Nursing interventions for impaired body alignment and mobility

this topic describes the nursing care to be provided for a patient who is having impaired physical mobility or who is immobile. various nursing are provided to prevent complications in different syatems oof the body.

1. Nursing Interventions For Impaired Body Alignment & Mobility By Mr. M. Shivanandha Reddy

2. Prevention Of Musculoskeletal Complications Goal: Prevent contractures, muscle weakness/atrophy. Prevent disuse osteoporosis Interventions: Provide Active or passive range of motion exercises(ROM ) three times/day. Encourage activities of daily living(ADLs) as possible and progressively.

3. Promote independence as much as possible. Provide Therapeutic devices as needed. (pillows, footboard, trochanter roll, hand rolls, trapeze bar). Consult appropriate health care provider (e.g. physician, physical therapist) if client's mobility and range of motion are more limited than expected. Provide foods high in calcium Prevention Of Musculoskeletal Complications

4. Prevention of cardio vascular complications Goal: Reducing orthostatic hypotension Reducing cardiac workload Preventing thrombus formation Interventions: Reducing orthostatic hypotension- Teaching patients to rise slowly from lying to standing. Sit for a while before standing

5. : Reducing cardiac workload: Discourage Valsalva maneuver. Encourage patient to take breath while sitting or standing. Stool softeners to avoid straining during defecation. Preventing thrombus formation. Exercise: perform active / passive exercises. Prevention of cardio vascular complications

6. Provide at least 2000 ml water daily. Encourage early mobilization. Medication: Aspirin or antiplatelet agents should be given. Compression stockings, sequential compressive devices must be used. Positioning: Avoid crossing the legs, sitting for prolonged period of time wearing clothing that constricts the leg. : Prevention of cardio vascular complications

7. Prevention of respiratory complications Goal Promotion of chest and lung expansion Removal of secretions Maintenance of patent airway Prevention of hypostatic pneumonia

8. Interventions: Place the client in fowlers position. Cough and deep breathing. Ambulate as soon as possible. Adequate fluid intake. Incentive spirometer. Chest physiotherapy. Prevention of respiratory complications

9. Prevention of metabolic complications Goal: To prevent negative nitrogen and calcium balance To meet the nutritional requirements Interventions: Nutritional needs: Provide protein rich diet Supply adequate calories in diet Vitamin D, C rich diet.

10. Prevention of urinary complications Goals : Prevent urinary stasis, calculi, and infection. Interventions: Ensure adequate fluid intake ( minimum 2L/day). provide Toileting aids. Foley’s or straight catheter if needed.  Observe output, assess for bladder distention, signs and symptoms of urinary tract infections (UTI).  

11. Prevention of gastrointestinal effects Goal: Prevention of constipation Interventions: Encourage daily fluid intake of 2000 to 3000 ml per day, if not contraindicated medically Encourage increased fiber in diet (e.g., raw fruits, fresh vegetables); a minimum of 20 gm of dietary fiber per day is recommended

12. Encourage physical activity and regular exercise Encourage a regular time for elimination Offer a warmed bedpan to bedridden patients Provide privacy and maintain dignity Stool softeners Suppositories Enema Prevention of gastrointestinal effects

13. Prevention of Integumentary complications Goal: To prevent skin breakdown Interventions: Change position every 2 nd hourly. Use proper transfer technique to avoid shearing/friction.

14. Therapeutic devices as needed (air mattress, water mattress, protective cushion, pressure rings, etc.) Adequate hydration and nutrition Protect skin from moisture. Assess skin for signs of pressure areas/skin breakdown. Proper wound care. Prevention of Integumentary complications

15. Prevention of psychosocial complications Goal: To improve self esteem To avoid depression Interventions: Provide psychological support. Encourage client’s verbalization of feelings.

16. Provide social interaction during care encourage participation in ADLs as able Provide stimuli to promote orientation and contact with reality – clock, radio, TV, newspaper. Prevention of psychosocial complications