Impaired Physical Mobility

Impaired Physical Mobility

Impaired physical mobility can be a result of disease or during rehabilitation process. For example, trauma, Multiple Sclerosis, morbid Obesity, Stroke, fracture etc. As the life expectancy has increased, the number of people experiencing disability, immobility and disease has also increased. The duration of hospital stay has decreased, where the discharged patients are sent to facilities specializing in rehabilitation or are asked to take up physical therapy at home.

What Is Impaired Physical Mobility?



The North American Nursing Diagnosis Association has defined impaired physical immobility as a state where a person has limited level of independence or restricted physical movement of the entire body or part of the body.

Due to the restricted mobility, other associated factors arise like, anxiety, pain, fear of having discomfort, limitation caused by musculoskeletal impairment. Since we are used to movements, keeping the body or part of the body immobile takes a toll on the anatomic system.

Causes and Complications of Impaired Physical Mobility
It can occurs due to aging, which can cause loss of muscle mass, reduced strength and functioning, reduced movement of muscles etc. These changes in the body affect daily life activities. There can be complications arising out of immobility in elderly patients.

The particular characteristics of this are:

• ŸInability in doing actions


• ŸInability to move around


• ŸDecrease in strength, muscle endurance, body control and mass


• ŸLimited range of movement

The other factors related to this are:

• ŸImpairment of musculoskeletal system, neuromuscular system and cognitive function


• ŸExtended bed rest, medical restriction, Depression, anxiety, pain and discomfort

Nursing Care Plan for Impaired Physical Mobility
Intervention of this condition includes prevention of dependent disabilities, restoring mobility when possible, as well as maintaining or preserving the existing mobility. Special patient care includes changing position, exercises, nutrition and giving a safe environment, etc. We look in detail at the nursing care plan for impaired physical mobility:

Symptoms
The symptoms can be classified into different categories as given below:

• ŸMusculoskeletal system: Decrease in muscle strength, joint pain, and stiff joints, limited motion range, pain, extended bed rest.


• ŸCardiovascular system: Generalized weakness, imbalance in oxygen supply and demand which causes intolerance to activities. Edema can also occur which can result in ineffective tissue perfusion.


• ŸRespiratory system: Chest muscle Atrophy, reduced lung expansion and medications like analgesics and sedatives can cause disturbance in breathing pattern. There can also be impaired gas exchange caused due to increase in buildup of lung secretions and declined lung functioning. Airway clearance will be ineffective due to pulmonary secretions and body positions.


• ŸMetabolic system: The nutritional requirements get imbalanced, when the intake is less or not proportional to the energy expenditure. There is catabolism of the muscle mass as well.


• ŸUrinary & excretory system: Urinary Tract Infection can occur due to stasis of urine and obstruction of urinary flow. If the diet is inadequate and the physical activity is reduced, it can lead to Constipation.


• ŸSkin: There will be friction and pressure on the skin surface due to limited mobilization.


• ŸOther changes: Decrease in reaction time, changes in gait, and tremors due to movement, jerky movements, cognitive impairment, and reduced integrity of bone structure which could lead to Osteoporosis, increased BMI and depression.

Interventions

• ŸCheck mobility on bed, followed by ability to sit with support or unsupported, ability to sit up from sleeping position or stand from sitting position.


• ŸIt is important to determine the cause of immobility, whether physical or psychological fear.


• ŸMonitor activity level and engage in using all extremities. Ensure that pulse, Blood Pressure, breathing and skin color are noted before and after the activity.


• ŸPain should be monitored as it can hinder activity and mobility.


• ŸIf required, make use of devices to assist movements. For example, canes, crutches, wheelchair or walker.


• ŸWhen patients are immobile they should be kept in upright position as many times in a day as possible to avoid cardiovascular problems.


• ŸUse water or air mattress which will help in dealing with the pressure on the skin and formation of bed sores.


• Urine output should be monitored and bowel movements should also be monitored.