ASSESSMENT Subjective data: Nasakit ti tumeng ku, as verbalized by the patient.

. Pain scale: 7/10 Objective data: Facial grimace

DIAGNOSIS Acute pain related to inflammation of the joints secondary to disease process

PLANNING At the end of 30 minutes, the patient will be able to report reduced pain as evidenced by: A decrease pain scale from 7/10 to 2/10 6/10 Absence of facial grimace

INTERVENTIONS INDEPENDENT Encouraged verbalization of feelings and concerns about pain

RATIONALE

EVALUATION Goal met.

to reduce concern of the unknown and associated muscle tension to distract attention and reduce tension to promote relaxation

Encouraged diversional activities such as watching television and talking to her SO Taught patient on how to do deep breathing exercise and encouraged the patient to do it frequently Provided a calm and well-ventilated environment Provided adequate rest periods Provided therapeutic touch Placed pillow under both knees. Encouraged frequent

At the end of 30 minutes, the patient was able to report reduced pain as manifested by decreased pain scale from 7/10 to 4/10 and absence of facial grimace

to prevent fatigue to prevent fatigue to promote feeling of comfort to reduce pressure on the inflamed joint. to prevent the occurrence of

change of position

general fatigue and joint stiffness.

DEPENDENT to reduce pain Administered Mefenamic acid 500 mg as ordered.

ASSESSMENT Subjective data: Haan nak unay makagaraw gamin nasakit atoy tumeng ku, as verbalized by the patient. Pain scale: 7/10 Objective data: Facial grimace Limited range of motion Muscle strength of both legs: 2 (Passive ROM) Reluctant to move Slowed movement

DIAGNOSIS Impaired Physical Mobility related to pain secondary to gouty arthritis

PLANNING At the end of the shift, the patient will be able to increase strength and function of the affected body part as evidenced by: performing range of motion exercises with minimal assistance improved muscle strength (muscle strength: 3-5)

INTERVENTIONS INDEPENDENT Determined degree of immobility in relation to functional level scale Assisted client in repositioning herself in a regular schedule from side to side Provided with adequate rest periods Emphasized low salt, low fat and low purine diet Monitored continuously degree of joint inflammation or pain

RATIONALE

EVALUATION Goal met.

to assess functional ability

to decrease numbness and pain. to help ease the pain to promote bone healing level of activity or exercise depends on progression and resolution of inflammation process to maintain or improve joint function, muscle strength, and

At the end of the shift, the patient was able to increase strength and function of the affected body part as evidenced by performing range of motion exercises with minimal assistance and improved muscle strength from 2 to 3.

Assisted patient with active and passive range of motion

general stamina Encouraged to increase oral fluid intake to assist with excretion of uric acid and decrease likelihood of stone formation to minimize energy consumption to reduce fatigue and improve strength to prevent acute attack

Maintained patient on bed rest Encouraged patient to eat foods rich in iron Encouraged patient to move the affected part from time to time Supported affected body part with pillow

to maintain position of function and reduce risk of pressure ulcers

DEPENDENT Collaborated with the physical therapist regarding patients rehabilitation

to improve joint function, muscle strength, and general

stamina

ASSESSMENT Subjective data: Haan ku maubra dagijay ububraek idi, kasi nasakit ti

DIAGNOSIS Activity Intolerance related to pain

PLANNING At the end of the shift, the patient will be able to

INTERVENTIONS INDEPENDENT Established

RATIONALE

EVALUATION Goal partially met.

to establish

At the end of the

tumeng ko, as verbalized by the patient. Pain scale: 7/10 Objective data: Facial grimace Muscle strength on both legs: 2 (Passive ROM) Inability to perform ADLs like walking and taking a bath

demonstrate increased tolerance to activity as evidenced by: Improved muscle strength (range: 3-5) - Ability to perform ADLs specifically walking with assistance

rapport to the patient Identified activities that the patient can perform Provided emotional support and encouragement to patient Assisted with activities of daily living as indicated Provided adequate rest periods Explained importance of bed rest in treatment Promoted independence in self care activities as tolerated

trust and cooperation on the patient to gradually increase activity to promote improvement in self-esteem to reduce energy expenditure to reduce cardiac work load to decrease metabolic demands thus conserving energy to enhance self-esteem

shift, the patient was able to demonstrate increased tolerance to activity as manifested by improved muscle strength from 2 to 3 but still unable to perform ADLs such as walking.

ASSESSMENT Subjective data: Adu itiy panpanunutek. Atoy sakit ku ken kwarta,as verbalized by the patient. Objective data: Usually sleeps at 11pm and wakes up at 4 in the morning

DIAGNOSIS Disturbed sleep pattern related to psychological stress

PLANNING At the end of 8-hour nursing interventions, the patient will be able to have improved sleep pattern as evidenced by: - Verbalizations of lessened thoughts of her illness and financial problems

INTERVENTIONS INDEPENDENT Encouraged verbalization of feelings Encouraged SO not to leave patient alone Discouraged long periods of sleep during the day Encouraged patient to drink milk before going to bed Advised SO to keep conversation at low level Provided calm and a well-ventilated room for rest Instructed patient to avoid heavy meal and large fluid intake before bed time

RATIONALE

EVALUATION Goal partially met.

to reduce concern of the unknown and associated muscle tension to make the patient feel the presence of the SO to promote sleep during the night to induce sleep

At the end of 8-hour nursing intervention, the patient was able to have improved sleep pattern as verbalized by: Nakaturog nak iti nasyaat idi rabii. Haan ku masyado panpanunuten iti problema kun.

to promote sleep and to prevent awakening the patient to prevent fatigue. to prevent awakening from gastric digestion and to minimize Interruption in sleep because of voiding to promote rest and peace of mind

Explained the need to avoid concentrating on onesj problem at bed time