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    NCP

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    yasayayasay yasay
    The patient reported anxiety related to an upcoming surgery. Upon assessment, the patient exhibited signs of anxiety including restlessness, a narrowed focus, voice quivering, and facial flushing. The nursing plan was to monitor the patient and provide interventions to reduce anxiety over 4 hours, including observing vital signs, behaviors, and defense mechanisms. The goal was to help the patient feel more relaxed and in control by providing accurate information and support. Intraoperatively, the patient was expected to establish effective breathing patterns. Postoperatively, the goal was for the patient to maintain function and skin integrity over 12 hours with interventions like pain medication, positioning, and encouraging adequate nutrition.

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    NCP

    Uploaded by

    yasayayasay yasay
    388 views4 pages
    The patient reported anxiety related to an upcoming surgery. Upon assessment, the patient exhibited signs of anxiety including restlessness, a narrowed focus, voice quivering, and facial flushing. The nursing plan was to monitor the patient and provide interventions to reduce anxiety over 4 hours, including observing vital signs, behaviors, and defense mechanisms. The goal was to help the patient feel more relaxed and in control by providing accurate information and support. Intraoperatively, the patient was expected to establish effective breathing patterns. Postoperatively, the goal was for the patient to maintain function and skin integrity over 12 hours with interventions like pain medication, positioning, and encouraging adequate nutrition.

    Original Description:

    Nursing Care Plan

    Original Title

    Ncp

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    The patient reported anxiety related to an upcoming surgery. Upon assessment, the patient exhibited signs of anxiety including restlessness, a narrowed focus, voice quivering, and facial flushing. The nursing plan was to monitor the patient and provide interventions to reduce anxiety over 4 hours, including observing vital signs, behaviors, and defense mechanisms. The goal was to help the patient feel more relaxed and in control by providing accurate information and support. Intraoperatively, the patient was expected to establish effective breathing patterns. Postoperatively, the goal was for the patient to maintain function and skin integrity over 12 hours with interventions like pain medication, positioning, and encouraging adequate nutrition.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    388 views4 pages

    NCP

    Uploaded by

    yasayayasay yasay
    The patient reported anxiety related to an upcoming surgery. Upon assessment, the patient exhibited signs of anxiety including restlessness, a narrowed focus, voice quivering, and facial flushing. The nursing plan was to monitor the patient and provide interventions to reduce anxiety over 4 hours, including observing vital signs, behaviors, and defense mechanisms. The goal was to help the patient feel more relaxed and in control by providing accurate information and support. Intraoperatively, the patient was expected to establish effective breathing patterns. Postoperatively, the goal was for the patient to maintain function and skin integrity over 12 hours with interventions like pain medication, positioning, and encouraging adequate nutrition.

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    © All Rights Reserved
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    of 4

    PR E O PE R AT I V E N C P

    ASSESSMENT DIAGNOSI PLANNING INTERVENTIO RATIONALE EVALUATI


    S N ON

    SUBJECTIVE: Anxiety After 4 hours of Monitor vital To identify Goal met as


    Kulbaan ko sa uma- related to nursing signs. physical evidenced by
    abot nga operasyon. actual/ intervention responses patient appear
    as verbalized by the perceived before the associated relaxed and
    patient. threat to death settled with both report anxiety
    as manifested operation, the medical is reduced to a
    OBJECTIVE: by increased patient will and manageable
    Restlessness tension. appear relaxed emotional level as
    Narrowed focus and report Observe conditions. manifested by
    Voice quivering anxiety is behaviors. This can decreased
    Facial flushing reduced to a point to tension after 4
    Observed: manageable the clients hours of
    Feelings level as level of nursing
    Be aware of
    of manifested by anxiety. intervention.
    defense
    adequac decreased Interferes
    mechanisms
    y tension. the ability
    being used.
    apprehen to deal
    Provide
    sion with
    accurate
    information problem.
    about the Helps the
    situation. client to
    Establish a identify
    therapeutic what is
    relationship, reality
    conveying based.
    To avoid a
    empathy and contagious
    unconditional effect/
    positive transmissi
    reward. on of
    anxiety.

    I N T R A O P E R A T I V E N C P (ANTICIPATED)
    ASSESSMEN DIAGNOSIS PLANNING INTERVENTI RATIONALE EVALUATIO
    T ON N
    Tachypnea Ineffective The patient will Administer For Goal met as
    Decreased breathing establish a oxygen at manageme manifested by
    respiratory pattern related normal/ effective lowest nt of patient
    depth/ vital to decreased respiratory concentrati underlying established a
    capacity lung expansion pattern as on pulmonary normal/ effective
    Decreased (pain and muscle evidenced by indicated condition, respiratory
    inspiratory/ weakness) absence of and respiratory pattern as
    expiratory secondary to cyanosis and prescribed distress, or evidenced by
    pressure surgery as other signs and respiratory cyanosis. absence of
    Decreased manifested by symptoms of medication cyanosis and
    minute decreased hypoxia after the s. To verify other signs and
    ventilation respiratory surgery. maintainan symptoms of
    Cyanotic depth/ vital Monitor hypoxia after the
    ce/
    capacity. pulse improveme surgery.
    oximetry, nt in
    as oxygen
    indicated. saturation.

    To
    maximize
    respiratory
    Stress effort.
    importance
    of good
    posture and
    effective
    use of
    accessory
    muscles.

    P O S T O P E R A T I V E N C P (ANTICIPATED)
    ASSESSMEN DIAGNOSI PLANNING INTERVENTIO RATIONALE EVALUATION
    T S N

    OBJECTIVE: Impaired After 12 hours Observe To note any Goal met as


    Limited physical of nursing movement in manifested by
    range of mobility intervention, when client congruencies the patient
    motion related to the patient will is unaware of with reports maintains
    Difficulty pain/discomfort maintain observation. of abilities. position of
    turning secondary to position of Instruct in For position function and skin
    Slowed surgical function and the use of changes and integrity as
    movement operation as skin integrity side rails, transfers. evidenced by
    Postural manifested by as evidenced overhead absence of
    instability limited range by absence of trapeze, and contractures,
    Gait of motion. contractures, roller pads. Permits foot drop,
    changes footdrop, Administer maximal decubitus, and so
    decubitus, and medications effort/ forth after 12
    so forth. prior to involvement hours of nursing
    activity as in activity. intervention.
    needed for
    pain relief. Maintains
    Support position of
    affected function and
    body reduce risk
    parts/joints of pressure
    using ulcers.
    pillows/ rolls,
    foot
    supports/
    shoes, air
    mattress, Promotes
    water bed, wellbeing
    and so forth. and
    Encourage maximizes
    adequate energy
    intake of production.
    fluids/
    nutritious
    foods.

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