Health Promotion and Maintenance Q 77
Following myocardial infarction, a hospitalized patient is encouraged to practice frequent leg exercises and ambulate in the hallway as directed by his physician. Which of the following choices reflects the purpose of exercise for this patient?
A. Increases fitness and prevents future heart attacks.
B. Prevents bedsores.
C. Prevents DVT (deep vein thrombosis).
D. Prevent constipations.
Correct Answer: C. Prevents DVT (deep vein thrombosis).
Exercise is important for all hospitalized patients to prevent deep vein thrombosis. Muscular contraction promotes venous return and prevents hemostasis in the lower extremities. Encourage physical activity consistent with the patient’s energy levels. Helps promote a sense of autonomy while being realistic about capabilities. Walking down the hall 20 feet or walking through the house, then slowly progressing walking outside the house, saving energy for the return trip.
Option A: This exercise is not sufficiently vigorous to increase physical fitness. Encourage active ROM exercises. Encourage the patient to participate in planning activities that gradually build endurance. Exercise maintains muscle strength, joint ROM, and exercise tolerance. Physical inactive patients need to improve functional capacity through repetitive exercises over a long period of time. Strength training is valuable in enhancing endurance of many ADLs.
Option B: Inspect skin regularly, particularly over bony prominences. Gently massage any reddened areas and provide aids such as sheepskin pads as necessary. Pressure points over bony prominences are most at risk for decreased perfusion. Circulatory stimulation and padding help prevent skin breakdown and decubitus development. Change positions at least every 2 hr (supine, side-lying) and possibly more often if placed on the affected side.
Option D: It is not intended to prevent bedsores or constipation. Have the patient perform the activity more slowly, in a longer time with more rest or pauses, or with assistance if necessary. Gradually increase activity with active range-of-motion exercises in bed, increasing to sitting and then standing. Gradual progression of the activity prevents overexertion.