Physical mobility is an important aspect of life. Without movement, it is almost impossible to perform basic activity of daily living. The ability to perform physical exercises decreases one’s risk for muscle mass deterioration, injury, joint stiffness, renal calculi, swelling, developing cardiovascular diseases. In this paper, I will be discussing the patient’s knowledge deficit of physical mobility and its importance in daily living. The nursing diagnosis, set goal, set patient outcomes, teaching content, evaluation of said outcome and criticism will also be included in the paper.
An 87-year-old female resident was admitted into the nursing home facility for history of multiple strokes, frequent falls, and hypertension.
Hypertension (high blood pressure) can lead to stroke by clogging or rupturing blood vessels. A stroke occurs when the blood vessels responsible for the transportation of oxygenated blood and nutrient to the brain is blocked or ruptured. Because of the defectiveness of these blood vessels, the brain does not receive its required oxygen and nutrients therefore, leading to brain cell death.
(Cinnamon L. VanPutte, Jennifer L. Regan, Andrew F. Russo, 2014).One major cause of hypertension and stroke is a sedentary lifestyle. Identification of learning deficit occurred when patient failed to verbalize the purpose of Range of Motion (ROM) exercises even after mentioning that she attends physical therapy sessions. “I don’t know, tell me” was her response when asked of the importance of ROM exercises.
The Nursing diagnosis “Knowledge deficit of physical mobility related to absence of information as evidenced by verbalization of insufficient knowledge” was chosen for number of reasons.
The patient’s verbalization of lack of information was the top reason for this diagnosis. Other reasons include: inability to recall previously taught information, total dependence for Activities of Daily living (ADLs) and dependence on a wheelchair for ambulation.
For my assigned resident, the overall goal was to enhance physical mobility. To achieve this goal, expected patient outcomes were formulated. Firstly, “By the end of the shift, patient will verbalize at least 3 benefits of performing Range of Motion (ROM) exercises”, Secondly, “Patient will correctly demonstrate simple upper and lower extremity ROM exercises by the end of the day” and lastly, “Patient will demonstrate proper body mechanics during transfer from bed to wheelchair.”
The teaching plan consisted of pictures displaying various passive and active assisted ROM exercises and how to perform them correctly. The patient was informed of the negative effects of immobility on the body regarding muscle mass, joint movement, blood circulation and overall energy. The patient was also taught on the importance and benefits of frequent physical activity such as improved quality of life, improved self-worth, and improved physical function. (Betty J. Ackley, Gail B. Ladwig, Mary Beth Flynn Makic, 2017). This was done by using the teach back method. I mentioned five benefits of frequent physical mobility and the patient was asked to verbalize them back to me. The third goal of demonstrating proper body mechanics during transfer was not implemented.
After the patient was asked to teach back what she had just learnt, she could only verbalize two out of five reasons why physical mobility was important. “It’ll help strengthen my weaker side and it will help with circulation, right?” When asked to show examples of ROM motion movements that can be performed, she could only demonstrate four movements. Based on the results of my evaluation, patient outcome was partially met. To modify my plan, Critique and Conclusion The setting was appropriate because teaching took place in a quiet room with privacy provided.
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