Cues Nursing Objectives Interventions Rationale Evaluation

Diagnosis
Subjective: Risk for After 1 hour of 1. Advise client’s significant - To prevent infection After the nursing
“May sugat po ako Infection health teaching, the others to constantly disinfect intervention, the
kasi prumeno yung related to skin client’s significant with povidone-iodine and dress wound was
van.” trauma others will have the wound with gauze disinfected and
Objective: knowledge on the dressed properly the
1. Unhealed risk for infection and 2. Give knowledge on the - To encourage the client next day.
wound on will know of the different effects infection may and the client’s significant
the chin different ways to bring (fever, bacterial, viral and others to do preventive
prevent infection fungal infections that cause measures against infection
from happening disease)
 Cues Nursing Objectives Interventions Rationale Evaluation
Diagnosis
Subjective: Risk for Injury After 4 hours of 1. Perform home assessment/ - To prevent the patient After 4 hours of
His sister verbalized related to nursing intervention, identify safety issues, such from wandering off nursing intervention,
that, “kinakabahan psychological the patient will be as locking up medications/ and might get injured. the patient verbalized
ako sa kapatid ko kasi developmental able to verbalize poisonous substance or the understanding of
malikot siya baka age. understanding of locking exterior doors. individual factors that
madisgrasya siya.” individual factors 2. Ascertain knowledge of - To prevent injury in contribute to
that contribute to safety needs/ injury home, community, possibility of injury.
Objective: possibility of injury. prevention and motivation. and work setting.
- The patient 3. Evaluate the client’s - May affect the
likes to emotional and behavioral patient’s view of and
explore response in environmental regard for own or
things surroundings. others’ safety.
around him
 Cues Nursing Objectives Interventions Rationale Evaluation
Diagnosis
Subjective: Constipation After 1 week of 1. Explain the advantages of - To provide bulk for After 1 week of
The patient’s sister related to nursing intervention, having a high fiber diet to stools. nursing intervention,
verbalizes, “two to insufficient patient will establish ease defecation. the patient
three times lang fiber/ fluid and regain normal 2. Promote adequate fluid - To promote passage of established and
siyang nadumi sa intake as pattern of bowel intake and suggest drinking soft stool regained normal
isang linggo, tapos evidenced by functioning. warm, stimulating fluids. pattern of bowel
medyo nasasaktan pain during 3. Encourage activity/ exercise - To stimulate functioning.
siyang ilabas.” defecation and After 2 hours of with limits of individual ability contractions of
Objective: hard formed health teaching, the intestines. After 2 hours of health
1. Drinks 3 glasses stools. patient will be able teaching, the patient
of water a day to verbalize verbalized the
2. Hard stool understanding of understanding of
3. Looks for iced appropriate appropriate
tea instead of interventions. interventions.
water; more
intake of iced tea
than water