NURSING DIAGNOSIS: Self-care deficit

related to impaired physical mobility associated with weakness, fatigue, pain, nausea, depressant effect of some medications, fear of dislodging tubes and compromising surgical wound, and activity restrictions.

Desired Outcome
The client will perform self-care activities within physical limitations and postoperative activity restrictions.
Nursing Actions and Selected Purposes/Rationales
  1. With client, develop a realistic plan for meeting daily physical needs.
  2. Implement measures to facilitate the client's ability to perform self-care activities:
    1. schedule care at a time when client is most likely to be able to participate (e.g. when analgesics are at peak effect, after rest periods, not immediately after meals or treatments)
    2. keep needed objects within easy reach
    3. allow adequate time for accomplishment of self-care activities
    4. perform actions to increase physical mobility (see Diagnosis 12, action a).
  3. Encourage maximum independence within physical limitations and postoperative activity restrictions.
  4. Assist the client with activities he/she is unable to perform independently.
  5. Inform significant others of client's abilities to perform own care. Explain the importance of encouraging and allowing client to maintain an optimal level of independence.