Careplan

NURSING EXPECTED PATIENT ASSESSMENT ACTION TEACHING

DIAGNOSES OUTCOMES interventions: interventions: interventions:
(consider orders, (consider home
(note priority for Be sure they are S. (assess /
safety, allergies, regimens,
each below) M. A. R. T. (Specific, monitor for )
code status, fall procedures,
measureable,
(Be sure to use risk, etc.) discharge plan,
achievable/
related to and etc.)
attainable, relevant
as evidenced
and time-bound)
by)

Impaired gas Patient will practice Assess for signs Place on Teach husband
exchange r/t deep breathing of respiratory supplemental signs of
COPD AEB SOB, exercises on an distress like oxygen if O2 respiratory
pneumonia, and incentive spirometer restlessness, saturations drop distress.
labored breath 7 times a day for 3 wheezing, below 93%.
Have patient
sounds. days ending sweating, and
Leave HOB demonstrate
10/21/2017. increase
elevated at 30% ability to
breathing rate
during sleeping. effectively use
Monitory O2 incentive
saturations spirometer
every hour. before
discharge.

Risk of Patient will intake Assess and Administer the Have patient
constipation r/t 15 grams of dietary record color, appropriate record each
bowel protocol fiber total after 3 size, and bowel protocol bowel moment
and miralax. meals for 5 days consistency of laxatives per they have upon
ending 10/23/2017. each movement. physicians discharge from
order. if BM not hospital
observed after 4
Teach patient
days
about specific
Have patient foods that are
intake adequate high in fiber
amounts of
Teach patient
water and walk
bowel protocol
around to
and have them
stimulate
recite it back to
movement of you before
bowels. discharge