Nursing Care Plans by: MARIA REYLAN GARCIA, R.N. · PDF fileNURSING CARE PLAN Nursing Diagnosis Expected Outcomes Nursing Intervention Evaluation Discharge Planning ... loss of appetite

Nursing Care Plans by: MARIA REYLAN GARCIA, R.N. A. Management of clients with Disruption of Cell Growth and Structure

Dx: Breast Cancer

CENTRAL PHILIPPINE UNIVERSITY School of Graduate Studies

Lopez Jaena Street, Jaro, Iloilo City

NURSING CARE PLAN

Nursing Diagnosis

Expected Outcomes

Nursing Intervention Evaluation Discharge Planning

Cues: Pain rated as 6-7 (moderate) on the pain intensity scale of 0-10 located on the right upper outer breast area Right upper outer breast tumor approximately 5cm in diameter, ulcerating in character Not able to rest or sleep well as claimed Grimacing Guarding behavior in right breast BP = 140/90 mmHg Temperature = 37.3 C/axilla CR = 90 beats/minute RR = 23 breaths/minute

1. After 2 hours of nursing and collaborative interventions, the patient will verbalize decreased or controlled pain with minimal to none physical manifestations such as grimacing, guarding and other signs of discomfort.

1. Assess complaints of pain; note the location, quality and intensity of pain (using pain scale intensity of 0-10). Note that accelerating factors and signs of non-verbal pain. 2. Help patient take a comfortable position when sleeping or sitting in a chair that will minimize pain sensation. 3. Administer ordered analgesic as ordered or before an activity / planned exercise. (NSAIDs, acetaminophen, coxibs) Ketorolac 30 mg IVTT every 6 hours RTC Tramadol+paracetamol 325 mg/37.5 mg/tab 1 tablet every 6 hours PRN for severe pain 4. Apply warm compress on the right upper outer breast area several times a day as necessary.

1. GOAL MET. The patient verbalized relief of pain rating it as mild (2-3) based on pain intensity scale and manifested less frequent grimacing and guarding. BP=120/90 mmHg; CR=87 beats/min; RR= 20 breaths/minute; Temperatue = 36.9 C 2. GOAL MET. The patient practices and uses deep breathing, distraction, touch therapy and warm compresses to minimize pain sensation.

Medications Analgesics 1.Tramadol+paracetamol 325 mg/37.5 mg/tab 1 tablet every 6 hours PRN for severe pain Tramadol+paracetamol must be taken with or after meals to prevent GI symptoms. Environment 1. Maintain a quiet and peaceful recovery environment to promote relaxation. 2. Keep environment safe and free from hazards of fall or injury. Treatment/Teachings 1.Continue non-pharmacologic pain management techniques such as deep breathing, visualization, touch therapy and warm compresses. 2. Emphasize to avoid injury especially to the affected right upper outer breast area.

Acute/Chronic Pain related to distention of the tissues by the accumulation of fluid / inflammation, tumor progression

2. After 3 days of nursing and collaborative interventions, the patient will use and practice non-pharmacologic pain management skills.

Monitor the temperature of the compress. 1. Assist patient to take a warm bath and overall hygiene care. 2. Offer relaxing massaging techniques. 3. Encourage the use of stress management techniques such as deep breathing exercises, touch therapy and visualization and distraction techniques.

Home Instructions 1. Keep home environment free from unnecessary hurdles that can act as hazards for falls and injury. 2. Advise patient not to engage in laborious household chores or tasks at home especially those that necessitates weight-bearing. Outpatient follow-up 1. Follow-up at the out-patient department 1 week after discharge. 2.Encourage patient to engage in regular consultation with physician. Dietary instructions 1. Eat foods that are high in nutritional value (high calorie, high protein) 2. Maintain adequate hydration 2.5-3 liters per 24 hours Support System 1. Advise significant others to not allow patient to engage in laborious household activities especially those that are weight-bearing. 2. Encourage family to assist patient in performing activities of daily living especially on self-care.

B. Problems of Protection: Management of Clients with Disruptions of the Immune System Dx: Systemic Lupus Erythematosus

CENTRAL PHILIPPINE UNIVERSITY

School of Graduate Studies Lopez Jaena Street, Jaro, Iloilo City

NURSING CARE PLAN

Nursing Diagnosis

Expected Outcomes

Nursing Intervention

Evaluation Discharge Planning

Cues:

WBC count = 3,000/mm

3

Patches of inflamed skin Intake of immunosuppresive drugs BP = 120/80 mmHg Temperature = 37.5 C/axilla CR = 99 beats/minute RR = 24 breaths/minute Risk for infection related to break in primary and secondary defenses (skin and immune response)

1. After 3 days hours of nursing and collaborative interventions, the patient will be free from opportunistic infection throughout the entire hospitalization.

