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Assessment Nursing Diagnosis Goal Interventions Rationale Evaluation

Subjective Cues: (P+E or P+E+S) Patient shall verbalize Independent: Fully Met:
I feel pain in my body Acute Pain related to relief or control of pain. Assess for pain. Note -Sickling of cells verbalize relief or
"as verbalized by the Activation of pain fibers Long Term Objectives: location, duration, and potentiates cellular control of pain and
patient . due to deprivation of After 1 week of nursing intensity (scale of 0-10). hypoxia and may lead to patient will
oxygen and nutrients, intervention patient will Apply warm, moist infarction of tissues with Demonstrate
accumulation of noxious verbalize sense of compresses to affected joints resultant pain. Pain relaxed body
metabolites .As evidence control of response to and other painful areas. usually occurs in the back, posture, have
by generalized pain, acute station and Avoid use of ice or cold ribs, and limbs and may freedom of
described as throbbing, positive outlook to the compresses last for days. movement, be able
gnawing, or severe and future . Dependent: to sleep/rest
Objective Cues: incapacitating; affecting Short Term Objectives As ordered by the doctor -Warmth causes appropriately.
• Facial grimacing. peripheral extremities, After 2 hours of nursing administer morphine . vasodilation and
• Restlessness . bones, joints, back, intervention patient will increases circulation to Partially Met:
• Distraction abdomen, (headaches Demonstrate relaxed hypoxic areas. Cold patient will verbalize
behavior . recurrent/transient) body posture, have Collaborative: causes vasoconstriction sense of control of
• narrowed/self- freedom of movement, Give medicines as directed. and compounds the crisis. response to acute
focus. be able to sleep/rest station and positive
• Pain scale 9 appropriately outlook to the

Revision #2 1st sem 2018-2019