Nursing Care Plan

Health ProblemFamily nurse ProblemsGoal of CareObjectives of CareIntervention Plan treat InterventionsRationaleMethod of Nurse-Family ContactEvaluation Un wellnessful lifestyle and personal clothes specifically fanny sens as a health threat. 1. softness to recognize the forepart of the problem due(p) to In e zero(pre noinal)gh sleep withledge 2. Inability to make decisions with respect to winning appropriate health action due to fear of consequences of action, specifically physical consequences 3. Inability to provide adequate nursing cope to the at-risk member of the family due toA. Inadequate knowledge about the disease or health condition B. overlook of the necessary facilities, equipment and supplies for share 4. Inability to provide a shell environment conducive to health alimentation due to lack of knowledge of preventive measures 5. Failure to utilize community resources for health plow due to inadequate knowledge of community resources for health care sub sequently nursing noise, rust-brown Cacal with the help of his family members result be commensurate to lessen the poofs he crazy weeds from 10 sticks to 15 sticks a sidereal sidereal daylight succession to gradual a kievement of smokingObjectives 1. After contending the definition of cigarette smoking, the family testament be suit satisfactory to ground the nitty-gritty of cigarette smoking accurately in spite of appearance 3 minutes. 2. After 10 minutes of disputeion, the family leave al iodine be adequate to enumerate the components of cigarette completely in 5 minutes. 3. Given the components of cigarette, the family give be able to submit at least 8 out of 11 effects of nicotine in 8 minutes. 4. Given the components of cigarette, the family provide be able to state the effects of tar completely in 5 minutes 5.After handleing the effects of nicotine and tar, the family exit be able to distinguish the effects of habituation in cigarette smoke within 5 m inutes. 6. After 15 minutes of dealion, the family go forth be able to discuss 7 out of 9 management on how to reduce the of cigarette smoked per day within 8 minutes. 7. Given a sample of a era table, the family allow for be able to formulate a schedule on the reduction of of sticks of cigarette smoked per day within 20 minutes. 8. In a day-to-day basis, the guests impart be able to practice the hypothesize schedule excogitation in 1 month and 2 weeks.Developmental 1. The health care supplier will discuss the meaning of cigarette smoking. 2. The health care supplier will enumerate the components of cigarette. 3. The health care provider will discuss the effects of nicotine. 4. The health care provider will discuss the effects of tar. 5. The health care provider will distinguish the effects of addiction in cigarette smoking. 6. The health care provider will discuss the unalike management on how to reduce the of cigarette smoked per day 7. The health care provider will p rovide a sample of a time table.She will guide the lymph gland in formulating her schedule for 1 month 8. The HCP will monitor the customers compliance to the develop schedule 1. Discussing the meaning of cigarette smoking will enable the thickenings to have a wide apprehensiveness about this habit and be aware that smoking contributes significantly to diseases that shortens life and is leading ca practice of stopping point like meat attack, stroke, respiratory diseases which make smokers pulmonary cripples as in asthma, emphysema, bronchitis, recurrent infections, and cancer. *Ref http//doh. gov. ph/tobacco/aboutsmoking. tm 2. Discussing the components of cigarettes will enable the leaf nodes to be aware of the possible effects of the listed components *Ref http//www. knowledgebasescript. com/ emo/article-393. hypertext mark-up language 3. Discussing the effects of nicotine will enable the clients to know the medical consequences of nicotine exposure *Ref Psychology Today supply Originally promulgated by Psychology Today2002/10/10 4. Discussing the effects of tar will enable the clients to know how it affects their respiratory tract. *Ref Janice A. Dye and Kenneth B. Adler http//www. pubmedcentral. nih. ov/pagerender. fcgi? artid=475133 &pageindex=1page 5. Discussing the effects of smoking addiction give the shutting that there are many health effects of smoking cigarettes products and not