NR 324 Week 7 Altered Mobility
Student Name
Chamberlain University
NR-324 Adult Health I
Prof. Name
Date
Week 7: Altered Mobility
Nursing Care of Mobility
Prepare: The Nursing Care of Mobility
Mobility is an essential aspect of health and wellness. Nurses play a vital role in recognizing, assessing, and intervening in cases of altered mobility. A thorough understanding of musculoskeletal, neurological, and systemic influences on mobility allows nurses to provide effective care plans.
Nursing Intervention – Recognizing Cues
Question: The nurse is caring for a client who was recently injured in the right leg while playing basketball. Which symptoms could be most consistent with a bone injury? (Select all that apply)
Answer:
- Deformity of the injured extremity
- Ecchymosis around the area of injury
- Inability to bear weight
Rationale: These symptoms typically indicate a possible fracture or bone injury, while capillary refill <3 seconds is normal and the presence of fever might suggest infection rather than trauma.
Recognizing Cues – Altered Mobility
Question: The nurse is caring for a client with a nerve impingement in the lower back around L4 and L5. Which symptoms are consistent with nerve injury? (Select all that apply)
Answer:
- Paresthesia
- Acute pain
Rationale: Nerve injuries commonly cause sensations like tingling (paresthesia) and sharp pain. Erythema and deformity are typically signs of inflammation or structural damage, not nerve involvement.
Nursing Intervention – Altered Mobility and Lifestyle
Question: The nurse is preparing a discharge plan for a client following a left tibial fracture. Which lifestyle changes should be encouraged to decrease healing time?
Answer:
- Stop smoking
Rationale: Smoking is known to impair bone healing. Adequate protein intake and physical activity (as prescribed) promote recovery. Milk products should not be eliminated unless contraindicated.
Self-Check: Analyze Cues – Altered Mobility
| Assessment Findings | Pertinent Information |
|---|---|
| Ambulation | With some assistance |
| Pedal Pulses | +2 below injury |
| Capillary Refill | <3 seconds |
| Smoking Status | 1 pack daily |
| Exercise Frequency | 4x/week |
| PMH | Vitamin D deficiency, right ulnar fracture |
Interpretation: Smoking and vitamin D deficiency are barriers to healing. Assistance with ambulation indicates current mobility limitation.
Self-Check: Nursing Assessment of Risk – Altered Mobility
Question: The nurse is caring for a client with a femur fracture on bedrest with the leg elevated. Which provider prescription requires urgent attention?
Answer: Sequential compression device
Rationale: Although often used to prevent DVT, applying a compression device on a fractured leg without proper clearance can cause complications.
Self-Check: Nursing Actions – Hematologic Alterations
| Nursing Actions | Best-Fitting Nursing Diagnosis |
|---|---|
| Monitoring CBC, assessing signs of bleeding | Risk for bleeding related to immobility |
| Encouraging ambulation | Risk for venous thromboembolism |
Self-Check: Outcome – Nursing Evaluation
Scenario: Patient in MVA requests pain meds (pain level 8/10), alert, stable vitals.
Answer: Give the pain medicine as ordered
Rationale: The patient is due for the pain medication and is experiencing unrelieved pain. Administering it as ordered is appropriate.
Reflect: The Nursing Care of Mobility
Recognizing Cues – Nursing Assessment
Question: Review the case below and select risk factors or items requiring follow-up.
Answer:
- Smoking
- Vitamin D deficiency
- Assisted ambulation
Analyzing Cues – Nursing Assessment
Question: Which assessment items are consistent with a fractured hip?
Answer:
- Deformity
- Ecchymosis
Nursing Diagnoses – Planning Interventions
| Nursing Diagnosis | Intervention |
|---|---|
| Impaired physical mobility | Assist with ambulation and physical therapy |
| Acute pain | Administer prescribed analgesics |
| Risk for delayed healing | Educate on smoking cessation and nutrition |
Planning Care – Fracture
Progress Note: Ernestine reports hip pain (6/10), vitals stable.
