The patient presented with symptoms of pneumonia including cough with phlegm, shortness of breath, and abnormal breath sounds. The nursing care plan within the next 8 hours aims to improve gas exchange and maintain optimal respiration through monitoring, medication administration, and health teaching.
The patient reported frequent, loose stools and was at risk for electrolyte imbalance from dehydration. The goal is to maintain hydration and fluid volume through increased oral intake and IV fluids if needed.
The patient experienced difficulty breathing and an increased heart rate. The nursing care focuses on improving airway clearance through breathing exercises, coughing, and expectorating secretions to maintain an open airway.
The patient presented with symptoms of pneumonia including cough with phlegm, shortness of breath, and abnormal breath sounds. The nursing care plan within the next 8 hours aims to improve gas exchange and maintain optimal respiration through monitoring, medication administration, and health teaching.
The patient reported frequent, loose stools and was at risk for electrolyte imbalance from dehydration. The goal is to maintain hydration and fluid volume through increased oral intake and IV fluids if needed.
The patient experienced difficulty breathing and an increased heart rate. The nursing care focuses on improving airway clearance through breathing exercises, coughing, and expectorating secretions to maintain an open airway.
The patient presented with symptoms of pneumonia including cough with phlegm, shortness of breath, and abnormal breath sounds. The nursing care plan within the next 8 hours aims to improve gas exchange and maintain optimal respiration through monitoring, medication administration, and health teaching.
The patient reported frequent, loose stools and was at risk for electrolyte imbalance from dehydration. The goal is to maintain hydration and fluid volume through increased oral intake and IV fluids if needed.
The patient experienced difficulty breathing and an increased heart rate. The nursing care focuses on improving airway clearance through breathing exercises, coughing, and expectorating secretions to maintain an open airway.
The patient presented with symptoms of pneumonia including cough with phlegm, shortness of breath, and abnormal breath sounds. The nursing care plan within the next 8 hours aims to improve gas exchange and maintain optimal respiration through monitoring, medication administration, and health teaching.
The patient reported frequent, loose stools and was at risk for electrolyte imbalance from dehydration. The goal is to maintain hydration and fluid volume through increased oral intake and IV fluids if needed.
The patient experienced difficulty breathing and an increased heart rate. The nursing care focuses on improving airway clearance through breathing exercises, coughing, and expectorating secretions to maintain an open airway.
Subj: “Nag sige og Impaired gas Within 8 hours of 1. Establish Goal Partially Met: suka akong anak exchange related to rendering nursing rapport Within 8 hours of gahapon, grabe na collection to mucus in care the patient will: 2. Monitor vital rendering nursing care iyang ka putla sa sige airway secondary to - Have good signs and the patient have: og ubo grabe and pneumonia hydration status regulate IVF - Good hydration plema murag ga luwa - Skin warm to 3. Monitor intake status na iyang mata” As touch and output - Skin warm to verbalized by the - Have better 4. Assess clinical touch mother of the patient health status signs for - Maintained - Maintain dehydration optimal gas Obj: optimal gas 5. Administer exchange as - Shortness of exchange as medication as evidence by breath - Abnormal evidence by ordered by the unlabored breath sound unlabored physician respirations - Productive cough respirations 6. Health teaching to the parent of VS the patient Temp: 36.5 RR: 28 PR: 110 DIARRHEA
Subj: Risk for electrolyte Within 8 hours of 1. Establish Goal Met “Grabe akong pag imbalance related to rendering nursing care rapport with libang nag sige kog excessive loose the patient will: patient. Within 8 hours of balik balik og cr, basa watery stool - Have good 2. Monitor, rendering nursing care pod kaayo akong tae secondary to diarrhea hydration status measure and the patient: nag sakit na akong - Maintain fluid record intake - Have good lubot sigeg libang” As volume at a and output hydration status verbalized by the functional level 3. Assess clinical - Maintained fluid patient - Drink lot of signs of volume at a fluids hourly dehydration functional level Obj: - Report 4. Administer IVF - Have taken a - Loose watery reduction of fluid like lot of fluids stool for 7 times loose water electrolytes as hourly already stools prescribed by the physician VS. 5. Assess the Temp: 36.5 cause of RR: 20 diarrhea & PR: 87 identify the BP: 110/60mmhg frequency, consistency and color of the stool 6. Instruct client to maintain hygiene in peri- anal area HYPERTENSION
Subj: “Nag lisod jod Ineffective airway Within 8 hours or 1. Establish rapport Goal Partially Met kog hinga maam, clearance related to rendering nursing with patient Within 8 hours or murag gina apas nako increased production care the patient will: 2. Monitor vital signs rendering nursing akong hininga, guot of secretions - Demonstrate 3. Monitor intake and care the patient have: kaayo akong dughan” behaviours to output - Demonstrated As verbalized by the improve 4. Auscultate Breath behaviours to patient airway sounds improve airway clearance and 5. Observe sputum clearance and Obj: cough color, odor and cough - Dyspnea effectively volume effectively - Productive - Expectorate 6. Encourage patient - Expectorated Cough secretions to do breathing secretions - Maintain and coughing - Maintained VS: patent airway exercise patent airway. Temp: 36.7 7. Do health teaching RR: 25 to patient and PR: 65 family BP: 100/80 CHRONIC OBSTRCTUCTIVE PULMONARY DISEASE
Subj: Non-compliance to the Within 8 hours or 1. Establish rapport Goal Partially Met: “Kalit ra ko nalipong og therapeutic regimen rendering nursing with patient Within 8 hours or natumba sa balay, grabe related to life long care the patient will: 2. Monitor vital signs rendering nursing care kasakit akong ulo og init treatment protocols - Have good 3. Elevate head and the patient: kaayo akong pamati” As secondary to blood encourage - Have good blood verbalized by the patient hypertension pressure frequent changes pressure status status of position - Have stable Obj: - Have stable 4. Encourage deep cardiac rythym Increased BMI cardiac breathing - Patient have Agitated Behaviour rythym 5. Advice the family verbalized its Obesity - Patient will to support the understanding verbalized client to better and regarding the VS: healthy lifetsyle understandin disease and Temp: 36.2 6. Educate patient g of the importance of RR: 20 and family and do disease and treatment regimen PR:90 health teaching importance BP: 190/110 of treatment regimen
URINARY TRACT INFECTION
Assessment Nursing Diagnosis Planning Intervention Evaluation Subj. Acute pain related to Within 8 hours of 1. Establish Goal Met “Sakit kaayo mag ihi biological factors rendering nursing care rapport with Within 8 hours of maam og medjo ga such as trauma or the patient will: patient rendering nursing care katol didtos baba dapit activity od disease - Have increased 2. Monitor vitals the patient maam” process fluid intake signs and - Have increased - Have good regulation of fluid intake Obj: perineal hygiene IVF - Has good - Perineal - Eliminate the 3. Monitor intake perineal Excoriations infection and and ouput hygiene - Restlesness prevent 4. Assess for pain - Eliminated the - Redness and recurrence characteristics infection and swelling in 5. Encourage prevent perineal area patient to void recurrence - Urinalysis frequently shows pus cells 6. Encourage & epithelial patient cells verbalization of VS: feelings Temp: 37.3 7. Observe further RR: 19 complaints PR: 82 BP: 120/90