Embed Size (px)
Citation preview
Nursing Interventions For Impaired Body Alignment &
Mobility
ByMr. M. Shivanandha Reddy
Prevention Of Musculoskeletal Complications
Goal: • Prevent contractures, muscle
weakness/atrophy.• Prevent disuse osteoporosisInterventions:Provide Active or passive range of
motion exercises(ROM ) three times/day.
Encourage activities of daily living(ADLs) as possible and progressively.
Promote independence as much as possible.
Provide Therapeutic devices as needed.(pillows, footboard, trochanter roll, hand rolls, trapeze bar). Consult appropriate health care provider (e.g. physician, physical therapist) if client's mobility and range of motion are more limited than expected.
Provide foods high in calcium
Prevention Of Musculoskeletal Complications
Prevention of cardio vascular complications
Goal: • Reducing orthostatic hypotension• Reducing cardiac workload• Preventing thrombus formation
Interventions:Reducing orthostatic hypotension- Teaching patients to rise slowly
from lying to standing. Sit for a while before standing
:
Reducing cardiac workload:• Discourage Valsalva maneuver.• Encourage patient to take breath
while sitting or standing.• Stool softeners to avoid straining
during defecation.Preventing thrombus formation. Exercise: perform active / passive
exercises.
Prevention of cardio vascular complications
Provide at least 2000 ml water daily. Encourage early mobilization.•Medication:Aspirin or antiplatelet agents should be given.•Compression stockings, sequential compressive devices must be used.•Positioning:Avoid crossing the legs, sitting for prolonged period of time wearing clothing that constricts the leg.
:
Prevention of cardio vascular complications
Prevention of respiratory complications
Goal• Promotion of chest and lung
expansion• Removal of secretions• Maintenance of patent airway• Prevention of hypostatic pneumonia
Interventions: Place the client in fowlers
position.Cough and deep breathing.Ambulate as soon as possible.Adequate fluid intake.Incentive spirometer.Chest physiotherapy.
Prevention of respiratory complications
Prevention of metabolic complications
Goal:• To prevent negative nitrogen and
calcium balance• To meet the nutritional requirementsInterventions: Nutritional needs:Provide protein rich dietSupply adequate calories in diet Vitamin D, C rich diet.
Prevention of urinary complications
Goals:• Prevent urinary stasis, calculi, and
infection. Interventions: Ensure adequate fluid intake (minimum
2L/day). provide Toileting aids.Foley’s or straight catheter if needed. Observe output, assess for bladder
distention, signs and symptoms of urinary tract infections (UTI).
Prevention of gastrointestinal effects
Goal:
• Prevention of constipation
Interventions:
• Encourage daily fluid intake of 2000 to
3000 ml per day, if not contraindicated
medically
• Encourage increased fiber in diet (e.g., raw
fruits, fresh vegetables); a minimum of 20
gm of dietary fiber per day is
recommended
Encourage physical activity and regular
exercise
Encourage a regular time for elimination
Offer a warmed bedpan to bedridden
patients
Provide privacy and maintain dignity
Stool softeners
Suppositories
Enema
Prevention of gastrointestinal effects
Prevention of Integumentary complications
Goal:
• To prevent skin breakdown
Interventions:
Change position every 2nd hourly.
Use proper transfer technique to
avoid shearing/friction.
Therapeutic devices as needed (air
mattress, water mattress, protective
cushion, pressure rings, etc.)
Adequate hydration and nutrition
Protect skin from moisture.
Assess skin for signs of pressure
areas/skin breakdown.
Proper wound care.
Prevention of Integumentary complications
Prevention of psychosocial complications
Goal:• To improve self esteem • To avoid depression
Interventions:
Provide psychological support.
Encourage client’s verbalization of
feelings.
Provide social interaction during care
encourage participation in ADLs as
able
Provide stimuli to promote
orientation and contact with reality –
clock, radio, TV, newspaper.
Prevention of psychosocial complications
