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Nursing CARE PLAN pt name: r.asperin Assessment Subjective: y Limited range of motion (client canPt fully extend his right arm and hold up his right shoulder) y Limited ability and difficulty to perform gross motor skills like extending and lifting of the right arms y Unsteady gait y Slowed movement y right arm numbness Nursing Dx Inference Intervention Independent: 1. Determine degree of immobility 2. Observe movement when client is unaware 3. Support affected part with pillows 4. Give
Nursing CARE PLAN pt name: r.asperin Assessment Subjective: y Limited range of motion (client canPt fully extend his right arm and hold up his right shoulder) y Limited ability and difficulty to perform gross motor skills like extending and lifting of the right arms y Unsteady gait y Slowed movement y right arm numbness Nursing Dx Inference Intervention Independent: 1. Determine degree of immobility 2. Observe movement when client is unaware 3. Support affected part with pillows 4. Give
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Nursing CARE PLAN pt name: r.asperin Assessment Subjective: y Limited range of motion (client canPt fully extend his right arm and hold up his right shoulder) y Limited ability and difficulty to perform gross motor skills like extending and lifting of the right arms y Unsteady gait y Slowed movement y right arm numbness Nursing Dx Inference Intervention Independent: 1. Determine degree of immobility 2. Observe movement when client is unaware 3. Support affected part with pillows 4. Give
Hak Cipta:
Attribution Non-Commercial (BY-NC)
Format Tersedia
Unduh sebagai DOCX, PDF, TXT atau baca online dari Scribd
Assessment Nursing Dx Inference Goals Intervention Rationale Evaluation Subjective: Impaired physical CVA can be caused by Long term: Independent: Independent: Long term goals met: • Client said, mobility r/t an occlusion in the After 4 days of nursing 1. Determine degree of 1. To Client is able to “namamanhid neuromuscular blood flow. This can intervention, client will be immobility establish ↑physical mobility as yung kanang damage involvement lead to ↓O2 and the able to ↑ physical mobility 2. Observe movement compara evidenced by kamay ko, (Right arm cause failure to Expected outcome: when client is tive resumption of activities, pero numbness) as nourish the tissues at • Demonstrate unaware baseline participation in his nagagalaw ko evidenced by ↓ the capillary level and resumption of 3. Support affected part 2. To note ADL’s and ↓ right arm naman xha motor control that can cause activities with pillows any numbness medyo hirap neuromuscular • Participate in 4. Give rest periods to incongru lng ako.” damage w/c can cause ADL’s activities ence Short term goals met: impaired physical • Maintain or ↑ 5. Encourage adequate with the The client is able to Objective: mobility muscle control fluids and right diet reports participate on the • Limited range Short term: as necessary to the of therapeutic regimen as of motion After 8 hrs of nursing client abilities evidenced by (client can’t intervention, client will be 3. Reduce verbalization of fully extend able to participate in risk of understanding of the his right arm therapeutic regimen pressure situation, therapy, and and hold up Expected outcome: ulcers he is able to participate his right • Verbalize 4. To help in the interventions shoulder) understanding of reduce rendered by the nurse • Limited ability the situation fatigue and difficulty • Verbalization of and O2 to perform understanding the demand gross motor therapy 5. ↑ energy skills like • Able to participate producti extending and in the interventions on lifting of the rendered by the right arms nurse • Unsteady gait • Slowed movement • Right arm numbness