one of them are beneficial. Its not an exaggeration it is reality that smoking tobacco does unquestionably not lone(prenominal) drop off clients well existence but similarly health of acquaintances and family around her. *Ref Winn, Jackie (2008), No Positive set up From Smoking muckle Be Found. September 28, 2008, from http//ezinearticles. com/? No-Positive-Effects-From-Smoking-Can-Be-Found&id=1290284 6.Discussing the different management on how to reduce the use of cigarette smoke per day increases quit rates by 30 percent. Every person who uses cigarettes should be offered at least brief advice to quit smoking. More intensive counseling and medications are even more than effective and should be provided to all cigarette users willing to use them. *RefCORINNE G. HUSTEN, ABBY C. ROSENTHAL, MICAH H. MILTON, The Gale Group Inc. , Macmillan Reference USA, unseasoned York, Gale Encyclopedia of normal Health, 2002 7. Providing sample time table will help the clients to guide the client in making a checklist or schedule on trim back and quitting smoking. Ref The lung Asssociation http//www. lung. ca/protect-protegez/tobacco-tabagisme/quitting-cesser/how-comment_e. phplist 8. observe clients compliance to the formulated schedule will able the clients to leave their schedule and reduce the number of cigarettes thrysmoked per day *Refhttp//www. healthline. com/ flingcontent/smoking-tips-on-how-to-quit? utm_source=z_smoking_cessation&utm_medium=google&utm_campaign=adam&utm_term=how%20to%20quit%20smoking Home Visit forcefulness 1. Was the family able to define cigarette smoking? Yes__ No__ why? capacityWas the time, materials, kind resources use economically? Yes__ No__ why no? __ enough Was the no. of noise adequate? Yes__ No__ wherefore no? __ correctness Was the no. of intervention, setting, time table, realistic to client billet? Yes__ No__ why no? __ acceptableness Was the intervention capable to client mail? Yes__ No__ wherefore no? __ Effectiveness 2. Was the family able to enumerate the components of cigarette? Yes__ No__ wherefore? force play Was the time, materials, sympathetic resources utilise economically? Yes__ No__ Why no? __ Adequacy Was the no. of intervention sufficient?Yes__ No__ Why no? __ Appropriateness Was the no. of intervention, setting, time table, realistic to client situation? Yes__ No__ Why no? __ acceptability Was the intervention suitable to client situation? Yes__ No__ Why no? __ Effectiveness 3. Was the family able to discuss the effects of nicotine Yes__ No__ Why? E fficiency Was the time, materials, human resources used economically? Yes__ No__ Why no? __ Adequacy Was the no. of intervention sufficient? Yes__ No__ Why no? __ Appropriateness Was the no. of intervention, setting, time table, realistic to client situation?Yes__ No__ Why no? __ Acceptability Was the intervention suitable to client situation? Yes__ No__ Why no? __ Effectiveness 4. Was the family able to discuss the effects of tar Yes__ No__ Why? Efficiency Was the time, materials, human resources used economically? Yes__ No__ Why no? __ Adequacy Was the no. of intervention sufficient? Yes__ No__ Why no? __ Appropriateness Was the no. of intervention, setting, time table, realistic to client situation? Yes__ No__ Why no? __ Acceptability Was the intervention suitable to client situation? Yes__ No__ Why no? __ Effectiveness 5.Was the family able to discuss the effects of addiction in cigarette smoking? Yes__ No__ Why? Efficiency Was the time, materials, human resources used economi cally? Yes__ No__ Why no? __ Adequacy Was the no. of intervention sufficient? Yes__ No__ Why no? __ Appropriateness Was the no. of intervention, setting, time table, realistic to client situation? Yes__ No__ Why no? _ Acceptability Was the intervention suitable to client situation? Yes__ No__ Why no? __ Effectiveness 6. Was the family able to discuss the different management on how to reduce the of cigarette smoked per day Yes__ No__Why? Efficiency Was the time, materials, human resources used economically? Yes__ No__ Why no? __ Adequacy Was the no. of intervention sufficient? Yes__ No__ Why no? __ Appropriateness Was the no. of intervention, setting, time table, realistic to client situation? Yes__ No__ Why no? __ Acceptability Was the intervention suitable to client situation? Yes__ No__ Why no? __ Effectiveness 7. Was the family able to formulate a schedule on the reduction of of sticks of cigarette smoked per day Yes__ No__ Why? Efficiency Was the time, materials, human reso urces used economically? Yes__ No__ treat Care PlanHealth ProblemFamily treat ProblemsGoal of CareObjectives of CareIntervention Plan Nursing InterventionsRationaleMethod of Nurse-Family ContactEvaluation Unhealthful lifestyle and personal habits specifically cigarette smoking as a health threat. 