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NCLEX & CGFNS Practice Questions
Impaired Physical Mobility
  • Actual
  • Risk for (Potential)

Related To: [Check those that apply]

  • Activity intolerance
  • Perceptual or cognitive impairment
  • Musculoskeletal impairment
  • Neuromuscular impairment
  • Medical restrictions
  • Prolonged bed rest
  • Limited strength
  • Pain or discomfort
  • Depression or severe anxiety

As evidenced by: [Check those that apply]

  • Inability to move purposefully within physical environment, including bed mobility, transfers, and ambulation
  • Reluctance to attempt movement
  • Limited range of motion (ROM)
  • Decreased muscle endurance, strength, control, or mass
  • Imposed restrictions of movement, including mechanical, medical protocol, and impaired coordination
  • Inability to perform action as instructed

Patient’s Diagnosis: –
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Objective/Expected Outcome;The patient will:

  • performs physical activity independently or with assistive devices as needed.
  • be free of complications of immobility, as evidenced by: intact skin, absence of thrombophlebitis, and normal bowel pattern
  • Others

Note: you need to indicate time frame/target as objective must be measurable.

Nursing Interventions Scientific Rationale
Assess for impediments to mobility. Identifying the specific cause guides design of optimal treatment plan.
Assess patient's ability to perform ADLs effectively and safely on a daily basis. Restricted movement affects the ability to perform most ADLs. Safety with ambulation is an important concern.
Assess patient or caregivers knowledge of immobility and its implications. Even patients who are temporarily immobile are at risk for some of the effects of immobility, such as skin breakdown, muscle weakness, thrombophlebitis, constipation, pneumonia, and depression).
Assess for developing thrombophlebitis (calf pain, Homans' sign, redness, localized swelling, and rise in temperature). Bed rest or immobility promotes clot formation.
Assess elimination status. Immobility promotes constipation.
Evaluate need for assistive devices. Proper use of wheelchairs, canes, transfer bars, and other assistance can promote activity and reduce danger of falls.
Evaluate the safety of the immediate environment. Obstacles such as throw rugs, children's toys, pets, and others can further impede one's ability to ambulate safely.
Encourage and facilitate early ambulation and other ADLs when possible. The longer the patient remains immobile the greater the level of debilitation that will occur.
Encourage appropriate use of assistive devices in the home setting. Mobility aids can increase level of mobility.
Provide positive reinforcement during activity. Patients may be reluctant to move or initiate new activity from a fear of falling.
Allow patient to perform tasks at his or her own rate. Do not rush patient. Encourage independent activity as able and safe. Hospital workers and family caregivers are often in a hurry and do more for patients than needed, thereby slowing patient's recovery and reducing his or her self-esteem.
Keep side rails up and bed in low position. To promote safe environment.
Turn and position every 2 hours, or as needed. To optimize circulation to all tissues and to relieve pressure.
Maintain limbs in functional alignment (e.g., with pillows, sandbags, wedges, or prefabricated splints). To prevent footdrop and/or excessive plantar flexion or tightness.
Support feet in dorsiflexed position (Use bed cradle) To keep heavy bed linens off feet.
Perform passive or active assistive ROM exercises to all extremities To promote increased venous return, prevent stiffness, and maintain muscle strength and endurance
Promote resistance training services. Research supports that strength training and other forms of exercise in older adults can preserve the ability to maintain independent living status and reduce risk of falling.
Turn patient to prone or semiprone position once daily unless contraindicated. To drain bronchial tree.
Use prophylactic antipressure devices as appropriate. To prevent tissue breakdown.
Use incentive spirometer to increase lung expansion. Decreased chest excursions, and stasis of secretions are associated with immobility.
Encourage liquid intake of 2000 to 3000 ml per day unless contraindicated. To optimize hydration status and prevent hardening of stool.
Initiate supplemental high-protein feedings as appropriate. Proper nutrition is required to maintain adequate energy level.
Administer medications as appropriate. Antispasmotic medications may reduce muscle spasms or spasticity that interfere with mobility.
Teach energy saving techniques. To optimize patient's limited reserves.

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