Name of Patient: Analyn M.

Tui Date of Admission: September 5, 2022 Room: 3002 Age: 29 years old Sex: Female Civil Status: Not
Stated Chief Complaint: Contractions and feeling uncomfortable. Religion: Not stated Attending Physician: Dr. Ong

Date / Time Cues Nursing Diagnosis

Rationale Evaluation

phenomenon of an from the surrounding during normal labor and

September 5, 2022 Nausea related to pain unpleasant feeling in (e.g., perfumes, delivery has been
7:10 AM the back of the throat dressings, emesis) shown to reduce the
Subjective: and risk of nausea in these
stomach, which may or situations.
may not result in Maintain fluid balance in The patient was able to
The patient is [diagnostic division: vomiting. patients at risk. report the
complaining of nausea. Food/Fluid] After 8 hours of Strong and noxious elimination of nausea
nursing intervention the odors can contribute to and verbalize some of
Objective: salivation patient will report relief nausea. the control techniques
● Increase in Rationale/ Scientific from nausea and will be to prevent nausea.
swallowing; basis: able to name strategies
● Trembling
● Increase in gagging to prevent nausea.
sensation A subjective Eliminate strong odors Sufficient hydration
Nsg Dx:
 Vital signs:

> Temperature:
37.6 degrees
Celsius Reference:
> Heart rate: 101
bpm > Respiratory These methods have helped patients
rate: alleviate the condition but needs to be used before it occurs.
17cpm
> Blood pressure:
90/60 mmHg

A well-ventilated room or having a fan close by promotes easier

breathing.

Aprn Bc, M. D. E., Crrn, M. M. R. M. F., & Bsn Rn, A. M. C. (2019, March 5). Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions and Rationales (Fifteenth). F.A. Davis
Company.