QLexNursing

1️⃣ Passive range-of-motion (PROM) exercises to lower extremities performed once each day 🦵

🛏️Why requires intervention: In clients with paraplegia, daily PROM is not enough to prevent joint stiffness, contractures, and muscle shortening. PROM should be performed at least 2–3 times daily on all affected joints.

🛏️Purpose: Maintains joint flexibility, stimulates circulation, and prevents musculoskeletal complications in immobile clients.

🛏️Best practice: Include all joints, moving them slowly and smoothly through their full range without causing pain.

2️⃣ Plantar flexion contractures noted bilaterally 🦶

🛏️Why requires intervention: Contractures indicate loss of joint mobility due to prolonged positioning without adequate stretching or use of supportive devices.

🛏️Complications: Can lead to foot drop, impaired mobility during rehabilitation, and difficulty with transfers or brace fitting.

🛏️Prevention & care: Use footboards, splints, or high-top sneakers, along with frequent PROM and proper positioning, to keep ankles at a 90° angle and maintain functional alignment.

3️⃣ Left heel has 1.3 cm x 1.3 cm area of nonblanchable erythema; skin is intact 🛏️

🛏️Why requires intervention: Nonblanchable erythema is a Stage 1 pressure injury, indicating early tissue damage from unrelieved pressure.

🛏️Risk factors: Paraplegia, immobility, and reduced sensation make this client highly susceptible to worsening skin breakdown.

🛏️Intervention: Relieve pressure from the heel immediately using pillows, heel protectors, or floating the heels off the bed. Increase repositioning frequency for at-risk areas (possibly every 1 hr for heels) and monitor skin closely.