A young adult patient was involved in a motorcycle accident. The patient was in the intensive care unit of the hospital for 2 months with immobility and was just discharged to a rehabilitation hospital
The patient asks the nurse, "Why am I so weak?" What is the best response from the nurse? a. "When you are in bed for a long time, your body begins to break down its own protein."
b. "When you don't use it, you lose it."
c. "You haven't eaten much for the past couple of months."
d. "Your body has spent energy trying to heal itself by increasing the metabolic rate."
A
Immobility disrupts normal metabolic functioning, decreasing the metabolic rate and altering the metabolism of carbohydrates, proteins, and fats. A patient's basal metabolic rate (BMR) decreases in response to reduced cellular energy because of the body's decreased ability to produce insulin and metabolize glucose. The body then begins to breakdown its protein stores for energy resulting in a negative nitrogen balance and increased oxygen demands. However, in the presence of an infection, immobilized patients have an increased BMR. It is the immobility that has caused the weakness, not what was eaten. Not using it leads to losing it is a cliché and should be avoided. The metabolic rate is decreased in immobility not increased.
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