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CUES NSG. DX ANALYSIS GOALS AND NSG.

RATIONALE EVALUATION
OBJECTIVES INTERVENTION
Disturbed Sleep Sleep deprivation Immediate Goals:
Pattern related to Cause: The client will
ineffective time Alteration in report an
Cues: management Sleeping optimal
I> the client state Pattern balance of
that he sleep and rest
has an Sleep deprivation Intermediate in 1 week
inadequat related to Cause:
e quantity sustained Interruptions Objective:
of sleep environmental from family After 5 Discuss the Discussing the Effectiveness:
because stimulation; members in minutes of factors that factors helps Was the client able to
of fully unfamiliar of his time of nursing contribute to the client identify 5 out of 10
booked uncomfortable sleep and in intervention, disturbed identify what factors that contribute
scheduled sleep his the client will sleeping pattern factors affects to disturbed sleeping
for school environment environment be able to such as: noise, the client’s pattern?
works identify 5 out lighting, ambient disturbed ___ Yes ___ No
Sleep deprivation: of 10 factors temperature and sleeping Why? ____________
O>Looks tired prolonged periods Health that contribute humidity, noxious pattern. ________________
Irritable of time without Implication: to disturbed odors, unfamiliar ________________
and sleep (sustained Insomnia is sleeping sleep furnishings,
anxious natural, periodic a symptom patterns. interruptions for
Excessive suspension of of a sleeping therapeutics,
stimulatio relative disorder monitoring,
n such as consciousness characterize laboratory test,
noise, d by other generated
interruptio persistent awakening,
n of family difficulty physical Was the client able to
members falling asleep restraints, lack of state all her usual
in her time or staying sleep sleep routine?
of sleep. asleep privacy/control, ___ Yes ___ No
despite the sleep partner Why?
M>Vital signs opportunity. After 5 _____________
BP – It is typically minutes of _________________
100/70 followed by nursing _________________
RR – 17 functional intervention Let the client cite Letting the
PR – 61 impairment the client will all his routines client cite his
T – 37.4 C⁰ while awake. be able to before going to routines Was the client able to
Insomniacs state all her bed such as enhances his sleep comfortably?
have been usual sleep watching ability to fall ___ Yes ___ No
known to routines television, asleep Why?
complain drinking hot milk _____________
about being or chocolate, _________________
unable to brushing teeth, _________________
close their praying etc.
eyes or "rest Efficiency
their mind" Encourage the Were the
for more After 20 client to do all interventions done
than a few minutes of bedtime routines. right and finished on
minutes at a nursing time?
time. interventions, ___ Yes ___ No?
the client will Discuss to the Why?
be able to client how _____________
sleep important the _________________
comfortably time _________________
management is.
Adequacy