impaired Walking Nursing Diagnosis

Impaired Walking Nursing Diagnosis & Care Plan

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Impaired walking is when an individual experiences limitation, difficulty, or inability to perform safe and effective ambulation. This nursing diagnosis focuses on identifying factors affecting mobility, implementing interventions to improve walking ability, and preventing complications associated with limited mobility.

Causes (Related to)

Impaired walking can result from various factors that affect a person’s ability to ambulate safely:

  • Neuromuscular conditions such as:
  • Musculoskeletal conditions include:
    • Arthritis
    • Fractures
    • Joint replacements
    • Muscle weakness
    • Balance disorders
  • Other contributing factors such as:
    • Pain
    • Visual impairment
    • Cognitive impairment
    • Environmental hazards
    • Medications affecting balance
    • Fear of falling

Signs and Symptoms (As evidenced by)

Impaired walking presents with various signs and symptoms that nurses must assess for proper diagnosis and intervention planning.

Subjective: (Patient reports)

  • Difficulty maintaining balance
  • Fear of falling
  • Pain during ambulation
  • Fatigue with walking
  • Decreased confidence in mobility
  • History of falls
  • Feeling unsteady

Objective: (Nurse assesses)

  • Unsteady gait pattern
  • Decreased walking speed
  • Poor balance
  • Muscle weakness
  • Limited range of motion
  • Use of assistive devices
  • Decreased step length
  • Abnormal gait characteristics
  • Impaired transfer ability

Expected Outcomes

The following outcomes indicate successful management of impaired walking:

  • The patient will demonstrate safe ambulation techniques
  • The patient will show improved balance and coordination
  • The patient will use assistive devices correctly
  • The patient will maintain safety during mobility
  • The patient will report increased confidence in walking
  • The patient will experience no falls
  • The patient will achieve maximum independence in mobility

Nursing Assessment

Evaluate Gait and Balance

  • Assess gait pattern
  • Check balance during standing and walking
  • Monitor coordination
  • Evaluate turning ability
  • Assess stride length and cadence

Assess Muscle Strength and Joint Function

  • Check muscle strength in lower extremities
  • Evaluate joint range of motion
  • Assess for pain during movement
  • Monitor endurance levels
  • Document any limitations

Review Environmental Factors

  • Assess home environment safety
  • Check for appropriate footwear
  • Evaluate lighting conditions
  • Identify potential hazards
  • Assess the need for assistive devices

Monitor Risk Factors

  • Review medication effects
  • Assess cognitive status
  • Check vision and hearing
  • Evaluate cardiovascular status
  • Document fall history

Evaluate Support Systems

  • Assess caregiver availability
  • Check community resources
  • Review rehabilitation options
  • Document social support
  • Evaluate financial resources

Nursing Care Plans

Nursing Care Plan 1: Risk for Falls

Nursing Diagnosis Statement:
Risk for Falls related to impaired walking and balance deficits as evidenced by unsteady gait and history of falls.

Related Factors:

  • Impaired balance
  • Muscle weakness
  • Environmental hazards
  • Medication effects

Nursing Interventions and Rationales:

  1. Implement fall precautions
    Rationale: Prevents falls and injuries
  2. Provide appropriate assistive devices
    Rationale: Enhances stability during ambulation
  3. Ensure proper footwear
    Rationale: Improves traction and balance

Desired Outcomes:

  • The patient will remain free from falls
  • The patient will demonstrate proper use of assistive devices
  • The patient will identify and avoid fall hazards

Nursing Care Plan 2: Impaired Physical Mobility

Nursing Diagnosis Statement:
Impaired Physical Mobility related to neuromuscular impairment as evidenced by difficulty with ambulation and decreased muscle strength.

Related Factors:

  • Muscle weakness
  • Pain during movement
  • Decreased endurance
  • Joint stiffness

Nursing Interventions and Rationales:

  1. Implement a progressive mobility program
    Rationale: Builds strength and endurance gradually
  2. Provide pain management before the activity
    Rationale: Facilitates participation in mobility activities
  3. Teach proper body mechanics
    Rationale: Promotes safe movement patterns

Desired Outcomes:

  • The patient will demonstrate improved strength and endurance
  • The patient will participate in a prescribed exercise program
  • The patient will show increased independence in mobility

Nursing Care Plan 3: Activity Intolerance

Nursing Diagnosis Statement:
Activity Intolerance related to decreased endurance as evidenced by fatigue during ambulation and decreased activity tolerance.

