Hambatan mobilitas fisik

Diagnosis Outcome Intervention

Impaired After being given intervention for 3 x Bed rest care

Physical 24 hours it is expected mobility 1. Explain reasons for
Mobility related physical patient is requiring bed rest
by activity 2. Position in proper body
Body Positioning : Self initiated
intolerance alignment
marked by 1. Move from lying to siting (5) 3. Use devices on the bed
decrease in that protect the patient
2. Move from siting to standing
range of motion. 4. Monitor for
(5)
complications of bed rest
3. Move from side to side while Environmental
lying (5) management
1. Create a safe
4. Move from front to back while
environment for the
lying (5)
patient
Ambulation 2. Remove harmful objects
from the environment
1. Bears weight (4)
3. Safeguard with side
2. Walks at slow pace (4) rails/side rail padding, as
appropriate
3. Walks around room (4)
4. Place frequently used
objects within reach
5. Provide a clean,
comfortable bed and
environment
6. Adjust environmental
temperature to meet
patient’s needs, if body
temperature is altered
7. Control or prevent
undesirable or excessive
noise, when possible
8. Limit visitors
Positioning
1. Encourage the patient to
get involved in
positioning changes, as
appropriate
2. Monitor oxygenation
status before and after
position change
3. Cncourage active or
passive range-of-motion
exercises, a appropriate
4. Avoid placing a patient
in a position that
increases pain
Fall prevention
1. Identify cognitive or
physical deficits of the
patient that may
increase potential of
falling in a particular
environment
2. Identify behaviors and
factors that affect risk
of falls
3. Review history of falls
with patient and family
4. Identify characteristics
o environment that
 may increase potential
for falls
5. Use side rails of
appropriate length and
height to prevent falls
from bed, as needed
6. Collaborate with other
health care team
members to minimize
side effects o
medications that
contribute to falling