Nursing interventions for impaired body alignment and mobility

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.

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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