Definition of Impaired Physical Mobility
- Limitation in independent, purposeful physical movement of the body or of one or more extremities
Defining Characteristics of Impaired Physical Mobility
- Gait changes, postural instability; difficulty turning
- Limited ROM; ability to perform fine and gross motor skills
- Movement-induced tremor, uncoordinated or jerky movements
- Slowed and/or uncoordinated movements; reaction time.
- Substitution of other behaviors for impaired mobility (for instance, increased attention to other’s activity and controlling behavior)
Related Factors of Impaired Physical Mobility
- Activity intolerance
- Altered cellular metabolism
- Body mass index above 75th percentile
- Cognitive impairment
- Contractures
- Cultural beliefs regarding age-appropriate activity
- Deconditioning
- Decreased endurance; muscle control, mass or strength
- Depressive mood state
- Deficient knowledge about value of exercise
- Developmental delay
- Discomfort
- Disuse
- Joint stiffness
Assessment Focus | Nursing Care Plan for Impaired Physical Mobility
Nursing Diagnosis for Impaired Physical Mobility | Assessment Focus of Impaired Physical Mobility; Expected Outcomes; Suggested NOC Outcomes
Assessment Focus of Impaired Physical Mobility (Refer To Comprehensive Assessment Parameters.)
- Activity/exercise
- Neurocognition
Expected Outcomes | Nursing Diagnosis for Impaired Physical Mobility
The patient will
- Maintain muscle strength and joint ROM.
- Be free from complications (e.g., contractures, venous stasis, thrombus formation, skin breakdown, and hypostatic pneumonia).
- Achieve the highest level of mobility (will transfer independently, will be wheelchair-independent, or will ambulate with assistive devices such as walker, cane, and braces).
- Carry out mobility regimen.
- Use resources to help maintain level of functioning.
Suggested NOC Outcomes | Nursing Diagnosis for Impaired Physical Mobility
Ambulation; Ambulation: Wheelchair; Joint Movement: Hip; Joint Movement: Shoulder; Mobility; Transfer Performance
Nursing Interventions | Nursing Care Plan for Impaired Physical Mobility
Nursing Care Plan for Impaired Physical Mobility | Nursing Interventions of Impaired Physical Mobility; Suggested NIC Interventions
Nursing Interventions of Impaired Physical Mobility and Rationales
- Identify level of functioning using a functional mobility scale. Communicate patient’s skill level to all staff members to provide continuity and preserve identified level of independence.
- Monitor and record daily any evidence of immobility complications as they may be more prone to develop complications.
- Perform ROM exercises to joints, unless contraindicated, at least once every shift to prevent joint contractures and muscular atrophy. Turn and reposition patient every 2 hr. Establish a turning schedule and post at bedside. Monitor frequency of turning to prevent skin breakdown by relieving pressure. Place joints in functional position. Use trochanter roll along the thigh, abduct thighs, use high-top sneakers, and pull a small pillow under patient’s head to maintain joints in a functional position and prevent musculoskeletal deformities.
- Place items within reach of the unaffected arm if patient has one sided weakness or paralysis to promote patient’s independence.
- Carry out medical regimen to manage or prevent complications (e.g., administer prophylactic heparin for venous thrombosis). This promotes patient’s health and well-being.
- Provide progressive mobilization to the limits of patient’s condition (bed mobility to chair mobility to ambulation) to maintain muscle tone and prevent complications of immobility.
- Instruct patient and family members in ROM exercises, transfers, skin inspection, and mobility regimen to help prepare for discharge and promote continuity of care. Request return demonstration to ensure use of proper technique.
- Help patient use a trapeze and side rails to encourage independence in mobility. Instruct him to perform self-care activities to increase muscle tone.
- Encourage physical therapy sessions and support activities on the unit by using the same equipment and technique. Request written mobility plans for reference. Ensure all members of the healthcare team are reinforcing learned skills in the same manner.
- Refer patient to a physical therapist for development of mobility regimen to help rehabilitate musculoskeletal deficits.
- Assist patient in identifying resources such as American Heart Association to provide a comprehensive approach to rehabilitation.
Suggested NIC Interventions | Nursing Diagnosis for Impaired Physical Mobility
Exercise Promotion: Strength Training; Exercise Therapy: Joint Mobility; Exercise Therapy: Muscle Control; Positioning: Wheelchair
This is a sample of Nursing Care Plan for Impaired Mobility: Nursing Diagnosis for Impaired Physical Mobility.