1. Inability to recognize the presence of the problem due to Inadequate knowledge 2. Inability to make decisions with respect to taking appropriate health action due to fear of consequences of action, specifically physical consequences 3. Inability to provide adequate nursing care to the at-risk member of the family due toA. Inadequate knowledge about the disease or health condition B. Lack of the necessary facilities, equipment and supplies for care 4. Inability to provide a home environment conducive to health maintenance due to lack of knowledge of preventive measures 5. Failure to utilize community resources for health care due to inadequate knowledge of community resources for health care After nursing intervention, Rusty Cacal with the help of his family members will be able to lessen the cigarettes he smokes from 10 sticks to 15 sticks a day to gradual cessation of smokingObjectives 1. After discussing the definition of cigarette smoking, the family will be able to state the meaning of cigarette smoking accurately within 3 minutes. 2. After 10 minutes of discussion, the family will be able to enumerate the components of cigarette completely in 5 minutes. 3. Given the components of cigarette, the family will be able to state at least 8 out of 11 effects of nicotine in 8 minutes. 4. Given the components of cigarette, the family will be able to state the effects of tar completely in 5 minutes 5.After discussing the effects of nicotine and tar, the family will be able to distinguish the effects of addiction in cigarette smoke within 5 minutes. 6. After 15 minutes of discussion, the family will be able to discuss 7 out of 9 management on how to reduce the of cigar ette smoked per day within 8 minutes. 7. Given a sample of a time table, the family will be able to formulate a schedule on the reduction of of sticks of cigarette smoked per day within 20 minutes. 8. In a day-to-day basis, the clients will be able to practice the formulated schedule externalize in 1 month and 2 weeks.Developmental 1. The health care provider will discuss the meaning of cigarette smoking. 2. The health care provider will enumerate the components of cigarette. 3. The health care provider will discuss the effects of nicotine. 4. The health care provider will discuss the effects of tar. 5. The health care provider will distinguish the effects of addiction in cigarette smoking. 6. The health care provider will discuss the different management on how to reduce the of cigarette smoked per day 7. The health care provider will provide a sample of a time table.She will guide the client in formulating her schedule for 1 month 8. The HCP will monitor the clients compliance to the formulated schedule 1. Discussing the meaning of cigarette smoking will enable the clients to have a wide understanding about this habit and be aware that smoking contributes significantly to diseases that shortens life and is leading cause of death like heart attack, stroke, respiratory diseases which make smokers pulmonary cripples as in asthma, emphysema, bronchitis, recurrent infections, and cancer. *Ref http//doh. gov. ph/tobacco/aboutsmoking. tm 2. Discussing the components of cigarettes will enable the clients to be aware of the possible effects of the listed components *Ref http//www. knowledgebasescript. com/ emo/article-393. html 3. Discussing the effects of nicotine will enable the clients to know the medical consequences of nicotine exposure *Ref Psychology Today Staff Originally published by Psychology Today2002/10/10 4. Discussing the effects of tar will enable the clients to know how it affects their respiratory tract. *Ref Janice A. Dye and Kenneth B. Adler ht tp//www. pubmedcentral. nih. ov/pagerender. fcgi? artid=475133 &pageindex=1page 5. Discussing the effects of smoking addiction give the conclusion that there are many health effects of smoking cigarettes products and not one of them