...Nursing 344 Nursing Diagnosis: Impaired Physical Mobility Immobility NOC Outcomes (Nursing Outcomes Classification) Suggested NOC Labels. Vision was screened using two charts from a distance of 20 feet. Patient is free of complications of immobility, as evidenced by intact skin, absence of thrombophlebitis, and normal bowel pattern. Diagnosis: Impaired physical mobility related to partial paralysis as evidenced by numbness of the right face, right arms and right leg, and having trouble in walking. List five steps in the nursing process. be free of complications of immobility, as evidenced by: intact skin, absence of thrombophlebitis, and normal bowel pattern. Syndrome, impaired What are nursing care plans? Assess elimination status (e.g., usual pattern, present patterns, signs of constipation). The patient has not be out of bed since the day before surgery. Exercise enhances increased venous return, prevents stiffness, and maintains muscle strength and stamina. [regulatory failure] Dentition, impaired Failure to thrive, adult * Intervention Admission Date: Admitting Diagnosis: Rt. Patient Presentation Page 8 Etiology and Pathophysiology Page 4 Surgery Type/Date (if any): Lumpectomy on Rt. * To identify actual & potential problems. Foot at 2002 3. This helps out in preference of actions since different methods are used for the following: flaccid and spastic paralysis. Therapeutic Regimen Good nutrition also gives required energy for participating in an exercise or rehabilitative activities. To optimize hydration status and prevent hardening of stool. Pressure ulcers build up more rapidly in patients with a nutritional insufficiency. Research supports that strength training and other forms of exercise in older adults can preserve the ability to maintain independent living status and reduce risk of falling. Encourage coughing and deep-breathing exercises. Community, ineffective -Patient’s pain rating will be less than 3 on 1-10 scale within 8 hours. Liquids maximize hydration status and avoid hardening of stool. A core competence of nursing is documentation of patient’s response to nursing interventions and effectively communicating the care given. The Electronic Health Record (EHR) improves the exchange of patient data, accuracy, and quality of patient care. Limited movement affects the performance of most ADLs. Assess for developing thrombophlebitis (e.g., calf pain, Homans’ sign, redness, localized swelling, and rise in temperature). Purpose of Nursing Assessment ▪ Content of documentation needs to be: use suction as necessary. Gordon’s functional health patterns Some hospitals may have the information displayed in digital format, or use pre-made templates. Clean, dry, and moisturize skin as necessary. The patient’s right leg is in a cast from thigh to ankle. In between this time there have been significant variances. 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