Impaired physical mobility

Domain 4. Activity-rest
Class 2. Activity-exercise
Diagnostic Code: 00085
Nanda label: Impaired physical mobility
Diagnostic focus: Mobility

Physical mobility is the ability of an individual to perform any task that requires movement from one place to another, or at the very least make any movements with their body parts. People who struggle with impaired physical mobility are unable to do this as efficiently and/or to a degree that serves their best interests. Other names for impaired physical mobility include reduced physical mobility, decreased mobility, and limited range of motion. It is important for medical practitioners to be aware of this diagnosis as it can provide an indication of the patient's overall health and wellbeing.

NANDA Nursing Diagnosis Definition

Impaired physical mobility according to NANDA International, Incorporation (NANDA-I) is defined as “a decrease in the ability to move or alternate positions”. This nursing diagnosis falls under the domain of activity and exercise, and it is one of the common nursing diagnoses among people of all ages.

Defining Characteristics

Subjective defining characteristics include:

• Complaints of pain and/or fatigue with activities
• Loss of range of motion and independence
• Difficulty reaching and/or maintaining designated positions

Objective defining characteristics include:

• Reduced ability to move or alternate positions
• Remarkably weakened abilities in functional mobility
• Range limitations in joint motion or flexibility (stiffness)

Related Factors

There are several related factors to consider when diagnosing an individual with impaired physical mobility. These related factors can include, but are not limited to:

• Muscle spasms, strains, or weakness
• Pain, especially when attempting to move or stand for long periods of time
• Weakened muscles due to lack of use
• Injury or trauma
• Inflammation, such as due to arthritis

Associated Conditions/Factors

Several associated conditions can affect an individual's mobility. These include:

• Gastrointestinal conditions, such as diarrhea, constipation, and esophagitis
• Cardiovascular conditions, such as coronary artery disease
• Respiratory conditions, such as bronchopneumonia and emphysema
• Neurological conditions, such as stroke, spinal cord injuries, multiple sclerosis, and Parkinson's Disease
• Musculoskeletal conditions, such as rheumatoid arthritis, osteoporosis, and fibromyalgia
• Medication side effect, including nerve pain medications and anti-inflammatory drugs

Suggestions of Use

An individual diagnosed with impaired physical mobility should start by consulting with a medical professional to determine the best course of action for managing their condition. Physical therapy is a valuable asset for improving strength, balance, and coordination, as well as developing helpful strategies such as learning how to use assistive devices. Taking part in activities that encourage physical activity, such as swimming, tai chi, and water aerobics, are also highly recommended.

Suggested Alternative NANDA Nursing Diagnosis

The following is a list of alternate NANDA nursing diagnoses that may be considered if the nurse suspects the patient is struggling with impaired physical mobility:

• Risk for falls
• Impaired carbohydrate metabolism
• Latex allergy response
• Impaired gas exchange
• Impaired sensory perception

Usage Tips

It is important for medical practitioners to be aware of possible nursing diagnoses that can provide an indication of a patient's overall health and wellbeing. When considering a diagnosis of impaired physical mobility, it is essential to assess the patient's current level of mobility and recommend treatments and activities for improving the patient's condition.

NOC Outcomes

The following is a NOC Outcomes (National Outcome Measures) associated with impaired physical mobility:

• Activity Tolerance – The patient’s ability to endure exertional activity over a period of time, usually increasing in intensity.
• Ambulation – The patient’s ability to walk and/or maneuver their body while standing up or transferring between various locations.
• Locomotion – The patient’s ability to maneuver within the environment and maintain appropriate balance and posture.
• Mobility – The patient’s ability to efficiently move the body in a smooth and coordinated manner.
• Performance Mobility – The patient’s ability to perform self-care activities both independently and safely.

Evaluation Objectives and Criteria

Nurses should assess the patient's mobility using objectives and criteria such as:

• Ability to ambulate with or without assistive device
• Gait patterns and balance
• Observation of performance of ADLs (Activities of Daily Living)
• Vital signs to detect blood pressure changes

NIC Interventions

The following is a list of interventions associated with impaired physical mobility (NIC):

• Ambulation Assistance – Assisting the patient with walking, maneuvering, and ambulation from one location to another.
• Balance Training – Training of balance and coordination to help improve functional mobility.
• Positioning – Positioning and support if needed for ambulation.
• Joint Mobility Training – Training in stretches and exercises to help improve range of motion, flexibility, and joint mobility.
• Use of Assistive Devices – Recommendation and use of appropriate assistive devices to improve safety of ambulation.

Nursing Activities

Nurses will need to undertake several activities to effectively manage and treat this nursing diagnosis. These activities can include, but are not limited to:

• Assessment of patient's level of mobility every shift
• Developing a plan of care for treatment
• Development of patient teaching materials for activities of daily living
• Instructional demonstration of activities such as transfers, gait, balance and strengthening exercises
• Monitoring of vital sign and reports of pain, fatigue, dizziness, lightheadedness and/or numbness

Conclusion

Impaired physical mobility is a condition that affects individuals of all ages. Nursing professionals should be aware of the signs and symptoms associated with this diagnosis in order to provide effective care. Nursing actions include thorough assessment, development of a care plan, instruction in activities of daily living, and monitoring of vital signs. Through these activities, nurses can help their patients to regain their mobility.

FAQs

• What is impaired physical mobility?
  Impaired physical mobility is the decrease in an individual’s ability to move or alternate positions. Common causes of impaired physical mobility include muscle spasms, inflammation, weakness, and injury or trauma.
• What conditions can adversely affect impaired physical mobility?
  Conditions such as gastrointestinal problems, cardiovascular diseases, respiratory issues, neurological disorders, musculoskeletal problems, and medication side-effects can adversely affect impaired physical mobility.
• How is impaired physical mobility treated?
  Impaired physical mobility is typically managed through physical therapy, activities that encourage physical activity, and assistive devices. Patients who are diagnosed with impaired physical mobility should consult with a medical professional to determine the best course of action.
• What alternatives are there to nursing diagnosis impaired physical mobility?
  Alternative NANDA nursing diagnoses that may be taken into consideration if impaired physical mobility is suspected include Risk for Falls, Impaired Carbohydrate Metabolism, Latex Allergy Response, Impaired Gas Exchange, and Impaired Sensory Perception.
• What NOC outcomes and NIC interventions should be considered for impaired physical mobility?
  NOC outcomes used to assess impaired physical mobility include Activity Tolerance, Ambulation, Locomotion, Mobility, and Performance Mobility. NIC interventions include Ambulation Assistance, Balance Training, Positioning, Joint Mobility Training, and Use of Assistive Devices.