Impaired Physical Mobility - Weebly
JORA MARJORIE M. DIMAYUGA IIIBSN-1 Group 3
Name of patient: Espinas, Mark Anthony Age: 23
Diagnosis: Post Appendectomy
Impaired Physical Mobility
|Cues |Nursing Diagnosis |Background Knowledge |Goals / Objective |Nursing Intervention |Rationale |Evaluation |
| | | | | | | |
|Subjective: |Impaired physical mobility |Limitation of independent, |Long Term: |VS monitored and recorded. |To have a baseline data and |Goal met. |
|“Hindi pa nga ako masyadong |related to presence of |purposeful physical movement |To accept the optimum possible| |monitor for any | |
|makagalaw. Sumasakit kasi yung|surgical incision as evidenced|of the body or one or more |goals in the light of | |irregularities. |Patient was able to practice |
|sugat ko. Nakakapanlambot |by slowed, limited movement, |extremities. |limitations, physical and | | |techniques such as using |
|din,” as verbalized by the |report of discomfort and pain | |emotional | | |pillow for position changes |
|patient. |on suture site upon movement, | | |Determined the degree of |This will serve as the basis |and having ROM exercises that |
| |and presence of IFC. | |Short Term: |immobility (2). |of the level of care to be |will help him resume to |
|Objective: | | |At the end of the shift, the | |applied. |activities with comfort. |
|Report of discomfort and pain | | |patient will be able to |Functional Level | | |
|upon movement | | |demonstrate techniques that |Classification: | |Patient’s family was able to |
|Slowed and limited movement | | |will enable resumption of |0-Completely | |understand and became aware to|
|With surgical dressing on RLQ;| | |activities with comfort. |independent | |the patient’s situation and |
|dry and intact | | | |1-Requires use of device | |was able to show assistance |
| | | | |2-Requires assistance from | |and care. |
|Functional level of 2 | | | |other person | | |
| | | | |3-Requires help from other | | |
| | | | |person and device | | |
| | | | |4-Completely | | |
| | | | |Dependent | | |
| | | | | | | |
| | | | |Health teachings given on: | | |
| | | | |repositioning on a regular | | |
| | | | |schedule | | |
| | | | |minimal, ROM, exercises | | |
| | | | |supporting surgical site with |Aside from enhancing the | |
| | | | |pillows when moving |knowledge of the patient | |
| | | | |adequate rest periods |regarding his condition, | |
| | | | | |health teachings promote self | |
| | | | |Encouraged significant others |care that may enable the | |
| | | | |to use comfort measures like |patient resume to his normal | |
| | | | |therapeutic touch and being |activities not minding the | |
| | | | |involved in assisting and |limitations he has. | |
| | | | |providing care. | | |
| | | | | |This can promote cooperation | |
| | | | | |and support that can uplift | |
| | | | | |the patient’s disposition and | |
| | | | | |minimize the threats to | |
| | | | |Kept comfortable on bed and |patient’s health due to | |
| | | | |needs were attended. |physical limitations. | |
| | | | | | | |
| | | | | |Attending to their needs and | |
| | | | | |providing comfort enhances | |
| | | | | |self-concept and decreases | |
| | | | | |feelings of frustration. | |
| | | | |Observed for any untoward | | |
| | | | |S/Sx. |To prevent any other | |
| | | | | |complications and to implement| |
| | | | | |immediate action. | |
| | | | | | | |
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