Chapter 38: Activity and Exercise in Nursing Care

Activity and Exercise in Nursing Care from Fundamentals of Nursing explores the essential principles of activity and exercise, emphasizing the intricate coordination between the musculoskeletal and nervous systems to regulate body movement, balance, and proprioception. It provides a detailed analysis of body mechanics, defining key concepts such as body alignment, center of gravity, friction, and shear, which are critical for preventing musculoskeletal injuries in healthcare workers and ensuring patient safety. The text distinguishes between various types of physical exertion, including isotonic (concentric and eccentric), isometric, and resistive isometric exercises, outlining their specific physiological benefits for muscle tone, joint mobility, and cardiopulmonary conditioning. A significant portion of the content focuses on Safe Patient Handling and Mobility (SPHM), advocating for the use of ergonomic principles and mechanical lifts rather than manual lifting to reduce work-related injuries. It details the nursing process for mobility, utilizing standardized assessment techniques like the Banner Mobility Assessment Tool (BMAT) to evaluate a patient’s ability to sit, stand, and walk. Furthermore, the chapter addresses the pathophysiology of deconditioning and disuse atrophy caused by prolonged bed rest and immobility, offering interventions such as early mobility protocols and range-of-motion (ROM) exercises. Practical guidance is provided on assisting with ambulation using gait belts and the correct measurement and utilization of assistive devices, including walkers, canes, and crutches, with specific explanations of crutch gaits like four-point, three-point, and swing-through patterns. Finally, the material integrates developmental, cultural, and environmental factors into patient-centered care planning to promote adherence to exercise programs and prevent complications like orthostatic hypotension and falls.