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DIAGNOSIS
Risk for infection SHORT TERM Note risk factors for To assess SHORT TERM
OBJECTIVE related to invasion At the end of the shift occurrence of infection. causative/contributing At the end of the
Prolonged admission in of pathogenic the parents of the client factors. shift, the client was
the hospital microorganism as will Stress proper hand Able to verbalize
manifested by Verbalize hygiene. To reduce/prevent and understand the
Chronic disease exposure to understanding of cross contamination or causative factors and
causative factors individual Stress proper use of spread of the infection. identify interventions
Use of pharmaceutical causative/risk personal equipment. to prevent/reduce
agents - Prolonged admission factors. infection.
(immunosuppressant) in the hospital Maintain sterile
Identify interventions
- Iressa (gefitinib) technique in all the
250mg/tab 1 tab OD - Chronic disease to prevent/reduce LONG TERM
procedures for the
Poor personal hygiene
the risk for infection After one week of
patient.
- Use of nursing intervention,
pharmaceutical LONG TERM Teach the patient how To promote wellness. the client
agents After one week of to maintain a clean Outcome not yet
(immunosuppressant) nursing intervention, the environment. met (not yet
- Iressa (gefitinib) client will completing the time
250mg/tab 1 tab frame)
Demonstrate
OD techniques, lifestyle
changes to promote
safe environment
Assessment Nursing Diagnosis Planning Intervention Rationale Evaluation
Objective: Impaired Short term goal: Determine diagnosis This will help the Short term goal:
Client is on physical After 8 hours of that contributes to healthcare provider After 8 hours of nursing
traction mobility related nursing intervention immobility to determine what intervention the client
Limited ability to to neuromuscular the client can Note decreased kind of intervention was able to
perform impairment as demonstrate motor to be use demonstrate
gross/fine motor manifested by the techniques/behavior agility/essential To lessen the techniques/behavior
skills presence of that enable tremor related to age tension to the that enable resumption
Requires help traction. resumption of Determine degree of exercise to be done of activities
from another activities immobility Assessment on the
person for Note emotional clients condition Long term goal:
assistance and Long term goal: /behavioral Feelings of After 3 days of nursing
supervision After 3 days of nursing responses to problem frustrations/powerl intervention the client
Client was intervention the client of immobility essness may impede was able to maintain or
diagnose with can maintain or Provide safety attainment of goal increase strength and
idiopathic increase strength and measures as To prevent further function of affected
scoliosis function of affected indicated by complication to the and/or compensatory
and/or compensatory individual situation, client body part
body part including This enhances
environmental commitment to plan
management/ fall and optimizing the
prevention. outcomes
Encourage the client’s
involvement in
decision as much as
possible