This nursing care plan addresses a client's dysfunctional grieving over the death of her husband 10 years ago. The short term goal is for the client to verbalize her feelings about the loss and identify accomplishments during her marriage. The long term goals are for the client to identify other people in her life and existing problems, and to discuss coping strategies. The nurse will provide support and encouragement to help the client express her emotions through open communication.
The document defines focus charting as a systematic method for organizing health information using nursing terminology to describe a patient's health status and care. It involves focusing on key concerns from the care plan like skin integrity or activity tolerance. A focus note includes subjective and objective data supporting the focus, nursing interventions, and the patient's response. An example focus note addresses a patient's pain by documenting their complaint, administering medication, repositioning the patient, and noting their improved pain level in response.
The document provides information on the Professional Adjustment, Leadership & Management, and Research (PALMER) section of the Philippine Nursing Licensure Examination (PNLE). Some key topics that may appear on the upcoming July 2012 PNLE include:
- Patient's bill of rights
- Organization and responsibilities of the Board of Nursing
- Requirements and qualifications for nursing licensure, practice, and education
- Nursing jurisprudence including laws affecting the nursing profession, negligence, malpractice, and informed consent
- Restraints, living wills, and advance directives
The document contains multiple sections from nursing notes on different patients. It includes assessments of patients' symptoms and concerns, nursing diagnoses, objectives for interventions, details of interventions provided and their rationales, and evaluations of outcomes. Key information includes patients presenting with anxiety about their health, pain, knowledge deficits, and weight gain related to changes in diet. Nurses addressed these issues through monitoring, education, and lifestyle counseling aimed at reducing anxiety and pain levels, increasing knowledge, and identifying unhealthy eating habits within 8 hours of interventions.
This document discusses the legal and ethical issues related to caring for aged people. It covers topics such as negligence, malpractice, intentional torts like assault and battery, defamation, invasion of privacy, elder abuse and neglect. It also discusses advance directives, restraint use, do not resuscitate orders, withholding treatment, assisted suicide, informed consent, enteral feeding, and patient opposition to placement. The goal is to increase awareness of these issues and ensure the elderly are treated with dignity while protecting their rights and safety.
The document outlines a nursing care plan for a patient at risk of powerlessness due to chronic illness and hospitalization. The short-term goals are for the patient to identify areas of control within an hour and express a sense of control and hopefulness within 2-3 days. The intervention is for the nurse to listen to the patient, show concern, and encourage participation. The rationale is that this will help establish rapport and a sense of empowerment to improve the patient-nurse relationship and care outcomes.
Chronic renal failure can result from diabetes, hypertension, glomerulonephritis, or other causes leading to irreversible kidney damage and decreased glomerular filtration rate. Key nursing priorities include monitoring for excess fluid retention and electrolyte imbalances, ensuring adequate nutrition given potential nausea or appetite changes, and supporting patient mobility despite possible fatigue. Outcome goals are normal fluid balance, adequate nutritional intake without signs of malnutrition, and activity levels within the patient's capabilities.
The document defines focus charting as a systematic method for organizing health information using nursing terminology to describe a patient's health status and care. It involves focusing on key concerns from the care plan like skin integrity or activity tolerance. A focus note includes subjective and objective data supporting the focus, nursing interventions, and the patient's response. An example focus note addresses a patient's pain by documenting their complaint, administering medication, repositioning the patient, and noting their improved pain level in response.
The document provides information on the Professional Adjustment, Leadership & Management, and Research (PALMER) section of the Philippine Nursing Licensure Examination (PNLE). Some key topics that may appear on the upcoming July 2012 PNLE include:
- Patient's bill of rights
- Organization and responsibilities of the Board of Nursing
- Requirements and qualifications for nursing licensure, practice, and education
- Nursing jurisprudence including laws affecting the nursing profession, negligence, malpractice, and informed consent
- Restraints, living wills, and advance directives
The document contains multiple sections from nursing notes on different patients. It includes assessments of patients' symptoms and concerns, nursing diagnoses, objectives for interventions, details of interventions provided and their rationales, and evaluations of outcomes. Key information includes patients presenting with anxiety about their health, pain, knowledge deficits, and weight gain related to changes in diet. Nurses addressed these issues through monitoring, education, and lifestyle counseling aimed at reducing anxiety and pain levels, increasing knowledge, and identifying unhealthy eating habits within 8 hours of interventions.
This document discusses the legal and ethical issues related to caring for aged people. It covers topics such as negligence, malpractice, intentional torts like assault and battery, defamation, invasion of privacy, elder abuse and neglect. It also discusses advance directives, restraint use, do not resuscitate orders, withholding treatment, assisted suicide, informed consent, enteral feeding, and patient opposition to placement. The goal is to increase awareness of these issues and ensure the elderly are treated with dignity while protecting their rights and safety.
The document outlines a nursing care plan for a patient at risk of powerlessness due to chronic illness and hospitalization. The short-term goals are for the patient to identify areas of control within an hour and express a sense of control and hopefulness within 2-3 days. The intervention is for the nurse to listen to the patient, show concern, and encourage participation. The rationale is that this will help establish rapport and a sense of empowerment to improve the patient-nurse relationship and care outcomes.
Chronic renal failure can result from diabetes, hypertension, glomerulonephritis, or other causes leading to irreversible kidney damage and decreased glomerular filtration rate. Key nursing priorities include monitoring for excess fluid retention and electrolyte imbalances, ensuring adequate nutrition given potential nausea or appetite changes, and supporting patient mobility despite possible fatigue. Outcome goals are normal fluid balance, adequate nutritional intake without signs of malnutrition, and activity levels within the patient's capabilities.
This nursing care plan addresses a patient with a diagnosis of fluid volume deficit. The plan includes assessments of vital signs, skin turgor, urine output, and weight to monitor the patient's fluid status. Interventions include encouraging oral fluid intake, assisting with feeding if needed, providing IV fluids, administering blood products if indicated, and educating the patient and family on monitoring intake and output. The goals are for the patient to understand factors contributing to their fluid deficit, how to treat and prevent it, and symptoms requiring follow up with their provider within 2 days, and to maintain normal fluid balance and demonstrate lifestyle changes to avoid dehydration within 2 weeks.
The document describes a 1 year old female patient presenting with difficulty breathing, coughing up phlegm, fever, and loss of appetite. Nursing diagnoses include ineffective airway clearance, altered body temperature, and imbalanced nutrition. The nursing care plan involves monitoring symptoms, assisting with clearing secretions, encouraging rest and increased fluids/nutrition, and administering medications to reduce fever and breathing difficulties.
Case study pregnancy induced hypertensionkiarratot
Pregnancy Induced Hypertension (PIH) is a condition characterized by high blood pressure, protein in the urine, and swelling during pregnancy. The exact cause is unknown, though it is more common in certain at-risk groups. PIH is classified based on symptoms from gestational hypertension with just high blood pressure to preeclampsia with additional symptoms to eclampsia which is the most severe form with seizures. Women at high risk should be monitored closely for symptoms during prenatal visits.
