Impaired Physical Mobility Nursing Diagnosis and Nursing Care Plans

Impaired Physical Mobility Nursing Diagnosis and Care Plans

Impaired Physical Mobility Nursing Care Plans Diagnosis and Interventions

Mobility is simply defined as the ability to transfer or move from one place or another. This involves the use of one or more modes of transport such as walking, utilizing assistive devices, and/or vehicles.

Impaired Physical Mobility is a NANDA nursing diagnosis that can be used to create a care plan for patients who have realized mobility issues due to debilitating illness, injury, or post-operative status.

Signs and Symptoms of Impaired Physical Mobility

  • Inability to intentionally move – this includes ambulation, bed mobility, and transfers
  • Inability to perform activity as instructed
  • Limited range of motion (ROM)
  • Hesitance to attempt movement due to pain or fear of pain

Common Diseases that Cause Impaired Physical Mobility

Impaired Physical Mobility Nursing Diagnosis

Impaired Physical Mobility Nursing Care Plan 1

Cauda Equina Syndrome (CES)

Nursing Diagnosis: Impaired Physical Mobility related to vertebral and joint inflammation secondary to cauda equina syndrome as evidenced by severe leg pain rated 8 out of 10, leg muscle weakness, failure to perform ADLs, and verbalization of fatigue

Desired Outcome: Patient will maintain or regain functional mobility.

Nursing Interventions for Impaired Physical MobilityRationales
Perform a mobility assessment. Assess the patient’s function ability to perform activities of daily living (ADLs) such as eating, bathing, oral and perineal care.To identify patient’s current strengths and problems related to performing ADLs while dealing with CES.
Check the patient’s need for assistance from significant others. Educate the significant others on how to assist the patient in performing ADLs and improving physical mobility through exercise.To identify patient’s support in terms of his/her physical, social, mental, and emotional health. To support the significant others on how they can assist the patient achieve optimal physical mobility.
Administer pain medications as prescribed, at least 30 minutes before exercise or physical activity.To provide pain relief and comfort so the patient will be able to move without fear of experiencing more pain. 30 minutes is the usual peak time for most pain relievers.
Encourage physical mobility and demonstrate range of motion exercises. Use the recommended equipment for mobility as per physiotherapist’s advice.To prevent muscle atrophy and joint contractures.
Refer the patient to the physiotherapist.To provide specialized care and individualized exercise program.
Consider joint decompressive surgery for severely damaged hip joint.Severe joint damage or pain due to cauda equina syndrome can make a patient eligible for surgery. Decompressive surgery may include lumbar laminectomy or discectomy. Hip replacement can also be done if the hip joint is severely damaged.

Impaired Physical Mobility Nursing Care Plan 2

Multiple System Atrophy

Impaired physical mobility related to disease process of multiple system atrophy (MSA) as evidenced by bradykinesia, cognitive impairment, inability to bear weight, rigidity, generalized weakness, inability to do activities of daily living (ADLs) as normal, and verbalization of overwhelming tiredness

Desired Outcome: The patient will be able to perform activities of daily living within the limits of the disease.

Nursing Interventions for Impaired Physical Mobility Rationales
Perform a mobility assessment. Assess the patient’s level of functional mobility and ability to perform ADLs.To assist in creating an accurate diagnosis and monitor effectiveness of treatment and therapy.
Assist the patient during exercises and when performing activities of daily living.To encourage the patient to perform muscle-strengthening exercises and promote dignity by allowing the patient to perform their ADLs while maintaining safety.
Ensure the safety of the environment. Check that the call bell is within reach, the bed rails are up when the patient is on the bed, the bed is in the lowest level, the room is well-lit, the floor is not slippery, and that important things like phone and eyeglasses are easy to reach.To maintain patient safety and reduce the risk of falls.      
Encourage the patient to perform range of motion (ROM) exercises in all extremities.To improve venous return, muscle strength, and stamina while preventing stiffness and contracture deformation.
Refer to the physiotherapy and occupational therapy team. Assist the patient in following the customized exercise and physical activity plan as recommended by the physiotherapist.To provide a specialized care for the patient to gain physical and mental support in performing ADLs and mobilizing.
Prior to discharge, ensure that the patient’s home is modified according to his/her functional mobility, as recommended by the physiotherapist.Home modifications according to the patient’s functional mobility will ensure patient’s safety and encourage him/her to move around the house as much as he/ she is able.

Impaired Physical Mobility Nursing Care Plan 3

Paget’s Disease

Nursing Diagnosis: Impaired Physical Mobility related to Paget’s disease of the bone as evidenced by presence of stiffness, weakness and gradual loss of movement in the right leg, moderate bilateral leg pain rated 6/10, failure to perform ADLs

Desired Outcome: Patient will maintain functional mobility despite progressive Paget’s disease of the bone.

