Medical Surgical Nursing

(Tina Sui) #1
joints.
 Promote use of
assistive ambulatory
devices.
 Explain use of safe
footwear.
 Use individual
appropriate
positioning/posture.

maintaining optimal
mobility.

to assist in
managing decreased
mobility


  1. Assist to identify
    environmental barriers.
    3. Furniture and
    architectural adaptations
    may enhance mobility.

  2. Encourage independence
    in mobility and assist as
    needed.


 Allow ample time
for activity
 Provide rest period
after activity.
 Reinforce principles
of joint protection
and work
simplification.


  1. Changes in mobility
    may lead to a decrease in
    personal safety.

  2. Initiate referral to
    community health agency.

  3. The degree of mobility
    may be slow to improve
    or may not improve with
    intervention.


Nursing Diagnosis: Self-care deficits related to contractures, fatigue, or loss of motion
Goal: Achieves self-care independently or with the use of resources


NURSING
INTERVENTIONS

RATIONALE EXPECTED


OUTCOMES



  1. Assist patient to identify
    self-care deficits and factors
    that interfere with ability to
    perform self-care activities.

    1. The ability to perform
      self-care activities is
      influenced by the disease
      activity and the
      accompanying pain,
      stiffness, fatigue, muscle
      weakness, loss of motion,
      and depression.




 Identifies factors
that interfere with
the ability to
perform self-care
activities
 Identifies alternative
methods for meeting
self-care needs
 Uses alternative
methods for meeting
self-care needs
 Identifies and uses
other health care
resources for


  1. Develop a plan based on
    the patient's perceptions and
    priorities on how to
    establish and achieve goals
    to meet self-care needs,
    incorporating joint
    2. Assistive devices may
    enhance self-care abilities.
    Effective planning for
    changes must include the
    patient who must accept
    and adopt the plan.

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