1. Assess for presence of physiological risk factors such as open wounds, breaks in skin or mucosal integrity. 2. Monitor laboratory examination results particularly WBC differential count. 3. Administer ordered antibiotic as ordered. Ciprofloxacin 750 mg/tab 1 tab OD 4. Plan together with the patient a menu plan, providing a diet high in vitamin C and protein. 5. Turn to sides frequently and advise to remain in the same position for more than two hours. 6. Limit the number of visitors. 7. Practice good handwashing technique among visitors and health care staff. 1. Encourage to

1. GOAL MET. The patient did not develop any sign or symptom of infection throughout the entire hospitalization BP=120/90 mmHg; CR=87 beats/min; RR= 20 breaths/minute; Temperatue = 36.9 C 2. GOAL MET. The patient practices and uses infection control and preventive measures properly and correctly.

Medications Ciprofloxacin 750 mg/tab 1 tab OD Cirpofloxacin must be take with or after meals as it can irritate gastric mucosa. Environment 1. Maintain a quiet and peaceful recovery environment to promote relaxation. 2. Maintain a clean and medically aseptic environment. Treatment/Teachings 1.Continue proper hand washing technique (patient and family members) especially before and after meals. 2. Continue to wear personal protective equipment as necessary (especially face mask). Home Instructions 1. Keep home clean and medically aseptic. 2. Advise patient not to engage in laborious household chores or

2. After 3 days of nursing and collaborative interventions, the patient will use and practice infection control and preventive measures.

wear face mask often. 2. Instruct not to stay in crowded and public places upon discharge. 3. Instruct to stay away from infectious persons at least 3 feet away. 4. Demonstrate and allow redemonstration of proper hand washing technique.

tasks at home especially those that necessitates weight-bearing. 3. Advise patient not to cohort with sick or ill family members. 4. Advise that a separate room be provided for patient to prevent cross contamination. Outpatient follow-up 1. Follow-up at the out-patient department 1 week after discharge. 2.Encourage patient to engage in regular consultation with physician. Dietary instructions 1. Eat foods that are high in protein and vitamin C. 2. Maintain adequate hydration 2.5-3 liters per 24 hours Support System 1. Advise significant others to not allow patient to engage in laborious household activities especially those that are weight-bearing. 2. Encourage family to assist patient in performing activities of daily living especially on self-care.

C. Problems of Digestion, Nutrition and Elimination: Management of clients with disruptions of the GI System

Dx: Gingivitis



NURSING CARE PLAN

Nursing Diagnosis

Expected Outcomes


Cues:

Daw nadulaan ko permi gana magkaon miskan sabaw. Indi man ko katulon maayo. 4 kgs of weight loss over the past week (July 22-27) Weight = 50 kgs Height = 5’7” BMI = 17.2 Hypoactive bowel sounds over all four quadrants Pale mucous membranes Presence of inflammed gingiva Imbalanced nutrition: less than body requirements related to inability to ingest adequate

After 1 week of

nursing and

collaborative

interventions,

the patient will

be able to

improve and

maintain

adequate

nutrition as

characterized

by progressive

weight gain

and increase

in appetite.

1. Assess patient’s dietary status, ability to eat, presence of nausea, vomiting, anorexia and actual intake. 2. Weigh patient everyday on the same scale and at same time of the day. 3. Identify food preferences and encourage family members to bring foods from home. 4. Provide small, frequent meals but those with dense caloric intake. Collaborate with dietary department. 5. Suggest to chew on unaffected side and that the head be titled to the unaffected side when swallowing. 6. If unable to chew adequately provide easier to swallow and softer meals but with high caloric value. 7. Maintain good oral hygiene before and after meals to stimulate appetite and prevent development of

1. GOAL MET. The patient was able to improve nutrition as characterized by a weight gain of 2kg over 1 week and verbalized, Naga amat-amak balik akon gana magkaon.