Nursing Interventions for Impaired Physical Mobility Rationales
Perform a mobility assessment. Assess the patient’s function ability to perform activities of daily living (ADLs) such as eating, bathing, oral and perineal care.To identify patient’s current strengths and problems related to performing ADLs while living with Paget’s disease of the bone.
Identify the patient’s need for assistance from significant others. Educate the significant others on how to assist the patient in performing ADLs and improving physical mobility through exercise.To identify patient’s support in terms of his/her physical, social, mental, and emotional health. To support the significant others on how they can assist the patient achieve optimal physical mobility.
Administer pain medications as prescribed, at least 30 minutes before exercise or physical activity.To provide pain relief and comfort so the patient will be able to move without fear of experiencing more pain. 30 minutes is the usual peak time for most pain relievers.
Encourage physical mobility and demonstrate range of motion exercises.To prevent muscle atrophy and joint contractures.
Refer to the physiotherapy and occupational therapy team. Assist the patient in following the customized exercise and physical activity plan as recommended by the physiotherapist.To provide specialized care and individualized exercise program.
Provide pain relief, ensure call bell is within reach, and advise patient to ask support with physical mobility during the night. Put bedrails up at night.Paget’s disease of the bone causes bone pain that is usually worse at night. The patient needs extra help and support during the night, and bedrails are recommended to be put up for safety.
Focus on muscle-strengthening exercises on the affected joints as recommended by the physiotherapist.To reduce the risk of skeletal complications of Paget’s disease.
Encourage the patient to walk longer distances daily as tolerated.There is research evidence that walking improves cardiovascular health in patients with Paget’s disease and similar illnesses.
If the spine is also affected by the disease, remind the patient to avoid twisting and bending exercises, as well as jogging, running, and jumping activities.These activities and exercises may worsen pain for a patient with Paget’s disease.
Prior to discharge, ensure that the patient’s home is modified according to his/her functional mobility, as recommended by the physiotherapist.Home modifications according to the patient’s functional mobility will ensure patient’s safety and encourage him/her to move around the house as much as he/ she is able.

Impaired Physical Mobility Nursing Care Plan 4

Psoriatic Arthritis

Nursing Diagnosis: Impaired Physical Mobility related to the clinical manifestations of psoriatic arthritis, as evidenced by distal interphalangeal predominant (DIPs) in the fingers, morning stiffness of wrists and elbows, pain score of 8 to 10 out of 10, fatigue, disinterest in ADLs due to pain, verbalization of tiredness and generalized weakness

Desired Outcome: The patient will demonstrate increase in functional physical mobility and successful performance of activities of daily living. 

Nursing Interventions for Impaired Physical Mobility Rationales
Perform a mobility assessment. Assess the patient’s activities of daily living, as well as actual and perceived limitations to mobility and physical activity. Ask for any form of exercise that he/she used to do or wants to try.To create a baseline of activity levels and mental status related to acute pain, fatigue, mobility, and activity intolerance.
Encourage progressive activity through self-care and exercise as tolerated. Explain the need to reduce sedentary activities such as watching television and using social media in long periods. Alternate periods of physical activity with 60-90 minutes of undisturbed rest.To gradually increase the patient’s tolerance to physical activity. To prevent triggering of acute pain by allowing the patient to pace activity versus rest.
Administer analgesics as prescribed  prior to mobilizing. Teach deep breathing exercises and relaxation techniques. Provide adequate ventilation in the room.To provide pain relief before an exercise session. To allow the patient to relax while at rest and to facilitate effective stress management. To allow enough oxygenation in the room.
Refer the patient to physiotherapy / occupational therapy team.To provide a more specialized care for the patient in terms of helping him/ her build confidence in increasing daily physical activity.
Encourage the patient to perform recommended exercises for psoriatic arthritis, such as walking, biking, stretching, and yoga.To alleviate stiffness of joints and prevent muscle atrophy.
Offer cryotherapy and hydrotherapy to the patient.Cryotherapy can help reduce the swelling and stiffness of the affected joints, thereby alleviating pain and encouraging mobilization. Hydrotherapy has been studied in recent years and has shown positive effects on the quality of life of patients with psoriatic arthritis, including increase in physical mobility.

Impaired Physical Mobility Nursing Care Plan 5

Hemiplegia

Nursing Diagnosis: Impaired physical mobility related to paralysis of one side of the body (hemiplegia) secondary to brain tumor as difficulty of movement, unsteady gait, generalized weakness, inability to do activities of daily living (ADLs) as normal, and verbalization of overwhelming tiredness/ fatigue

Desired Outcome: The patient will be able to perform activities of daily living within the limits of the present condition.

