GOAL Intervention GOAL:

 Within 1 hr of intervention patients fever of  HYPERTHERMIA  HYPERTHERMIA

Tyhphoid fever 38 °C will alleviate to its normal range of Nursing intervention: After 1 hr of interventions
37°C  Monitor patient’s vital signs. patient’s fever of 38 °C
Is a bavterial infection transmitted by  Initiate tepid sponge bath. alleviated to its normal
 Within 4 hrs of intervention and health
contaminated water, milk, shellfish or  Promotes surface cooling through range of 37°C
teachings patients pain will be relieve AEB undressing or removing extra linens.
other food. It is an infection of the GIT verbalizing of pain scale 4 out of 10  Encourage adequate fluid intake.  ACUTE PAIN
affecting the lymphoid tissues (peyer’s  Within 8 hrs of intervention and health  Encourage adequate bed rest After 4 hrs of interventions
patches) of small intestines. teachings patient will be able to  ACUTE PAIN and health teachings
demonstrate and verbalize understanding Nursing Intervention: patient’s pain was relieved
The disease is caused by organism
about the risk factors AEB verbalizing of pain
SALMONELLA TYPHOSA a gram  Determine possible pathophysiologic/
scale 4 out of 10
negative motile and non-spore forming. psychologic causes of pain.
Pathogenic to man only an organism  Observe for non verbal cues.
 RISK FOR CONSTIPATION
that easily survives in natural habitat like  Encourage verbalization of feelings about
NURSING DIAGNOSIS pain
After 8 hrs of intervention
water or inorganic materials. and health teachings
 Encourage us of relaxation techniques such
 HYPERTHERMIA related to presence of as deep breathing exercises. patient was able to
Can be transmitted through 5 F’s bacterial infection 2° typhoid fever  Instruct patient to position affected arm demonstrate and
 Flies properly. verbalized understanding
 Acute PAIN related to inflamed IV site  Apply warm and cold compress on the
 Fomites about the risk factors
due to antibiotic medication affected site
 Finger  Administer analgesics as indicated.
 Feces  Risk for constipation related to  RISK FOR CONSTIPATION
 Foods insufficient physical mobility Nursing intervention:
 Auscultate abdomen for presence, location, and
characteristics of bowels sounds
 Encourage intake of balanced fiber and bulk in POSSIBLE
diet.
LABORATORY RESULT COMPLICATION
Assessment 9-25-10
 Promote increase in fluid intake unless
contraindicated.
Tyhpidot IgM: POSITIVE  Hemorrhage
 Encourage participation in activity/ exercise
 Febrile temp 38°C IgG: NEGATIVE  Peritonitis
within limits of own ability.
 Skin warm to touch  Instruct patient to respond to urge to defecate.  Bronchitis and
 Headache 9-26-10 pneumonia
 Restless Hematocrit 0.30 Medical management:  Meteorism
 Body malaise platetet count 71  Typhoid dpine
 Administer Paracetamol 500mg /tab > Temp of 37.8°C  Septemia
 No bowel movement  Administer Pacetamol i amp IV PRN for Temp > 38.5 °C
since 1st day of 9-27-10  Ceftriaxone 2 gm IV OD as ordered  Reiter’s syndrome
admission Dengue rapid test  Diet as tolerated with except dark color foods
 Inflamed IV site IgM: POSITIVE  IVF D5 LR iL x 8hrs
 Complain of pain IgG: NEGATIVE  Laboratories :-CBC, PC
 Dengue rapid test
(7/10)  Typhidot
 Urinalysis