Question 1: Select appropriate nursing actions:
- Acetaminophen 500mg PO q4-6h
- Ketorolac 60mg IM q6h
- Play favorite music
- Ice pack
- Reposition
Question 2: Expected outcomes:
- Client will verbalize a reduction of pain on the numeric scale
- Client will ambulate 100 feet with minimal pain
Magnetic Properties
Prepare: Magnetic Properties
Magnets
Question: When a magnet is passed back and forth through a copper circle, what happens?
Answer: A current is produced inside the copper wire
MRI Scans
Question: MRI scans are beneficial because they:
Answer: Have no ionizing radiation
Self-Check: Magnetic Concepts Table
| Topic | Correct Answer |
|---|---|
| Non-magnetic metal | Lead |
| Magnetic microstructures | Domains |
| Current effect | A magnetic field |
| Magnet therapy | No more effective than placebo |
| MRI technology | Uses strong magnets |
| Attraction property | Magnetic materials |
| Current in metal | Electricity is produced |
| Unique MRI property | Does not emit radiation |
| Common magnetic metals | Nickel, cobalt, iron |
| Magnetic domain effect | Align |
| Magnet near copper | Produces current in copper |
| Magnet therapy in body | Exerts force on iron in blood |
| MRI effect | Aligns protons in the body |
Osteoarthritis (OA)
Recognizing Cues – Pathophysiology
Answer: Joint destruction from excessive use caused by intrinsic and environmental factors.
Recognizing Cues – Risk Factors
Answer:
- Age
- Gender
- Family history
- Joint overuse
Nursing Intervention – OA and Lifestyle
Question: Post-op discharge plan education should include (Select all that apply):
Answer:
- Increase dietary protein
- Exercise as prescribed
- Smoking cessation
Self-Check: Analyze Cues – Arthritis
| Arthritis Type | Expected Cues |
|---|---|
| Osteoarthritis | Unilateral pain, crepitus, joint deformity |
| Rheumatoid Arthritis | Bilateral joint pain, swelling, morning stiffness |
Self-Check: Planning for Intervention – Osteoarthritis
| Medication | Class | Consideration |
|---|---|---|
| Celecoxib | NSAID (COX-2 Inhibitor) | GI protection, cardiovascular risk |
| Diclofenac Gel | Topical NSAID | Lower systemic side effects |
Rheumatoid Arthritis (RA)
Recognizing Cues – Pathophysiology
Answer: Autoimmune condition that attacks small joints
Risk Factors for RA
Answer:
- Gender
- Smoking
- Family history
- Age
Planning Care – RA Interventions Before Infliximab
Answer:
- Tuberculin skin test
- CBC
- Hepatitis B titer
- Influenza and pneumococcal vaccines
Generating Hypotheses – RA Nursing Diagnosis
| Diagnosis | Evidence |
|---|---|
| Activity intolerance | Moderate joint pain, fatigue, difficulty at work |
| Knowledge deficit | Confusion about symptom variability |
| Risk for impaired social interaction | Sole wage earner with work absenteeism |
Delegation for RA Client
| Task | Can Delegate to UAP? |
|---|---|
| Teach medication management | No |
| Help change gown | Yes |
| Teach rest/activity balance | No |
| Passive ROM exercises | Yes |
| Assess and administer pain meds | No |
References
American Nurses Association. (2021). Nursing: Scope and standards of practice (4th ed.). ANA.
Ignatavicius, D. D., Workman, M. L., & Rebar, C. R. (2020). Medical-surgical nursing: Concepts for interprofessional collaborative care (9th ed.). Elsevier.
NR 324 Week 7 Altered Mobility
Potter, P. A., Perry, A. G., Stockert, P., & Hall, A. (2021). Fundamentals of nursing (10th ed.). Elsevier.
U.S. National Library of Medicine. (2023). Osteoarthritis. MedlinePlus. https://medlineplus.gov/osteoarthritis.html
NR 324 Week 7 Altered Mobility
U.S. National Library of Medicine. (2023). Rheumatoid arthritis. MedlinePlus. https://medlineplus.gov/rheumatoidarthritis.html