Impaired Walking nursing diagnosis is when an individual experiences difficulty or limitations in their ability to walk, which can cause distress or physical injury. The patient can struggle with balance, coordination, muscle strength, and visual and spatial perception.
Causes of Impaired Walking
Musculoskeletal disorders: Arthritis, osteoporosis, fractures, or joint deformities can lead to impaired walking.
Neurological conditions: Stroke, multiple sclerosis, Parkinson’s disease, or spinal cord injuries can impair walking.
Cardiovascular problems: Peripheral artery disease (PAD), heart failure, or deep vein thrombosis (DVT).
Injuries: Fractures, sprains, strains, or ligament tears, can impair walking temporarily or permanently.
Post-surgical complications: Surgeries involving the lower extremities, spine, or joints can cause a temporary impairment in walking due to pain, surgical site limitations, or healing processes.
Systemic diseases: Diabetes or peripheral neuropathy can affect the nerves in the lower extremities, leading to impaired sensation, balance issues, or muscle weakness.
Age-related changes: Musculoskeletal and neurological systems
Signs and Symptoms of Impaired Walking
- Abnormal gait
- Difficulty initiating or maintaining walking
- Reduced stride length
- Altered balance and coordination
- Pain or discomfort
- Weakness or muscle atrophy
- Use of assistive devices
- Fear of falling
Goals for Impaired Walking
- Improved mobility: The primary goal is to improve the patient’s mobility and walking ability. This can include goals such as:
- The patient will demonstrate improved gait pattern with minimal or no assistance.
- The patient will be able to walk a specified distance (e.g., 50 feet) without experiencing pain or difficulty.
- The patient will be able to initiate and maintain walking without hesitation or fear of falling.
- Enhanced safety: Ensuring patient safety during mobility is crucial. Goals in this area may include:
- The patient will demonstrate safe and proper use of assistive devices (e.g., cane, walker) if required.
- The patient will exhibit improved balance and stability while walking, reducing the risk of falls.
- The patient will be able to identify and avoid environmental hazards that may affect walking safety.
- Pain management: If pain is a contributing factor to impaired walking, the goal is to alleviate or manage pain effectively. Goals may include:
- The patient will report a reduction in pain levels during walking activities.
- The patient will demonstrate the ability to use pain management techniques (e.g., heat or cold therapy, medication) as appropriate.
- Increased strength and endurance: Building strength and endurance is essential for improving walking ability. Goals in this area may include:
- The patient will demonstrate improved muscle strength in the lower extremities as evidenced by increased ability to perform exercises or activities requiring leg strength.
- The patient will exhibit increased walking endurance, being able to walk for an extended period of time or distance without excessive fatigue.
- Independence in activities of daily living (ADLs): Impaired walking can impact a patient’s ability to perform ADLs. Goals may include:
- The patient will be able to independently perform ADLs, such as dressing, bathing, and toileting, without assistance or with minimal assistance.
- The patient will demonstrate improved ability to perform transfers (e.g., from bed to chair) independently or with minimal assistance.
Nursing Assessment for Impaired Walking
- Inquire about any recent injuries or surgeries that may affect mobility
- Ask about the onset and progression of the impaired walking
- Assess the patient’s gait pattern
- Check for joint mobility and range of motion
- Assess balance and coordination
- Evaluate sensory perception
- Evaluate the patient’s ability to perform activities of daily living (ADLs)
- Assess the ability to transfer from one surface to another
- Determine the patient’s level of independence
- Assess the patient’s emotional well-being and mental health status
- Assess available support system and resources
Impaired Walking Nursing Interventions and Rationales
Provide appropriate assistive devices like canes, walkers, or crutches to support the patient’s walking. Rationale: Assistive devices help improve stability, balance, and weight-bearing, reducing the risk of falls and supporting independent mobility.
Encourage and assist the patient with prescribed range of motion exercises for the lower extremities. Rationale: Range of motion exercises help maintain joint mobility, prevent contractures, and improve flexibility, ultimately enhancing the patient’s ability to walk.
