Nursing Essay Example: Cerebral Palsy and Nursing Diagnoses

In a patient with cerebral palsy, there are various nursing diagnoses that a nurse would be able to pick depending on the patient's presentation. In the described scenario one nursing diagnosis is impaired physical motility related to neuromuscular impairment due to cerebral palsy (Ladwig, Ackley & Makic, 2017). This nursing diagnosis is evidenced by the infant is 11 months old and not being able to roll over or attempting to sit. Also, he has hypertonia of the lower limbs which limits the purposeful physical movement of the infant's body. The infant is already behind on the expected milestones by his age. He should be able to sit down, roll over and reach for objects by now. Such motor activities develop early in an infant's life. The hypertonic state of his lower limbs predisposes the patient to contractures at the limb joints which would further worsen the condition and cause the infant not to learn how to walk. The expected outcome for the infant is that he will obtain maximum physical mobility without developing contractures and achieve all the developmental milestones.

The nurses have a significant role in the management of an infant with cerebral palsy. It is through their interventions that the patient's health goals will be realized. One such intervention that nurses can undertake is to assist the infant in doing activities that involve gross and fine motor skills (Pillitteri, 2014). These motor activities enable the infant to hasten physical growth and development. Such skills include holding objects such as pens or spoons in their hands and positioning of toys to encourage the infant to reach out and roll over. The nurses should teach the infant how to sit, crawl, stand with support and make small steps when held. These activities should be done at the pace of the infant allowing them to rest between activities. These patients have limited ability compared to other children and therefore rest periods are vital for the maintenance of energy. When one motor skill is achieved, the next one should be undertaken to enable them to catch up on the developmental milestones.

The second intervention that should be undertaken is performing of physical therapy and range of motion exercises for the lower limbs when the infant is alert (Pillitteri, 2014). The increased tonicity in the limbs is a result of spasticity which prevents motion at the joints which put the infants at an increased risk for development of contractures. The ranges of motion exercises include flexion, extension, abduction, adduction, and rotation of joints to promote movement and discourage the development of contractures. When correctly done it would be a pivotal intervention that would determine the ability of the child to crawl and eventually walk. Physical therapy also includes the use of orthotic devices that help build strength and stability in the limbs. The family members can also be educated on how to assist the child in doing limb exercises which promote mobility and joint flexibility.

The management of cerebral palsy requires a multi-disciplinary approach. The nurse should work with family counselors to manage the family. The mother of the infant is having a rough time accepting the new diagnosis of her child which may lead to chronic sorrow. The counselor would play a vital role in advising the family on how to cope with the daily needs of the child (Pillitteri, 2014). She would teach the parents the need to express their feelings about the infant's disease and how to join groups formed for parents with children having similar conditions.

References

Ladwig, G., Ackley, B., & Makic, M. (2017). Mosbys guide to nursing diagnosis (5th ed.). St. Louis, MO: Elsevier.

Pillitteri, A. (2014). Maternal and child health nursing: Care of the childbearing and childrearing family (7th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.