ACTIVITY INTOLERANCE

NURSING SCIENTIFIC NURSING NURSING RATIONALE EVALUATION

ASSESSMENT DIAGNOSIS EXPLANATION GOAL INTERVENTION

Subjective: -Activity Decreased After 2 hrs of Independent After 2 hrs of nursing

Intolerance oxygen carrying nursing Management: intervention, Goal
Nahihirapan related to capacity of Hgb intervention the was partially met as
akong gumalaw Surgical patient will: -Assess pts. -Influences choice evidence by:
as verbalized by procedure Ability to perform of interventions
the patient. secondary to Dec. nutrition in -be free from ADLs noting or needed -Patients back and
decreased cells. decubitus and reports of assistance. buttocks are free
hemoglobin level. bed sores or weakness, fatigue from
Objective: hematomas on and difficulty in bedsores/hematomas
the most accomplishing respectively and free
-Weak in Dec. energy or prominent parts task. from swelling/
appearance. muscles of the body such redness as well.
-Looks thin in weakness. as the back and -Promote -Mild moderate
appearance the buttocks. independence in activities and -Demonstrate
-With Pale skin self care activities improved self Improved skin turgor
Activity -have good skin as tolerated. care are and well being.
Intolerance turgor. promoted.

-Encourage -Minimized
alternating exhaustion and
activity with rest. balance O2 supply
and demand.

-Encourage -To increase iron

increase intake of supplement of
iron rich food. the body.
 Self Care Deficit

ASSESSMENT NURSING SCIENTIFIC NURSING GOAL NURSING RATIONALE EVALUATION

DIAGNOSIS RATIONALE INTERVENTION

Subjective: -Self Care deficit -Due to After 2hrs of -Provide health -To provide After 2hrs of
-Nahihirapan in limitations in the nursing teaching on the adequate nursing
na akong bathing,hygiene, individual he is intervention, the client regarding knowledge on intervention,
kumilos lalo sa dressing, prevented from patient will: the proper way the client. goal was
pagligo at grooming and performing ADLs on effective oral partially met as
pagkain as feeding and that allow her to -Be able to hygiene. evidenced by:
verbalized by impairment due manage her increased sense
the patient. to fracture of hygiene such as of well being. -Explain the -To provide -Able to
the humerus. bathroom -Be able to know procedure of correct pattern participate in
Objective: privileges and and have proper bathing. of performing self care
-Inability to feed clothing oneself. knowledge on the procedure. activities.
self how to work -Gain knowledge
independently independently in -Teach use of -Adaptive on how to do
-Inability to ADLs. adaptive bathing devices extend ADLs
bathe and equipment (e.g.. the clients independently.
groom self washcloth mitt, reach, increased
independently. commode, long speed and safety
-Inability to hand brushes. and decrease
perform exertion and
toileting tasks. reduce burden.
Follow up
teaching in the
home increases
device use and
safety of
bathing.