The nursing care plan addresses a patient experiencing renal failure who presents with edema, fatigue, and weakness, and notes an assessment of fluid overload and compromised renal function. The plan includes monitoring intake and output, daily weighing, skin assessments for edema, oral fluid replacement within restrictions, and administering diuretics and antihypertensives as needed to manage fluid levels, reduce edema, and treat hypertension. The expected outcomes are appropriate urinary output, stable weight and vital signs, and resolution of edema.
This nursing care plan addresses a patient with decreased cardiac output. It outlines short and long term goals of explaining cardiac disease precautions and maintaining adequate cardiac function. It provides a comprehensive list of assessments and interventions to monitor the patient's condition, administer medications, educate the patient and family, and promote lifestyle changes to improve cardiac health. The plan aims to optimize the patient's cardiac output through close monitoring, treatment, and establishing self-care practices.
This document outlines the objectives of a study on Hepatitis C Virus Disease (HCVD), Cirrhosis of the Liver Secondary to Hepatitis C (CASHD), and Nursing Intervention Formulation (NIF). The objectives are to gain knowledge about these conditions, increase awareness, and teach proper patient care. Specific objectives include determining the patient's health history, functional health patterns, review of systems, physical assessment, affected anatomy/physiology, disease process, lab/test results, medical management, medications, and developing a discharge/care plan.
The document discusses preeclampsia, including its signs, symptoms, risk factors, diagnostic tests, pathophysiology, and treatment. Preeclampsia is a pregnancy complication characterized by high blood pressure and signs of damage to other organ systems. It is caused by abnormal development of the placenta leading to reduced blood flow and endothelial cell dysfunction systemically. Proper management involves monitoring blood pressure, delivering the baby to resolve symptoms, and potentially using antihypertensive medications.
This document defines focus charting as a systematic approach to nursing documentation using key words to describe a patient's health status and care. It outlines the components of a focus note including data, action, and response. Data includes subjective and objective information about the focus or significant event. Action describes nursing interventions performed or planned. Response is the patient's response to care and progress toward outcomes. An example focus note addresses a patient's pain with medication and repositioning, noting the patient's improved rating of pain.
The document describes several physiological changes that occur with aging. Key changes include a decline in organ function such as the heart, lungs, and kidneys. Muscle and bone mass is also lost. Other changes involve thinning skin, graying hair, declining vision and hearing. Maintaining regular exercise, a healthy diet, and preventative healthcare can help optimize health and well-being in older age.
The document discusses a nursing assessment and plan of care for a patient experiencing disturbed sleep patterns due to environmental factors. The nursing diagnosis is disturbed sleep pattern related to environmental noise and light. Short term goals are for the patient to understand their sleep disturbance and verbalize their usual sleep pattern. Interventions include observing the patient's sleep habits, addressing misconceptions, and advising limiting caffeine and taking naps. The objective is to evaluate sleep quality measures and the long term goal is improved sleep and well-being.
This document outlines nursing care during the prenatal period. It discusses assessment of the pregnant woman including estimating due date, gestational age, obstetric history and physical assessment. Common diagnostic tests are described like ultrasound, amniocentesis, non-stress test and biophysical profile. The nursing care plan involves nutrition assessment, prenatal exercises, hygiene, travel advice, immunizations, managing discomforts, and regular prenatal visits. The goal is to monitor the health of the mother and fetus during pregnancy.
Mr. Aproniano Castro, a 56-year-old Filipino jeepney driver, was admitted to the hospital for cholecystitis with multiple gallstones. He experiences symptoms like severe abdominal pain, weight loss, and jaundice. His medical history includes thyroidectomy and asthma. Diagnostic tests show elevated white blood cell count indicating infection. He is scheduled for cholecystectomy to remove his inflamed gallbladder. Pre-operative nursing care focuses on managing his pain and risk of dehydration from vomiting.
The nursing care plan addresses Mr. JRB's presenting issues of ineffective airway clearance due to productive cough, ineffective breathing pattern due to retained secretions, and ineffective thermoregulation manifested by an elevated temperature of 38.5°C. The plan involves monitoring respiration and breath sounds, encouraging increased fluid intake and chest physiotherapy to loosen secretions, and promoting surface cooling to address the fever. The goals are for the patient to expectorate secretions, maintain clear airway, and reduce temperature.
Frailty is a condition primarily affecting older adults that increases the risk of disability, falls, and mortality. It is characterized by loss of muscle and bone strength due to aging. Factors like multiple chronic diseases and physical inactivity can contribute to frailty. Key components include weight loss, fatigue, weakness, and slowed movement. Exercise can help improve symptoms but also carries risks for frail individuals like injury and dehydration that must be managed.
This document discusses care of patients with dementia. It begins by providing statistics on dementia prevalence worldwide and in India. It then defines dementia and lists its common causes and warning signs. The main rules of care are outlined as well as guidance for activities of daily living like eating, communication, preventing wandering, bathing, toileting, dental care, grooming, and dressing. Recommendations are provided for adapting the home environment for safety and to aid with orientation.
The nursing care plan is for a 26-year-old female patient diagnosed with schizophrenia. One diagnosis is disturbed sensory perception related to altered sensory reception, as evidenced by restlessness, disorientation, poor concentration, hallucinations, and inappropriate responses. The plan includes interventions to preserve the patient's sense of identity and orientation through reorientation, validating her reality does not include voices, and avoiding isolation. A second diagnosis is impaired verbal communication related to altered perceptions evidenced by disturbances in thought processes. The plan aims to help the patient communicate thoughts and feelings coherently through a calm environment and diversionary tactics to reduce anxiety and establish communication methods.
The document describes a case of a 30-year-old female patient who was admitted to the hospital due to abruptio placenta and severe preeclampsia. She experienced vaginal bleeding and abdominal pain at 37 weeks and 5 days of gestation. Upon admission, she was found to have high blood pressure of 190/120 mmHg and her baby was in fetal distress. She underwent an emergency c-section but unfortunately her baby was stillborn. Her medical history included a previous pregnancy, hypertension since age 20 that was untreated, and a family history of hypertension and other conditions. She was confined for 14 days following the c-section.
The document describes Focus-Data-Action-Response (F-DAR) charting, which organizes health information in a patient's record with three columns: Date/Hour, Focus, and Progress Notes. The Progress Notes column contains three sections - Data (assessment findings), Action (nursing care provided), and Response (patient outcomes). Several examples of completed F-DAR charts are provided addressing issues like pain, fever, risk of infection, nausea, and more. F-DAR charting aims to make the patient and their concerns the focus of care through systematic documentation of assessments, interventions, and responses.
Ethical issues of Care of elderly patients:-
Decision making capacity.
Informed consent.