Nursing Interventions for Impaired Physical Mobility Rationales
Perform a mobility assessment. Assess the patient’s level of functional mobility and ability to perform ADLs.To assist in creating an accurate diagnosis and monitor effectiveness of treatment and therapy.
Assist the patient during exercises and when performing activities of daily living.To encourage the patient to perform muscle-strengthening exercises and promote dignity by allowing the patient to perform their ADLs while maintaining safety.
Ensure the safety of the environment. Check that the call bell is within reach, the bed rails are up when the patient is on the bed, the bed is in the lowest level, the room is well-lit, the floor is not slippery, and that important things like phone and eyeglasses are easy to reach.To maintain patient safety and reduce the risk of falls.      
Encourage the patient to perform range of motion (ROM) exercises in all extremities.To improve venous return, muscle strength, and stamina while preventing stiffness and contracture deformation.
Refer to the physiotherapy and occupational therapy team.To provide a specialized care for the patient to gain physical and mental support in performing ADLs and mobilizing.
Encourage the patient to perform recommended exercises for hemiplegia such as circuit training and conventional gait training.Gait is severely affected in patients with hemiplegia, so conventional gait training that includes symmetric weight bearing exercises and single leg standing can help retain functional physical mobility. This is usually followed by circuit training, which involves sitting and standing exercises and walking over obstacles.

Impaired Physical Mobility Nursing Care Plan 6

Congenital Hip Dysplasia

Nursing Diagnosis: Impaired Physical Mobility related to muscular dysfunction such as hip weakness secondary to congenital hip dysplasia as evidenced by movement limitation imposed by bandage, harness, cast, or traction and loss of the ability to move intentionally.

Desired Outcome: The patient will be able to rise in bed with the use of a tension bar, and walk the distance of the corridor and return twice a day.

Nursing Interventions for Impaired Physical MobilityRationale
Examine extremity sensory and motor coordination of the patient and the operative treatment of musculoskeletal anomalies.  This intervention provides information about mobility-related disorders or therapies.  
Maintain good posture during bed rest by changing positions every two (2) hours or as necessary, or provide a sketch for the patient to adhere to for positioning and area to sleep in the bed.    Contractures and physical deformities are avoided with this approach.
Support and encourage the patient with muscular development and passive stretching exercises as required.  This method preserves muscle strength or prepares the patient for using assistive devices.  
Educate the family and the patient about the consequences of impaired mobility.    This intervention encourages adherence to the regimen to maintain mobility and provides comprehension of the implications of decreased mobility.
Provide and secure a harness and a splint for the patient. When applicable, utilize assistance such as a wheelchair, crutches, supportive reading, eating, and other aids for activities of daily living (ADL).      This strategy encourages independence and provides assistance with mobility and activity.

Impaired Physical Mobility Nursing Care Plan 7

Scoliosis

Nursing Diagnosis: Impaired Physical Mobility related to dysfunction, pain, and discomfort in the musculoskeletal system secondary to scoliosis as evidenced by refusal to move freely and constrained range of motion.

Desired Outcome: The patient will learn to maintain good body posture and improve with physical activities as directed by the doctor.

Nursing Interventions for Impaired Physical Mobility Rationale
Educate the patient regarding the non-pharmacologic pain treatment approaches such as visualization, meditation, touch, and music.    The use of these approaches will shift the focus of the patient, reducing pain.
As advised, work with the medical professional, especially the physical therapist.      Physical therapy employs remedial measures to avoid curve advancement, allowing for ongoing maintenance and enhancing the quality of life.
Examine the patient’s pain report, including the nature, location, and severity.    Chronic spinal deformity exerts tension and force on the lumbar discs, tendons, nerves, and ligaments, which can cause discomfort.
Encourage the patient to do vigorous range-of-motion activities.  This approach improves excellent blood circulation and aids in the maintenance of strength and muscular function.    
Educate and support the patient in the use of the brace as advised.    The main objective of using a brace is to prevent or reduce the growth of the lumbar curve.

Impaired Physical Mobility Nursing Care Plan 8

Guillain-Barre Syndrome

Nursing Diagnosis: Impaired Physical Mobility related to neuromuscular dysfunction secondary to Guillain-Barre Syndrome as evidenced by ataxia and the inability to change movements purposefully within the physical environment, including bed mobility, relocation, and ambulation.

Desired Outcome: The patient’s endurance and performance of the affected limb will be improved, and he or she will illustrate the utilization of adaptive equipment to boost mobility.

