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Nursing Goals and

Cues/Data Rationale Interventions Rationale Evaluation


Diagnosis Objectives
Subjective: Impaired Complications After 8 hours • Assess degree • Patient may be After 8 hours of
“ Nahirapan siya gumalaw Physical of fractures of nursing of mobility restricted by nursing
galaw lalo na nung unang Mobility related include intervention, produced by self-view or intervention, the
linggo pagkatapos niyang to problems the patient the injury. self – patient was able
mahulog sa duyan”’ as neuromuscular associated with will be able to perception to maintained and
verbalized by the client’s impairement immobility. maintain or with actual increased
mother. increased physical mobility at the
mobility at the limitation. highest level
Objective: highest level possible.
• Limited range possible. • Instruct and • Increases
of motion assist patient blood flow to
• Pain upon in active or the muscle and
moving the passive range bone to
affected part of motion. improve
muscle tone.

• Educate • Keeeps the


mother to body hydrated
encourage her and promotes
child increase faster wound
fluid intake. healing.

• Instruct • To help the


mother to child regain
report to a bone and
therapist as muscle
indicated. integrity
Nursing Goals and
Cues/Data Rationale Interventions Rationale Evaluation
Diagnosis Objectives
Subjective: Acute pain Is an After 30 min .After 30 min of
“Umiiyak siya sa sakit nung related to unpleasant of nursing • Provide • To nursing
nakita namen siya fractured sensory and intervention, comfort promote relief intervention, the
pagkatapos niyang elbow emotional the patient measures and wellness patient should be
mahulog. Ganun siya experience should be able (such as able to display
hanggang mga 2 linggo”; as associated to display massage) relax manner and
verbalized by the patient’s with actual or relax manner participate in
mother. potential tissue and participate • Teach • Contribut activities
damage, in activities. and show es to relief of
Objective: patient how pain
• Guarding to do deep
Behavior on the breathing
affected part exercise.
• Facial mask of • Instruct
pain patient to • Only the
• Pain scale of report any client can
3/10 (at present) increase in describe the
pain quality of pain
• Educate he feels
mother to
provide soft • To avoid
blankets or exacerbation
pillows for of pain in the
the child to affected
support elbow.
affected
elbow while
at rest.
Nursing Goals and
Cues/Data Rationale Interventions Rationale Evaluation
Diagnosis Objectives
Subjective: Ineffective Change in After 4 hours After 4 hours of
“Gusto ko na siya family Coping family of nursing • Assess • Dependi nursing
mapaoperahan kaso related to relationships intervention, family ng on the intervention, the
hindi namne alam financial and/or the family members’ stressor, a family was able to
san kukuha ng constraints functioning due should be perceptions of variety of express
pera”; as verbalized to 1 family able to problem. strategies understanding of
by the patient’s member’s express Resolution is may be the problem and
mother. condition and understanding possible only if required to identify resource.
the issue of of the each person’s facilitate
deprived money problem and perceptions are coping.
identify understood
resources.
• Evaluat • This
e strengths, facilitates
coping skills, the use of
and current previously
support systems successful
techniques
• Provide .
opportunities to • This
express promotes
concerns, fears, communicat
expectations, or ion and
questions. support.

• Refer
family to social
service or
counseling. • Long-
term
intervention
or
assistance
may be
required.

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