7 Cerebral Palsy Nursing Care Plans

Impaired Physical Mobility

Impaired physical mobility in cerebral palsy patients is due to damage to the areas of the brain responsible for controlling motor function, muscle tone, and coordination. This damage results in difficulty with voluntary movements and can cause stiffness or spasticity in the muscles, making it challenging to move around.

Nursing Diagnosis

• Impaired Physical Mobility

May be related to

• Disease condition (Cerebral Palsy)
• Decrease muscle control
• Neuromuscular impairment

Possibly evidenced by

• Inability to control lower extremities
• Limited range of motion (ROM)
• Muscle spasm

Desired Outcomes

• The child/infant will achieve maximum movement ability and absence of contractures.

Nursing Assessment and Rationales

1. Assess the type of auditory, visual, motor, or intellectual deficit.
Knowing the type of deficit will aid in planning interventions appropriate for the child.

2. Do a developmental assessment and note the development of milestones (such as standing with help, or walking when led).
A client with cerebral palsy usually has delayed developmental milestones.
If one skill is attained, interventions are changed in order to achieve
the succeeding one.

Nursing Interventions and Rationales

1. Facilitate activities in using fine and gross motor skills (such as giving a ball on hand to encourage throwing, or holding a spoon)
Most of the activities of daily living and
play exercises hasten physical
development.

2. Allow the child to perform activities or care routines at his or her own pace.
A child may have difficulty completing tasks in time compared to normal children.

3. Encourage the child to rest between activities that are tiring.
Given the limitations of the child’s ability, rest periods are given to maintain energy.

4. Perform range-of-motion exercises every 4 hours for the child unable to move body parts.
Children with cerebral palsy have a decreased range of motion (ROM) due to limited mobility and the presence of spasticity. ROM exercises promote movement and minimize the risk of contractures.

5. Educate the family on how to use an orthotic device as indicated.
Orthotic devices help build stability while increasing strength, balance, comfort, and independence.

6. Administer medications as prescribed: 

• 6.1. Anticholinergics (e.g., Benztropine mesylate)
  These medications are used to treat uncontrolled body movements such as tremors, muscle stiffness, and spasms.

• 6.2. Muscle relaxants (e.g., Baclofen [Lioresal])
  These medications are used to relax contracted, overactive, or stiff muscles.

• 6.3. Anticonvulsants (e.g., Gabapentin [Neurontin])
  These medications are given to reduce or prevent seizure activity.

7. Assist the parents in referring the child to a rehabilitation therapist as appropriate.
A rehabilitation therapist can provide specialized services in promoting effective mobility.