Refusal of treatment.
Advance directive.
Major ethical principles.
Psycho-social aspects of aging.
Med-Surg Case Presentation german measlesVan Macabio
1. The patient presented with fever, rashes and cough and was suspected of having Rubella. Her vital signs and physical exam were normal except for the presence of red rashes on her skin.
2. A history and physical assessment was conducted where it was found that the patient had no significant medical history and her symptoms started 1 week prior with cough.
3. The patient's condition was being managed supportively as there is no specific treatment for Rubella.
This nursing care plan addresses grief in response to a loss. The plan assesses cognitive, emotional, behavioral, and physical responses to grief. Expected outcomes include the client adequately perceiving and coping with the loss by expressing feelings, maintaining self-care, establishing social support, understanding the grief process, and developing future plans integrating the loss. Nursing interventions establish rapport, discuss the loss supportively, encourage expression of feelings, and provide verbal support for coping with grief.
This nursing care plan addresses a patient with a diagnosis of fluid volume deficit. The plan includes assessments of vital signs, skin turgor, urine output, and weight to monitor the patient's fluid status. Interventions include encouraging oral fluid intake, assisting with feeding if needed, providing IV fluids, administering blood products if indicated, and educating the patient and family on monitoring intake and output. The goals are for the patient to understand factors contributing to their fluid deficit, how to treat and prevent it, and symptoms requiring follow up with their provider within 2 days, and to maintain normal fluid balance and demonstrate lifestyle changes to avoid dehydration within 2 weeks.
The document describes a 1 year old female patient presenting with difficulty breathing, coughing up phlegm, fever, and loss of appetite. Nursing diagnoses include ineffective airway clearance, altered body temperature, and imbalanced nutrition. The nursing care plan involves monitoring symptoms, assisting with clearing secretions, encouraging rest and increased fluids/nutrition, and administering medications to reduce fever and breathing difficulties.
Case study pregnancy induced hypertensionkiarratot
Pregnancy Induced Hypertension (PIH) is a condition characterized by high blood pressure, protein in the urine, and swelling during pregnancy. The exact cause is unknown, though it is more common in certain at-risk groups. PIH is classified based on symptoms from gestational hypertension with just high blood pressure to preeclampsia with additional symptoms to eclampsia which is the most severe form with seizures. Women at high risk should be monitored closely for symptoms during prenatal visits.
The nursing care plan addresses a patient experiencing renal failure who presents with edema, fatigue, and weakness, and notes an assessment of fluid overload and compromised renal function. The plan includes monitoring intake and output, daily weighing, skin assessments for edema, oral fluid replacement within restrictions, and administering diuretics and antihypertensives as needed to manage fluid levels, reduce edema, and treat hypertension. The expected outcomes are appropriate urinary output, stable weight and vital signs, and resolution of edema.
This nursing care plan addresses a patient with decreased cardiac output. It outlines short and long term goals of explaining cardiac disease precautions and maintaining adequate cardiac function. It provides a comprehensive list of assessments and interventions to monitor the patient's condition, administer medications, educate the patient and family, and promote lifestyle changes to improve cardiac health. The plan aims to optimize the patient's cardiac output through close monitoring, treatment, and establishing self-care practices.
This document outlines the objectives of a study on Hepatitis C Virus Disease (HCVD), Cirrhosis of the Liver Secondary to Hepatitis C (CASHD), and Nursing Intervention Formulation (NIF). The objectives are to gain knowledge about these conditions, increase awareness, and teach proper patient care. Specific objectives include determining the patient's health history, functional health patterns, review of systems, physical assessment, affected anatomy/physiology, disease process, lab/test results, medical management, medications, and developing a discharge/care plan.
The document discusses preeclampsia, including its signs, symptoms, risk factors, diagnostic tests, pathophysiology, and treatment. Preeclampsia is a pregnancy complication characterized by high blood pressure and signs of damage to other organ systems. It is caused by abnormal development of the placenta leading to reduced blood flow and endothelial cell dysfunction systemically. Proper management involves monitoring blood pressure, delivering the baby to resolve symptoms, and potentially using antihypertensive medications.
This document defines focus charting as a systematic approach to nursing documentation using key words to describe a patient's health status and care. It outlines the components of a focus note including data, action, and response. Data includes subjective and objective information about the focus or significant event. Action describes nursing interventions performed or planned. Response is the patient's response to care and progress toward outcomes. An example focus note addresses a patient's pain with medication and repositioning, noting the patient's improved rating of pain.
The document describes several physiological changes that occur with aging. Key changes include a decline in organ function such as the heart, lungs, and kidneys. Muscle and bone mass is also lost. Other changes involve thinning skin, graying hair, declining vision and hearing. Maintaining regular exercise, a healthy diet, and preventative healthcare can help optimize health and well-being in older age.
The document discusses a nursing assessment and plan of care for a patient experiencing disturbed sleep patterns due to environmental factors. The nursing diagnosis is disturbed sleep pattern related to environmental noise and light. Short term goals are for the patient to understand their sleep disturbance and verbalize their usual sleep pattern. Interventions include observing the patient's sleep habits, addressing misconceptions, and advising limiting caffeine and taking naps. The objective is to evaluate sleep quality measures and the long term goal is improved sleep and well-being.
This document outlines nursing care during the prenatal period. It discusses assessment of the pregnant woman including estimating due date, gestational age, obstetric history and physical assessment. Common diagnostic tests are described like ultrasound, amniocentesis, non-stress test and biophysical profile. The nursing care plan involves nutrition assessment, prenatal exercises, hygiene, travel advice, immunizations, managing discomforts, and regular prenatal visits. The goal is to monitor the health of the mother and fetus during pregnancy.
Mr. Aproniano Castro, a 56-year-old Filipino jeepney driver, was admitted to the hospital for cholecystitis with multiple gallstones. He experiences symptoms like severe abdominal pain, weight loss, and jaundice. His medical history includes thyroidectomy and asthma. Diagnostic tests show elevated white blood cell count indicating infection. He is scheduled for cholecystectomy to remove his inflamed gallbladder. Pre-operative nursing care focuses on managing his pain and risk of dehydration from vomiting.
The nursing care plan addresses Mr. JRB's presenting issues of ineffective airway clearance due to productive cough, ineffective breathing pattern due to retained secretions, and ineffective thermoregulation manifested by an elevated temperature of 38.5°C. The plan involves monitoring respiration and breath sounds, encouraging increased fluid intake and chest physiotherapy to loosen secretions, and promoting surface cooling to address the fever. The goals are for the patient to expectorate secretions, maintain clear airway, and reduce temperature.
Frailty is a condition primarily affecting older adults that increases the risk of disability, falls, and mortality. It is characterized by loss of muscle and bone strength due to aging. Factors like multiple chronic diseases and physical inactivity can contribute to frailty. Key components include weight loss, fatigue, weakness, and slowed movement. Exercise can help improve symptoms but also carries risks for frail individuals like injury and dehydration that must be managed.