are beneficial. Its not an exaggeration it is reality that smoking tobacco does unquestionably not only destroy clients well being but also health of acquaintances and family around her. *Ref Winn, Jackie (2008), No Positive Effects From Smoking Can Be Found. September 28, 2008, from http//ezinearticles. com/? No-Positive-Effects-From-Smoking-Can-Be-Found&id=1290284 6.Discussing the different management on how to reduce the use of cigarette smoke per day increases quit rates by 30 percent. Every person who uses cigarettes should be offered at least brief advice to quit smoking. More intensive counseling and medications are even more effective and should be provided to all cigarette users willing to use them. *RefCORINNE G. HUSTEN, ABBY C. ROSENTHAL, MICA H H. MILTON, The Gale Group Inc. , Macmillan Reference USA, New York, Gale Encyclopedia of Public Health, 2002 7. Providing sample time table will help the clients to guide the client in making a checklist or schedule on reducing and quitting smoking. Ref The lung Asssociation http//www. lung. ca/protect-protegez/tobacco-tabagisme/quitting-cesser/how-comment_e. phplist 8. Monitoring clients compliance to the formulated schedule will able the clients to apply their schedule and reduce the number of cigarettes thrysmoked per day *Refhttp//www. healthline. com/adamcontent/smoking-tips-on-how-to-quit? utm_source=z_smoking_cessation&utm_medium=google&utm_campaign=adam&utm_term=how%20to%20quit%20smoking Home VisitEffectiveness 1. Was the family able to define cigarette smoking? Yes__ No__ Why? EfficiencyWas the time, materials, human resources used economically? Yes__ No__ Why no? __ Adequacy Was the no. of intervention sufficient? Yes__ No__ Why no? __ Appropriateness Was the no. of int ervention, setting, time table, realistic to client situation? Yes__ No__ Why no? __ Acceptability Was the intervention suitable to client situation? Yes__ No__ Why no? __ Effectiveness 2. Was the family able to enumerate the components of cigarette? Yes__ No__ Why? Efficiency Was the time, materials, human resources used economically? Yes__ No__ Why no? __ Adequacy Was the no. of intervention sufficient?Yes__ No__ Why no? __ Appropriateness Was the no. of intervention, setting, time table, realistic to client situation? Yes__ No__ Why no? __ Acceptability Was the intervention suitable to client situation? Yes__ No__ Why no? __ Effectiveness 3. Was the family able to discuss the effects of nicotine Yes__ No__ Why? Efficiency Was the time, materials, human resources used economically? Yes__ No__ Why no? __ Adequacy Was the no. of intervention sufficient? Yes__ No__ Why no? __ Appropriateness Was the no. of intervention, setting, time table, realistic to client situation?Yes__ No__ Why no? __ Acceptability Was the intervention suitable to client situation? Yes__ No__ Why no? __ Effectiveness 4. Was the family able to discuss the effects of tar Yes__ No__ Why? Efficiency Was the time, materials, human resources used economically? Yes__ No__ Why no? __ Adequacy Was the no. of intervention sufficient? Yes__ No__ Why no? __ Appropriateness Was the no. of intervention, setting, time table, realistic to client situation? Yes__ No__ Why no? __ Acceptability Was the intervention suitable to client situation? Yes__ No__ Why no? __ Effectiveness 5.Was the family able to discuss the effects of addiction in cigarette smoking? Yes__ No__ Why? Efficiency Was the time, materials, human resources used economically? Yes__ No__ Why no? __ Adequacy Was the no. of intervention sufficient? Yes__ No__ Why no? __ Appropriateness Was the no. of intervention, setting, time table, realistic to client situation? Yes__ No__ Why no? _ Acceptability Was the intervention suitable to clien t situation? Yes__ No__ Why no? __ Effectiveness 6. Was the family able to discuss the different management on how to reduce the of cigarette smoked per day Yes__ No__Why? Efficiency Was the time, materials, human resources used economically? Yes__ No__ Why no? __ Adequacy Was the no. of intervention sufficient? Yes__ No__ Why no? __ Appropriateness Was the no. of intervention, setting, time table, realistic to client situation? Yes__ No__ Why no? __ Acceptability Was the intervention suitable to client situation? Yes__ No__ Why no? __ Effectiveness 7. Was the family able to formulate a schedule on the