Rehabilitative Nursing - Adult Health I

Objective:
- Identify, reach, and maintain optimal levels of health in various domains: physical, sensory, intellectual, psychological, and/or social.
Focus:
- Emphasize existing abilities to promote independence, self-determination, and social integration.
Goal of Rehabilitation Nursing:
  - Assist patients in achieving and sustaining optimum health as defined by the patient themselves.
  - Maximize independence and prevent secondary disability.
  - Promote a quality of life that is acceptable to the patient.

Key Roles in Rehabilitation:
  - Patient / Family: Central to decision-making and goal-setting.
  - Nurses: Provide ongoing assessment and care plans.
  - Physicians and Nurse Practitioners: Oversee medical treatment and guide rehabilitation strategies.
  - Therapists:
    - Physical Therapy (PT)
    - Occupational Therapy (OT)
    - Speech Therapy
    - Recreational Therapy
  - Social Workers: Facilitate access to resources and assist with social integration.
  - Psychologists: Address mental health aspects and coping mechanisms.
  - Spiritual Advisors: Offer support for psychological and emotional recovery.

Ambulation & Mobility:
- Prevent contractures through proper movement (e.g., range of motion exercises).
Independence in Activities of Daily Living (ADLs):
- Promote autonomy by allowing patients to perform as many self-care tasks as possible.
Prevent Secondary Disabilities:
  - Monitor and address:
    - Urinary issues (e.g. urinary retention, urinary tract infections).
    - Proper body alignment during mobility.

Patients recovering from procedures such as hip or knee replacements may require specialized support.
Risks:
  - Infection due to prolonged hospitalization.
  - Muscle atrophy (to counteract: promote mobility).
  - Mental health concerns such as depression due to loss of independence or body image issues.

Definition:
- Self-care activities necessary for daily living (e.g., bathing, grooming, dressing, feeding, toileting).

Definition:
- More complex skills required for independent living (e.g., meal preparation, grocery shopping, household management, financial tasks, transportation).

Potential diagnoses can be created based on the observation of the patient's performance in these activities.
Clinical Scenario Example:
  - A client being discharged after a hemorrhagic stroke might require referrals based on their IADL needs.
  - Recommended Referral Options:
    - a) Occupational therapy
    - b) Physical therapy
    - c) Speech therapy
    - d) Case management

Types of Goals:
- Short-term and long-term goals tailored to individual patient needs.
- Focus on allowing patients to independently perform essential activities or with assistance.

Encourage appropriate use of assistive devices for enhancing patient independence.
Foster patient satisfaction concerning their degree of independence.

Interventions May Include:
- Assessing and recommending assistive or adaptive devices to aid mobility and daily functioning.
- Supporting patients in accepting personal limitations while actively encouraging their capabilities.
Risks to Consider:
  - Risk of injury (e.g., falls).
  - Risk of aspiration due to improper feeding or swallowing.
  - Activity intolerance impacting gas exchange.
Example Support Equipment:
- Walkers, wheelchairs, ramps for home use.
- Special utensils weighted for easier handling in patients with Parkinson’s Disease or other motor impairments.

Resources Required for Rehabilitation:
- Understanding that a mix of people, tools, and equipment may be necessary to help return a patient to their highest possible level of functioning.

Hinkle, J. L., Cheever, K. H., & Overbaugh, K. (2026). Brunner & Suddarth’s textbook of medical-surgical nursing (16th ed.). Wolters Kluwer.