VII.

Nursing Care Plans

Assessment Subjective: nars panu #o lilinisin ng maayos ang ari #o$

Diagnosis Ris# for infection related to insufficient #no%ledge to avoid e"posure to pathogens

Planning After hours of nursing intervention& the patient verbali'e understanding of ris# factors

Intervention !teach ris# factors for occurrence of infection (e") s#in integrity& environmental e"posure* !Proper hand %ashing !cleanse incision sites daily

Rationale !to have proper #no%ledge about ris# factors in infection !to avoid cross contamination !to prevent build up of pathogens

Evaluation After hours of nursing intervention& the patient has verbali'ed understanding of ris# factors

Assessment Subjective:$Suma sa#it sa#it ung inoperahan sa#in$ as verbali'ed by the patient +bjective: !,rimace facial reaction !pain scale of -

Diagnosis Pain related to surgical incision

Planning After hours of nursing intervention& the patient %ill sho% decrease or relief of pain)

Intervention !monitor vital signs& including pain scale

!provide ade.uate rest periods and assist in a comfortable position !encourage deep breathing e"ercises !administer analgesics as ordered Diagnosis Safe care deficit: hygiene related to Planning After hours of nursing Intervention ! identify degree of individual impairment

Rationale !establish baseline in order to determine needed interventions !promotes recovery ! relieves muscle and emotional tension ! to relieve pain

Evaluation After hours of nursing intervention& the patient has sho%n relief of pain)

Assessment Subjective: nahihirapan

Rationale !to identify the e"tent of the

Evaluation After hours of nursing

a#ong linisan ang ari #o Assessment Subjective: madalas a#o matuyuan ng lalamunan ngayon at tuyo lagi ang bibig #o$ +bjective: !Decrease urine output !1hirst (drin#ing eagerly* !Dry lips and s#in !Poor s#in turgor

pain& discomfort Diagnosis 2luid volume Deficit related to dehydration as manifested by diarrhea

intervention& the patient0s patient %ill be able !allo% patient to perform strength to perform safe activities to the fullest Evaluation of !to ma#e the Planning Intervention Rationale care activities his ability and assist as patient %ithin level of o%n independent After hours !monitor I/+ needed !accurately 1he goal %as met of ability their o%n s#ills of 3ursing !instruct to measuring and assist if Interventions& increase oral inta#e and !provide positive needed) the patient fluid inta#e reinforcement output is vital for tas#s !for %ill sho% !advice to successfully for the client and/or encouragement improved avoid caffeine& %ith fluid independently of the patient to accomplished participate in the hydration tea& grape and volume activities status fruit juice overload (diuretics* !to add more !advice to ta#e electrolyte to fluids that the body replaces needed electrolytes (e") ,atorade*

intervention& the patient is able to perform safe care activities