Two Nursing Interventions with Rationale for EACH Nursing Diagnosis

Designing a Care Map

Assessment

and

Data Collection
Three NANDA-I Approved Nursing Diagnosis
One Smart Goal for EACH Nursing Diagnosis
Two Nursing Interventions with Rationale for EACH Nursing Diagnosis

Disease Process:

Imbalance of bone resorption and re-modelling resulting in decreased skeletal mass.

Common Labwork/Diagnostics:

Assessment of bone mineral density using a dual X-ray absorptiometry. This test reveals the bone mineral density of skeletal muscle and may reflect the likelihood of developing the disease.

Assessment Data (consider subjective, objective, and health history):

Subjective findings in osteoporosis are positive of various risk factors for the disease. Significant history of smoking, heavy alcohol consumption, age, and female gender are risk factors for the disease. Family history of the disease and history of fractures are also subjective findings suggestive of osteoporosis.

Objective data:

Loss of height and kyphosis are suggestive of osteoporosis.

Nursing Diagnosis:

Risk for falls related to bone breakage and stooped posture. This is evidenced by muscular weakness and poor postural control.

Nursing Diagnosis:

Impaired physical mobility related to muscular weakness and susceptibility to fracture. This is evidenced by loss of bone mass and lower back pain.

Nursing Diagnosis

Impaired walking is related to poor postural control and muscular weakness. This is evidenced by spine kyphosis, lower back pain, and fragility-related fractures.
SMART Goal:

Reduce the chances of a patient falling and sustaining a physical injury from falls

SMART Goal:

Perform physical activity independently or to the agreeable limits of the disease.

SMART Goal:

Walk independently at a regular pace without the use of assistive devices.
1. Design a patient-centred plan for preventing falls. This approach will tailor fall preventive interventions to the individual presentation of the patients (Montejano-Lozoya et al., 2020). This may include lowering the bed to reduce the distance to the ground, using assistive devices, frequent rounding, and having a companion.

2. Provide signs that are indicative of the patient’s risk for falling. This may remind healthcare providers to implement fall precautionary measures for the patient.

1. Assist patients with muscular exercises such as aerobics. This enables patients to gain an enhanced sense of balance. These exercises also strengthen the compensatory body parts enabling patients to have enhanced mobility (Ferreira & Duran, 2019).

3. Present a safe clinical and home environment, such as putting things that the patient often uses close to them. This may reduce the chances of the patients incurring injuries from falls.

1. Implement passive or assistive exercise on the lower extremities. This enhances their stamina, increases their lower extremities muscle mass, increases venous return, and prevents stiffness (Gideon Asuquo et al., 2021).

4. Implement measures to prevent thrombophlebitis due to the patient’s inability to walk. These include the use of embolic stockings and use of pressure-relieving devices. This increases venous return and blood flow to the extremities.

References
Ferreira, R. C., & Duran, E. C. (2019). Clinical validation of nursing diagnosis “00085 impaired physical mobility” in multiple traumas victims. Revista Latino-Americana De Enfermagem, 27. https://doi.org/10.1590/1518-8345.2859.3190

Gideon Asuquo, E., Tighe, S. M., & Bradshaw, C. (2021). Interventions to reduce work-related musculoskeletal disorders among healthcare staff in nursing homes; an Integrative Literature Review. International Journal of Nursing Studies Advances, 3, 100033. https://doi.org/10.1016/j.ijnsa.2021.100033

Montejano-Lozoya, R., Miguel-Montoya, I., Gea-Caballero, V., Mármol-López, M. I., Ruíz-Hontangas, A., & Ortí-Lucas, R. (2020). Impact of nurses’ intervention in the prevention of falls in hospitalized patients. International Journal of Environmental Research and Public Health, 17(17), 6048. https://doi.org/10.3390/ijerph17176048

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Assessment and Data Collection	Three NANDA-I Approved Nursing Diagnosis	One Smart Goal for EACH Nursing Diagnosis	Two Nursing Interventions with Rationale for EACH Nursing Diagnosis
Disease Process: Imbalance of bone resorption and re-modelling resulting in decreased skeletal mass. Common Labwork/Diagnostics: Assessment of bone mineral density using a dual X-ray absorptiometry. This test reveals the bone mineral density of skeletal muscle and may reflect the likelihood of developing the disease. Assessment Data (consider subjective, objective, and health history): Subjective findings in osteoporosis are positive of various risk factors for the disease. Significant history of smoking, heavy alcohol consumption, age, and female gender are risk factors for the disease. Family history of the disease and history of fractures are also subjective findings suggestive of osteoporosis. Objective data: Loss of height and kyphosis are suggestive of osteoporosis.	Nursing Diagnosis: Risk for falls related to bone breakage and stooped posture. This is evidenced by muscular weakness and poor postural control. Nursing Diagnosis: Impaired physical mobility related to muscular weakness and susceptibility to fracture. This is evidenced by loss of bone mass and lower back pain. Nursing Diagnosis Impaired walking is related to poor postural control and muscular weakness. This is evidenced by spine kyphosis, lower back pain, and fragility-related fractures.	SMART Goal: Reduce the chances of a patient falling and sustaining a physical injury from falls SMART Goal: Perform physical activity independently or to the agreeable limits of the disease. SMART Goal: Walk independently at a regular pace without the use of assistive devices.	1. Design a patient-centred plan for preventing falls. This approach will tailor fall preventive interventions to the individual presentation of the patients (Montejano-Lozoya et al., 2020). This may include lowering the bed to reduce the distance to the ground, using assistive devices, frequent rounding, and having a companion. 2. Provide signs that are indicative of the patient’s risk for falling. This may remind healthcare providers to implement fall precautionary measures for the patient. 1. Assist patients with muscular exercises such as aerobics. This enables patients to gain an enhanced sense of balance. These exercises also strengthen the compensatory body parts enabling patients to have enhanced mobility (Ferreira & Duran, 2019). 3. Present a safe clinical and home environment, such as putting things that the patient often uses close to them. This may reduce the chances of the patients incurring injuries from falls. 1. Implement passive or assistive exercise on the lower extremities. This enhances their stamina, increases their lower extremities muscle mass, increases venous return, and prevents stiffness (Gideon Asuquo et al., 2021). 4. Implement measures to prevent thrombophlebitis due to the patient’s inability to walk. These include the use of embolic stockings and use of pressure-relieving devices. This increases venous return and blood flow to the extremities.