This document discusses care of patients with dementia. It begins by providing statistics on dementia prevalence worldwide and in India. It then defines dementia and lists its common causes and warning signs. The main rules of care are outlined as well as guidance for activities of daily living like eating, communication, preventing wandering, bathing, toileting, dental care, grooming, and dressing. Recommendations are provided for adapting the home environment for safety and to aid with orientation.
The nursing care plan is for a 26-year-old female patient diagnosed with schizophrenia. One diagnosis is disturbed sensory perception related to altered sensory reception, as evidenced by restlessness, disorientation, poor concentration, hallucinations, and inappropriate responses. The plan includes interventions to preserve the patient's sense of identity and orientation through reorientation, validating her reality does not include voices, and avoiding isolation. A second diagnosis is impaired verbal communication related to altered perceptions evidenced by disturbances in thought processes. The plan aims to help the patient communicate thoughts and feelings coherently through a calm environment and diversionary tactics to reduce anxiety and establish communication methods.
The document describes a case of a 30-year-old female patient who was admitted to the hospital due to abruptio placenta and severe preeclampsia. She experienced vaginal bleeding and abdominal pain at 37 weeks and 5 days of gestation. Upon admission, she was found to have high blood pressure of 190/120 mmHg and her baby was in fetal distress. She underwent an emergency c-section but unfortunately her baby was stillborn. Her medical history included a previous pregnancy, hypertension since age 20 that was untreated, and a family history of hypertension and other conditions. She was confined for 14 days following the c-section.
The document describes Focus-Data-Action-Response (F-DAR) charting, which organizes health information in a patient's record with three columns: Date/Hour, Focus, and Progress Notes. The Progress Notes column contains three sections - Data (assessment findings), Action (nursing care provided), and Response (patient outcomes). Several examples of completed F-DAR charts are provided addressing issues like pain, fever, risk of infection, nausea, and more. F-DAR charting aims to make the patient and their concerns the focus of care through systematic documentation of assessments, interventions, and responses.
Ethical issues of Care of elderly patients:-
Decision making capacity.
Informed consent.
Refusal of treatment.
Advance directive.
Major ethical principles.
Psycho-social aspects of aging.
Med-Surg Case Presentation german measlesVan Macabio
1. The patient presented with fever, rashes and cough and was suspected of having Rubella. Her vital signs and physical exam were normal except for the presence of red rashes on her skin.
2. A history and physical assessment was conducted where it was found that the patient had no significant medical history and her symptoms started 1 week prior with cough.
3. The patient's condition was being managed supportively as there is no specific treatment for Rubella.
This nursing care plan addresses grief in response to a loss. The plan assesses cognitive, emotional, behavioral, and physical responses to grief. Expected outcomes include the client adequately perceiving and coping with the loss by expressing feelings, maintaining self-care, establishing social support, understanding the grief process, and developing future plans integrating the loss. Nursing interventions establish rapport, discuss the loss supportively, encourage expression of feelings, and provide verbal support for coping with grief.
The document provides information about a 89-year-old female patient, Mrs. Torralba, who was admitted to the hospital due to a fracture of the right femoral neck. She fell two days prior and experienced pain and limited movement in her right hip. Diagnostic tests revealed decreased hemoglobin and hematocrit levels, indicating anemia. Her prothrombin time was increased, suggesting a deficiency in clotting factors. All other lab results were normal. The patient has a history of breast cancer, diabetes, and osteoporosis, putting her at high risk for fractures from falls.
The patient's mother understands the situation and treatment regimen including safety measures such as limiting range of motion and use of Taylor brace after nursing interventions of encouraging position changes every 2 hours, scheduling rest periods with activities, providing skin care and passive exercises, explaining use of devices, and encouraging nutritious intake.
The document provides information about a case study on a woman who underwent an ovariectomy and was diagnosed with a probably benign ovarian cyst and pulmonary tuberculosis. It includes background information on ovarian cysts and tuberculosis, the objectives and scope of the case study, and Lydia Hall's core-care-cure theoretical framework for the nursing assessment and management. The case study focuses on assessing the client's health status while confined at Quezon City General Hospital from July 9-14, 2011.
A 48-year-old Hispanic male was admitted to the emergency room for left ankle pain and swelling. He has a history of IV drug use, hepatitis C, and other health issues. Since admission, he has undergone surgery to drain infection from his ankle joint. He has been treated with antibiotics and pain medication. The patient remains concerned about his recovery and living situation upon discharge.
The nursing care plan addresses a patient experiencing disturbed sleep patterns related to bipolar disorder. Bipolar disorder involves periods of excitability and alternating periods of depression. The plan involves assessing the patient's sleep patterns after 8 hours and documenting any improvements. Interventions include assessing past sleep patterns, avoiding stimulants before bed, increasing daytime activity, and creating a comfortable sleep environment. Medications may also be administered as ordered to help the patient fall and stay asleep. The overall goal is to promote regular sleep patterns and reduce symptoms.
This document discusses sleep disturbances and patterns. It begins with objectives of gaining knowledge about sleep disturbances, patterns, and their application in patient care. It then covers definitions of sleep, sleep facts, sleep patterns in different age groups, sleep physiology including stages of sleep and sleep regulation. Factors affecting sleep and consequences of sleep deprivation are explained. Common sleep disorders like insomnia are described along with international classification of sleep disorders and their management.
This patient has been diagnosed with renal failure due to decreased glomerular filtration rate and sodium retention. Objective findings include edema, hypertension, weight gain, pulmonary congestion, oliguria, distended jugular veins, and changes in mental status. The nursing diagnosis is fluid volume excess related to decreased glomerular filtration rate and sodium retention impairing the kidneys' ability to filter fluids and excrete excess sodium. Short term goals are for the patient to demonstrate behaviors to monitor fluid status and reduce recurrence of fluid excess within 4-8 hours. Long term goals are for the patient to have stabilized fluid volume as evidenced by balanced intake/output, normal vital signs, stable weight, and freedom from edema signs within 3 days with nursing
This document provides information about a case study on a 30-year-old female patient who was admitted to the hospital for postpartum hypertension. It includes her medical history, physical assessment findings, laboratory results, nursing diagnoses of postpartum hypertension and urinary tract infection. Her hemoglobin, hematocrit and urine tests showed abnormalities consistent with her conditions. The case study aims to improve nursing students' skills and knowledge in caring for patients with pregnancy-induced complications.
This document discusses perinatal loss and grief. It begins by outlining expected learning outcomes related to defining perinatal loss, identifying types and risk factors, and describing emotional responses and the grief process. It then defines perinatal loss and describes the main types - ectopic pregnancy, miscarriage, stillbirth, and neonatal death - providing details on signs, risks, and causes. Statistics on the frequency of perinatal loss are presented. Emotional responses are discussed, as well as the grief and mourning process. Finally, potential nursing diagnoses and interventions are outlined, focusing on ineffective sexuality patterns, complicated grieving, and the importance of support.