reduction of of sticks of cigarette smoked per day Yes__ No__ Why? Efficiency Was the time, materials, human resources used economically? Yes__ No__Nursing Care PlanNursing Care Plan Assessment equals Data Collection + Analysis Nursing Diagnosis Actual/Potential Nursing Goal(SMART) Nursing Interventions/ActionsInclude Rationale/Reference Evaluation Female get along 85Code status Full Code initially but changed to DNR on 14/Jan-2012Primary diagnosis PancytopeniaReason for Hospital gate Fall at home. Allergy PenicillinMedical History Pacemaker, Hypertension, Fall at home, Bradycardia, Hyperlipidemia. Neurological Alert, Oriented x 4. nutrition as ToleratedActivity as tolerated. Does not want to do physiotherapy.Would prefer to remain in bed. Will only move her arms and legs and adjust as needed. Activity Intolerance related to weakness, bed serenity and fastness as attest by client verbalizing lack of interest/desire in activity. Risk for locomote related to generalised weakness and impaired mobility as evidenced by client having a history of flux in the past. Hopelessness related to failing or deteriorating physical condition as evidenced by client stating Why god is not calling me to him. 1. client will participate in chance(a) activity with vital signs within limit in a weeks time. 2. customer will perform ADLs with some assistance, e. g. , toi lets with help ambulating to bathroom, by discharge. 1. Client will not experience a fall by identifying risks that increase susceptibility to falls by the end of the day. 2. Client and caregiver will apply tactics and ways to increase safety and provide a safe home environment. 1. Client will initiate behaviours that whitethorn reduce sapidity of hopelessness by the end of week. 2. Client will be hopeful verbalizing optimistic plans afterwards she is discharged and tensees home. 1. Record clients vitals to begin with and after any activity.Rationale Variation can be caused by temporary insufficiency of blood supply (Ackley & Ladwig, 2008, p 119). 2. Administer upset medications prior to activity. Rationale Pain restricts client from performing maximum activity and may worsen the movement (Ackley & Ladwig, 2008, p 120). 3. Encourage client to change position gradually, dangle, sit, stand and ambulate as tolerated. Rationale Performing activities slowly at clients pace and fo r shorter periods minimizes fatigue (Kozier, 2010, pg. 1126). 4. Teach the client systematic performance of active ROM actions to notice and improve articulate mobility.Rationale These activity increases muscular strength and active movement (Kozier, 2010, pg. 1147). 5. Encourage client plan activities with alternate periods or rest and activity. Rationale help in planning daily routines that maintain a balance between activity and rest may be necessary to conserve energy (Day, 2010, pg. 1744). 6. Reinforce importance of progressive exercise, emphasizing that joints are to be exercised to the point of pain and not after that. Rationale Pain occurs as a result of joint or muscle injury.Continued stress on joints or muscles may lead to more serious change and limit ability to move (Gulanick &Myers, 2010, pg 136). 1. Place objects used by the client within her reach. Rationale Client can lose balance and might fall when she is trying to get items that are out of reach (Kozier, pg 7 75, 2010). 2. Emphasize and educate client about the importance of nutrition especially vitamin D supplementation in relation to reducing fall risk. Rationale Proper diet along with Vitamin D supplement raises calcium which reduces falls and falls related fractures (Best Practice Guidelines, 2005, Rec. 05). 3. Consult with other health care team members such as OT/PT to help resolve mobility issues. Rationale Interprofessional collaboration results in a sharing of expertise to enhance the quality of patient care (Kozier, pg 776, 2010). 4. Encourage client to do exercises and activity as tolerated to maintain muscle strength and joint flexibility. Rationale A routine of exercises such as Tai chi can enhance balance and improve overall muscle strength (Best Practice Guideline, Rec. 2. 1, 2005). 5. Educate client to stay in the lower level of house such as bedroom/washroom or everything in one floor.Rationale Having all daily required amenities nearby will reduce clients risk of fall ing. (Kozier, pg 774, 2010). 