00091 Deterioration Of Mobility In Bed

Domain 4: activity/rest
Class 2: activity/exercise
Diagnostic Code: 00091
Nanda label: deterioration of mobility in bed
Diagnostic focus: mobility
Approved 1998 • Revised 2006, 2017, 2020 • Level of evidence 2.1

NANDA Nursing Diagnosis Definition

Nanda nursing diagnosis « deterioration of mobility in bed is defined as: limitation of independent movement to change posture in bed.

Definite characteristics

  • Difficulty moving from the position sitting with the legs stretched to supine
  • Difficulty to move from prone to supine
  • Difficulty moving from the sitting to supine
  • Difficulty to achieve objects in bed
  • Difficulty changing posture in bed
  • Difficulty returning to bed
  • Difficulty rolling in bed
  • Difficulty sitting on the edge of the bed
  • Difficulty turning side

Related factors

  • Cognitive dysfunction
  • Decreased flexibility
  • Limitations of the environment
  • Postural balance deterioration
  • Inadequate head angle
  • Inappropriate knowledge about mobility strategies
  • Insufficient muscle strength
  • Obesity
  • Pain
  • Loss of physical condition

Risk population

  • Children
  • People who experience prolonged bed rest
  • People in the immediate postoperative period
  • Older adults

Associated problems

  • Artificial breathing
  • Severe condition
  • Dementia
  • Drain tubes
  • Musculoskeletic deterioration
  • Neurodegenerative diseases
  • Neuromuscular diseases
  • Parkinson’s disease
  • Pharmacological preparations
  • sedation

Suggestions of use

  • 1. When patient mobility cannot be improved in bed, this label should be used as a risk factor or factor related to other nursing diagnoses, as a risk of deterioration of skin integrity.
  • 2. Specify the degree of mobility, as is done in the deterioration of physical mobility and in the deterioration of wheelchair mobility:
  • Level 0: totally independent
  • Level 1: You need to use equipment or devices
  • Level 2: You need the help of another person for assistance, supervision, or teaching
  • Level 3 needs the help of another person and equipment or devices
  • Level 4: It is dependent, does not participate in the activity

See the suggestions for use of physical mobility, deterioration of the.

Suggested alternative diagnostics

  • Cutaneous integrity, risk of deterioration of
  • injury, risk of
  • Physical mobility, deterioration of
  • disuse syndrome, risk of

NOC Results

  • Body position change: initiated by the individual: Ability to change body position independently, with or without the help of an auxiliary device
  • Mobility: Ability to move intentionally in its own environment, independently or with an auxiliary device
  • Coordinated movement: capacity of the muscles of working together voluntarily in intentional movements

Evaluation objectives and criteria

  • It presents mobility in bed, as evidenced by the change of body position initiated by the individual, the coordinated movement and a satisfactory mobility
  • demonstrates mobility, as manifested by the following indicators (specify from 1 to 5: severely, substantially, moderately, slightly or not compromised):
    • Coordination
    • Body position change
    • Muscle and joint movement
  • Other examples

    The patient will be able to:

    • Make complete movements of all joints
    • Move on the bed or establish the real level of help necessary
    • Demonstrate the correct use of auxiliary devices (for example, of the trapeze)
    • Request help to change position, as required

    NIC Interventions

    • Help in self -care: Help another person to perform daily life activities (AVD)
    • Care in bed rest: improvement of comfort and safety, as well as prevention of complications of a patient who cannot get out of bed
    • Position: Deliberate placement of the patient or from his body to improve physiological and psychological well -being
    • Promotion of bodily mechanisms: Facilitation of the use of postures and movement in daily activities to prevent fatigue and musculoskeletal lesions or tensions
    • Promotion of exercise: strength training: facilitation of muscle training against resistance and regular, to maintain or increase muscle strength
    • Exercise therapy: Muscle control: Use of activity or exercise protocols to improve or restore controlled body movement
    • Exercise therapy: joint mobility: use of active or liability body movement to maintain or restore the flexibility of joints

    Nursing Activities

    Valuations

    • Continuously evaluate the mobility of the patient
    • Assess the level of consciousness
    • Assess muscle strength and joint mobility (amplitude of movements)

    Patient and family education

    • Teach the patient amplitude exercises of both active and passive movements to improve strength and muscle resistance
    • Teach the patient techniques to turn and correct body alignment

    Collaboration activities

    • Use the help of occupational and physical therapists to develop a plan in order to maintain and improve mobility in bed

    Others

    • Place a button or an alarm light within reach of the patient
    • Offer auxiliary devices (trapeze)
    • Provide positive reinforcement during activities
    • Apply measures for pain control before starting exercises or physiotherapy
    • Ensure that the care plan includes the necessary personnel to turn the patient

    At home

    • above interventions are also suitable for home care
    • Assess the capacity of caregivers to move and turn the patient; obtain domestic health care as required
    • Assess the need for the help of a health center or other organization
    • Evaluate the need to have a durable medical team; help obtain it, if necessary
    • Teach caregivers to move the patient’s body
    • Teach caregivers and patient to use auxiliary devices
    • Use the usual patient bed, if possible. For example, blocks could be used to raise the head of the bed.
    • Acquire a hospital bed if the patient’s medical state demands so, or if caregivers need it to take care of the patient
    • Suggest that the patient’s bed is placed in an easily accessible area of ??the house and where the patient can interact with the other relatives
    • Indicate caregivers to allow the patient to perform self -care as far as possible; Explain the advantages of maintaining independence