The document provides information and guidance to nursing students on how to write a care plan, including defining the different components such as nursing diagnosis, goals, interventions, and evaluation. It explains each section in detail and provides examples. Resources are also included to help students understand and complete their care plan assignments.
Dr. Iglesia has no conflicts of interest to disclose. The objectives of the document are to develop effective treatment plans, communicate treatment goals, minimize medication side effects, and describe new therapies for overactive bladder in women. Overactive bladder affects millions of Americans, especially women, and prevalence increases with age. New therapies aim to change stereotypes about overactive bladder and provide realistic information about prevalence and severity. Behavioral interventions like pelvic floor exercises and bladder training can be effective treatment approaches.
Exercise provides numerous health benefits. It makes the heart muscle stronger and larger, allowing it to pump more blood with less effort. Regular exercise also helps keep arteries elastic, reducing blood pressure and the risk of heart disease. Everyone can benefit from at least 30 minutes of moderate exercise daily such as brisk walking or other aerobic activity. Strength training exercises twice a week can further improve heart health and reduce disease risk.
The document discusses dysautonomia and mitochondrial disease, focusing on how abnormalities in the autonomic nervous system can lead to various functional disorders. It provides examples of how dysautonomia can affect different body systems like the eyes, blood vessels, heart, gut, and secretory glands. Specific conditions are explained like postural orthostatic tachycardia syndrome, complex regional pain syndrome, and gastroesophageal reflux disease. Treatment options emphasize lifestyle modifications and medications to manage symptoms originating from mitochondrial dysfunction impacting the autonomic nervous system.
This document provides biographical and career information about Rachmat Gunadi Wachjudi, including his place and date of birth, education history, specializations, current position, and professional organizations. It then discusses osteoarthritis (OA) management in primary care settings and lists common symptoms and signs used in the EULAR diagnostic criteria for knee OA. Finally, it outlines factors implicated in OA development and goals for OA treatment according to OARSI recommendations.
1. Prolonged immobility can lead to serious physical and psychological complications for older adults due to deconditioning and loss of mobility.
2. Key physical risks include muscle atrophy, bone loss, skin breakdown, cardiovascular deconditioning, pulmonary issues, and functional decline.
3. Interventions like range of motion exercises, proper positioning, ambulation assistance, and pain management can help mitigate risks while immobilization is necessary. Regular mobility is important for overall health in older adults.
The document discusses natural remedies for arthritis and joint pain, including proper posture, exercise, massage, and diet. Maintaining good posture helps distribute weight evenly in joints to reduce pressure and inflammation. Regular exercise can strengthen muscles around joints to provide stability. Massage increases blood and lymph flow to nourish joints and reduce scar tissue buildup. Diet plays a role as an acidic environment contributes to joint pain, so an alkaline diet along with supplements can help balance the body's internal environment to support joint health.
Osteoarthritis is a degenerative joint disease characterized by progressive loss of articular cartilage. Risk factors include age, obesity, joint injury, genetics, and occupation. Symptoms include joint pain, tenderness, and stiffness. Treatment focuses on reducing pain and inflammation through measures like exercise, weight loss, bracing, oral medications, and injections. Surgery is considered if more conservative treatments fail to improve function and quality of life.
A physiatrist is a doctor who specializes in physical medicine and rehabilitation. They focus on improving patients' function and quality of life by treating problems ranging from minor injuries to spinal cord injuries. Physiatrists utilize treatments like physical therapy, medication, injections, and bracing to reduce pain and treat conditions like arthritis, back pain, and nerve injuries without surgery when possible.
Irritable bowel syndrome (IBS) is a functional bowel disorder characterized by chronic abdominal pain and altered bowel habits in the absence of any detectable organic cause. IBS affects 10.5% of the population, with higher rates in women. IBS often co-occurs with other functional somatic syndromes and psychiatric disorders like anxiety. Early trauma, especially sexual and physical abuse, is linked to higher rates of IBS and other functional somatic syndromes. Cognitive biases and increased attention to threat and negative emotions are also associated with IBS. Hypnotherapy has been shown to be an effective treatment for IBS and may work by disconnecting affective and cognitive links in the brain.
The Use of Resistance Training in the Prevention and Treatment of Osteoporosi...alicia_jade
Resistance training can help prevent and treat osteoporosis in the elderly. It maintains or increases bone mineral density by offsetting age-related declines in bone health. A resistance training program for osteoporosis prevention and treatment should include 2 sessions per week focusing on all areas of the body using 8-10 exercises of 15 reps each at a moderate intensity. Proper form, progression over time, and consideration of safety factors are important. Resistance training is a suitable lifestyle addition to prevent osteoporosis when combined with a healthy diet and regular physical activity.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Kosmoderma Academy, a leading institution in the field of dermatology and aesthetics, offers comprehensive courses in cosmetology and trichology. Our specialized courses on PRP (Hair), DR+Growth Factor, GFC, and Qr678 are designed to equip practitioners with advanced skills and knowledge to excel in hair restoration and growth treatments.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Co-Chairs, Val J. Lowe, MD, and Cyrus A. Raji, MD, PhD, prepared useful Practice Aids pertaining to Alzheimer’s disease for this CME/AAPA activity titled “Alzheimer’s Disease Case Conference: Gearing Up for the Expanding Role of Neuroradiology in Diagnosis and Treatment.” For the full presentation, downloadable Practice Aids, and complete CME/AAPA information, and to apply for credit, please visit us at https://bit.ly/3PvVY25. CME/AAPA credit will be available until June 28, 2025.
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These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
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There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
How to Control Your Asthma Tips by gokuldas hospital.Gokuldas Hospital
Respiratory issues like asthma are the most sensitive issue that is affecting millions worldwide. It hampers the daily activities leaving the body tired and breathless.
The key to a good grip on asthma is proper knowledge and management strategies. Understanding the patient-specific symptoms and carving out an effective treatment likewise is the best way to keep asthma under control.
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1. Appendix
Using the B1
Body Systems
Model
Refer to Chapter 2 “Assessment,” p. 62: Care Plans Developed after Using the
Body Systems Assessment Model
Client’s name: Mrs. Mary Jones
Age: 70 years
Document Includes: Scenario, activities 1–7, pathoflow sheet, assessment
(The Body Systems Model) and three care plans.
Scenario
This client was brought to the emergency room. She complained of pain in her
left thigh. She stated she tripped over a telephone cord in her kitchen and fell.
An X-ray of her leg revealed a fracture of the left femur (medical diagnosis).
Activity 1
Use this initial information from the client’s record to assure you are caring for
the right client chosen or assigned by your instructor.
