Cirrhosis

Imbalance Nutrition: Less than Body Requirements related to anorexia,

metabolic imbalance
Activity Intolerance related to fatigue
Assess patient's level of mobility. This aids in defining what patient is capable of,
which is necessary before setting realistic goals.
Encourage adequate rest periods, especially before meals, other ADLs, exercise
sessions, and ambulation. Rest between activities provides time for energy
conservation and recovery. Heart rate recovery following activity is greatest at
the beginning of a rest period.
Risk for Impaired Skin Integrity related to edema, immobility, pruritis,
hypoproteinem Ineffective Breathing Patterns related to ascites Risk for Injury
related to impaired coagulation
Disturbed Thought Processes related to elevated blood ammonia

Copd
Ineffective airway clearance
Assess respirations: note quality, rate, pattern, depth, and breathing effort. Both
rapid, shallow breathing patterns and hypoventilation affect gas exchange.
Shallow, "sighless" breathing patterns postsurgery (as a result of effect of
anesthesia, pain, and immobility) reduce lung volume and decrease ventilation.
Avoid high concentration of oxygen in patients with COPD. Hypoxia stimulates
the drive to breathe in the chronic CO2 retainer patient. When applying oxygen,
close monitoring is imperative to prevent unsafe increases in the patient’s PaO2,
which could result in apnea.

NOTE: If the patient is allowed to eat, oxygen still must be given to the patient
but in a different manner (e.g., changing from mask to a nasal cannula). Eating is
an activity and more oxygen will be consumed than when the patient is at rest.
Immediately after the meal, the original oxygen delivery system should be
returned.

Stroke
Impaired Physical Mobility

Evaluate the safety of the immediate environment. Obstacles such as throw

rugs, children’s toys, and pets can further impede one’s ability to ambulate
safely.
 Provide positive reinforcement during activity. Patients may be reluctant to
move or initiate new activity due to a fear of falling.
Allow patient to perform tasks at his or her own rate. Do not rush patient.
Encourage independent activity as able and safe. Hospital workers and family
caregivers are often in a hurry and do more for patients than needed, thereby
slowing the patient’s recovery and reducing his or her self-esteem.