Impaired Physical Mobility

Published on Saturday March 10th , 2007

Impaired Physical Mobility

(_)Actual (_) Potential

**Related To:**
*[Check those that apply]*
(_) Amputation (_) Cardiovascular (_) External devices (_) Impaired balance (_) Limited ROM (_) Musculoskeletal impairment	(_) Neuromuscular impairment (_) Pain (_) Surgical procedure (_) Trauma (_) Other:_____________________________ ____________________________________ ____________________________________

**As evidenced by:**
*[Check those that apply]*
Major: (Must be present)	(_) Inability to move purposefully within the environment, including bed mobility, transfers, and ambulation.
Minor: (May be present)	(_) Range of motion limitations. (_) Limited muscle strength or control. (_) Impaired coordination.

Date &
Sign.

Plan and Outcome
[Check those that apply]

Target
Date:

Nursing Interventions
[Check those that apply]

Date
Achieved:

The patient will:

(_) Maintain or increase strength and endurance of upper/lower limbs A.E.B.:

(_) Will not develop complications of immobility.

(_) Demonstrate use of adaptive device(s) to increase mobility.
Device:

(_) Other:

(_) Assess symmetry, strength, and degree of mobility.

(_) Passive/active ROM exercises as ordered by physician q_____ to:__________(body part).

(_) Position in proper alignment and resposition q____ hrs.

(_) Encourage isometric exercises when indicated.

(_) Up in chair _____ minutes q____.

(_) Check/teach proper use/function of adaptive equipment.

(_) Provide progressive mobilization.

(_) Referral:

PT
OT
other:

(_) Other:________________
________________________
________________________
________________________

__________________________
Patient/Significant other signature

__________________________
RN signature

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