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Disuse Osteoporosis demineralization of bone due to absence of stress of weight bearing activity Disuse Atrophy unused muscle decrease in size, losing most of their strength and normal function Contractures permanent shortening of the muscle limiting joint mobility Ankylosis stiffness and pain in the joints

Diminished Cardiac Reserve imbalance in the Autonomic Nervous System resulting in preponderance of sympathetic activity over cholinergic activity that increases the heart rate, reducing diastolic pressure, coronary blood flow and the capacity of the heart to respond to any metabolic demands above the basal levels Increased use of Valsalva Maneuver refers to holding the breath and straining against a closed glottis

Orthostatic Hypotension or Postural Hypotension blood pools in the lower extremities and central blood pressure drops, cerebral perfusion is seriously compromised and th person feels dizzy or light headed or may even faint Venous Vasodilation and Stasis blood pools in the leg veins

Dependent Edema serous par of the blood is forced out of the blood vessel into the interstitial space surrounding the blood vessel causing edema

Thrombus Formation a clot that is loosely attached to an inflamed vein wall

Decreased Respiratory Movement muscle atrophy of the respiratory muscle because there is no stimulus of activity Pooling of Respiratory Secretions secretions pool by gravity interfering the normal diffusion of O2 and CO2 in the alveoli Atelectasis collapse of a lobe or of an entire lung Hypostatic Pneumonia pooled secretion provide excellent media for bacterial growth

Decreased Metabolic Rate the BMR and GI motility and secretions of various digestive glands decrease as the energy requirements of the body decrease

Metabolism refers to the sum of all the physical and chemical processes by which living substance is formed and maintained and by which energy is made available for use by the body Basal Metabolic Rate the minimal energy expended for the maintenance of bodily processes

Negative Nitrogen Balance depletion of protein stores that are essential for building muscle tissue and for wound healing Anabolism protein synthesis Catabolism protein breakdown

Anorexia loss of appetite due to decreased metabolic rate and increased catabolism
Negative calcium Balance greater amount of calcium are extracted from the bone than can be replaced

Urinary Stasis stoppage or slow down of urine flow Renal Calculi urine becomes alkaline and calcium salts precipitate out as crystals to form renal stones

Urinary retention accumulation of urine in the bladder Urinary Infection static provides an excellent medium for bacterial growth Escherichia coli most common causative microorganism, normal flora of the colon

Constipation decreased peristalsis and colon motility

Reduced Skin Turgor skin atrophies causing loss of elasticity Skin Breakdown diminished supply of nutrients in the skin

Frustration due to increased dependence to others Decreased Self-Esteem

pillows mattresses bed boards chair beds foot boot foot board

bed position n which head and trunk are raised 45 to 90 degrees

position of choice for people who have difficulty in breathing and people with heart problems

Low Fowlers/Semi-Fowlers head and trunk are raised 15 45 degrees High Fowlers head and trunk are raised 90 degrees

Orthopneic Position client sits either in bed or on the side of the bed with an over bed table across the lap
facilitates respiration by allowing maximum chest expansion

Dorsal Recumbent Position back lying with head and shoulders slightly elevated

Prone Position client lies in the abdomen with the head turned to one side
promotes drainage

Lateral Position side-lying

Sims Position semi-prone

Trendelenburge Position bed is inclined so that the feet are higher than the head Reverse Trendelenburge Position bed is inclined so that the head is higher than the feet Lithotomy Position lower extremities are elevated and supported by stirrups