Objective General Objectives: After 5 days of varied learning activities, the patient as well as the significant others or family

will be able to acquire knowledge, attitude and skills in preventing complications of immobility. Specific Objectives: After 45 minutes of teaching, the patients as well as the significant other or family will be able to: 1. Explain the goals of frequent position changes.

Content

Methodology

Evaluation

Positioning (Goals) * to prevent contractures * stimulate circulation and prevent pressure sores * prevent thrombophiebitis and pulmonary embolism. * promote lung expansion and prevent pneumonia * decrease edema of the extremities * changing position from lying to sitting several times a day can help prevent changes in the CVS known as deconditioning. *the recommendation is to change body position at least every 2 hours, and preferably more frequently in patients who have no spontaneous movement.

Informal discussion

-the patients was able to explain the goal of frequent position changes and she was motivated to perform the different positions to become at ease from pain or any discomfort felt

2. Enumerate the positions for proper body alignment

Proper Body Alignment 1. Dorsal or Supine Position. a. the head is in line with the spine both laterally and anteroposteriority. b. the trunk is positioned so traction of the hips is minimized to prevent hip contractive. c. The Arms are flexed at the elbow with the hands resting against the lateral abdomen. d. the legs are extended in a neutral position with the toes pointed towards the ceiling. e. the neels are suspended in a space between the mattress and the footboard to prevent neel pressure. f. trochanter tons are place under the greater trochanter in the hip joint areas. 2. Side lying or lateral position a. the head is in line with the spine b. the body is an alignment and is not twisted c. the uppermost hip joint silently forward and supported by a pillow in a position of slight abduction. d. a pillow supports the arm which is flexed of both the elbow and shoulder joints. 3. Prone position a. the head is turned laterally and is in alignment with the rest of the body b. the arms are abducted and externally rotated at the shoulder joint; the elbow are fexed

Informal discussion

-the patient was able to verbalize the different proper positions for proper body alignment

c. a small flat support is placed under the pelvis extending from the level of the umbilicus to the upper third of the thigh. d. the lower extremities remain in a neutral position. Therapeutic Exercises 1. Positive range of motion exercise 2. active assistive range of motion 3. active range of motion 4. Resistive exercise 5. Isometric or muscle settings exercise. Range of motion * Flexion extension of shoulder. * Flexion extension of elbow * adduction-abduction of shoulder. * Pronation-supination of elbow. * Dorsiflexion and palmar flexion of wrist. * Ulnar-radial deviation of wrist. * Adduction-abduction and opposition of thumb * Adduction-abduction, flexion-hyper extension of fingers. *Dorsiflexion-Plantarflexion, Eversion of the ankle. * Flexion-extension; adduction-abduction of toes * Adduction-abuction; internal rotation or external rotation of the hip. * Flexion-hyperextension; rotation of cervical spine * Lateral bending of cervical spine. Informal discussion and demonstration -the patient was able to discuss the different therapeutic exercises and was able to demonstrate them with assistance

3. Discuss the different therapeutic exercises

4. Practice the different kinds of range of motion

Informal discussion and demonstration

The patient was able to practice the different kinds of ROM exercise with assistance