Medications Multivitamins 1 tablet once day Multivitamins can be taken with or without meals Environment 1. Maintain a quiet,and safe environment for comfort and recovery. 2. Maintain a clean eating area to prevent loss of appetite due to unpleasant environment. Treatment/Teaching 1. Eat progressively from softer foods to harder food once tolerated to avoid further damage to oral cavity. 2. Make a dietary menu or plan for an entire week. 3. Keep a food diary to monitor which foods bring more discomfort or which foods stimulate better appetite. 4. Weigh daily using same type of clothes, same scale and at the same time of the day.

nutrients

plaques. 7. Administer the following medications as ordered: Multivitamins 1 tablet once day

5. Maintain good oral hygiene before and after meals. Home Instructions 1. Procure needed oral care equipment such as toothbrush, dental floss and mouth rinse solutions. 2. Avoid or stop smoking cigarettes and drinking alcoholic beverages. Outpatient follow-up 1. Follow up for prosthodontics treatment after 2 months for planned attachment of gingival prosthesis. 2. Regular dentist visit at least every 6 months or whenever patient chipped a tooth, lost filling or an oral sore that persists longer than 2 weeks or a toothache. Dietary Instructions 1. Avoid food that are rich in sugar and starch 2. Avoid alcohol and tobacco products. 3. Eat foods that are less cariogenic such as fruits, vegetables, nuts, cheeses or plain yogurt. 4. Brush teeth every after meal. 5. Eat a diet high in Vitamin C or ascorbic acid such as citrus fruits. 6. Eat foods that are high in caloric value.

7. Eat small frequent meals. Support System 1. Encourage significant others to help patient or assist patient in oral care practices during the first few weeks of the recovery period. 2. Encourage significant others especially those who prepare food for the patient to observe the dietary restrictions. 3. Encourage significant others to follow the dietary plan or menu constructed by the patient to enhance appetite. 4. Support smoking cessation and alcohol avoidance progress of the patient.

D. Problems of Regulation and Metabolism: Management of Clients with Disruptions of the Endocrine System

Dx: Diabetes Mellitus



NURSING CARE PLAN

Nursing Diagnosis

Expected Outcomes


Cues:

Ka-dry nag id sang panit ko tapos matyag ko daw dehydrated ko permi. Skin turgor = 2 seconds Generally dry skin Pale and dry oral mucous membranes Urine output of more than 300cc/hour BP = 90/60 mmHg Temperature = 37.7˚C/axilla RR= 23 breaths/minute CR= 110 beats/minute Fluid Volume Deficit related to osmotic diuresis

After 24 hours

of nursing and

collaborative

interventions,

the patient will

demonstrate

adequate

hydration and

not develop

signs and

symptoms of

unnecessary

dehydration.

1. Obtain history from client and significant other related to duration and intensity of symptoms, such as vomiting and excessive urination. 2. Monitor vital signs: Note orthostatic BP changes 3. Assess peripheral pulses, capillary refill, skin turgor, and mucous membranes. 4. Monitor intake and output (I&O); note urine specific gravity. 5. Weigh daily using same scale, same type of clothes and same time of day. 6. Maintain fluid intake of at least 2,500 mL/day within cardiac tolerance when oral intake is resumed. 7. Promote comfortable environment. Cover client with light sheets. 8. Investigate changes in mentation and sensorium.

1. GOAL PARTIALLY MET. The patient was able to maintain hydration with adequate and within normal limits of urine output (150cc/hour) and stable vital signs of BP= 100/70 mmHg, RR = 24 breaths/minute, CR= 98 beats/minute and Temperature 36.9˚C/axilla; however, patient continues to have pale and dry skin and oral mucosa.

Medications KCl tablet 1 tablet TID Environment 1. Maintain a quiet,and safe environment for comfort and recovery. 2. Have oral fluids sources readily available for patient (kitchen, living room bed room) Treatment/Teaching 1. Weigh daily using same type of clothes, same scale and at the same time of the day. 2. Maintain adequate oral fluid intake of 2.5-3 liters per 24 hours. 3. Practice proper skin care. 4. Practice good oral hygiene. Home Instructions 1. Procure needed oral care equipment such as toothbrush, dental floss and mouth rinse solutions. 2. Procure needed oral skin care equipment

9. Administer fluids, as indicated: Isotonic (0.9%) or lactated Ringer’s solution without additives 10. Administer potassium and other electrolytes intravenously (IV) or by oral route, as indicated.

such as lotions and moisturizers. Outpatient follow-up 1. Follow up at out patient department after 1 week. 2. Regular consultative check-up. Dietary Instructions 1. Avoid food that are rich in sugar and starch 2. Avoid alcohol and tobacco products. 3. Eat a diet high in Vitamin C or ascorbic acid such as citrus fruits. 4. Eat foods that are high in caloric value. 5. Eat small frequent meals. Support System 1. Encourage significant others especially those who prepare food for the patient to observe the dietary restrictions. 2. Encourage significant others to monitor constantly patient’s intake and output and refer if beyond or below normal limits.

