ASSESSMENT NURSING RATIONALE DESIRED NURSING JUSTIFICATION EVALUATION

DIAGNOSIS OUTCOMES INTERVENTIONS

Subjective: Imbalanced unsafe After 2 days of Independent After 2 days of
 pallor nutrition: less environment rendering care the  Assess weight; - to establish nursing
 dry mouth than body patient will be able measure or baseline intervention the
 poor appetite requirements to: calculate body parameters client was able to:
 weak Aedis Egypti fat and muscle
Definition: intake 1. Demonstrate mass via triceps 1) Eat a
of nutrients progressive weight skin fold and regular
Objective cues: insufficient to dengue gain toward goal. midarm muscle meal 3
 weight loss meet metabolic hemorrhagic circumference or times a day.
needs fever 2. Verbalize other
Strengths: understanding of anthropometric
 strong family causative factors measurements
support from poor appetite when known and  Note age, body - helps determine 2) Walk
mother and necessary build, strength, nutritional needs around the
siblings \ interventions. activity/ rest room and
Imbalanced level, etc. able to do
 compliance to
nutrition: less 3. Demonstrate  Evaluate total - to reveal possible ADLs
medications
than body behaviors, lifestyle daily food cause of
requirements changes to regain intake. Obtain malnutrition/ 3) Show
and/or maintain diary of calorie changes that could interest by
appropriate intake, patterns be made in client’s conversing
weight. and times of intake with family
eating members
and other
Collaborative people
- Refer to social - for possible
services/ other assistance with
Reference: community clients limitations
BY: DIANNE
Nurse’s Pocket resources in buying/
ALEXIS UYTIEPO
Guide edition 11 preparing foods
BN 3K