ASSESSMENT DIAGNOSIS PLANNING NURSING RATIONALE EVALUATION

INTERVENTION
SUBJECTIVE: STO: Dx: STO:
“Napansin ko na Decreased Within 8 hours > Monitored >Comparison of After 8 hours of nursing
bigla na lang cardiac output of nursing blood pressures interventions, goal met:
bumigat ang related to interventions, pressure of the provides a more
timbang ko” (I decreased the patient patient. complete >The patient was able to
noticed that I venous return. will be able Measure picture of participate in
gained a to: in both arms or vascular activities that reduce
lot of weight) as thighs three involvement or blood pressure or
verbalized by the >The patient times, 3-5 scope of the cardiac work load
patient. will minutes apart problem.
Objective: participate in while patient
• Variations in activities is at
blood that rest, then
pressure. reduce blood sitting,
• Edema pressure or then standing
• V/S taken as cardiac work for
follows: load. initial
T: 37.1 evaluation.
P: 78
R: 20 LTO: > Observed skin > Presence of LTO:
BP: 140/90 >Within 3 days color, pallor, cool, After 8 hours of nursing
of nursing moisture, moist skin and interventions, goal met:
interventions, temperature and delayed
the patient capillary capillary refill >The patient was able to
will be able refill time may be explains actions and
to: time. due to precautions to take care
peripheral for cardiac disease.
>The patient vasoconstriction
will explains
actions and
precautions to
take care for
cardiac > Noted >May indicate
disease. dependent heart failure,
or general renal or
edema. vascular
impairment.

> Provided >Help reduce

calm, restful sympathetic
surroundings, stimulation,
minimize promotes
environmental relaxation.
activity or
noise.

>Maintained > Reduces

activity physical stress
restrictions. and tension that
affect blood
pressure and
course of hypertension.

Tx:
> Administered >Depending on
medications as etiological factors,
prescribed, common medications
noting side include digitalis
effects and therapy, diuretics,
toxicity. vasodilator therapy,
antidysrhythmics,
angiotensin-converting
enzyme inhibitors, and
 > Assissted the initropic agents.
patient in
supine position >For hypovolemia,
supine positioning
increase venous return
Edx: and promotes diuresis.
> Implemented
dietary
sodium, fat, >These
and restrictions can
cholesterol help manage
restrictions as fluid retention
indicated. and with
associated
hypertensive
response,
which decrease
cardiac
workload.

SOURCES:

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https://www.scribd.com/doc/84658306/Ncp-for-Pregnancy-Induced-Hypertension