC EXERCISE
  • Promotes cardiorespiratory conditioning and
    increase in lean muscle mass
  • Isotonic exercise should be at the target heart
    rate

12
Isometric exercise
  • Consists of stationary exercises generally
    performed against a resistive force.
  • Examples- body building, weight lifting,
    contracting and relaxing muscle groups while
    sitting or standing.
  • Isometric exercises-increase muscle mass,
    strength, and tone and define muscle groups.
  • Improve blood circulation, but do not promote
    cardio-respiratory function.

13
THERAPEUTIC EXERCISE
  • Activity performed by people with health risks or
    being treated for an existing health problem
  • Prevent health-related complications to restore
    lost functions

14
ACTIVE VERSUS PASSIVE EXERCISES
  • THERAPEUTIC ACTIVITY THAT THE CLIENT PERFORMS
    INPENDENTLY
  • Example Following a mastectomy squeezing a ball
  • THERAPEUTIC ACTIVITY THAT THE CLIENT PERFORMS
    WITH ASSISTANCE OF ANOTHER WHEN THE CLIENT CANNOT
    MOVE ONE OR MORE PARTS OF THE BODY
  • Example Paralyzed client requires the nurse to
    move the clients legs to maintain muscle tone
    and flexibility

15
Range of motion
  • Exercises in which joints are moved in the
    directions that the normal joint permits. Could
    be performed by the patient their-self which
    would be known as active exercise.
  • The exercises could be done by someone else and
    these are known as passive exercises.
  • A continuous passive motion machine, as seen on
    page 511 523, could also do the exercises
    passively. The degree of flexion, and cycles per
    minute are increased until the prescribed levels
    are reached.
  • Why perform ROM? Page 510b

16
RANGE-OF-MOTION EXERCISES
  • To assess joint flexibility before initiating an
    exercise program
  • To maintain joint mobility and flexibility in
    inactive clients
  • To prevent ankylosis (permanent loss of joint
    movement)
  • To stretch joints before performing more
    strenuous activities
  • To evaluate the clients response to a
    therapeutic exercise program
  • Page 511 nurse guidelines 24-1

17
NURSING IMPLICATIONS NURSING DIAGNOSES
  • Impaired Physical Mobility
  • Risk for Disuse Syndrome
  • Unilateral Neglect
  • Risk for Delayed Surgical Recovery
  • Activity Intolerance

18
GERONTOLOGICAL CONSIDERATIONS
  • Older adults need to balance physical activity
    with rest
  • Older adults need to increase noncaffeinated and
    nonalcoholic beverages before and during physical
    activity
  • Encourage adults to join organizations and social
    clubs
  • Encourage mall walking
  • Encourage swimming or exercising in water
  • Exercise and walk in non-skid shoes
  • Encourage families and caregivers of adults with
    cognitive impairment to participate in physical
    activity

19
Skills
  • 24-1 Performing Range-of-Motion exercises
  • 24-2 Using a Continuous Passive Motion machine
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