Preventing Complications of Immobility

Immobility is when a patient’s movement is restricted. Immobility can be purposeful and temporary like when a patient is immobilized to promote healing due to a broken bone; the result of a pathologic condition, like a stroke; or secondary to pain, which causes patients to be reluctant to move. As the nurse you are responsible for preventing complications of immobility.

Now, immobility can affect multiple body systems and cause a number of complications. In the respiratory system, immobility can cause weakening of chest wall muscles, decreasing the ability to cough, and pooling of pulmonary secretions. This can result in respiratory complications, like atelectasis, which happens when the alveoli in the lungs collapse, leading to pneumonia, as well as hypoventilation and decreased gas exchange.

In the cardiovascular system, a decreased autonomic response to position changes can lead to orthostatic hypotension; and decreased return of venous blood to the heart, along with slowed blood flow, promotes clot formation, increasing the risk of venous thromboembolism.

Next, in the GI system, peristalsis is decreased, which can cause constipation. Anorexia is also common, which can result in a negative nitrogen balance and weight loss.

Effects on the urinary system include urinary stasis and an increased risk of urinary tract infections.

There are also musculoskeletal effects, like muscle atrophy and weakness. When immobility is prolonged, the skeletal muscle tissue attached to the bone becomes fibrotic, causing the muscle fibers to become short and stiff, resulting in a fixed joint that’s difficult and painful to move. Immobility also causes loss of calcium from the bones, causing decreased bone density and osteoporosis.

Other complications of immobility affect the integumentary system, where prolonged pressure on the skin and underlying tissues can lead to tissue hypoxia and ischemia, and eventually pressure injuries.

Lastly, psychosocial complications, such as decreased social interaction and loss of independence, can lead to symptoms like anxiety, depression, and loneliness.