Risk for Disuse Syndrome is a nursing diagnosis focusing on patients at risk of deterioration in body systems due to prescribed or unavoidable musculoskeletal inactivity. This comprehensive care plan addresses prevention and management strategies for patients at risk of developing complications from prolonged immobility.
Causes (Related to)
Risk for Disuse Syndrome can develop due to various factors affecting patient mobility:
- Prescribed bed rest or immobilization
- Mechanical ventilation
- Severe pain limiting movement
- Neurological impairment
- Post-surgical recovery
- Chronic conditions affecting mobility
- Cognitive impairment
- Severe obesity
- Advanced age
- Multiple trauma
Signs and Symptoms (Risk Factors)
Early identification of risk factors is crucial for preventing Disuse Syndrome:
Subjective: (Patient reports)
- Decreased motivation to move
- Fear of movement or falling
- Pain with movement
- Fatigue
- Feeling of weakness
- Depression or anxiety
- Decreased appetite
Objective: (Nurse assesses)
- Decreased muscle strength
- Reduced joint mobility
- Decreased endurance
- Poor skin integrity
- Dependent edema
- Decreased respiratory function
- Altered bowel patterns
- Decreased bone density
- Impaired balance
- Weight changes
Expected Outcomes
Successful prevention of Disuse Syndrome includes:
- The patient will maintain optimal muscle strength and joint mobility
- The patient will demonstrate improved endurance
- The patient will maintain skin integrity
- The patient will avoid complications of immobility
- The patient will participate in the prescribed exercise program
- The patient will maintain optimal respiratory function
- The patient will maintain bowel and bladder function
- The patient will maintain or improve current functional status
Nursing Assessment
Physical Assessment
- Evaluate muscle strength and tone
- Assess joint range of motion
- Check skin integrity
- Monitor vital signs
- Assess respiratory function
- Evaluate bowel and bladder function
Functional Assessment
- Determine current mobility level
- Assess ability to perform ADLs
- Evaluate balance and coordination
- Check transfer abilities
- Assess exercise tolerance
Risk Factor Evaluation
- Review medical history
- Assess current medications
- Check nutritional status
- Evaluate cognitive function
- Assess support system
Psychological Assessment
- Evaluate motivation level
- Assess anxiety and depression
- Check pain levels
- Determine an understanding of the condition
- Assess compliance with therapy
Nursing Care Plans
Nursing Care Plan 1: Risk for Impaired Physical Mobility
Nursing Diagnosis Statement:
Risk for Impaired Physical Mobility related to prescribed bed rest and decreased muscle strength.
Related Factors:
- Extended bed rest
- Muscle weakness
- Pain
- Fear of movement
- Limited endurance
Nursing Interventions and Rationales:
- Implement a progressive mobility program
Rationale: Prevents muscle atrophy and maintains joint function - Perform a range of motion exercises
Rationale: Maintains joint mobility and prevents contractures - Position patient properly
Rationale: Prevents pressure injuries and maintains proper body alignment
Desired Outcomes:
- Patient will participate in the prescribed mobility program
- Patient will maintain or improve muscle strength
- Patient will demonstrate proper positioning techniques
Nursing Care Plan 2: Risk for Impaired Skin Integrity
Nursing Diagnosis Statement:
Risk for Impaired Skin Integrity related to prolonged immobility and pressure.
Related Factors:
- Immobility
- Poor nutritional status
- Pressure points
- Altered circulation
- Moisture
Nursing Interventions and Rationales:
- Perform regular skin assessments
Rationale: Early detection of skin breakdown - Implement turning schedule
Rationale: Reduces pressure on vulnerable areas - Maintain proper nutrition and hydration
Rationale: Supports skin health and healing
Desired Outcomes:
- Patient will maintain intact skin
- Patient will demonstrate an understanding of skincare
- Patient will participate in repositioning the schedule
Nursing Care Plan 3: Risk for Ineffective Breathing Pattern
Nursing Diagnosis Statement:
Risk for Ineffective Breathing Pattern related to decreased mobility and shallow breathing.
Related Factors:
- Prolonged supine position
- Decreased lung expansion
- Retained secretions
- Weakened respiratory muscles
Nursing Interventions and Rationales:
- Perform deep breathing exercises
Rationale: Improves lung expansion and prevents atelectasis - Practice incentive spirometry
Rationale: Maintains airway clearance and lung function - Position for optimal breathing
Rationale: Facilitates maximum lung expansion
Desired Outcomes:
- Patient will maintain effective breathing pattern
- Patient will demonstrate proper deep breathing techniques
- Patient will maintain optimal oxygen saturation
Nursing Care Plan 4: Risk for Constipation
Nursing Diagnosis Statement:
Risk for Constipation related to decreased mobility and altered dietary intake.
Related Factors:
- Immobility
- Decreased fluid intake
- Medication side effects
- Changed eating patterns
- Weakened abdominal muscles
Nursing Interventions and Rationales:
- Monitor bowel movements
Rationale: Early detection of constipation - Encourage adequate fluid intake
Rationale: Maintains proper bowel function - Implement bowel program
Rationale: Prevents constipation and maintains regular elimination
Desired Outcomes:
- Patient will maintain regular bowel movements
- Patient will demonstrate adequate fluid intake
- Patient will follow prescribed bowel program
Nursing Care Plan 5: Risk for Social Isolation
Nursing Diagnosis Statement:
Risk for Social Isolation related to decreased mobility and restricted activities.
Related Factors:
- Limited mobility
- Depression
- Altered body image
- Reduced social interactions
- Communication barriers
Nursing Interventions and Rationales:
- Encourage social interactions
Rationale: Maintains psychological well-being - Facilitate communication with family/friends
Rationale: Prevents isolation and maintains support system - Promote participation in activities
Rationale: Improves mood and motivation
Desired Outcomes:
- Patient will maintain social connections
- Patient will demonstrate improved mood
- Patient will participate in social activities as able
References
- 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.
- Copanitsanou P. Mobility, Remobilisation, Exercise and Prevention of the Complications of Stasis. 2018 Jun 16. In: Hertz K, Santy-Tomlinson J, editors. Fragility Fracture Nursing: Holistic Care and Management of the Orthogeriatric Patient [Internet]. Cham (CH): Springer; 2018. Chapter 6. Available from: https://www.ncbi.nlm.nih.gov/books/NBK543820/ doi: 10.1007/978-3-319-76681-2_6
- Dyer, I. (1995). Preventing the ITU syndrome or how not to torture an ITU patient! Part I. Intensive and Critical Care Nursing, 11(3), 130-139. https://doi.org/10.1016/S0964-3397(95)80618-0
- Harding, M. M., Kwong, J., & Hagler, D. (2022). Lewis’s Medical-Surgical Nursing: Assessment and Management of Clinical Problems, Single Volume. Elsevier.
- 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.
- Javed MJ, Davis DD. Assisting Patients With Mobility. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559100/
- Silvestri, L. A. (2023). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.
