Plan for the important nursing care
1. Impaired Physical Mobility related to decreased muscle strength and control
• Perform development assessment and record age of achievement of milestones
• Plan activities to use gross and fine motor skills
• Perform range-of-motion exercises every 4 hours for the child unable to move body parts. Position the child to promote tendon stretching
2. Sensory/Perceptual Alteration: Visual or Auditory related to cerebral damage
• Facilitate eye and auditory examinations by specialist. Promote the use of adaptive devices and encourage recommended return visits to specialists.
• Maximize the use of intact senses
3. Altered Nutrition: Less than Body Requirements related to difficulty in chewing and swallowing and high metabolic needs
• Monitor height and weight and plot on a growth grid. Perform hydration status assessment.
• Teach the family techniques to promote caloric and nutrient intake
• Perform frequent respiratory assessment. Teach the family to avoid aspiration pneumonia. Teach care of gastrostomy and tube feeding technique as appropriate.
4. Ineffective Management of Therapeutic Regimen: Family related to excessive demands made on family with child’s complex care needs
• Allow opportunities for parents to verbalize the impact of cerebral palsy on the family. Provide referral to other parents and support groups.
• Teach the families skills needed to manage the child’s care
• Involve siblings in the care for the child with cerebral palsy. Review for parents the needs of all children in the family
5. Diversional Activity Deficit (Child) related to poor social skills
• Refer the family to early childhood stimulation programs. Encourage contact with other children. When hospitalized, place the child in a room with other children when possible.
• Work with the local school to develop an individualized education plan that allows the child contact with other children and a variety of activities.
• Investigate recreational programs for children with disabilities and share information with the parents.