In Partial Fulfillment of the

Requirements in NCM 209 RLE

PEDIATRIC NURSING ROTATION

Submitted to:
Florence L. Puno, RN, MN
Clinical Instructor

Submitted by:
Chal Sea S. Canonigo, St. N
BSN 2A – GROUP 2

January 30, 2021

 NURSING CARE PLAN
Patient: J.K.
Chief Complaint: Emotional Distress
Attending Physician: Dr. Hobi
DATE CUES NEED NURSING DIAGNOSIS
/TIME
J Subjective: C Anxiety related to conflict
A “Te basin di nako O about life goals as
N makadula ug basketball P evidenced by restlessness,
U ba, matanggal najud ko I fidgeting, insomnia, and nail
A ani sa varsity team” as N biting
R verbalized by the patient G R: Helps relieve anxiety.
Y / Rationale:
“Dugay kayko makatulog S Life goals, an integral part of
2 mag sigeg hunahuna te” T the development of one's
8 as verbalized by the R identity, give meaning to an
patient E individual's life. The
2 S experience of cancer can
0 Constantly worrying about S greatly impact the life goals
2 his teammate’s current of a person, and the time
0 events according to the T commitment required for
Mother of the patient O care can disrupt the
Age: 16 Gender: M Room & Bed no.: 613
Diagnosis: Ewing’s Sarcoma Ward: St. Mary’s Ward
PATIENT OUTCOME NURSING INTERVENTIONS
After 8 hours of care, a) Provide an open environment in which patient feels safe to
the patient will be able discuss feelings.
to identify healthy ways R: This helps the patient to feel relaxed in discussing feelings
to deal with anxiety. without feeling judged.
b) Provide reassurance and comfort measures.
c) Recognize awareness of the patient’s anxiety.
R: Acknowledgement of the patient’s feelings validates their
emotions and communicates acceptance of those feelings.
d) Assist the patient in developing new anxiety-reducing skills,
such as:
• Relaxation
• deep breathing
• positive visualization
• meditation
• reassuring self-statements.
@ Objective: L processes involved in R: Discovering new coping methods provides the patient with
• Vital Signs: E achieving the life goals of the a variety of ways to manage anxiety and help improve their
7 - BP:90/130 mmHg R patient. It can also affect the sleep. In addition, relaxation exercises are effective
A - HR:108 bpm A mental functioning of the nonchemical ways to reduce anxiety.
M • Restlessness N patient, which, in turn, can e) Assess possible need for special counseling services for the
• Fidgeting of hands C lead to depression and child.
7 and feet E anxiety as it interferes with R: Supports the child’s ability to deal with illness and promotes
- • Nail biting daily life, impairs the quality adjustments to lifestyle changes.
3 of life and can have a f) Encourage parents to stay with their child.
P negative effect on the R: This enhances care and promotes emotional comfort to the
M achievement of life goals. child.
g) Communicate with the child based on developmental age level
REFERENCE:
S and answer questions calmly and honestly; use of pictures,
Hullmann, S. E., Robb, S.
H models, and drawings for explanations.
L., & Rand, K. L.
I R: Allows better understanding and promotes trust. And
(2017). Life goals in
F accurate information allows patient to deal more effectively
patients with cancer:
T with the reality of the situation, thereby reducing anxiety.
a systematic review
h) Use therapeutic touch (with permission), presence,
of the literature.
verbalization, and demeanor to remind clients that they are not
Psycho-Oncology,
alone.
25(4), 387–399.
Retrieved January
 26, 2021, from R: Being supportive, approachable, and the healing touch may
doi:10.1002/pon.385 be one of the most useful nursing interventions available to
2 reduce anxiety.
i) Teach client and family the symptoms of anxiety. If client and
family can identify anxious responses, they can intervene
earlier than otherwise.
R: Information is empowering and reduces anxiety.
j) Encourage use of appropriate community resources like
family, friends, and teammates.
R: One of the most reassuring elements of care includes
access to the family.
k) If the situational response is rational, use empathy to
encourage client to interpret the anxiety symptoms as normal.
R: Anxiety is a normal response to actual or perceived danger.
REFERENCES:
Doenges, M. E., Moorhouse, M., & Murr, A. C. (2019). Nurse's Pocket Guide (15th ed.). Philadelphia: F.A. Davis Company. Retrieved January 24,
2021
Herdman, H., & Kamitsuru, S. (2017). NANDA International Nursing Diagnoses (Definitions & Classification, 2018-2020) (11th ed.). Thieme.
Retrieved January 24, 2021
Hullmann, S. E., Robb, S. L., & Rand, K. L. (2017). Life goals in patients with cancer: a systematic review of the literature. Psycho-Oncology,
25(4), 387–399. Retrieved January 26, 2021, from doi:10.1002/pon.3852
Nursing Care Plans. (2017). Nursing Care Plans for Anxiety. Nursing Concept Blogspot. Retrieved January 25, 2021 from http://nursing-
concept.blogspot.com/2009/02/nursing-care-plans-for-anxiety.html
Wayne, G. B. (2019). Anxiety Nursing Care Plan. Nurseslabs. Retrieved January 25, 2021 from https://nurseslabs.com/anxiety/
 CLUSTERING OF CUES:
Health Perception/ Nutritional Elimination Pattern Activity/ Exercise Pattern Cognitive Perceptual Sleep/ Rest Pattern
Health Management Metabolic Pattern

• BP: 90/130mmHg • “dugay kayko makatulog mag

• HR: 108bpm sigeg hunahuna te” as verbalized
by the patient
Self-Perception/ Role Relationship Sexual Coping/ Stress Tolerance Value/ Belief Pattern
Self-Concept Pattern Pattern Reproductive Pattern
Pattern
• “te basin di nako makadula ug
basketball ba, matanggal najud
ko ani sa varsity team” as
verbalized by the patient
•
• Constantly worrying about his
teammate’s current events
according to the Mother
•
• Fidgeting
• Restlessness
• Nail biting
Scenario:
Patient JK, a 17-year-old male, expressed his worries upon VS checking. He verbalized, “te basin di nako makadula ug basketball ba, matanggal
najud ko ani sa varsity team”. Patient appeared restless and is always fidgeting his hands and feet. Signs of nail biting noted. When asked about his
sleep, he answered, “dugay kayko makatulog mag sigeg hunahuna te”. Mother also added that she notices that his son is constantly worrying about
his teammate’s current events. Vital signs appeared that his blood pressure was 90/130mmHg while his heart rate was 108bpm.