Domain 4. Activity-rest
Class 2. Activity-exercise
Diagnostic Code: 00040
Nanda label: Risk for disuse syndrome
Diagnostic focus: Disuse syndrome
A Nursing Diagnosis is a clinical judgment about an individual, family or community response to actual or potential problems/life processes. It is a clinical judgement about the individual, family or community responses to actual and potential health problems. Nursing Diagnoses are the basis for selection of nursing interventions to achieve outcomes for which the nurse is accountable. An appropriate nursing diagnosis reflects the nurse’s understanding of the nursing process.
NANDA Nursing Diagnosis Definition
Risk for disuse syndrome is a NANDA nursing diagnosis classified in the domain of altered health maintenance, and defined as “a state in which an individual is at risk for impaired functioning due to possibly experiencing decreased use of body parts or movement”.
Risk Factors
There are many factors that can contribute to an individual being at a greater risk of developing a disuse syndrome, including: physical inactivity, chronic illnesses such as arthritis, diabetes or stroke, trauma or injury, surgery, being bedridden due to illness, medication side effects and aging.
Associated Conditions
The associated conditions of disuse syndrome may include reduced range of motion, muscle atrophy and weakness, joint stiffness, pressure related wounds, increased risk of fracture, impaired balance and coordination and decreased physical endurance. Other conditions can also coexist, such as depression, anxiety, fatigue and impaired cognitive function.
Suggestions for Use
The best way to prevent disuse syndrome is to ensure the patient remains active, with appropriate levels of exercise and physical activity. It is important for nurses to assess for risk factors for developing disuse syndrome, so appropriate interventions can be implemented early to maintain physical functioning and reduce complications associated with disuse syndrome.
Suggested Alternative NANDA Nursing Diagnosis
Other NANDA nursing diagnosis which may apply to patients at risk of disuse syndrome may include: Impaired physical mobility, Activity intolerance, Risk for falls, Risk for impaired skin integrity, Risk for other-directed violence, Risk for ineffective health management and Risk for injury.
Usage Tips
When assessing for and diagnosing patients with disuse syndrome, consider not just the physical functional limitations brought on by the disuse syndrome, but also the impact on mental health and the patient’s overall wellbeing.
NOC Outcome
When managing patients with disuse syndrome, it is important to focus on a number of outcomes, as classified by NOC – Nursing Outcome Codes, which include: Physical mobility, Attainment of therapeutic regimen, Balance, Fear and Anxiety, Self-care and Activities of daily living.
Explanation
The Physical Mobility NOC outcome focuses on the patient maintaining their physical capabilities, in terms of safe and independent mobility, joint flexibility, and ability to perform activities of daily living. The Attainment of therapeutic regimen outcome focuses on the patient understanding, remembering and completing the instructions of their therapeutic regime. Balance focuses on maintaining balance both statically and dynamically, and being able to transfer from one position to another and move safely in any environment. Fear and Anxiety focuses on recognizing fear and feelings affecting the patient in order to effectively manage them. Self-care outcome focuses on the patient engaging in activities that allow for self care and maintenance of personal safety and comfort. Activities of daily living outcome focuses on the patient performing the activities of daily living, such as dressing, bathing, maintaining good hygiene, food preparation and eating.
Evaluation Objectives and Criteria
When evaluating the effectiveness of care received by a person with disuse syndrome, there are a number of objectives and critical parameters to measure progress towards desired wellness outcomes. These objectives and parameters include: regaining physical strength and improving range of motion; maintaining balance; being able to independently meet self-care needs and perform activities of daily living; understanding and following a therapeutic plan; psycho-social support and preventing the development of further physical or functional damage.
NIC Interventions
NIC Interventions are specific strategies or actions that must be observed in the provision of nursing care. In managing disuse syndrome, some of the NIC Interventions that can be implemented include: Bed Mobility, Transfer Training, Exercise Therapy, Home Exercise Program, Education: Activity/Exercise, Education: Disease Process, Nutrition Management and Psychosocial Support.
Explanation
Bed Mobility is the use of assistive devices, such as bed beds, to facilitate safe and comfortable movement for a person with disuse syndrome. Transfer Training is the use of assistive devices, such as transfer belts, to help the person to transfer from one position to another independently. Exercise Therapy is the use of various activities to improve physical functioning, strength and range of motion. Home Exercise Program is the provision of customized exercises that the patient can do at home to maintain range of motion and function. Education on Activity/Exercise is to create awareness on the importance of staying active and aiming for a healthier lifestyle. Education on Disease Process is to educate the patient on what the cause of the disuse syndrome is and how to manage it better. Nutrition Management is to provide the patient with a healthy, balanced and nutritionally adequate diet. Psychosocial Support is to provide emotional, social and spiritual support to the patient; to help them cope with the symptoms of disuse syndrome and maintain quality of life.
Nursing Activities
In providing care for a person with disuse syndrome, nurses need to do a thorough assessment of the patient, before implementing any care plan. During assessment, the nurse needs to obtain information about the patient’s medical history, current physical condition, symptoms, and nutritional status, with supporting documents from the patient’s medical team. Once all of the information has been gathered, nurses then need to develop an individualized plan of care for the patient.
In providing nursing care for the patient, nurses should focus not only on relieving symptoms, but also on improving patient function and quality of life. This can involve helping the patient to restore physical capacity and learn new ways to meet their self-care needs. A key role of nursing care of people with disuse syndrome is to teach and incite the them to remain fixed in a program of physical activity. In doing so, they might increase the range of motion, reduce pain, and enhance independence.
Conclusion
Disuse Syndrome is a condition that puts individuals at a high risk for impaired functioning. It’s important for nurses to recognize the signs and symptoms, as well as the risk factors, associated conditions and complications, when assessing for disuse syndrome. Nursing care for people with disuse syndrome needs to be comprehensive and evidence based to ensure maximal outcomes. Nurses need to keep in mind the importance of providing emotional, social and spiritual support in addition to physical treatment, in order to maximize the patient’s quality of life.
FAQs
- What is a Disuse Syndrome?
A disuse syndrome is a physical condition caused by limited or restricted use of certain body parts or movements. Over time, this lack of use can lead to physical impairment, physical dysfunction, and decreased mobility.
- What causes Disuse Syndrome?
Many factors can contribute to an individual being at risk of developing disuse syndrome, including: physical inactivity, chronic illnesses such as arthritis, diabetes or stroke, trauma or injury, surgery, being bedridden due to illness, medication side effects and aging.
- What are the associated conditions of Disuse Syndrome?
The associated conditions of disuse syndrome may include reduced range of motion, muscle atrophy and weakness, joint stiffness, pressure related wounds, increased risk of fracture, impaired balance and coordination and decreased physical endurance. Other conditions can also coexist, such as depression, anxiety, fatigue and impaired cognitive function.
- What interventions can be used to manage Disuse Syndrome?
When managing patients with disuse syndrome, some of the NIC interventions that can be used include: Bed Mobility, Transfer Training, Exercise Therapy, Home Exercise Program, Education: Activity/Exercise, Education: Disease Process, Nutrition Management and Psychosocial Support.
- What types of evaluation is used for Disuse Syndrome?
When evaluating the effectiveness of care received by a person with disuse syndrome, there are a number of objectives and critical parameters to measure progress towards desired wellness outcomes. These objectives and parameters include: regaining physical strength and improving range of motion; maintaining balance; being able to independently meet self-care needs and perform activities of daily living; understanding and following a therapeutic plan; psycho-social support and preventing the development of further physical or functional damage.