E. Problems of Oxygenation: Management of Clients with Disruptions of the Respiratory System Dx: Chronic Obstructive Pulmonary Disease (Chronic Bronchitis)



NURSING CARE PLAN

Nursing Diagnosis

Expected Outcomes


Cues:

Grabe guid akon plemas permi. Productive cough expectorating to whitish-yellowish sputum RR = 35 breaths per miunute Nasal flaring Use of accessory muscles Diminished breath sounds on both lung fields Ineffective airway clearance related to obstruction by excessive mucus production

1. After 4

hours of

nursing and

collaborative

interventions,

The patient will

be able to

maintain a

patent airway

as evidence by

absence of

mucus plug

formation,

reduction of

congestion

and

expectoration

clear

secretions.

2. After 3 days

of nursing and

collaborative

interventions,

1. Place the patient in Fowler’s position. 2. Monitor vital signs and according to postoperative routine. 3. Auscultate breath sounds as needed. In the immediate post-operative period, place the stethoscope over the trachea to assess for stridor. 4. Provide adequate hydration by increasing oral fluid intake of at least 2.5 to 3 liters of clear fluids per 24 hours unless contraindicated. 5. Suction the airway as ordered and as needed using sterile technique and a soft catheter. 6. Administer humidified air or oxygen as ordered. 7. Administer acetylcysteine 500mg/tab 1 tab to be dissolved in 30cc of water at HS 1. Encourage deep breathing and coughing exercises.

1. GOAL PARTIALLY MET. The patient was able to maintain patent airway. There was no mucus plug formation. The patient verbalized to be breathing more comfortably. Lesser nasal flaring and use of accessory muscles were noted and the RR decreased to 24 breaths per minute. However, patient still coughed out yellowish-colored secretions. 2. GOAL MET. The patient was able to demonstrate

Medications Acetylcysteine 500mg/tab 1 tab to be dissolved in 30cc of water at 8:00 pm Acetylcysteine should be immediately taken while the effervescence is still manifested to ensure optimum potency of the drug. Environment 1. Maintain a quiet,and safe environment for comfort and recovery. 2. Have oral fluids sources readily available for patient (kitchen, living room bed room) Treatment/Teaching 1. Continue practicing deep breathing and coughing exercises. 2. Maintain adequate oral fluid intake of 2.5-3 liters per 24 hours. 3. Practice good oral hygiene. Home Instructions 1. Procure needed oral care equipment such as toothbrush, dental floss

The patient will

be able to

demonstrate

behaviors to

improve or

maintain clear

airway

2. Place the patient in a sitting position and allow the supporting of the neck area with both hands. 3. Teach patient regarding postural drainage positions.

behaviors to improve and maintain clear airway such as coughing and deep breathing exercises and maintaining postural drainage positions.

and mouth rinse solutions. 2. Procure at least 1-2 pillows on head of bed during sleep. Outpatient follow-up 1. Follow up at out patient department after 1 week. 2. Regular consultative check-up. Dietary Instructions 1. Avoid foods that are thick in consistency and hard to swallow. 2. Eat small frequent meals. Support System 1. Teach simple physiotherapy techniques to folks so that at anytime patient will be able to receive effective postural drainage and back tapping interventions.

F. The Cardiovascular System: Interventions for clients with cardiac disorders

Dx: Congestive Heart Failure



NURSING CARE PLAN

Nursing Diagnosis

Expected Outcomes


Cues:

Ang akon bala dughan daw permi nalang ga kuba-kuba. Kung gis-a daw ga pin-ot man. BP= 160/90 mmHg CR= 120 beats/minute RR = 28 breaths/minute Dysrhythmic ECG tracings Edematous lower extremities, pitting +2 Complaints of dyspnea Cool clammy skin Decreased cardiac output related to structural changes of the heart (hypertrophy)

1. After 4

hours of

nursing and

collaborative

interventions,

The patient will

be able to

improve

cardiac output

as

characterized

by stable vital

signs and

decreasing

peripheral

manifestations

of increased

fluid volume.

