Patient’s Name: Terisita Tutor Sex: Female

Address: Mabini Comval Province Age: 43 yrs old

NURSING CARE PLAN

DATE ASSESMENT NEEDS NURSING PLAN OF CARE NURSING EVALUATION
DIAGNOSIS INTERVENTION

73 shift Subjective: “Pasagdan P Risk for Infection After 5 hours of After 5 hours of
lang man nku maghulat H related to Inadequate nursing care, Patient *Wash hands and teach nursing care, patient
N Y primary defenses: remains free of other caregivers to wash
lng ko kung mahugaw Experience free of
O S hands before contact with
najud unya ilisan na sa broken skin, injured infection, as infection as evidence
V I patient and between
E nurse. tissue. evidenced by: procedures with patient. by:
O
M
L ® Friction and running  Having a clean,
B Objectives: ® Absence of purulent water effectively remove dry and intact
E
O Persons at risk for drainage from microorganisms from wound dressing
R G infection are those whose hands. Washing between on the surgical
 Fresh Surgical I natural defense
wounds
procedures reduces the site.
13 wound on the C mechanisms are risk of transmitting
Right lower inadequate to protect pathogens from one area  Comfortable
2 quadrant of the N them from the inevitable of the body to another Feeling
0 E injuries and exposures (e.g., perineal care or
abdoment.
0 E that occur throughout the central line care). Use of  having proper
8 D course of living. disposable gloves does hygiene
 Untidy Wound Infections occur when an not reduce the need for
S
dressing organism (e.g., hand washing.
 Poor body bacterium, virus, fungus,
(Proper Hygiene) or other parasite) invades
hygiene *Limit visitors.
a susceptible host. Breaks
 Swelling wound in the integument, the ® This reduces the
 Irritable face body’s first line of number of organisms in
defense, and/or the patient’s environment and
mucous membranes restricts visitation by
allow invasion by individuals with any type
pathogens. If the host’s of infection to reduce the
(patient’s) immune transmission of
system cannot combat the pathogens to the patient
invading organism at risk for infection. The
adequately, an infection most common modes of
occurs. Open wounds, transmission are by direct
traumatic or surgical, can contact (touching) and by
be sites for infection; soft droplet (airborne).
tissues (cells, fat, muscle)
and organs (kidneys, * Teach patient the
lungs) can also be sites importance of
for infection either after
trauma, invasive
avoiding contact
procedures, or by with those who have
invasion of pathogens infections or colds.
carried through the
bloodstream or lymphatic ® To prevent the spread
system. Infections can be of microorganism and to
transmitted, either by prevent infection.
contact or through
airborne transmission, *Change wound dressing
sexual contact, or sharing if it is very bloody and
of intravenous (IV) drug Untidy.
paraphernalia.
®To prevent the risk of
being infected by the
microorganism.

* encourage patient to
take a bath everyday

® to have a good hygiene