erBprolongedBbedBrest.BEnhanceByourBunderstandingBofBnursingBassessment,Bintervent
ions,Bgoals,BandBnursingBdiagnosis,BallBspecificallyBtailoredBtoBaddressBtheBuniqueBnee
dsBofBindividualsBunderBprolongedBbedBrest.
WhatBisBbedBrest?
BedBrestBisBtherapeuticallyBusedBasBaBmeansBtoBdecreaseBtheBmetabolicBdemandBon
BtheBbodyBandBpromoteBrecoveryBduringBanBillness.BHowever,BprolongedBbedBrestBm
ayBhaveBdeleteriousBeffectsBonBtheBcardiovascular,Brespiratory,Bmusculoskeletal,Bintegu
mentary,BandBcognitiveBsystemsBofBtheBpatientBwhichBmayBleadBtoBtheBonsetBofBdise
asesBresultingBinBirreversibleBdamage.BWithBpatientsBbeingBreleasedBearlierBfromBtheB
hospital,BmostBofBtheBhealthcareBproblemsBareBbeingBmanagedBinBassistedBlivingBfacil
itiesB(nursingBhomes)BorBatBhome.
NursingBcareBplanBgoalsBforBpatientsBonBprolongedBbedBrestBincludeBmaintainingBperi
pheralBandBcerebralBtissueBperfusion,BmaximizingBtheBpatient’sBfunctionalBability,Bmain
tainingBbowelBfunction,BBpromotingBsexualBfunctioning,BpreventingBdisuseBsyndrome,B
achievingBaBmaximumBlevelBofBself-
care,BandBmanagingBpotentialBhealthBcomplications.
NursingBCareBPlansBandBManagement
TheBnursingBcareBplanBforBpatientsBonBprolongedBbedBrestBfocusesBonBmaintainingBp
atientBcomfort,BpreventingBcomplicationsBsuchBasBdeepBveinBthrombosis,BmuscleBwasti
,ng,BandBurinaryBtractBinfections,BandBpromotingBphysicalBandBpsychologicalBwell-
being.
NursingBProblemBPriorities
TheBfollowingBareBtheBnursingBprioritiesBforBpatientsBonBprolongedBbedBrest:
• AssessBandBpreventBcomplicationsBofBprolongedBbedBrest.
• AssistBwithBrepositioningBandBmobilityBexercises.
• MonitorBvitalBsignsBandBrespiratoryBfunction.
• ProvideBeducationBandBemotionalBsupport.
• CoordinateBwithBhealthcareBproviders.
• ScheduleBregularBassessmentsBandBinterventions.
• SupportBgradualBreintegrationBintoBactivity.
NursingBAssessment
AssessBforBtheBfollowingBsubjectiveBandBobjectiveBdata:
• FatigueBandBweakness
• PainBorBdiscomfortBinBtheBmusclesBorBjoints
• DifficultyBsleepingBorBchangesBinBsleepBpatterns
• FeelingsBofBboredom,Bfrustration,BorBrestlessness
• DecreasedBmuscleBstrengthBandBtone
• LossBofBmuscleBmassBorBatrophy
• LimitedBrangeBofBmotionBinBjoints
• PresenceBofBpressureBulcersBorBskinBbreakdown
• ChangesBinBvitalBsigns,BsuchBasBincreasedBheartBrateBorBdecreasedBbloodBpres
sure
• EdemaBorBswellingBinBtheBextremities
NursingBDiagnosis
AfterBthoroughBassessment,BnursingBdiagnosesBareBformulatedBtoBaddressBtheBchallen
gesBofBprolongedBbedBrest,BguidedBbyBtheBnurse’sBclinicalBjudgmentBandBunderstandi
ngBofBtheBpatient’sBuniqueBcondition.BWhileBnursingBdiagnosesBhelpBorganizeBcare,Bth
eirBuseBmayBvaryBacrossBclinicalBsettings.BUltimately,BtheBnurse’sBexpertiseBandBjudgm
entBshapeBtheBcareBplanBtoBprioritizeBeachBpatient’sBneeds.BHereBareBexamplesBofBn
, ursingBdiagnosesBthatBmayBbeBusefulBforBcommonBconcernsBassociatedBwithBprolonge
dBbedBrest:
• RiskBforBImpairedBSkinBIntegrityBasBevidencedBbyBimmobility,BpressureBoverBb
onyBprominences,BandBdecreasedBmovementBduringBbedBrest.
• ImpairedBPhysicalBMobilityBrelatedBtoBprolongedBbedBrestBasBevidencedBbyBm
uscleBweakness,BlimitedBrangeBofBmotion,BandBdecreasedBmuscleBmass.
• ImpairedBGasBExchangeBrelatedBtoBdecreasedBlungBexpansionBasBevidencedBby
BshallowBbreathing,BdiminishedBbreathBsounds,BandBfatigue.
• RiskBforBConstipationBdueBtoBreducedBphysicalBactivityBandBinadequateBfluidBi
ntake.
• ActivityBIntoleranceBrelatedBtoBimmobilityBandBmuscleBatrophyBasBevidencedBb
yBweakness,BshortnessBofBbreathBuponBexertion,BandBincreasedBheartBrateBwit
hBactivity.
• RiskBforBDisuseBSyndromeBasBevidencedBbyBprolongedBinactivityBandBbedBrest,
BincreasingBsusceptibilityBtoBmuscleBatrophy,BjointBcontractures,BandBdecreased
Bstrength.
• RiskBforBPowerlessnessBasBevidencedBbyBdependencyBonBothersBforBcareBneed
sBandBlossBofBautonomyBduringBextendedBbedBrest.
NursingBGoals
GoalsBandBexpectedBoutcomesBmayBinclude:
• TheBpatientBwillBhaveBadequateBperipheralBperfusionBasBevidencedBbyBnormalB
skinBcolorBandBtemperatureBandBadequateBdistalBpulsesB(greaterBthanB2+BonBa
B0-4+Bscale)BinBperipheralBextremities.
• TheBpatientBwillBperformBexercisesBindependently,BcomplyBwithBtheBprophylacti
cBtherapy,BandBmaintainBanBintakeBofB2-
3BlitersBperBdayBofBfluidBunlessBcontraindicated.
• TheBpatientBwillBrelateBsatisfactionBwithBsexualityBandBunderstandingBofBtheBa
bilityBtoBresumeBsexualBactivity.
• TheBpatientBwillBverbalizeBknowledgeBofBstrategiesBthatBpromoteBbowelBelimin
ation.
• TheBpatientBwillBstateBtheBreturnBofBnormalBpatternBandBcharacterBofBbowelB
eliminationBwithinB3-5BdaysBofBthisBdiagnosis.
• TheBpatientBandBcaregiversBwillBdevelopBrealisticBgoalsBforBindependenceBandB
participationBinBself-care.