Activity 2
Examine the pathoflow sheet to determine the sequencing of events that proba-
bly led to Mrs. Jones’ fall, the fracture of her femur, and the likely complications
9
2. 10 Appendix B1
that could follow due to immobility and the nursing diagnoses that relate to
each body system (see example provided). This process will help you provide
comprehensive nursing care to your clients.
Activity 3
Review the Body Systems Assessment provided (for Mrs. Jones) and become
familiar with this approach. Be aware that any model chosen should provide
the information you need to develop comprehensive individualized care plans
for your client.
What seemed to be the most pressing need of Mrs. Jones at this time?
Activity 4
Examine the first care plan and note that the client is crying and preoccupied
with her husband’s death (see ordered and selected data). Now review the
NANDA diagnoses list and note that these behaviors are categorized as
Grieving, Dysfunctional.
Activity 5
Examine care plan 2, to determine that the problem of altered self concept is
likely less pressing than that of grieving.
Why was knowledge deficit about cast care assigned third priority?
Activity 6
Examine care plan 3 and conclude that the client did not have the cast applied
until after the first two problems were identified. Remember to use criti-
cal thinking, problem solving, and decision making to meet client’s needs
(prioritize).
Is each care plan individualized?
Activity 7
Use the guidelines specified in Appendix A for Chapter One (Individualized
Care Plans) to draw conclusions about Mrs. Jones’s care plans.
Note: Remember that a scenario, a pathoflow sheet, and a comprehensive
assessment help you provide comprehensive individualized client care.
3. Aging Process (70-year-old client)
Decreased calcium intake Female Small frame
Pregnancy and lactation Longevity Family history (mother
depletes calcium and sisters had osteoperosis)
Sedentary lifestyle
Ethnicity (Caucasian)
Postmenopausal
Low bone mass Alcohol ingestion
Cigarette smoking
Increased bone fragility
Fractured femur
(closed reduction)
long leg cast)
Gastrointestinal function
Respiratory function
Decreased stomach motility
Immobility Decreased rate and depth
Decreased peristalsis
of respiration
Increased intraabdominal pressure
Stasis of secretions
Increased distention
O2/CO2 imbalance
Nursing diagnosis
Decreased expiratory
Nutrition altered less than
volume
body requirements
Hypoxemia
Tissue hypoxia
Nursing diagnosis
Risk for breathing pattern, ineffective
Cardiac function Risk for airway clearance, ineffective
Increased heart rate:
Decreased blood flow
Drceased diastolic blood pressure
Decreased oxygenation
Risk for tissue perfusion, ineffective Self perception
Altered self concept Musculo-skeletal
Altered body image Decreased range of option
Decreased activity Decreased muscle tone
Decreased strength and
Elimination
endurance
Decreased exercise
Nursing diagnosis
Decreased muscle tone
Risk for impaired tissue
Nursing diagnosis
integrity
Risk for constipation
Risk for altered
urination
FIGURE B1–1 Assessment and nursing care plan using the Body Systems Model. Pathoflow sheet
for Mrs. Mary Jones, a 70-year-old client with a fractured left femur (medical diagnosis)
and dysfunctional grief (nursing diagnosis).
4. 12 Appendix B1
ASSESSMENT AND NURSING CARE PLAN
USING THE BODY SYSTEMS MODEL FOR
MRS. MARY JONES (MEDICAL MODEL)
Client Assessment Body Systems Model:
Sensory Perceptual: Mental Status and Neurological Exam
1. Mental status, physical appearance, and behavior
a. Posture and movement, lying supine in bed, shoulders symmetrical
b. Dress somewhat inappropriate (larger than size—loose fitting)
c. Grooming and hygiene: hair hanging over face, oily skin, clean, nails
very short, evidence of frequent biting
d. Face: symmetrical, facial expressions: anxious
e. Affect: flat, somewhat withdrawn, tears in eyes
2. Speech: low volume (crying), intact comprehension of spoken words,
nods “yes” and “no”
3. Level of consciousness: oriented to time, place, and person
4. Cognitive abilities/mentation
a. Attention: within normal limits—not easily destructive
b. Long-term and short-term memory intact
c. Judgment: abnormal preoccupation with husband’s death
d. Insight: abnormal preoccupation with husband’s death—states,
“I cannot do anything for myself.”
e. Spatial perception: intact to familiar sounds, unable to draw due to
distraction with fear of surgery and husband’s death
f. Calculation: unable/reluctant to perform serial 7’s (crying spell)
g. Abstract reasoning, unable, unwilling to perform
h. Thought process and content: consistent and coherent
5. Sensory
a. Exteroceptive sensation
1. Light touch: intact on both upper and lower extremities
2. Superficial pain: intact (more sensitive on left lower extremity—
broken femur)
3. Temperature: normal findings (warm to touch)
b. Proprioceptive sensation
1. Motion and position: normal findings (identifies changes of posi-
tion of body part)
2. Vibration sense: normal findings (perceives vibration over all
bony prominences)
5. Appendix B1 13
c. Cortical sensation
1. Stereognosis: normal (client able to identify dime placed in hand)
2. Graphesthesia: normal (identifies the number 3 written in palm
of hand)
3. Two-point discrimination: normal (client able to identify two
points at 5 mm apart on the fingertip
4. Extinction: normal (recognizes both stimuli on opposites sides
of body)
6. Cranial nerves
I. Normal findings (able to distinguish various odors)
II. Visual acuity 20/30 OU, funduscopic examination deferred
III., IV.,
& VI. EOM—normal findings (both eyes move symmetrically in
each of the six fields of gaze, converges on held object toward the
nose, no nystagmus; pupils equal, round, briskly react to light and
accommodation— PERRLA) No ptosis
V. Masseter and temporalis muscles equally strong; sensation to super-
ficial and light touch intact bilaterally
VII. Motor component—face symmetrical
Sensory component (identifies sweet, sour, salty, and bitter tastes accurately)
VIII. Gross hearing intact: Rinne—ACϾBC, Weber Ø laterization
IX. & X. Gag reflex present, speech clear, no hoarseness or nasal quality,
swallows water easily
XI. Turns head against resistance with smooth, strong, and symmetrical
movement
XII. Tongue in midline of the mouth symmetrical and moves freely
7. Cerebella Function
a. Coordination
1. Finger to nose, no impairment on either side
2. Finger from nose to examiner’s finger—coordinated bilaterally
3. Heel to shin deferred (fractured femur)
b. Station
1. Posture not tested unable to stand
2. Gait not tested, unable to walk (fractured femur)
3. Romberg, unable to test balance
c. Reflexes—deep tendon reflexes
1. Brachioradialis 2ϩ bilaterally, biceps 2ϩ bilaterally, triceps 2ϩ
bilaterally, patella 3ϩ bilaterally, planter 2ϩ bilaterally, Achilles
2ϩ bilaterally, Babinski negative
6. 14 Appendix B1
Cardiovascular: Heart and Peripheral Vascular
Assessment of the heart
1. Inspection: No pulsations visible at aortic, pulmonic, midprecordial
(Erb’s point), and tricuspid areas; pulsations visible at mitral land mark
(point of maximum impulse—PMI), normal finding
2. Palpation: No pulsations, thrills, or heaves palpated at the aortic, pul-
monic, midprecordial, and tricuspid areas. Apical impulse palpable at
mitral area (small amplitude, no heaves or thrills)
3. Normal findings at aortic and pulmonic areas, S2 louder than S1, no ejec-
tion clicks at aortic area. Tricuspid and mitral areas, S1 louder than S2
(normal finding) no murmurs heard throughout the cardiac landmarks.
