NURSING EXPECTED PATIENT ASSESSMENT ACTION TEACHING

DIAGNOSES OUTCOMES interventions: interventions: interventions:

(consider orders, (consider home
(note priority for Be sure they are S. M. (assess / monitor
safety, allergies, regimens,
each below) A. R. T. (Specific, for )
code status, fall procedures,
measureable,
(Be sure to use risk, etc.) discharge plan, etc.)
achievable/ attainable,
related to and
relevant and time-
as evidenced by)
bound)

At risk for 1. Pt. will be 1. Pt. will be 1. Nurse will 1. Teach Pt.
wandering r/t accompanied monitored for provide one- family member
alteration in when going out wandering by on-one time how to monitor
cognitive into the using the use with the Pt. in the
functioning AEB community for of an ankle patient while community by
continuous observations of bracelet they are out in remaining in
movement from their safety until 2. Nurse will the close proximity
place to place next physician visit monitor the community to the pt. at all
2. Pt. will have a patient every 2. Nurse will times
designated safe 15 mins for provide a safe, 2. Providing the
zone that they are safety hazards fun, learning pt.s family
able to visit 1 hour within the safe environment with ideas of
daily with 15 min zone for Pt. to be in how to provide
increments of for 1 hour a a safe zone for
supervision day with mild the pt.
monitoring
At risk for self- 1. Pt. will be 1. Pt. will be 1. Nurse will 1. Nurse will
neglect r/t prompted to clean monitored for encourage the teach family
alternation in their peri area UTIs and pt. to use the members the
cognitive function from front to back inadequate proper signs and
AEB insufficient after each use of peri care. technique symptoms of
personal hygiene the restroom. 2. Pt. will be when wiping, UTIs and will
2. Pt. will be monitored and will give encourage
prompted every during aid if needed. them to assist
morning with morning 2. Nurse will use the pt. during
pictures of tasks hygienic tasks pictures when restroom visits.
that will help direct and will explaining to 2. Nurse will
them in their daily assessed upon the pt. what is encourage and
hygienic tasks. the needed to be instruct the
helpfulness of done next in family
the use of the their hygienic members on
pictures. care. how to use the
hygienic
picture tasks,
and will also
encourage
them to be
present during
the pt.s
hygienic
routines.

1
2