Assessment Diagnosis Inference Planning Interventions Rationale Evaluation

Impaired Patient will • Encourage • This aid the

physical state relief patient to assessment
mobility from pain. verbalize of the
related to pain Patient will pain and location,
or discomfort. begin to discomfort. quality and
accept Observe for intensity of
limitations non-verbal pain.
imposed by cues of
immobility and pain,
accompany including
lifestyle favoring a
changes. body part
and
grimacing. • To assess
• Perform the
the effectivene
prescribed ss of the
treatment treatment.
regimen for
the
underlying
condition
producive
pain or • To increase
discomfort. the muscle
• Encourage tone of and
patient in increase
active patient’s
movements feeling and
by using self-
assistive esteem.
devices. • This
• Implement prevents
ROM joint
excersises contracture
 every shift and muscle
after pain atrophy.
medication
unless
medically
contraindic
ated;
progress
from
passive as • To prevent
tolerated. skin
• Reposition breakdown.
patient
every 2
hours and
provide • To reduce
meticoulou anxiety and
s skin care. promote
• Encourage compliance
d patient to .
verbalize
feelings
and
concerns
about his
altered
state of
mobility
Assessment Diagnosis Inference Planning Interventions Rationale Evaluation
Impaired bone Patient’s • Apply • To reduce
tissue condition of continuous intensity of
perfusion impaired or inflammati
related to tissue will intermitten on.
continuation improves as t wet
infectious evidence by dressings. • To prevent
process. decreased • Discourage further
redness, rubbing injury and
swelling and and delayed
pain. scratching healing.
then
provide
gloves if • To treat
necessary. skin and
• Provide tissue
medicated infections.
soaks in
open
wound as • To treat
ordered. infection.
• Administer
IV • To enhance
antibiotics venous
as ordered return.
• encourage
early
ambulation • To
, when maximize
possible tissue
 • Elevate the perfusion.
legs when
sitting,
avoiding
sharp • To prevent
angulation further
at the injury.
lower
extremities
.
• Discourage
sitting/stan
ding for
long
periods,
wearing
constrictive
clothing,
crossing
legs.

Assessment Diagnosis Inference Planning Intervention Rationale Evaluation

Bone infection Patient • Assess • Assessmen
related to response to affected t allows for
infection that antibiotic area for care plan
has migrated therapy, as signs and modificatio
to bone tissue. evidence by symptoms n as
normal WBC, of needed.
negative infection. • To evaluate
wound culture • Assess lab further
findings. values, abnormaliti
especially es.
WBC and
sedimentat
ion rate.
• Assess • To aid in
bones scan establishin
finding. g
diagnosis.
• Obtain • Wound
appropriate cultures
cultures are
and; necessary
sensitivities to identify
; blood; causative
aspirate agent.
from bone
abscess if
present. • Aggressive
• Administer antibiotic
IV treatment
antibiotics is the
as ordered. primary
therapy.
• To prevent
• Provide dehydratio
fluids. n in febrile
state.
• to prevent
close
• Ensure contaminat
sterile ion
technique
during
dressing