4. Jugular veins: no distention, no hepatojugular reflux
5. Palpation and auscultation of arterial pulses: pulses, rate, and rhythm
equal bilaterally; no bruits auscultated in carotid and femoral pulses,
amplitude 2ϩ (carotids, brachials, radials, femorals, papliteals, pos-
terior tibials, dorsals pedis
6. Inspection and palpation of peripheral perfusion
a. Ulcerations: no ulcerations noted—casted left leg (long leg cast)
b. Manual compression (competency of saphenous veins) valves are
competent, no impulse felt
c. Retrograde filling: not tested, client not able to stand. Homans’ sign
negative. Client’s blood pressure 140/88, pulse 86.
Capillary refill 3ϩ.
Skin
1. Color
2. Bleeding: no ecchymosis or bleeding, no increased vascularily
3. Lesions: no skin lesions present, except for raised mole on right cheek
4. Edema: no edema palpated
Inspection of Hair
1. Color: pale blond, graying on scalp, eyelashes, and body
2. Distribution: even on scalp, eyebrows, eyelashes and axila and pubis hair
3. Palpation of hair feels thin, straight, lacks luster, strands easily removed
Inspection of Nails
1. Color: pink cast; capillary refill 3 seconds.
2. Shape and configuration: nail surface smooth and slightly rounded
(normal)
7. Appendix B1 15
Palpation of Nails
Texture: nail bases firm on palpation
Respiratory System—Assessment of Thorax and Lungs
1. Intercostal spaces: no retractions or bulging of intercostal spaces
2. Muscles of respiration: no accessory muscles being used
3. Respiratory rate: 20 beats per minute (eupnea)
4. Pattern: regular and even in rhythm
5. Depth of inspiration: nonexaggerated and effortless
6. Symmetry: thorax rises and falls in unison, no paradoxical movement
7. Position: breathes comfortably in low Fowler’s position
8. Audibility: respirations heard by nurse about 8 inches away (normal)
9. Mode of breathing: inhales and exhales through nose
10. Sputum; small amount, clear, odorless
Gastrointestinal—Abdomen
Contour: normal (flax)
Symmetry: normal (symmetrical bilaterally)
Pigmentation and color: normal (uniform in color and pigmentation)
Scars: no abdominal scars present
Striae: no evidence of striae present
Respiration—movement: there is no evidence of respiratory retractions—
abdomen rises with inspiration and falls with expiration
Masses or nodules: no masses or nodules present
Visible peristalsis: slightly perceptible movements of peristalsis, traverses the
abdomen in a slanting downward direction (normal)
Umbilicus: umbilicus depressed and beneath the abdominal surface (normal)
Auscultation
Bowel sounds: bowel sounds heard in all four quadrants
Vascular sounds: no audible bruits on auscultation
Venous hum: no venous hum heard
Friction rubs: no friction rubs heard over liver, spleen, or abdominal quadrants
Percussion: dullness felt over liver and spleen area but not over bladder
Liver span: no hepatomegally
Spleen: dullness not percussed (client obese)
Stomach: gastric air bubble percussed—no abdominal size detected
8. 16 Appendix B1
Palpation
Light palpation: abdomen smooth with consistent softness
Deep palpation: no organ enlargement, abnormal masses, bulges, or swelling
palpated
Genital
Hair distribution: pubic hair distribution, normal; shaped like an inverse tri-
angle, graying, (shows some sparse areas)
Presence of parasites: no parasites present
Skin color and condition: the skin color over the mons pubis hair is clear; the
labia majora and minora are wrinkled but unbroken; there are no lesions,
ecchymosis, excorations, nodules, swelling, or rash.
Clitoris: without lesions
Musculoskeletal: overall appearance—client 5Ј3Љ tall, body weight 165 lbs,
medium body frame; approximately 37 pounds over-weight, demonstrating
pain behavior (at times clinches left hip area, states, “that hurts”), unable to
access unit area by walking.
Posture: unable to assess, cannot stand
Gait and mobility: unable to access, broken femur
Inspection: muscle size and shape—no accentuation noted
No evidence of hypertrophy or atrophy, strong muscle strength in upper
extremity and right lower leg
9. CLIENT: Mrs. Mary Jones Nursing Care Plan – Priority Nursing Diagnosis 1
AGE: 70
Ordered &
Selected Data Nursing Diagnosis Goals Interventions Rationale Evaluation
Subjective data: Grieving, Short term: • Encourage client to • Expression of grief Short-term goal met:
Client states Dysfunctional • Client will verbalize verbalize deep-seated enables client to hear Client was delighted
“Life has not been feelings about loss. feelings and and analyze own that a whole 45 minutes
the same since my Defining • Client will identify emotions about statements. was devoted to her by
husband died characteristics: own accomplish- husband’s death: her nurse. She cried for
10 years ago. Oh, • Crying episodes ments while provide atmosphere about 5 minutes before
how I miss • Sadly recalling husband was alive. for verbalization talking and then spoke
him—only if my past events (quiet room, privacy, freely. Admitted feeling
husband were here.” • Reluctance to Long term: allotted time, better because she
engage in activities • Client will identify effectively listening, “never thought anyone
Objective data: of daily living significant others giving of self and cared enough to listen”;
Frequent crying • Sleep disturbance who are available to attentiveness). accepted the suggestion
spells • Low self-concept interact with her. for another session.
Reluctant to engage • Preoccupation with • Client will identify • Use good communica- • An atmosphere that
in activities of daily lost object or person existing specific tion skills: restate- encourages open Long-term goal met:
living • Refusal to live in the problems. ment, clarification, communication helps • Nurse read Bible and
present • Client will discuss simple questions, and the client enunciate prayed with client.
the benefits of silence. intimate thoughts. Bible left in room with
religious support. several passages
• Client will name • Encourage client to • Effective listening marked for further
agencies that can verbalize behaviors (empathy) builds exploration by client.
provide counseling and circumstances trust, encourages • Hospital Chaplain
and psychological surrounding husband’s soul searching, informed. Stated he
support. death: care received verbalization, would add client to
during last days of examination, and his visitation list.
illness, funeral, appreciation of
accomplishments. accomplishments. continues
17
10. CLIENT: Mr. Mary Jones Nursing Care Plan – Priority Nursing Diagnosis 1 (continued)
AGE: 70
Ordered &
Selected Data Nursing Diagnosis Goals Interventions Rationale Evaluation
• Encourage client to • Recalling events • Cousin from
verbalize positive as helps to categorize neighboring state
well as negative be- bad from good promised to spend
haviors; emphasize occurrences, provides one week with client
positive behaviors of data for the nurse to during hospitaliza-
self, and others. focus and examine tion.
occurrences and thus • Agencies and groups
helps the client to identified. Client
identify issues. expressed apprecia-
tion for the list,
• Have client identify • Significant others can began to eat larger
individuals who have provide support over portions of diet,
contributed to her time. engaged in selecting
coping needs— items from menu.
stating what they did. Asked about cast
Capitalize on these. care.
