[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Nursing](https://durgical.com/en/nursing/) › [Mobility and comfort](https://durgical.com/en/nursing/areas/mobility/) › Complications of immobility and how to prevent them # Complications of immobility and how to prevent them - Fundamental Staying in bed affects almost every body system; mobilising early and safely is the best prevention. Updated Nov 5, 2026 ## Key points - Muscle strength can fall by about 20% per week of immobility. - Joint changes can start after three days: begin range-of-motion exercises as soon as possible. - Orthostatic hypotension: a drop of 20 mmHg or more in systolic or 10 mmHg or more in diastolic pressure within 3 minutes of sitting or standing. - Early mobilisation is linked with less delirium, pain, urinary tract infection, deep vein thrombosis and pneumonia. - Bed-bound patient: reposition at least every 2 hours and head of bed at 30–45° unless contraindicated. ## What it is Prolonged immobility harms almost every system: blood pools in the legs and clots form, the lungs ventilate less and collect secretions, the skin breaks down under pressure, muscles waste and joints contract, the bowel slows, and urinary retention, infection, anxiety and depression appear. Nursing assesses these risks system by system and prevents them by mobilising the patient as early and as fully as possible, with repositioning, range-of-motion exercises, deep breathing and coughing, fluids and skin care. ## Key points - Cardiovascular: venous stasis, orthostatic hypotension, lower cardiac output and thrombosis. - Respiratory: hypoventilation, weak cough, pooled secretions, atelectasis, pneumonia and pulmonary embolism. - Skin: ischaemia, friction and shear, pressure injuries and infection. - Musculoskeletal: atrophy, loss of strength, contractures, foot drop, bone loss, falls and fractures. - Gastrointestinal and urinary: constipation, faecal impaction, ileus, poor appetite, urinary retention and urinary tract infection. - Psychological: anxiety, depression, isolation and lower quality of life. ## Components - System-by-system assessment: strength, coordination, skin, lungs, leg circulation, elimination and mood. - Staged mobility assessment: bed mobility, sitting on the edge, weight-bearing, standing and walking. - Prevention measures: mobilisation, repositioning, exercises, breathing and coughing, fluids and skin care. - Teamwork with physiotherapy, occupational therapy and nutrition. ## What it is for - Detecting the risks and the first signs of each complication in time. - Keeping physical function and independence in daily activities. - Reducing hospital days, infections and thromboembolic events. ## In nursing practice - Mobilise as early and as fully as the condition allows, according to the order and the surgery. - Teach deep breathing and coughing and encourage fluids: they prevent atelectasis and pneumonia. - Do or teach passive, active or active-assisted range-of-motion exercises, slowly and without forcing. - Take blood pressure lying, sitting and standing if you suspect orthostatic hypotension before walking. - Encourage the patient to do their own daily activities as much as they can. - Assess and treat pain: uncontrolled pain holds back mobilisation. ## Common mistakes - Waiting for the patient to "get better" before mobilising, when the order already allows it. - Forgetting the legs and lungs in a patient who is "only" on bed rest. - Doing sudden or painful stretches: they reduce cooperation and can injure. - Not recording activity tolerance, which makes the plan impossible to adjust. ## Test yourself Think of the answer, then tap the question to see it. ## How much muscle strength can be lost per week of immobility? About 20% per week. That is why patients are mobilised as early as possible and do range-of-motion exercises. ## How is orthostatic hypotension defined? A drop of 20 mmHg or more in systolic pressure, or 10 mmHg or more in diastolic pressure, within 3 minutes of sitting or standing up. ## What respiratory complications does immobility cause? Hypoventilation, weak cough, pooled secretions, atelectasis, pneumonia and pulmonary embolism. ## What simple measures prevent atelectasis and pneumonia in a bed-bound patient? Early mobilisation, repositioning, raising the head of the bed, deep breathing and coughing, and adequate fluids. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/nursing/complications-of-immobility-and-how-to-prevent-them/) ## Connections ## Related 2 - [Mechanical prevention of venous thromboembolism: stockings and intermittent compression](https://durgical.com/en/nursing/mechanical-prevention-of-venous-thromboembolism-stockings-and-intermittent-compr/) - [Preventing pressure injuries: risk scales, repositioning and skin care](https://durgical.com/en/nursing/preventing-pressure-injuries-risk-scales-repositioning-and-skin-care/) [← All of nursing](https://durgical.com/en/nursing/) Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order. Sources: [Nursing Fundamentals, 13.2: Basic Concepts (Mobility)](https://med.libretexts.org/Bookshelves/Nursing/Nursing_Fundamentals_(OpenRN)/13%3A_Mobility/13.02%3A_Basic_Concepts) (Open RN, Chippewa Valley Technical College (LibreTexts), 2021); [Nursing Fundamentals, 13.3: Applying the Nursing Process (Mobility)](https://med.libretexts.org/Bookshelves/Nursing/Nursing_Fundamentals_(OpenRN)/13%3A_Mobility/13.03%3A_Applying_the_Nursing_Process) (Open RN, Chippewa Valley Technical College (LibreTexts), 2021). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/nursing/complications-of-immobility-and-how-to-prevent-them/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/nursing/complications-of-immobility-and-how-to-prevent-them/