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Asses Ment
Asses Ment
Diagnosis
Planning
Intervention
Evaluation
S> Masakit ang tiyan ko Namamaga pa ang itlog ko, as verbalized by the client O> BP: 120/80 mmHg PR: 90 bpm RR: 23 bpm T: 38.5 C > Swelling and tenderness on the right scrotum
Acute pain at the lower abdomen related to swollen lymph nodes as evidenced by swollen and tender on the right scrotum
Establish rapport
Evaluate behaviors
pain
After 4 hours of nursing intervention the pt. pain has been lessen
Administer medications ordered physician Note lifestyle effect of pain such as by the
depression
Subjective: "Natatakot ako di ko malaman kung ano ba nangyayari dito sa itlog ko," as verbalized by the patient.
Anxiety related to fear of unknown as evidence to facial flushing and pale in appearance
After 4 hours of nursing intervention, the patient's anxiety level will gradually decreased to manageable level.
-Monitor vital signs, increased anxiety may affect physiologic changes - Determine prescribed medications or OTC medications, some medications can heighten sense of anxiety such as steroids, weightloss pills, and caffeine. - Observe behaviors, to determine the level of patient's anxiety: mild, moderate, severe or panic - Encourage therapeutic relationship and be available to client for listening and talking - Provide accurate information to the situation and do not give false
After 4 hours of nursing intervention, the patient's anxiety level was gradually decreased to manageable level.
Objectives: - cold clammy skin - pale in apperance - facial flushing - poor eye contact v/s taken BP: 120/80 mmHg PR: 90 bpm RR: 23 bpm T: 38.5 C