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Promoting Joint Mobility

Unit 8 Lesson 2

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Describe appropriate interventions to maintain client joint mobility
Explain how to adapt ADLs according to the needs of the client

Student Learning Outcomes

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Importance of Joint Mobility

Key Concept: "Use it or lose it"
Musculoskeletal system declines without regular use
Small, daily activities maintain flexibility, strength, and bone health

Sandquist-Reuter, 2023

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Benefits of Mobility

Prevents complications associated with immobility
Enhances self-esteem
Promotes independence
Improves quality of life

Sandquist-Reuter, 2023

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Encouraging Self-Care in Residents

Self-Dressing Activities

Maintains joint flexibility

Shoulders, wrists, hips, knees

Improves finger dexterity and hand-eye coordination
Assess the client’s ability to use buttons and zippers
Provide alternative clothing if needed
Offer adaptive tools for clientts with limited hand function

Example: Button hooks

Sandquist-Reuter, 2023

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Encouraging Self-Care in Residents continued…

Toileting Independence

Encourage walking to the bathroom to maintain lower limb strength
Promotes autonomy and dignity in personal care

Sandquist-Reuter, 2023

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Critical Thinking Question

A client struggles with buttoning their shirt due to arthritis and becomes frustrated, asking for assistance. How can the nurse's aide support the resident while promoting independence in dressing?

A. Button the shirt for them to save time.

B. Encourage them to wear clothing without buttons to avoid frustration.

C. Provide a button hook and guide them through the process patiently.

D. Suggest they wait for a family member to help later.

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Mobility During Meals and Activities

Walking to Meals

Encourages use of leg muscles, enhancing strength and balance
Supports social interaction and mental well-being
Provide walking aids or support for residents who require assistance
Adjust the distance to be walked based on the client's endurance level

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

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Mobility During Meals and Activities continued…

Engagement in Games

Board and card games enhance upper body mobility
Stimulates cognitive function and provides entertainment
Choose games that match the client's cognitive and physical abilities
Modify rules or provide larger game pieces for easier handling

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

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Critical Thinking Question

A client enjoys playing cards but has recently experienced a decline in upper body mobility. They express a wish to continue playing. What action can the nurse's aide take to adapt this activity to the resident's current needs?

A. Play the game for them while they watch.

B. Use larger playing cards and support their arm while they play.

C. Stop playing card games and find a new activity.

D. Encourage them to watch others play to stay engaged.

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Feeding and Personal Care Independence

Encouraging Self-Feeding

Supports hand coordination and finger strength
Offer utensils with larger grips for residents with limited hand strength
Provide options between finger foods and traditional meals based on the resident's comfort

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

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Feeding and Personal Care Independence continued…

Personal Hygiene Tasks

Encourage residents to wash their face, brush teeth, and shave
Prepare necessary items
Promote independence
Use adaptive equipment such as electric razors or toothbrushes with larger handles
Adjust the level of assistance based on the resident's ability to perform tasks independently

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

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Critical Thinking Question

The nurse's aide is assisting a client who has difficulty walking long distances to the dining area. The client wishes to walk part of the way to maintain mobility. Which strategy best supports the client’s goal?

A. Insist they use a wheelchair to ensure safety.

B. Walk with them, offering support and taking breaks as needed.

C. Have them walk only when a physical therapist is present.

D. Ask them to skip walking to meals to avoid fatigue.

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Additional Mobility Interventions

Mobility in Wheelchair Users

Encourage foot movement for self-propulsion
Customize wheelchair settings to enhance mobility

Example: Seat height, pedal removal

Encourage alternative exercises for those unable to move their feet
Enhances independence and self-reliance within the facility

Participation in Daily Activities

Inform residents of daily activities, promoting involvement
Social interaction enhances mental health and physical activity

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

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Critical Thinking Question

A resident is unable to move their legs but wishes to participate more actively in activities within the facility. How can the nurse's aide adapt the resident's mobility to enhance their independence?

A. Remove the foot pedals from their wheelchair and encourage them to move by pushing with their hands.

B. Suggest they limit participation to activities that don't require movement.

C. Use a motorized wheelchair to move them quickly to activities.

D. Ask them to wait for staff assistance for all movements.

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References

Sandquist-Reuter, M. (2023). Nursing Assistant. WisTech Open. https://wtcs.pressbooks.pub/nurseassist/

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