Metabolic Processes
The functional changes resulting from prolonged rest include the following: a decreased metabolic rate, tissue atrophy, protein catabolism, bone demineralization, altered exchange of nutrients and vital substances between the intracellular and extracellular compartments, fluid and electrolyte imbalance, and changes in gastrointestinal motility.
Some of the above changes resulting from immobility have been discussed: the decreased metabolic rate, protein breakdown, threat of renal calculi, decreased muscular use, and loss of stress to the skeletal system. Another important effect of bedrest is the loss of heat by conduction and radiation because of the pressure of the bed and its linens. Blood vessels are dilated in the supine position, and since much of the body`s surface is covered with bedclothes, perspiration is increased. This adds to the fluid loss, and with perspiration the essential electrolytes, sodium, potassium, and chloride are lost.
Diurnal patterns are closely bound to metabolic response. Activity of body functions such as temperature, hormone secretion, and renal regulation is at its best during a person`s waking hours; during sleep most body functions are reduced to a minimum. If a person is supine for long periods, whether asleep or awake, these physicological functions will decline to a minimal output.
Metabolic homeostasis is preserved through the nursing measures discussed in relation to all the functional body systems: around-the-clock exercise and movement, increased fluid intake, acid-ash foods, attention to nutritional and elimination needs, care and stimulation of the integument, and interventions that converse heat loss and cardiac output.
References :
Olson, Edith V., “The Hazards of Immobility”, American Journal of Nursing, 67: No.4, 1971.
Murray, RB and Zentner JP., Nursing Concepts for Health Promotion, Second Edtion, Prentice-Hall, Inc, Englewood Cliffs, N.J, 1979.
