Muscular dystrophy (MD) is a group of inherited diseases characterized by progressive muscle weakness and loss of muscle mass. This nursing diagnosis focuses on identifying symptoms, managing complications, and improving quality of life for patients with muscular dystrophy.
Causes (Related to)
Muscular dystrophy can affect patients in various ways, with several factors influencing its progression and severity:
- Genetic mutations affecting muscle protein production
- Family history of muscular dystrophy
- Gender (some types affect males more frequently)
- Progressive muscle degeneration affecting:
- Skeletal muscles
- Cardiac muscles
- Respiratory muscles
Signs and Symptoms (As evidenced by)
Muscular dystrophy presents with characteristic signs and symptoms that nurses must recognize for proper care management.
Subjective: (Patient reports)
- Muscle weakness
- Frequent falls
- Difficulty rising from a sitting position
- Balance problems
- Fatigue
- Pain and stiffness
- Difficulty breathing
- Learning disabilities (in some types)
Objective: (Nurse assesses)
- Progressive muscle weakness
- Decreased muscle mass
- Gait abnormalities
- Contractures
- Scoliosis
- Enlarged calf muscles
- Decreased respiratory function
- Cardiac abnormalities
Expected Outcomes
The following outcomes indicate successful management of muscular dystrophy:
- The patient will maintain optimal muscle function
- The patient will demonstrate improved mobility within limitations
- The patient will maintain adequate respiratory function
- The patient will avoid complications
- The patient will demonstrate proper use of assistive devices
- The patient will maintain independence in ADLs as possible
- Patient will verbalize understanding of disease management
Nursing Assessment
Monitor Muscle Function
- Assess muscle strength
- Evaluate range of motion
- Monitor for contractures
- Document the progression of weakness
- Assess gait and balance
Evaluate Respiratory Status
- Monitor breathing patterns
- Assess respiratory muscle strength
- Check oxygen saturation
- Monitor for signs of respiratory distress
- Document cough effectiveness
Assess Cardiac Function
- Monitor vital signs
- Check for arrhythmias
- Assess activity tolerance
- Monitor for signs of heart failure
- Document exercise capacity
Evaluate Functional Status
- Assess ADL independence
- Monitor mobility status
- Evaluate the need for assistive devices
- Check transfer abilities
- Document fatigue levels
Monitor for Complications
- Assess skin integrity
- Check for contractures
- Monitor for respiratory infections
- Evaluate nutritional status
- Assess for psychological impact
Nursing Care Plans
Nursing Care Plan 1: Impaired Physical Mobility
Nursing Diagnosis Statement:
Impaired Physical Mobility related to progressive muscle weakness as evidenced by difficulty walking, frequent falls, and decreased muscle strength.
Related Factors:
- Progressive muscle weakness
- Muscle atrophy
- Joint contractures
- Fatigue
- Fear of falling
Nursing Interventions and Rationales:
- Assess mobility status regularly
Rationale: Monitors disease progression and adapts interventions accordingly - Implement range of motion exercises
Rationale: Prevents contractures and maintains joint flexibility - Teach proper use of assistive devices
Rationale: Promotes safe mobility and prevents falls
Desired Outcomes:
- The patient will demonstrate safe mobility using assistive devices
- The patient will maintain the current level of mobility as long as possible
- The patient will avoid falls and injuries
Nursing Care Plan 2: Risk for Impaired Breathing Pattern
Nursing Diagnosis Statement:
Risk for Impaired Breathing Pattern related to respiratory muscle weakness as evidenced by decreased vital capacity and shortness of breath.
Related Factors:
- Respiratory muscle weakness
- Decreased chest wall compliance
- Ineffective cough
- Fatigue
- Recurrent respiratory infections
Nursing Interventions and Rationales:
- Monitor respiratory status regularly
Rationale: Enables early detection of respiratory compromise - Teach breathing exercises
Rationale: Improves respiratory muscle strength and lung expansion - Position for optimal breathing
Rationale: Maximizes respiratory function and comfort
Desired Outcomes:
- The patient will maintain adequate respiratory function
- The patient will demonstrate effective breathing techniques
- The patient will avoid respiratory complications
Nursing Care Plan 3: Self-Care Deficit
Nursing Diagnosis Statement:
Self-Care Deficit related to progressive muscle weakness as evidenced by the inability to perform ADLs independently.
Related Factors:
- Decreased muscle strength
- Fatigue
- Limited mobility
- Joint contractures
- Pain
Nursing Interventions and Rationales:
- Assess the level of independence in ADLs
Rationale: Determines the appropriate level of assistance needed - Teach energy conservation techniques
Rationale: Maximizes independence and reduces fatigue - Provide assistive devices
Rationale: Promotes independence and safety
Desired Outcomes:
- The patient will maintain maximum independence in ADLs
- The patient will demonstrate proper use of assistive devices
- The patient will verbalize understanding of energy conservation techniques
Nursing Care Plan 4: Risk for Impaired Skin Integrity
Nursing Diagnosis Statement:
Risk for Impaired Skin Integrity related to decreased mobility and pressure points as evidenced by prolonged periods of immobility.
Related Factors:
- Limited mobility
- Pressure points
- Poor nutritional status
- Decreased sensation
- Incontinence
Nursing Interventions and Rationales:
- Perform regular skin assessments
Rationale: Enables early detection of skin breakdown - Implement pressure relief techniques
Rationale: Prevents pressure ulcer development - Maintain proper nutrition and hydration
Rationale: Supports skin integrity
Desired Outcomes:
- The patient will maintain intact skin integrity
- The patient will demonstrate an understanding of skin care measures
- The patient will maintain adequate nutrition and hydration
Nursing Care Plan 5: Risk for Social Isolation
Nursing Diagnosis Statement:
Risk for Social Isolation related to progressive physical limitations as evidenced by decreased social interactions and expressed feelings of loneliness.
Related Factors:
- Physical limitations
- Communication difficulties
- Altered body image
- Depression
- Environmental barriers
Nursing Interventions and Rationales:
- Assess the social support system
Rationale: Identifies available resources and support needs - Encourage participation in support groups
Rationale: Provides peer support and coping strategies - Facilitate communication aids if needed
Rationale: Promotes social interaction and connection
Desired Outcomes:
- The patient will maintain meaningful social connections.
- The patient will participate in social activities as able
- The patient will express satisfaction with social support
References
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- Herdman, T. H., Kamitsuru, S., & Lopes, C. (2024). NANDA International Nursing Diagnoses – Definitions and Classification, 2024-2026.
- Ignatavicius, D. D., Rebar, C., & Heimgartner, N. M. (2023). Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care. Elsevier.
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