Impaired Physical Mobility Care Plan

Nursing Care Plan for Impaired Physical Mobility

Definition
  • Mobilization is an irregular movement, organized and orderly.
  • Mobilization is an individual's ability to move freely, easily and regularly with the aim to meet the needs of the activity in order to maintain health.
  • Mobilization is the ability to move freely. (Musrifatul Uliyah and A. Aziz A. H., 2008; 10)
  • Mobilization is the ability to move freely and regularly to meet the needs of a healthy self-reliance and mobilization which refers to the inability of a person to move freely. (Perry and Potter, 1994)


Types of Mobility

Full mobility

Is a condition in which a person's ability to move fully and freely in order to make social interaction and run the day-to-day role. Full mobility is a function of the motor nerves, sensory voluntary and to be able to control all areas of a person's body.

Partially mobility

A person's ability to move with clear boundaries and are not able to move freely because it is influenced by the motor and sensory neurological disorders in areas of the body.
Mobilization of this portion is divided into two parts, namely:
  • Temporary part time mobility, an individual's ability to move with temporary restrictions. This can be caused by trauma to the musculoskeletal system such as reversible on any dislocation of joints and bones.
  • Permanent part time mobility, an individual's ability to move with boundaries that are fixed. It is caused by damage to the nervous system that is reversible. For example: the occurrence of hemiplegia due to stroke, spinal cord injury praplegi for and specific to poliolemitis due to disruption of sensory and motor nervous system.


Etiology
  • Lifestyle
  • Process of disease / injury
  • Culture
  • Energy levels
  • Age and developmental status
  • Activity intolerance
  • Neuromuscular disorders
  • Muscular disorders


Signs and Symptoms
1. Joint contracture
Caused by disuse, muscle atrophy and neural approaches.
2. Changes in urinary elimination
Urinary elimination is changing due to the immobilization of the patient in the upright position, urine flows out of the renal pelvis and into the ureter and bladder due to the force of gravity.
3. Changes in integument system
Pressure sores are caused by tissue ischemia and anorexia. Depressed tissue, blood forming and strong constriction of the blood vessels due persistem pressure on the skin and under the skin structure so that cellular respiration becomes impaired and cell death.
4. Changes in metabolic
When injury or stress occur, endocrine system triggers a series of responses that aim to maintain blood pressure and maintain life.
5. Changes in the musculoskeletal system
Limitations affect the mobilization of clients through loss of muscle endurance, decreased muscle mass atrophy and decreased stability.
6. Changes in the respiratory system
Clients with postoperative immobilization and an increased risk of complications in the lungs.


Benefits Mobilization
1. Patients feel healthier and stronger with early ambulation.
2. Reduce the pain so the patient feels healthy.
3. Helps accelerate the body's organs to work as before.
4. Mobilization allows us to quickly teach the patient to be able to care for himself.
5. Prevent the occurrence of thrombosis and thromboembolism.
6. Maintaining the flexibility of the bones and joints also increases muscle strength.



Clinical Symptoms / Problems of Mobilization
1. Diseases of the nervous system.
2. muscular dystrophy.
3. Tumors of the central nervous system.
4. Increase in intra-cranial.
5. connective tissue disease.


ADL Scale (Activity Daily Living)
0: Patients can stand.
1: Patients need help / minimal equipment.
2: Patients requiring assistance are being / with supervision.
3: Patients requiring special assistance and the needed tools.
4: It depends totally on the provision of care.


Things to consider in mobilization

Usually do assessments on time before mobilization and after mobilization like the signs that will be studied in intolerance among other activities (Goldon, 1976)


Management
1 Assist the patient sitting up in bed
This action is one way of maintaining patient mobility.
Purpose:
Maintaining comfort.
Maintain tolerance to activity.

2 Adjust the position of the patient in bed
a. Fowler position is the position of the patient half sitting / sitting
Purpose:
Maintaining comfort
Facilitate respiratory function

b. Sim's position is the patient lying on his side up to the right or to the left
purpose:
Blood circulation to the brain.
Provide comfort.
Doing an enema.
Giving drugs per rectum.
To examine the anal area.

c. Trendelenburg position is to place the patient in bed with the head lower than the feet.
Purpose: to improve blood circulation.

d. Dorsal recumbent position is the position of the patient is placed in the supine position with flexed knees on the bed
Purpose:
Genetalia area treatment.
Examination genetalia.
The position on the delivery process.

e. Lithotomy position is the position of the patient is placed in the supine position with both legs lifted and pulled to the top of the abdomen.
Purpose:
Examination genetalia.
The delivery process.
Installation of contraception.

f. Genupectoral position, is the position with both legs bent and torso attached to the top of the bed.
Transporting patients to the tdiur / to wheelchair
Purpose:
Doing skeletal muscles to prevent contractures.
Maintain patient comfort.
Maintaining self-control patients.
Transferring patients for examination.

Helping the patient to walk
Purpose:
Activity tolerance.

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