1. Assess for signs and symptoms of heart failure and decreased cardiac output: variations in BP, tachycardia pulsus alternans (alternating strong and weak pulse), presence of an S3 heart sound, fatigue and weakness dyspnea, orthopnea, tachypnea dry, hacking cough or cough productive of frothy or blood-tinged sputum abnormal breath sounds, 2. Review chest x-ray results showing pulmonary vascular congestion, pleural effusion, or pulmonary edema. 3. Place client in a semi- to high Fowler's position 4. Instruct client to avoid activities that create a Valsalva response (e.g. straining to have a bowel movement, holding breath while moving up in bed) 5. Implement

1. GOAL PARTIALLY MET. The patient was able to improve cardiac output as characterized by stable vital signs BP= 140/90mmHg, CR = 98 bpm, RR = 23 breaths/minute and no further complaints of dyspnea; however, patient still manifests cool clammy skin and edematous extremities.

Medications Furosemide 20mg/tab 1 tab OD Propanolol 20mg/tab 1 tab TID Furosemide and Propanolol must be given with BP precautions before and a few minutes after administration. Furosemide also necessitates intake-output monitoring. Environment 1. Maintain a quiet,and safe environment for comfort and recovery. 2. Have oral fluids sources readily available for patient (kitchen, living room bed room) 3. Keep the environment safe by eliminating hazardous furniture that may increase patient’s risk for injury. Treatment/Teaching 1. Continue practicing deep breathing and coughing exercises. 2. Refrain from activities

measures to promote emotional and physical rest (e.g. maintain a calm, quiet environment; limit the number of visitors; maintain activity restrictions) 6. Provide small meals rather than large ones 7. Discourage excessive intake of beverages high in caffeine such as coffee, tea, and colas 8. Limit oral fluid intake as ordered to 1.8 liters/24 hours. 9.Increase activity gradually as allowed and tolerated 10. Administer medications as ordered Furosemide 20mg/amp IVTT every 6 hours Propanolol 20mg/tab 1 tab TID

that stimulate Valsalva reflex. Home Instructions 1. Avoid strenuous and laborious activities at home especially those that require weight-lifting. 2. Procure at least 1-2 pillows on head of bed during sleep. 3. Monitor intake and output. Outpatient follow-up 1. Follow up at out patient department after 1 week. 2. Regular consultative check-up. Dietary Instructions 1. Avoid intake of beverages and foods high in caffeine. 2. Eat small frequent meals. 3. Limit oral fluid intake to 2 liters per day. Support System 1. Teach how to correctly take vital signs especially CR and BP and report values beyond and below normal limits. 2. Advise to conscientiously monitor intake and output of patient.

G. Interventions of clients with Vascular disorders Dx: Thromboangitis obliterans (Buerger’s disease)



NURSING CARE PLAN

Nursing Diagnosis

Expected Outcomes

Nursing Intervention

Evaluation Discharge Planning

Cues:

Anhun ta ni bi kay piang na ta. Siyempre ki-ang guid maglakat. Limping gait Amputated right foot Needs assistance in walking spontaneously Risk for injury related to unstable gait and ineffective mobility

1. After 8 hours of nursing and collaborative interventions, the patient will not experience any form of injury throughout the entire period of hospitalization.

1. Lock the wheels of the bed. 2. Provide adequate lighting. 3. Place bed in low position. 4. Remove unnecessary furniture especially those that are easily breakable and those that are unstable. 5. Place the call system within the reach of the client even without going out of the bed. 6. Place the side rails up whenever leaving the patient. 7. Provide handrails especially in the bathroom. 8. Keep the floor clean but not slippery.

1. GOAL MET. The patient did not experience any form of injury throughout the entire period of hospitalization.

Medications Vitamin B Complex 1. Vitamin B Complex 500 mg once a day. Vitamin B complex can be taken with or without regard to food. Environment 1. Keep environment safe and free from hazards of fall or injury. 2. Place necessary items nearer to the patient or within his or her reach. 3. Provide handrails to the pathway of the patient especially in the bathroom. Treatment/Teachings 1. Emphasize to avoid injury especially to the joint involved (knee) by wearing protective gear when necessary such as knee pads. 2. Review and re-demonstrate correct and proper use of assistive walking devices. 3. Instruct and initiate start of active range of

2. After 3 days of nursing and collaborative interventions, the patient will show changes in lifestyle behaviors to reduce risk factors and to protect themselves from injury.

