NR 324 Week 7 Altered Mobility

Student Name

Chamberlain University

NR-324 Adult Health I

Prof. Name:

Date

Adult Health 1: Altered Mobility

Introduction to Nursing Care of Mobility

Mobility plays a vital role in maintaining health and functionality in individuals. A loss of mobility, whether partial or complete, may result in severe health complications. Nurses have a critical role in identifying early signs of immobility-related complications and implementing interventions that support movement. This proactive approach can improve client outcomes and significantly reduce healthcare expenditures.

Recognizing Cues: Nursing Assessment

Three anatomical systems influence mobility: bones, muscles/tendons/ligaments, and nerves. Dysfunction in any of these can result in limited mobility.

Bone-related immobility may be due to trauma or chronic conditions like arthritis and osteoporosis. These issues typically present with pain, deformity, and inflammation. Without proper intervention, bone injuries can lead to long-term disability. X-rays are commonly used to diagnose these conditions. Interventions include immobilization via casting or splinting, surgical repair, and controlling inflammation.

Injuries to soft tissue structures are often caused by overuse or minor trauma. Healing may be impaired if scar tissue replaces healthy tissue, making the structure more vulnerable to future injury. Assessment findings include reduced movement, inability to bear weight, and atrophy. MRI or CT scans are used for diagnosis. Treatment involves reducing inflammation and immobilizing the area.

Nerve damage, often caused by spinal cord injuries or neurological diseases, may result in paresthesia, paralysis, or incontinence. MRI and EMG are useful diagnostic tools. Disorders like multiple sclerosis and Parkinson’s disease can progressively impair nerve function and mobility.

Altered Mobility Due to Trauma

Trauma can simultaneously affect bones, muscles, and nerves. Assessment may be complicated by pain and inflammation. Nurses must focus on pain management and preventing further injury. Imaging tools, including MRI and X-rays, are essential in diagnosing trauma.

Risk Factors and Clinical Manifestations

Several factors affect recovery from mobility-related conditions:

Age: Older adults have reduced bone density and muscle mass.
Lifestyle/Nutrition: Poor dietary habits and inactivity delay healing.
Comorbid Conditions: Diseases like diabetes can impair recovery.

Table: Signs and Symptoms of Altered Mobility

Assessment: Symptoms	Assessment: Signs
Pain	Skin color changes
Loss of movement	Skeletal or muscular deformity
Numbness or tingling	Atrophy
Inability to bear weight	Erythema, ecchymosis
Activity intolerance	Gait and balance abnormalities

Contributing History

Category	Examples
Social History	Smoking, alcohol use, poor nutrition, occupational risks
Family History	Osteoporosis, neuromuscular diseases
Past Medical	Diabetes, arthritis, trauma
Medications	Opiates, corticosteroids, muscle relaxants
Vital Signs	Elevated BP and pulse

Other Nursing Considerations

Age: Encourage mobility while acknowledging limitations.
Culture: Cultural beliefs may affect perceptions and behaviors related to mobility.
Family Dynamics: Family expectations may hinder or promote recovery.
Healthcare Access: Determines availability of necessary equipment and therapy.

Generating Hypotheses: Nursing Diagnosis

Potential Nursing Diagnoses

Impaired physical mobility
Acute/chronic pain
Altered coping
Impaired skin integrity
Self-care deficit

Possible Complications

Risk for thromboembolism
Risk for falls or injury
Risk for disuse syndrome

Generating Solutions: Interventions

Table: Nursing Diagnoses and Actions

Nursing Diagnosis	Nursing Interventions
Impaired mobility	Use assistive devices, assist with movement
Pain	Repositioning, warm/cool compresses, analgesics, distraction
Altered coping	Therapeutic communication
Impaired tissue integrity	Use of splints, casts
Self-care deficit	Occupational health referrals, ADL support

Table: Risk Prevention Strategies

Risk Factor	Preventive Measures
Thromboembolism	Support stockings, anticoagulants
Falls	Handrails, ambulation aid, call bell within reach
Injury	Braces, pillows
Disuse Syndrome	Passive ROM exercises, physical therapy

Health Promotion and Wellness

Nursing Diagnosis	Health Promotion Interventions
Sedentary lifestyle	Develop exercise plans and goal setting
Ineffective protection	Educate on safety measures
Ineffective coping	Counseling, therapeutic conversation

Developing a Plan: Pharmacological Interventions

Medication Overview

Drug Class	Examples	Considerations
Opiates	Morphine, fentanyl	Short-term use preferred, risk of dependence
Muscle Relaxers	Cyclobenzaprine, dantrolene	May cause drowsiness
NSAIDs	Ibuprofen, naproxen	GI side effects, cardiovascular risks
Corticosteroids	Prednisone, dexamethasone	Avoid long-term use due to bone loss and other complications

Evaluating Outcomes

To evaluate interventions, use SMART goals (Specific, Measurable, Attainable, Realistic, Timely):

Increase in strength
Improvement in range of motion
Pain reduction
Lower inflammatory markers

Standardized tools like the pain scale and functional mobility scale are useful for outcome evaluation.

References

Ackley, B. J., Ladwig, G. B., Flynn Makic, M. B., Martinez-Kratz, M., & Zambroski, C. H. (2023). Nursing diagnosis handbook: An evidence-based guide to planning care (13th ed.). Elsevier Health Sciences.

Gulanick, M., & Myers, J. L. (2021). Nursing care plans: Diagnoses, interventions, and outcomes (9th ed.). Elsevier Health Sciences.