Care Plan: TURB and Kyphoplasty Recovery Situation and Background E.P. is an 88-year-old Caucasian male. He was admitted on 02/18/13. His code status is full code‚ and he declines to bring in his advanced directive. He reports that he is 68.5” tall‚ and his actual weight is 165 pounds. He and his wife are the sources of information‚ and they are reliable. His blood pressure is 124/62‚ taken on his right arm in a lying position‚ his oral temperature is 99.8‚ his right radial pulse is 74 beats per
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objective cues. __________ _ Scientific Explanation : Disturbance in urine elimination. After 8 hrs of nursing interventio n the client will be able to portray and verbalize improve urinary elimination pattern. Plan of care to meet the desired outcome for the client. Make a teaching plan appropriate for the clients condition. .Determine clients previous pattern of elimination and compare with current situation. Note reports of frequency‚ urgency‚ burning‚ incontinence‚ nocturia‚ enuresis. Palpate
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Why should we be doing this? Use a textbook for reference if possible. Actual interventions Usually past tense What care was provided for patient? How did you gather data to measure against your normal ranges in your outcome criteria? Frequency - How often did you obtain patient data? Each goal met/not met: Should read like you actually documented vital signs‚ assess‚ care on your patient What were the results of labs/dx What was taught/what support measures‚ comfort used? WBC 14.2 Keep
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References: Gulanick‚ M.‚ Myers‚ J.L. (2013). Nursing care plans. Diagnose‚ interventions‚ outcomes. USA: Mosby.
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Nursing Care Plan for Chest Pain NURSING DIAGNOSIS OUTCOME/GOALS INTERVENTIONS EVALUATION Acute chest pain related to ischemic cardiomyopathy as evidenced by tightness in chest. Patient will be chest pain free for duration of shift. Assess for chest pain q 4 hours during shift. Monitor vital signs q 4 hours during shift. Educate patient on importance of lifestyle modifications such as weight loss. Goal was met. Pt was chest pain free during shift. NURSING DIAGNOSIS
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Care Plan For Angina Pectoris Angina Pectoris Chief Complaint: Patient complains of having tightness and pain in his chest that seems to move down the left arm. Patient describes the pain as being sharp and can be sometimes a mild pain or an immobilizing pain. Medical Diagnosis: Coronary Artery Disease Pathophysiology of: Angina Pectoris Angina Pectoris develops when coronary blood flow becomes inadequate to meet myocardial oxygen demand. This causes myocardial
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Family Health Problem | Family Nursing Problem | Goal of Care | Objective of Care | Nursing Intervention | Method of Family Contact | Resources Required | 1. Malnutrition as health deficit. | Inability to recognize the presence of malnutrition due to lack of knowledge. | After the intervention‚ the family will be able to recognize the problem. | After the nursing Intervention‚ the family will be able to plan and prepare balanced meals within the family’s budget.After the intervention‚ the family
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Student Name: Dealon Rouse | Patient Initials: JB | Admission Diagnosis: Left Total Knee Arthroplasty &Excision of Left Knee Mass Related to Gouty Arthritis | Date(s) of Care: 11/10/11- 11/12/11 | Age: 46 | | Date of Admission: 11/10/11 | Gender: Male | | Marital Status: Married | Room #: 507 | Code Status: Full Code | Occupation: Electrician | Race: Hispanic | Isolation Type: | Religion: Roman Catholic | | Allergies: No Known Allergies | History of Present Illness:
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Nursing Care Plan Client name: Mrs. Chan Age/ sex: 48/F Medical diagnosis: Fluid overload‚ decreased TK output and decreased Hb Assessment date: 25-11-2012 Diagnostic statement (PES): Excess fluid volume related to compromised regulatory mechanism secondary to end-stage renal failure as evidence by peripheral edema and patient’s weight gained from 69.8kg to 73.6kg within 4 days. Assessment Nursing Diagnosis Goals & Expected Outcomes Nursing Interventions
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X Nursing Care Plan |Assessment |Diagnosis |Planning |Intervention |Rationale |Evaluation | | | | | | | | |Subjective: “nahihirapan siyang |Activity intolerance related to |Within the
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