Nursing care plan for patient with musculoskeletal injury.

Nursing
Assessment Planning Intervention Evaluation
Diagnosis
Subjective: Pain related to After 2 hours of Dependent: After 2 hours
“Ang sakit po ng chronic nursing  Administer analgesics, as of nursing
paa ko”, as inflammation interventions the indicated. interventions
verbalized by the
of joints. patient will report the patient
patient.
that the pain is Independent: reported that
Objective: relieved or  Evaluate pain characteristics the pain is
 Crying controlled. and intensity. controlled as
 Facial  Provide nonpharmacologic evidenced by
grimace pain management. pain scale of 3
 Irritability  Encourage presence of parent and absence of
 Pain scale of to comfort the child. crying.
8

Nursing
Assessment Planning Intervention Evaluation
Diagnosis
Subjective: Deficient After 2 hours of Independent: After 1 hour of
“Gusto ko na diversional nursing  Review history of activities nursing
pong maglaro ng activities intervention the and hobbies client has intervention
basketball, wala related to a enjoyed. Discuss reasons the the
client will know client
po akong need for client is not doing these
magawa sa imposed the alternative determined the
activities now and determine
bahay”, as activity satisfying whether the client can and alternative
verbalized by the restriction for activities within would like to resume these activities that
patient. 4 weeks. personal activities. satisfies his
Objective: limitations.  Encourage mix of desired boredom, and
 Current activities and stimuli (e.g., within
setting does music, TV, movies, books, or personal
not allow arts and crafts).
limitations.
engagement  Determine the client’s actual
in activity. ability to participate and
interest in available activities,
 Client noting attention span, physical
expresses limitations and intolerance,
boredom. level of interest or desire, and
safety needs.

Assessment Nursing Planning Intervention Evaluation

 Diagnosis
Subjective: Disturbed After 1 hour of Independent: After 1 hour of
“Sana po hindi ko body image nursing  Assess the perceived impact nursing
na gagamitin related to the intervention the of change in ADLs and social intervention
itong body brace participation.
continuous use patient will the patient had
kasi po nahihiya  Explain to the patient about
ako sa mga of a body verbalize verbalized
the importance of using body
kaklse ko”, as brace. acceptance of self brace to her condition and acceptance of
verbalized by the in situation. how it help him in everyday self in situation
patient. activities. as evidenced
 Discuss with patient about the by increased
Objective: normalcy of body image confidence.
 Lack of disturbance and the grief
confidence process.
 Self-negating  Evaluate the patient’s
verbalizations behavior and verbal remarks
 Situational about his condition.
challenge to
self image