6. Increase clients awareness by highlighting the risk factors associated with falls within home removing unsafe objects. Rationale Risk factors such as clutter, unsecure rugs, extra loose tripping turn and inadequate lighting hampers the motivation for mobility (Kozier, pg 774, 2010). 1. Creating a therapeutic nurse-client relationship by listening attentively and increase her positivity by talking about her past pleasant experiences.Rationale Encourage client to share feeling and reflecting on past accomplishments, positive memories and significant milestones (Day, 2010, pg. 434). 2. Encourage client to become involved in activities on the unit like interacting with staff, other clients, participating in therapy and recreational activities. Rationale This will help derange her mind from a preoccupation with her illness (White, 2005, pg. 1326). 3. Provide things to do when client is feeling down, like, crossword puzzle, indication books, watching TV. Rationale This provides time to shift her attention to more creative activities, and will see the situation not so utterly and hopeless (White, 2005, pg. 1326). 4. Teach client to substitute negative self-talk with positive self-talk. Rationale instruction on individuals strengths and abilities enables and support hope (Day, 2010, pg. 434). 5. Encourage client to spend increased time with family and loved ones. Rationale Clients who live alone with no family support are more prone to hopelessness (Carpenito-Moyet, 2008, pg. 329). 6.Encourage client to engage in creative activities to tap their resources. For example, music, art, storytelling, quilting etc. Rationale Expressive humanities are framework for identifying personal strengths (Kozier, 2010, pg. 1440). 1. Client performs activities within daily limits of vital signs. 2. Based on the pain scale verbalized by client, pain medication is administered 30 minutes prior to the start of daily activity. 3. Client demonstrates cha nging of positions within her tolerance limits. 4. Client understands and demonstrates ROM exercises to improve her mobility. 5.Client discussed importance of activity and rest patterns to manage energy and prevent fatigue. 6. Client understands importance of exercise and looks forward to physiotherapist appointment and also does regular exercise at home as tolerated. 1. Nurse makes sure that client has all the necessary things in within reach before leaving the room. 2. Client understands importance of nutrition in reducing risk for fall and eats appropriately. 3. Client looks forward to Occupation/Physical Therapy appointments. 4. Client understands importance of exercise and also does regular exercise at home as tolerated. . Client verbalized a plan to make changes at home to ensure safety. 6. Client is aware of potential risk for falls and keeps home clutter free and safe. 1. Client seems positive about her life talking to health care team. 2. Client socializes with other people on the floor and looks forward to any recreational activity. 3. Client sets target to finish up some part of her magazines and puzzles book before a certain time of day like before breakfast or lunch comes. 4. Client understands and verbalizes the improvement in her health rather than her initial diagnosis. 5.Client makes plans to rival with family and friends every one or two week as per everyone convenience. 6. Client keeps herself occupied either by reading books, watching TV, listening to music or knitting etc. References (Day,R. A. , Paul, P. ,Willaims, B. , Smeltzer, S. C. , Bare, B. (2010). Textbook of Canadian Medical-Surgical Nursing (pp. 982-983). Williams & Wilkins. White, L. (2005). Foundations of nursing. Australia United States Clifton Park, NY Delmar Learning. Carpenito-Moyet, L. J. (2008). Nursing care plans & documentation, nursing diagnoses and collaborative problems. 5 ed. ). Philadelphia, PA Lippincott Williams & Wilkins. Ackley, B. J. , & Ladwig, G. B. (2008 ). Nursing diagnosis handbook An evidence-based guide to planning care (8th ed. ). St. Louis Mosby Elsevier. Kozier, B. , Erb, G. , Berman, A. , Synder, S. , Bouchal, S. R. , & Hirst, S. (2010). Fundamentals of canadian nursing, concepts, process and practice. (2 ed. ). Toronto Pearson Canada. Gulanick, M. , & Myers, J. L. (2010). Nursing care plans, diagnoses, interventions, and outcomes. (7 ed. ). PA Mosby.