9. Let patient wear non-slip shoes or slippers whenever ambulating. 1. Enforce the use of walking or assistive devices. Evaluate and correct proper use. 2. Tell the client to change positions slowly. 3. Let patient use protective gear such as knee pads or wrist pads.

2. GOAL MET. The patient demonstrates behavior that displays consideration of safety principles and would ask assistance whenever necessary.

motion exercises especially on affected joints. Home Instructions 1. Keep home environment free from unnecessary hurdles that can act as hazards for falls and injury. 2. Advise patient not to engage in laborious household chores or tasks at home especially those that necessitates weight-bearing. 3. Hazard prone areas of the house must have handrails such as the bathroom and the stairs. 4. Slippery floor must be carpeted or covered with non-slip mats. Outpatient follow-up 1. Follow-up at the out-patient department 1 week after discharge. 2. Encourage patient to engage in regular consultation with physician. 3. Encourage patient to continue physical rehabilitation as necessary. Dietary instructions 1. Eat foods rich in calcium such as green leafy vegetables and milk. 2. Avoid food rich in

purine such as internal

organ meat, beans,

legumes, anchovies.

Support System 1. Advise significant others to not allow patient to engage in laborious household activities especially those that are weight-bearing. 2. Encourage family to assist patient in performing activities of daily living especially on self-care (bending over to clean lower limbs or wearing socks or taking a bath) 3. Encourage family to not let the patient walk or ambulate long distances without a companion or guide.

H. Problems of Tissue Perfusion: Management of the Clients with Disruptions of the Hematologic System

Dx: Beta-Thalassemia



NURSING CARE PLAN

Nursing Diagnosis

Expected Outcomes


Cues:

Ginahapo guid ako permi bala. Non productive cough RR = 35 breaths per miunute Nasal flaring Use of accessory muscles Malaise Generalized pallor Hemoglobin = 5.7 g/dl pCO2= 32mmHg HCO3 = 28mEq/L pO2= 75mmHg O2 saturation = 89% Impaired gas exchange related to decreased oxygen-carrying

1. After 8

hours of

nursing and

collaborative

interventions,

The patient will

be able to

demonstrate

improved

ventilation and

adequate

oxygenation of

tissues.

1. Place the patient in Fowler’s position. 2. Monitor vital signs every hour until stable. 3. Auscultate breath sounds as needed. In the immediate post-operative period, place the stethoscope over the trachea to assess for stridor. 4. Administer humidified air or oxygen as ordered. 5. Administer packed red blood cells as ordered. 6. Encourage deep breathing and coughing exercises. 7. Place the patient in a sitting position and allow the supporting of the neck area with both hands. 8. Limit or schedule patient’s physical activity. 9. Maintain adequate rest periods. 10. Provide small but frequent feedings to

1. GOAL PARTIALLY MET. The patient was able to improve ventilation and oxygenation as characterized by normal respiration patterns: RR=23 breaths/minute, minimal nasal flaring and use of accessory muscles and no further complaints of dyspnea. ABG and Hgb results yet to be reviewed.

Medications Oxygen therapy for home care use as needed. Environment 1. Maintain a quiet,and safe environment for comfort and recovery. 2. Have a safe environment especially for oxygen use. No smoking within proximity to oxygen tank. Treatment/Teaching 1. Continue practicing deep breathing and coughing exercises. 2. Maintain adequate oral fluid intake of 2.5-3 liters per 24 hours. 3. Wear personal protective equipment as necessary especially face mask. Home Instructions 1. Procure at least 1-2 pillows on head of bed during sleep. 2. Limit or schedule physical and strenuous activities at home (less

capacity and structural defects of erythrocytes

decrease oxygen consumption of larger meals to digest.

assignment of household tasks/chores for the patient while recuperating) Outpatient follow-up 1. Follow up at out patient department after 1 week. 2. Regular consultative check-up. Dietary Instructions 1. Eat foods rich in protein, iron and vitamin C. 2. Eat small frequent meals. Support System 1. Teach oxygen administration guidelines and procedure to folks. 2. Advise to prevent patient from being exposed to ill and sickly persons both at home and in public. 3. Advise to avoid assigning strenuous tasks to patient in the household.

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Nursing Care Plans by: MARIA REYLAN GARCIA, R.N. · PDF fileNURSING CARE PLAN Nursing Diagnosis Expected Outcomes Nursing Intervention Evaluation Discharge Planning ... loss of appetite