Related Factors:

  • Deconditioning
  • Cardiovascular limitations
  • Respiratory compromise
  • Fatigue

Nursing Interventions and Rationales:

  1. Plan activities with rest periods
    Rationale: Prevents excessive fatigue
  2. Monitor vital signs during activity
    Rationale: Ensures safe activity tolerance
  3. Gradually increase activity duration
    Rationale: Builds endurance safely

Desired Outcomes:

  • The patient will demonstrate improved activity tolerance
  • The patient will maintain stable vital signs during activity
  • The patient will report decreased fatigue with ambulation

Nursing Care Plan 4: Self-Care Deficit

Nursing Diagnosis Statement:
Self-Care Deficit related to impaired mobility as evidenced by difficulty performing activities of daily living independently.

Related Factors:

  • Limited mobility
  • Decreased strength
  • Safety concerns
  • Environmental barriers

Nursing Interventions and Rationales:

  1. Assess the level of independence
    Rationale: Determines appropriate assistance needed
  2. Teach adaptive techniques
    Rationale: Promotes independence in self-care
  3. Provide assistive devices
    Rationale: Facilitates safe self-care activities

Desired Outcomes:

  • The patient will demonstrate increased independence in self-care
  • The patient will use adaptive equipment properly
  • The patient will maintain safety during activities

Nursing Care Plan 5: Anxiety

Nursing Diagnosis Statement:
Anxiety related to fear of falling as evidenced by verbalized concerns about mobility and hesitation during ambulation.

Related Factors:

  • Fear of falling
  • Previous fall experience
  • Decreased confidence
  • Loss of independence

Nursing Interventions and Rationales:

  1. Provide emotional support
    Rationale: Reduces anxiety and builds confidence
  2. Teach coping strategies
    Rationale: Helps manage fear during mobility
  3. Encourage gradual progression
    Rationale: Builds confidence through successful experiences

Desired Outcomes:

  • The patient will report decreased anxiety about walking
  • The patient will demonstrate increased confidence during mobility
  • The patient will use effective coping strategies

References

  1. Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2023). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier. 
  2. Brach JS, Vanswearingen JM. Interventions to Improve Walking in Older Adults. Curr Transl Geriatr Exp Gerontol Rep. 2013 Dec;2(4):10.1007/s13670-013-0059-0. doi: 10.1007/s13670-013-0059-0. PMID: 24319641; PMCID: PMC3851025.
  3. Corbetta D, Campbell P, Wijck F, Filippi M, Kwakkel G, Lynch EA, Mehrholz J, Todhunter-Brown A. Interventions for improving walking after stroke: an overview of Cochrane Reviews. Cochrane Database Syst Rev. 2023 Mar 27;2023(3):CD015044. doi: 10.1002/14651858.CD015044. PMCID: PMC10042275.
  4. Giacino JT, Katz DI, Schiff ND, Whyte J, Ashman EJ, Ashwal S, Barbano R, Hammond FM, Laureys S, Ling GSF, Nakase-Richardson R, Seel RT, Yablon S, Getchius TSD, Gronseth GS, Armstrong MJ. Practice guideline update recommendations summary: Disorders of consciousness: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology; the American Congress of Rehabilitation Medicine; and the National Institute on Disability, Independent Living, and Rehabilitation Research. Neurology. 2018 Sep 4;91(10):450-460. doi: 10.1212/WNL.0000000000005926. Epub 2018 Aug 8. Erratum in: Neurology. 2019 Jul 16;93(3):135. doi: 10.1212/WNL.0000000000007382. PMID: 30089618; PMCID: PMC6139814.
  5. Harding, M. M., Kwong, J., & Hagler, D. (2022). Lewis’s Medical-Surgical Nursing: Assessment and Management of Clinical Problems, Single Volume. Elsevier.
  6. Herdman, T. H., Kamitsuru, S., & Lopes, C. (2024). NANDA International Nursing Diagnoses – Definitions and Classification, 2024-2026.
  7. Ignatavicius, D. D., Rebar, C., & Heimgartner, N. M. (2023). Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care. Elsevier.
  8. Silvestri, L. A. (2023). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier. 
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Anna Curran. RN, BSN, PHN

Anna Curran. RN, BSN, PHN I am a Critical Care ER nurse. I have been in this field for over 30 years. I also began teaching BSN and LVN students and found that by writing additional study guides helped their knowledge base, especially when it was time to take the NCLEX examinations.
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