Nursing Interventions for Impaired Physical Mobility Rationale
Analyze the requirement for assistance equipment and create a safe atmosphere, such as lowering the bed and raising the handrails.    The appropriate use of wheelchairs, canes, transfer bars, and other assistive devices can increase mobility and lessen the danger of falling
Evaluate the necessity of home health care, such as physical and occupational therapy.    Develop a treatment plan that includes specialized interventions to promote muscular strength and retrain patients to conduct daily activities (ADLs).
Keep an eye on the patient’s nutritional requirements because they are linked to decreased or impaired mobility.    Proper nutrition also supplies the energy needed to participate in various physical or rehabilitation activities.
Padding should be applied to bony prominences, including the elbows and heels. Additionally, conduct dynamic, relaxed, and isotonic range of motion exercises if needed.  Retaining the extremities in a natural position decreases the chances of pressure ulcers. As a result, it promotes joint mobility, promotes oxygenation, and increases muscular strength.    
Allow the patient to have relaxation periods throughout activities.    Consider an energy-saving method. Rest moments are critical for preserving energy and avoiding weariness.

Impaired Physical Mobility Nursing Care Plan 9

Kawasaki Disease

Nursing Diagnosis: Impaired Physical Mobility related to joint pain and inflammation secondary to Kawasaki disease as evidenced by trouble in walking and constrained range of motion (ROM).

Desired Outcome: The patient will engage in activity on his or her own or within the limits of the health condition.

Nursing Interventions for Impaired Physical Mobility Rationale
Examine the patient’s level of energy and capacity to perform activities (ADL).    The inability to perform activities of daily living (ADLs) effectively is hampered by limited mobility caused by joint pain. That is why it is necessary to perform this intervention to ensure that the patient has enough energy to execute ADLs.
Allow enough time for the patient to complete mobility-related activities and encourage them to relax in between exercises.    Increase the patient’s involvement and commitment in the activity because it helps promote energy conservation and relieves tension.
Help the patient execute passive range of motion (ROM) exercises as permitted.    This intervention retains and strengthens the patient’s joint mobility, muscular strength, and overall endurance.
As needed, instruct the patient on the use of appropriate assistive devices.    The use of adjunct devices helps the patient during ambulation and improves walking security.
Encourage the patient to consume foods such as salmon, tuna, rain products, and vegetables.  These foods help improve patients’ muscle strength and optimize energy production. Proper nutrition aids in the improvement of decreased or impaired physical mobility.

Impaired Physical Mobility Nursing Care Plan 10

Amputation

Nursing Diagnosis: Impaired Physical Mobility related to the removal of a limb, particularly in the lower extremities, as well as physical discomfort, and sensory impairment, such as a distorted balance and stability secondary to amputation as evidenced by a hesitancy to move, loss of coordination, decreased muscular endurance, control, and mass.

Desired Outcomes:

  • The patient will learn to comprehend the health condition, effective treatments, and safety precautions.
  • The patient will also learn to demonstrate strategies that can resume practices.
InterventionRationale
Regularly provide wound care: Examine the area, then thoroughly wash and disinfect it.Cover the stump in an elastic bandage or an air splintFor deferred prosthesis, use a wound shrinker, such as a heavy knitted fabric sock.    This method allows the healthcare professional to assess recovery and identify complications unless covered by an immediate prosthesis. Enclosing the wound reduces inflammation and helps define the stump into a cylindrical shape to enable prosthesis fitting.
Advise the patient to rest in a prone position as sustained, at least two times a day. Make sure that there is a pillow underneath the stomach and lower-extremity stump.    This intervention enhances lower extremities muscles and hinders hip flexion nerve damage, which can occur within 24 hours of prolonged malpositioning.
Keep the patient’s knees stretched.        This treatment aims to mitigate leg muscle nerve entrapment.
Energetic and strength training exercises for the upper torso and least affected limbs are suggested to the patient.    This method builds muscle strength and stamina to fuel transfers and ambulation and enhance mobility. This intervention aims to produce a more typical lifestyle.
As advised, provide trochanter rolls for the patient.    This approach inhibits the lower-extremities stump from rotating externally.

Nursing References

Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.  Buy on Amazon

Gulanick, M., & Myers, J. L. (2022). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon

Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2020). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier.  Buy on Amazon

Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.  Buy on Amazon

Disclaimer:

Please follow your facilities guidelines, policies, and procedures.

The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes.

This information is intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment.

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Anna C. RN, BSN, PHN

Anna C. RN, BSN, PHN
Clinical Nurse Instructor

Emergency Room Registered Nurse
Critical Care Transport Nurse
Clinical Nurse Instructor for LVN and BSN students

Anna began writing extra materials to help her BSN and LVN students with their studies. She takes the topics that the students are learning and expands on them to try to help with their understanding of the nursing process.

Her experience spans almost 30 years in nursing, starting as an LVN in 1993. She received her RN license in 1997. She has worked in Medical-Surgical, Telemetry, ICU and the ER. She found a passion in the ER and has stayed in this department for 30 years.

She is a clinical instructor for LVN and BSN students along with a critical care transport nurse.

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