A nurse is monitoring a client for complications of immobility. Which of the following findings should the nurse expect? (Select all that apply.)

Choice A rationale Immobility reduces the body's metabolic demand and lowers venous return due to the lack of skeletal muscle pump action, leading to a compensatory decrease in sympathetic activity. This generally results in orthostatic hypotension and a trend toward lower resting blood pressure, or at least a lack of the expected rise in blood pressure, rather than hypertension. Choice B rationale Immobility often reduces peristalsis, the coordinated muscular contractions of the gastrointestinal tract, leading to decreased bowel motility. This reduced movement of contents through the colon typically results in constipation and fecal impaction, rather than the rapid transit and loose stools characteristic of diarrhea. Choice C rationale Immobility impairs the expansion of the chest wall and diaphragm, leading to shallow respirations and atelectasis, the collapse of alveoli, especially in dependent lung areas. Crackles (rales) are adventitious lung sounds that indicate the presence of fluid in the small airways or alveoli, often a sign of pneumonia or pulmonary congestion, which are common complications of atelectasis. Choice D rationale Prolonged immobilization reduces tissue perfusion and subjects localized areas of skin and underlying tissue, particularly over bony prominences, to sustained pressure and shearing forces. This sustained mechanical load impedes capillary blood flow, resulting in ischemia and eventual tissue necrosis, which clinically manifests as pressure ulcers (decubitus ulcers). Choice E rationale Lack of active or passive range of motion across a joint causes the periarticular connective tissues, tendons, and muscles to shorten and become fibrotic. Without regular movement to maintain elasticity and joint capsule volume, this structural change results in a fixed position of the joint, limiting motion and leading to the development of contractures of extremities.