NURSING DIAGNOSIS: Impaired physical mobility

related to:
  1. pain and weakness in weight-bearing extremity associated with the fracture and subsequent surgical repair;
  2. prescribed activity and weight-bearing restrictions following internal fixation or prosthesis insertion;
  3. generalized weakness associated with surgery;
  4. depressant effect of anesthesia and some medications (e.g. narcotic [opioid] analgesics, centrally acting muscle relaxants, some antiemetics);
  5. fear of falling, moving operative hip improperly, and compromising surgical wound.
Desired Outcome
The client will achieve maximum physical mobility within prescribed activity and weight-bearing restrictions.
Nursing Actions and Selected Purposes/Rationales
  1. Refer to Standardized Postoperative Care Plan, Diagnosis 12, for measures to increase client's mobility.
  2. Implement additional measures to increase client's mobility:
    1. perform actions to reduce pain (see Postoperative Diagnosis 2)
    2. instruct client in and assist with quadriceps- and gluteal-setting exercises to strengthen muscles needed for ambulation
    3. encourage client to use overhead trapeze to move self in order to strengthen arm and shoulder muscles needed for proper use of ambulatory aids
    4. reinforce physical therapist's instructions regarding muscle strengthening exercises, transfer and ambulation techniques, and use of ambulatory aids
    5. perform actions to prevent falls (see Postoperative Diagnosis 5, actions a and b) in order to decrease client's fear of injury
    6. assist client with ambulation as soon as allowed (usually by the 2nd postoperative day).
  3. Consult appropriate health care provider (e.g. physician, physical therapist) if client is unable to achieve expected level of mobility.