Nursing Diagnosis: Application to Clinical Practice
11th Edition

Impaired Walking
DEFINITION
Impaired Walking: State in which a person experiences, or is at risk of experiencing, limitation in walking
DEFINING CHARACTERISTICS
Impaired ability to climb stairs
Impaired ability to walk required distances
Impaired ability to walk on an incline
Impaired ability to walk on uneven surfaces
Impaired ability to navigate curbs
RELATED FACTORS
P.494

Focus Assessment Criteria
Goal
The person will increase walking distances (specify distance goal).
Indicators
  • Demonstrate safe mobility.
  • Use mobility aids correctly.
General Interventions
Explain that safe ambulation is a complete movement involving the musculoskeletal, neurologic, and cardiovascular systems and cognitive factors such as mentation and orientation.
A person who is deconditioned needs a progressive exercise program. Consult with a physical therapist for evaluation and planning.
Ascertain that client is using ambulatory aids (eg, cane, walker, crutches) correctly and safely.
  • Wears well-fitting shoes
  • Can ambulate on inclines, uneven surfaces, and up and down stairs
  • Is aware of hazards (eg, wet floors, throw rugs)
Provide progressive mobilization if indicated.
  • Assist slowly to a sitting position.
  • Allow person to dangle legs over the side of the bed for a few minutes before standing.
  • Limit the time to 15 min, three times a day, the first few times out of bed.
  • Increase time out of bed, as tolerated, by 15-min increments.
  • Progress to ambulation, with or without assistive devices.
If client cannot walk, assist him or her out of bed to a wheelchair or chair.
Encourage ambulation for short frequent walks (at least three times daily), with assistance if unsteady.
Increase lengths of walks progressively each day.
Evaluate response to ambulation.
Refer to Activity Intolerance if needed.
Refer to Activity Intolerance and Risk for Falls.