Nursing Care Plan for Osteosarcoma - Impaired Physical Mobility

Osteosarcoma is a primary malignant bone tumors are the most common and often fatal and can occur as a secondary metastases from extremity limb in 50% of cases. Usually found on the former site of radiation or more often as a broadcaster in Paget's disease. Osteosarcoma often occurs in men in the age group 10-25 years and the parents who have Paget's disease.

Nursing Diagnosis for Osteosarcoma : Impaired physical mobility related to muskuluskletal damage, pain, and amputation.

Goal: mobillitas physical damage is resolved entirely.

Subjective data: The client said it was difficult to move.
Objective data: The client looks impaired coordination; decreased muscle strength, control and mass.

Expected outcomes:

• The patient stated understanding of individual situations, treatment programs, and security measures,
• The patient seemed to participate in training programs / shows willingness to participate in activities,
• The patient showed technique / behaviors enabling the move action, and
• The patient seemed to maintain coordination and mobility corresponding optimal level.

Intervention:

1. Assess the level of immobilization caused by edema and the patient's perception of immobilization.
R /: The patient will restrict the movement as one of perception (perception are not proportional).

b. Encourage participation in recreational activities (watching TV, reading newspapers, etc.).
R /: Provides the opportunity to expend energy, focus, improve the patient's sense of self control and help in reducing social isolation.

3. Instruct the patient to perform active and passive exercises on the injury or not.
R /: Increases blood flow to the muscles and bones to improve muscle tone, maintain joint mobility, prevent contractures / atrophy and reapsorbsi Ca unused.

4. Assist patients in self-care.
R /: Increases strength and muscle circulation, improve the patient in control of the situation, increasing the willingness of the patient to recover.

5. Provide High-protein diet and High calories, vitamins, and minerals.
R /: Speed up the process of healing, prevent weight loss, because the immobilization usually weight loss.

6. Collaboration with the physiotherapy department.
R /: To determine the exercise program.

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Parkinson's Disease Nursing Care Plan - Diagnosis Interventions

Parkinson's disease is a progressive neurodegenerative disorder that affects movement control, impacting millions of people worldwide. This article explores the key aspects of Parkinson's disease, including its causes, symptoms, and current management strategies.

Causes of Parkinson's Disease:

1. Neurodegeneration: Parkinson's disease is characterized by the gradual loss of dopamine-producing neurons in the substantia nigra, a region of the brain involved in movement control.
2. Genetic Factors: While most cases of Parkinson's are sporadic, some have a genetic component. Mutations in specific genes, such as LRRK2 and SNCA, are associated with an increased risk of developing the condition.
3. Environmental Factors: Exposure to certain environmental toxins, such as pesticides and herbicides, has been linked to an elevated risk of Parkinson's disease.

Symptoms of Parkinson's Disease:

1. Tremors: Involuntary shaking or trembling, typically starting in the hands, is a hallmark symptom of Parkinson's.
2. Bradykinesia: Slowed movement and a gradual reduction in the ability to initiate and complete physical activities.
3. Muscle Rigidity: Stiffness and resistance to movement in the muscles, leading to reduced flexibility.
4. Postural Instability: Difficulty maintaining balance and an increased risk of falls.
5. Changes in Handwriting: Micrographia, or the shrinking of handwriting, is a common early sign.

Parkinson's Disease Nursing Care Plan

1. Nursing Diagnosis Impaired physical mobility related to the stiffness and muscle weakness.

Goal: The client is able to perform physical activity according to ability.

Expected results: the client can participate in training programs, joint contractures did not occur, increased muscle strength and the client indicates an act to increase the mobility

Nursing Interventions for Parkinson's Disease :

1. examine existing mobility and observation of an increase in damage
2. do an exercise program increases muscle strength.
3. encourage hangan bath and massage the muscle
4. help clients perform ROM exercises, self-care according to tolerance
5. collaboration physiotherapists for physical exercise

2. Nursing Diagnosis Self care deficit related to neuromuscular weakness, decline in strength, loss of muscle control / coordination.

Goal: self-care clients are met

Expected results: the client can indicate a change of life for the needs of taking care of themselves, clients are able to do self-care activities in accordance with the level of ability, and identify personal / community that can help.