Collaborate with the healthcare team to refer the patient to a physical therapist for specialized rehabilitation. Rationale: Physical therapy focuses on restoring and improving mobility, strengthening muscles, correcting gait abnormalities, and maximizing functional independence.
Administer prescribed pain medications and assist the patient with pain management techniques, such as heat or cold therapy, as appropriate. Rationale: Managing pain can help alleviate discomfort, reduce muscle tension, and promote engagement in mobility exercises and activities.
Implement exercises and techniques to improve balance and coordination, such as weight shifting, standing on one leg, or performing proprioceptive activities. Rationale: Enhancing balance and coordination helps reduce the risk of falls, increases confidence in walking, and improves overall mobility.
Educate the patient on proper body mechanics during walking and transferring activities to maintain optimal posture, reduce strain, and prevent injuries. Rationale: Teaching correct body mechanics promotes safe movement, minimizes stress on joints and muscles, and enhances efficiency in walking.
Assess the patient’s home environment for potential hazards and make necessary modifications, such as removing clutter, installing handrails, or ensuring adequate lighting. Rationale: Creating a safe and accessible environment reduces the risk of accidents or falls, promoting independent mobility.
Provide emotional support, encouragement, and motivation to the patient throughout their rehabilitation journey. Rationale: Positive reinforcement and emotional support can boost the patient’s confidence, increase engagement in therapy, and foster a sense of empowerment and determination.
Continuously assess and reevaluate the patient’s progress, modifying interventions and goals as needed to ensure the most effective care. Rationale: Regular reevaluation allows for adjustments based on the patient’s changing condition, individual response, and evolving goals, promoting optimal outcomes.
Impaired Walking Nursing Care Plan
Impaired Physical Mobility
Nursing Diagnosis: Impaired Physical Mobility
Related factors/causes:
- Musculoskeletal disorders (e.g., arthritis, fractures)
- Neurological conditions (e.g., stroke, Parkinson’s disease)
- Cardiovascular problems (e.g., peripheral artery disease, heart failure)
- Injuries (e.g., fractures, sprains)
- Post-surgical complications
- Systemic diseases (e.g., diabetes, peripheral neuropathy)
- Age-related changes
Defining characteristics/as evidenced by:
- Abnormal gait pattern
- Difficulty initiating or maintaining walking
- Reduced stride length
- Altered balance and coordination
- Pain or discomfort
- Weakness or muscle atrophy
- Use of assistive devices
- Fear of falling
Expected outcomes:
- The patient will demonstrate improved gait pattern with minimal or no assistance.
- The patient will be able to walk a specified distance without experiencing pain or difficulty.
- The patient will exhibit improved balance and stability while walking, reducing the risk of falls.
- The patient will report a reduction in pain levels during walking activities.
- The patient will demonstrate increased muscle strength in the lower extremities.
- The patient will exhibit increased walking endurance.
- The patient will be able to independently perform activities of daily living (ADLs) involving walking.
- The patient will express increased confidence and motivation in engaging in mobility exercises and activities.
Assessment (what to assess for):
- Gait pattern and abnormalities
- Muscle strength and tone in the lower extremities
- Joint mobility and range of motion
- Balance and coordination
- Sensory perception and proprioception
- Presence of pain or discomfort during walking
- Use of assistive devices
- Performance of ADLs involving walking
Nursing Interventions
Provide appropriate assistive devices (e.g., canes, walkers) to support walking. Assistive devices provide support and enhance stability during walking.
Encourage and assist with prescribed range of motion exercises for the lower extremities. Range of motion exercises maintain joint mobility and prevent contractures.
Collaborate with the healthcare team to refer the patient to physical therapy for specialized rehabilitation. Physical therapy specializes in improving mobility, strength, and functional independence.
Administer prescribed pain medications and assist with pain management techniques (e.g., heat or cold therapy). Pain management techniques alleviate discomfort, reduce muscle tension, and promote engagement in mobility exercises.
Implement exercises and techniques to improve balance and coordination. Balance and coordination exercises reduce the risk of falls and improve overall mobility.
Educate the patient on proper body mechanics during walking and transferring activities. Proper body mechanics minimize strain on joints and muscles, promoting safe movement.
