Impaired Physical Mobility related to Herniated Nucleus Pulposus

Nursing Care Plan for Herniated Nucleus Pulposus - Nursing Diagnosis : Impaired Physical Mobility

HNP, or a herniated nucleus pulposus, is the more medically oriented term for what most people refer to as a “herniated disc.” The nucleus pulposus is the gel-like inner material found within the thick, outer wall of each intervertebral disc, which are soft, sponge-like bodies responsible for providing support and flexibility along the entire length of the spine. Due to the gradual deterioration of these discs over time as part of the natural aging process, these discs develop a tear and the nucleus pulposus can push through the disc wall and extrude into the spinal canal – a condition known as a herniated nucleus pulposus.


Impaired Physical Mobility

A limitation in independent, purposeful physical movement of the body or of one or more extremities

Defining Characteristics:

• Postural instability during performance of routine activities of daily living (ADLs);
• limited ability to perform gross motor skills;
• limited ability to perform fine motor skills;
• uncoordinated or jerky movements;
• limited range of motion;
• difficulty turning;
• decreased reaction time;
• movement-induced shortness of breath;
• gait changes (e.g., decreased walking speed, difficulty initiating gait, small steps, shuffles feet, exaggerated lateral postural sway);
• engages in substitutions for movement (e.g., increased attention to other's activity, controlling behavior, focus on preillness/predisability);
• slowed movement;
• movement-induced tremor

Nursing Diagnosis for Herniated Nucleus Pulposus : Impaired Physical Mobility
related to pain and discomfort, muscle spasm restrictive therapy. For example: bed rest, neurovascular damage.
Goal: No impairment of physical mobility.

Outcomes:

• Clients expressed understanding of the situation / risk factors and individualized treatment rules.
• Demonstrate behavioral techniques.
• Maintain or improve the strength and function of body parts affected and or compensation.

Nursing Intervention:

1. Provide protective measures as indicated by the specific situation.
2. Note the emotional response / behavior on immobilization. Provide appropriate activities with patients.
3. Follow the activities / procedures with rest methods. Instruct the patient to participate in regular daily activities within individual limitations.
4. Help the patient to perform range of motion exercises active or passive.
5. Instruct the patient to train the lower leg / knee. Value of the edema, erytema the lower extremities.
6. Assist patients in performing activities of progressive ambulation.
7. Demonstrate the use of auxiliary equipment such as a walker, cane.
8. Provide good skin care, massage pressure points after each change of position. Check the state of the skin under the brace, with a specific time period.