• Have client state • Identifying lingering
problems that are hurt will provide data
most bothersome at for intervention.
this time.
• Discuss religious • Pastoral care and
affiliation and counseling often
availability of brings peace and
counseling. additional support.
• Provide list of groups • Specialists who deal
and agencies that with grieving
help with grieving. individuals have tools
that are proven and
effective.
11. CLIENT: Mrs. Mary Jones Individualized Care Plan – Priority Nursing Diagnosis 2
AGE: 70
Ordered &
Selected Data Nursing Diagnosis Goals Interventions Rationale Evaluation
Subjective data: Body image, disturbed Short term: • Work with client to • Recounting the past Short-term goals met:
“Look how ugly Defining characteristics • Client will identify relive her past will enable identifica- Client discussed her
I have become. I positive aspects of (childhood through tion of strengths and happy years as a child,
cannot help myself.” • Lack of motivation self. elder years). List accomplishments. stated she took piano
• Rejection of self • Client will identify positives and Praise and commen- lessons from her mother
Objective data: • Neglect of cosmetic past accomplishments. negatives, give praise dation will show who was a music
Demonstrates lack principles and tasks for positives. appreciation and teacher and that she
of pride in cosmetic Long term • Identify skills/ acceptance. excelled above the other
appearance (large, • Client will discuss talents/ tasks with • Identification of students, not only played
loose-fitting dress, tasks that will bring which client is strengths and piano but also played
hair unkept). satisfaction. familiar and has accomplishments harp, violin, and guitar.
Reluctant to engage • Client will list benefited in the past. will divert self- Stated she played and
in activities of daily reasons for reengag- • Explore possibility of preoccupation and sang for the church until
living (hygiene). ing in these tasks. restructuring a denouncement and she was 25 years old
• Client will identify project where these will create positive when she got married.
benefits that can be can be recreated. focus. From then her husband
derived from these • Explore ways of • Engagement in “supported and gave her
tasks. beginning while in tasks/skills that all she ever needed.”
• Client will discuss the hospital. previously generated
ways to improve • Explore available positive results should Long-term goals met:
body image. resources such as provide the stimulus The possibility of forming
occupational for new desire to a small orchestra in her
therapists. make worthwhile home and teaching all the
continues
19
12. 20
CLIENT: Mrs. Mary Jones Individualized Care Plan – Priority Nursing Diagnosis 2 (continued)
AGE: 70
Ordered &
Selected Data Nursing Diagnosis Goals Interventions Rationale Evaluation
• Explore benefits contributions to instruments she was
previously achieved, societal needs. comfortable with was
ways of marketing • Insight into factors explored. Client showed
and distributing of that create a positive positive reaction and
product. business arena said those were her
• Identify community should stimulate dreams before marriage.
resources that need motivation. Collaboration with
client’s expertise. occupational therapists
• Discuss appropriate resulted in a keyboard
appearance of the being brought to the
new business- client’s room. She played
woman: hair, clothes for the staff and
(attire), body weight, requested music books
cosmetic appearance. for the harp, piano,
violin, and guitar.
It was suggested that
the hairdresser style her
hair the next morning.
She agreed. She stated
she would be choosing
foods low in calories so
she wouldn’t gain extra
weight while in “this
cast and would possibly
“lose a pound or two.”
13. CLIENT: Mrs. Mary Jones Nursing Care Plan – Priority Diagnosis 3
AGE: 70
Ordered &
Selected Data Nursing Diagnosis Goals Interventions Rationale Evaluation
Subjective data: Knowledge deficient Short term: Tell client: Short-term goal met:
Client states “I have about care of cast. Client will discuss the • The cast was applied to • Understanding of Client complaint,
never had a cast care of the cast for days maintain good bone underlying principles stated, “I never knew
before. I wonder Evidenced by client’s 1–3 after application. alignment and mobility provides satisfaction there was so much to
what I am to do statement and behavior (fracture should heal and aids compliance. know about a cast.”
about it.” (see objective/subjective properly).
data). • Keep cast uncovered • Provides understanding Long-term goal met:
Objective data: until completely dry that covering the cast There were several
Long leg cast on left Defining characteristics: Long term: (will take from 1–3 will retain the moisture teaching sessions, client
lower extremity for • Verbalizes concern Client will discuss care of days). and cause weakness to stated, “I will need
immobilizing leg, • Actively seeks the cast for the rest of the • Avoid putting anything the structure. someone to help me
after closed reduction knowledge about a hospital stay and wet or applying any because I have not done
of fractured femur health care situation discharge planning. pressure on cast. anything for myself for
Noncompliance • Keep elevated on pillow • Minimizes swelling. almost 10 years.” She
Touching cast only • Lack of ownership (above heart) for was assured that the
with one finger • Distancing self 48 hours. Home Health Agency
• Do not remove the • Prevents skin tears would evaluate her need
padding. Do not insert and abrasions for help before discharge.
any objects inside the (prevents infection)
cast. continues
21
14. 22
CLIENT: Mrs. Mary Jones Nursing Care Plan – Priority Diagnosis 3 (continued)
AGE: 70
Ordered &
Selected Data Nursing Diagnosis Goals Interventions Rationale Evaluatio
• Report feeling of tingling • These are abnormal
sensation, numbness, changes that may be
tightness, pain, heat, sequela of infection or
bleeding, foul odor, and cardiovascular or
color changes of foot neurological problems.
and toes. Quick attention
minimizes complications.
• Tell client that you will • Provides understanding
be turning her every of the regimen of care
2 hours, checking cast and facilitates conjugal
for drainage, discol- partnership.
oration, wetness,
pulses, swelling,
tightness, and asking
her about pain.
• Instruct client that “if • Reduces fear of the
the cast gets wet, it unknown, generates
should be dried right confidence and
away (this can be done encourages self-help.
with a small fan at
home). Ambulation will
be allowed with some
type of assistive device:
cane, walker, crutches.
Teaching will be done
by the physical
therapist.
Reference: Smith, S., Duell, D., & Martin, C. (2000) Clinical nursing skills: Basic to advanced skills. Stamford, CT: Appleton & Lange.