Assess the patient’s home environment for potential hazards and make necessary modifications. Environmental modifications create a safe and accessible environment, reducing the risk of accidents.
Collaborate with occupational therapy to address self-care deficits and provide adaptive equipment or techniques. Collaboration with occupational therapy promotes independence in ADLs and enhances functional abilities.
Provide emotional support, encouragement, and motivation to the patient. Emotional support and motivation positively influence the patient’s engagement and rehabilitation outcomes.
Regularly reevaluate the patient’s progress, modifying interventions and goals as needed. Regular reevaluation ensures the care plan remains effective and individualized to the patient’s changing needs.
More Impaired Walking Nursing Diagnoses
- Risk for Falls
- Risk for Injury
- Ineffective Peripheral Tissue Perfusion
- Ineffective Cerebral Tissue Perfusion
- Risk for Disuse Syndrome
Test Questions for Impaired Walking
Question 1: A nurse is caring for a patient with impaired walking due to arthritis. Which intervention would be most appropriate to include in the patient’s plan of care?
A. Encouraging the patient to perform weight-bearing exercises.
B. Providing heat therapy to the affected joints.
C. Assisting the patient with ambulation using a walker.
D. Referring the patient to occupational therapy for self-care training.
Answer: C. Assisting the patient with ambulation using a walker.
Rationale: For a patient with impaired walking due to arthritis, assisting them with ambulation using a walker would be the most appropriate intervention. It provides stability, support, and helps reduce the risk of falls.
Question 2: A patient with impaired walking due to a stroke has difficulty initiating walking and exhibits an unsteady gait. Which intervention should the nurse prioritize?
A. Implementing range of motion exercises for the affected limbs.
B. Assisting the patient with balance and coordination training.
C. Collaborating with physical therapy for specialized rehabilitation.
D. Educating the patient on proper body mechanics during walking.
Answer: C. Collaborating with physical therapy for specialized rehabilitation.
Rationale: For a patient with impaired walking due to a stroke, collaborating with physical therapy for specialized rehabilitation is a priority intervention. Physical therapy focuses on restoring mobility, improving strength, coordination, and gait patterns in patients with neurological impairments.
Question 3: A nurse is caring for an older adult patient with impaired walking. Which assessment finding is consistent with impaired walking in older adults?
A. Decreased muscle strength and atrophy.
B. Altered gait pattern and limping.
C. Increased joint mobility and range of motion.
D. Enhanced balance and coordination.
Answer: B. Altered gait pattern and limping.
Rationale: Altered gait patterns and limping are common findings in older adults with impaired walking. These changes may be due to age-related musculoskeletal and neurological changes, such as muscle weakness, joint stiffness, or balance impairments.
Question 4: A patient with impaired walking reports fear of falling while walking. Which intervention should the nurse implement to address the patient’s fear?
A. Encouraging the patient to use a wheelchair for all mobility.
B. Teaching the patient proper body mechanics during walking.
C. Assisting the patient with balance and coordination exercises.
D. Creating a safe environment and removing potential hazards.
Answer: D. Creating a safe environment and removing potential hazards.
Rationale: To address the patient’s fear of falling while walking, creating a safe environment and removing potential hazards would be the most appropriate intervention. This intervention helps minimize the risk of accidents and promotes the patient’s confidence in walking.
Question 5: A patient with impaired walking due to peripheral artery disease experiences pain during walking. Which intervention would be most effective in managing the patient’s pain?
A. Applying heat therapy to the affected limbs before walking.
B. Administering prescribed pain medications prior to walking.
C. Encouraging the patient to rest and avoid walking activities.
D. Teaching the patient relaxation techniques during walking.
Answer: B. Administering prescribed pain medications prior to walking.
Rationale: To manage pain during walking in a patient with impaired walking due to peripheral artery disease, administering prescribed pain medications prior to walking would be the most effective intervention. This can help alleviate pain and enable the patient to engage in walking activities.
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.
Gulanick, M., & Myers, J. L. (2022). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier.
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.
Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.
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This information is intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment.
