Patient- 14y/o male

Medical Dx- Spastic Cerebral Palsy, Osteopenia

Risk for Constipation R/T Immobility 1.Increase fluid intake PO greater than 600 mL day and evening shift. 300 mL night shift. -Fluid intake decreases chances of dehydration which is a cause of constipation. Fluids will increase bulk and softness of stool. 2. Administer Polyethlene PO once a day for 2 weeks when constipation is present. - Polyethelene causes water to be retained within the stool. This increases the number of bowel movements and softens the stool so it is easier to pass. 3. Increase fiber intake with every meal. ( whole grains, fruits, green leafy vegetables) -Fiber increase bulk of stool aiding peristalsis.

Risk for Fractures R/T Lower than normal bone mineral density. (Dx Osteopenia) 1. Monitor patient while being ambulated in the wheel chair. Make sure arms are inside the wheel chair while moving. (Hands are not grasping the wheels). Legs cannot hit hard surfaces. -Any movements causing impact to the extremities may cause a fracture. 2. Wear loose fitting clothing. One size larger than clients size. - Trying to apply tight fitted clothing to a person with decreased range of motion will increase risk for fractures due to manipulating the body. 3. Keep ambulatory parts including the extremities moving. Have client attend group activities like gym and playing music. (the drums are great for soft impact). -Increased use of bone structure in the extremities will increase bone density.

Chronic Decreased Self Esteem R/T Disturbed body image. 1. Give client jobs to do to increase self esteem like playing the guitar. Compliment their ability. -Children at his developmental age aim to please, and also strive to be creative.

2. Sit and talk to the patient about whatever he or she wants for 15 minutes q morning and evening shift. - When time is taken to communicate with the client, he/she is able to express themselves on a daily basis. They may also understand and appreciate that someone does care about what they have to say. 3. Have the client wear age appropriate clothing that reflects their personal interests. -The client will have an increased self esteem when they feel they are treated with a sense of normalcy. They want to look like their peers while also expressing their own style.