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NURSING CARE PLAN

ASSESSMENT DIAGNOSIS INFERENCE PLANNING INTERVENTION RATIONALE EVALUATION


Subjective:
Hindi ko alam
kung bakit ganito
ang paa ng baby
ko. (I don t know why
my baby s feet are like
this) as verbalized
by patient.
· Knowledge
deficient
regarding
condition,
prognosis,
treatment, self-
care, and
discharge
needs.
· Clubfoot or
Talipes
Equinovarus
is a
congenital
anomaly in
which the
foot is
· After 8 hours
of nursing
interventions,
the patient will
acknowledge
feelings and
identify health
ways to deal
with them.
Independent:
· Review
pathology,
prognosis and
future
expectations.
· Discuss the
deformity and
· Provides
knowledge base
from which
parents can
make informed
choices.
· To rule out
misconceptions
· After 8 hours of
nursing
interventions,
the patient was
able to
acknowledge
feelings and
identify health
ways to deal
with them.
Objective:
· Request for
information.
· Statement of
misconception
· V/S taken as
follows:
T: 36.8
P: 120
R: 40
plantar
flexed at the
ankle and
subtalar
joints, the
hind foot is
inverted,
and the
midfoot and
forefoot are
adducted
and
inverted.
Contracture
s of the soft
tissues
maintain the
malalignme
nts. The
exact cause
of clubfoot
is unknown,
but genetic
factors may
expected
treatment in
terms the parent
s can
understand.
· Encourage
parents to hold
and play with
child and
participate in
care.
· Assess and
teach parent to
assess for signs
of excessive
pressure on
skin, redness,
excoriation.
· Elevate the
extremity.
· Stimulate
movement of
toes.
· Provide comfort
measures such
and to provide
accurate
information
about the
deformity.
· To promote
bonding
between the
baby and the
parents.
· These signs
require
immediate
evaluation and
intervention.
· To promote
venous return
and prevents
edema.
· To promote
circulation
· Promotes
relaxation and
include
intrauterine
infection,
bone
infection,
vascular
and nerve
lesions have
been
suspected.
Complicatio
ns include
rocker
bottom
deformity,
disturbance
in growth,
and
recurrent or
residual
deformity.
as soft music,
pacifier, teething
ring, or rocking.
Collaborative:
· Discuss the
importance of
physical
therapist.
may enhance
patient s coping
abilities by
refocusing
attention.
· Physical
therapist is
important to
enhance
mobility.
include
intrauterine
infection,
bone
infection,
vascular
and nerve
lesions have
been
suspected.
Complicatio
ns include
rocker
bottom
deformity,
disturbance
in growth,
and
recurrent or
residual
deformity.
as soft music,
pacifier, teething
ring, or rocking.
Collaborative:
· Discuss the
importance of
physical
therapist.
may enhance
patient s coping
abilities by
refocusing
attention.
· Physical
therapist is
important to
enhance
mobility.