Nursing Interventions for Parkinson's Disease :

1. assess the ability and the rate of decline and the scale of 0-4 to perform ADL
2. avoid what not to do the client and help if needed.
3. collaborative provision of laxatives and consult a doctor of occupational therapy
4. teach and support the client during the client's activities
5. environmental modifications

3. Nursing Diagnosis Impaired Verbal Communication related to the decline in speech and facial muscle stiffness

characterized by:

• Subjective Data: client / family says the difficulty in talking
• Objective data: the words are difficult to understand, face rigid.

Goal: maximize the ability to communicate.

Nursing Interventions for Parkinson's Disease:

1. Keep the complications of treatment.
2. Refer to speech therapy.
3. Teach clients to use facial exercises and breathing methods to correct the words, volume, and intonation.
4. Breath deeply before speaking to increase the volume and number of words in sentences of each breath.
5. Practice speaking in short sentences, reading aloud in front of the glass or into a voice recorder (tape recorder) to monitor progress.

 

Bibliography:

1. Olanow, C. W., Stern, M. B., & Sethi, K. (2009). The scientific and clinical basis for the treatment of Parkinson disease (2009). Neurology, 72(21 Suppl 4), S1–S136. doi: 10.1212/WNL.0b013e318198db1d
2. Dorsey, E. R., Bloem, B. R., & Okun, M. S. (2020). The past, present, and future of Parkinson's disease: A special essay on the 200th Anniversary of the Shaking Palsy. Movement Disorders, 35(6), 795–801. doi: 10.1002/mds.27986
3. Schapira, A. H., Chaudhuri, K. R., & Jenner, P. (2017). Non-motor features of Parkinson disease. Nature Reviews Neuroscience, 18(7), 435–450. doi: 10.1038/nrn.2017.62

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Impaired Physical Mobility Nanda Nursing Diagnosis

Nanda Definition:

Impaired physical mobility a nursing diagnosis approved by the North American Nursing Diagnosis Association, defined as the state in which an individual has a limitation in independent, purposeful physical movement of the body or of one or more extremities.


Alteration in mobility may be a temporary or more permanent problem. Most disease and rehabilitative states involve some degree of immobility (e.g., as seen in strokes, leg fracture, trauma, morbid obesity, and multiple sclerosis). With the longer life expectancy for most Americans, the incidence of disease and disability continues to grow. And with shorter hospital stays, patients are being transferred to rehabilitation facilities or sent home for physical therapy in the home environment.

Mobility is also related to body changes from aging. Loss of muscle mass, reduction in muscle strength and function, stiffer and less mobile joints, and gait changes affecting balance can significantly compromise the mobility of elderly patients. Mobility is paramount if elderly patients are to maintain any independent living. Restricted movement affects the performance of most activities of daily living (ADLs). Elderly patients are also at increased risk for the complications of immobility. Nursing goals are to maintain functional ability, prevent additional impairment of physical activity, and ensure a safe environment.

Impaired physical mobility - Related factors arising from within the person include pain or fear of discomfort, anxiety or depression, and physical limitations due to neuromuscular or musculoskeletal impairment. External factors include enforced rest for therapeutic purposes, as in the case of immobilization of a fractured limb. The human body is designed for motion; hence, any restriction of movement will take its toll on every major anatomic system.

Defining Characteristics:

• Inability to move purposefully within physical environment, including bed mobility, transfers, and ambulation
• Reluctance to attempt movement
• Limited range of motion (ROM)
• Decreased muscle endurance, strength, control, or mass
• Imposed restrictions of movement including mechanical, medical protocol, and impaired coordination
• Inability to perform action as instructed

NOC Outcomes (Nursing Outcomes Classification)
Suggested NOC Labels

• Ambulation: Walking
• Joint Movement: Active
• Mobility Level

NIC Interventions (Nursing Interventions Classification)
Suggested NIC Labels

• Exercise Therapy: Ambulation
• Joint Mobility
• Fall Precautions
• Positioning
• Bed Rest Care

Expected Outcomes

• Patient performs physical activity independently or with assistive devices as needed.
• Patient is free of complications of immobility, as evidenced by intact skin, absence of thrombophlebitis, and normal bowel pattern.

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