Domain 4. Activity-rest
Class 2. Activity-exercise
Diagnostic Code: 00088
Nanda label: Impaired walking
Diagnostic focus: Walking
Impaired walking is a medical condition that affects people who are having difficulty in walking, standing, and even maintaining balance on their feet. To properly assess and diagnose this condition, nurses use NANDA nursing diagnosis to identify and describe its characteristics, related factors, and associated conditions so care plans may be established accordingly.
NANDA Nursing Diagnosis Definition
NANDA nursing diagnosis for impaired walking pertains to the impaired ability of an individual to ambulate or participate within his environment which causes distress or risk for physical injury. It is closely related to a person’s problem with balance, coordination, muscle strength, and visual and spatial perception.
Defining Characteristics
The signs and symptoms associated with impaired walking include subjective and objective defining characteristics. Subjective characteristics refer to the reported experiences of the patient including pain, dizziness, restlessness, and words like unsteady, wobbling, exhausted, etc. Objective characteristics include the measurable signs of the condition such as fatigue, poor physical balance, weakened lower body, labored gait, and inability to stand or stay upright without assistance.
Related Factors
Different factors can contribute to the impaired walking condition. These include chronic diseases like Parkinson’s and arthritis, traumatic injuries to bones and muscles, infections, decreased muscle strength and endurance, use of certain medications, lowered sensory input from the extremities, environmental hazards such as uneven terrain or cluttered walkways, improper foot wear and more.
Associated Conditions
The associated conditions that could lead to the impaired walking situation can be classified into two groups of conditions: Specific and general disabilities. In the first group, there are physical disabilities caused by arthritis, cerebral palsy, multiple sclerosis, Parkinson’s disease, peripheral neuropathy, and sciatica. The second group includes conditions like muscle weakness, postural instability, joint deterioration and other problems that can arise due to aging.
Suggestions of Use
In order to properly assess and treat a patient with impaired walking, several methods can be used. The patient’s gait pattern should be assessed and evaluated through observation during ambulation. A subjective assessment should also be conducted to determine the person’s level of discomfort. Additionally, a physical therapy evaluation should be performed to check alignment, coordination, and muscle strength as well as implementing exercise programs and strengthening plans that would improve the patient’s quality of life.
Suggested Alternative NANDA Nursing Diagnosis
For the purpose of diagnosis and management of impaired walking, alternate NANDA nursing diagnosis may be used such as Imbalanced Nutrition: Less than Body Requirements and Activity Intolerance. These conditions can further complicate the existing impaired walking situation as they are related to nutritional factors, physical capability, and balance.
Usage Tips
In order to effectively manage impaired walking, nurses and other healthcare professionals need to consider the following tips. Assesment of the patient’s previous functional levels need to be evaluated so that goals can be set for improvement. Care plans should be established in accordance to the patient’s needs and capabilities. The patient should be encouraged to fully participate in the therapeutic program. Additionally, making necessary adjustments in the patient’s environment should be considered in order to minimize the risks of falling.
NOC Outcomes
To be able to measure the effectiveness of the management and scenario of the impaired walking condition, the following NOC outcome measures should be taken into account: Ambulation,steadiness, coordination and balance, endurance, performance skills, lower-extremity strength, stability, mobility, and confidence level.
Evaluation Objectives and Criteria
In order to assess the success of the treatment plan and the patient’s improvement, these evaluation objectives and criteria need to be met. Assessment of gait pattern, speed, coordination, balance, steadiness, and stance should be observed and measured. Patient’s evaluation of physical therapy outcomes should be asked. Questions regarding discomfort and pain should be asked. Additionally, mental faculty and confidence level should be monitored.
NIC interventions
To ensure a successful treatment plan, nursing interventions should be implemented accordingly. These include monitoring for safety, proper positioning of the patient, exercising, promoting independence, teaching lifestyle adjustments, reinforcing compliance, instruction of aerobic and balance exercises, application of splints, bracing, and/or orthotics for stability, provision of assistive devices as needed, observation of pain levels and comfort, and supportive care.
Nursing Activities
The activities involved in providing care to a patient with impaired walking include reassurance, providing emotional support, education on the condition, compliance monitoring, proper positioning, safe ambulation, transfer guidance and assistance, observing gait pattern, body mechanics practice, promoting proper nutrition, nerve conduction studies, providing assistive devices, and performing splint-casting.
Conclusion
Impaired walking is a medical condition that requires proper diagnosis and handling by skilled medical professionals. With the help of NANDA nursing diagnosis and its associated interventions, nurses and healthcare workers can provide patients with the best care possible. Effective implementation of preventive strategies, individualized care plans, proper assessment and diagnosis, and evaluation criteria are all important measures that need to be taken when managing impaired walking.
FAQs
- Q: What is impaired walking?
A: Impaired walking is a medical condition that affects an individual’s ability to ambulate or move around in his environment, causing distress or a risk for physical injury. - Q: What are some factors that can contribute to impaired walking?
A: Chronic diseases, traumatic injuries to bones and muscles, infections, decreased muscle strength and endurance, use of certain medications, lowered sensory input from the extremities, and environmental hazards can contribute to impaired walking. - Q: What are the defining characteristics associated with impaired walking?
A: The defining characteristics of impaired walking include subjective and objective features. Subjective features involve reported experiences of the patient such as pain, dizziness, and restlessness while objective features comprise measurable signs such as fatigue, poor physical balance, and weakened lower body - Q: What is the best way to assess and treat a patient with impaired walking?
A: In order to properly assess and treat a patient with impaired walking, several methods should be used. This includes observer gait patterns, conducting a subjective assessment, physical therapy evaluation, encouraging the patient to participate in the program, and making necessary adjustments in the environment. - Q: What are the nursing interventions and activities involved in caring for a person with impaired walking?
A: The nursing interventions and activities involved in providing care to a patient with impaired walking include reassurance and emotional support, monitoring and education, positioning, safe ambulation, transfer guidance and assistance, providing assistive devices, practicing body mechanics, reinforcing compliance and independence, and performing splint-casting.