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Prioritized List of Nursing Problems Nursing Problems Identified Cues Justification

Impaired skin Subjective integrity r/t - Pagnagkakaroonakongsugat cellulitis as matagalgumaling. Mga lima evidenced by hanggangpitongaraw. As decreased verbali ed by the client sensation and circulation in the Objective left foot. - Physical assessment to left lower e!tremity shows" #$%cellulitis #$%pain/discomfort #$%edema #$%disruption of skin surface #- %sensation and circulation - &aboratory studies #$% non pulsatile

Maslo !s 'he problem is on the physiologic need of the client "egree of Problem 'he problem is highly prioriti ed because it needs immediate intervention the most since cellulitis the chief complaint of the client Inter#retation 'his is highly prioriti ed because this is an actual problem. 'he nurse or the health care provider has the necessary resources to solve this problem such as time( skills( knowledge and money. )liminating this problem may help to prevent further complications and completely eliminate the actual problem. Maslo !s 'he problem is on the physiologic need of the client. "egree of Problem 'he problem is moderately prioriti ed because the problem needs immediate action yet it isn.t life threatening. Inter#retation 'his is moderately prioriti ed because this is an actual problem. 'he nurse or the health care provider has the necessary resources to solve this problem

Ineffective Subjective peripheral tissue - $%& cellulitis on left foot/leg perfusion r/t - *gb - ++.,- g/dl diabetes mellitus secondary to Objective cellulitis - discoloration of the skin - warm skin temperature - delayed wound healing - edema

such as time( skills( knowledge and money. )liminating this problem may help to prevent further complications and completely eliminate the actual problem. Impaired physical Subjective' mobility r/t - 'he client mentioned that he decreased muscle cannot get up and walk around strength as the room without assistance eveidenced by because his legs cannot endure cellulitis on the him anymore. left foot. Objective' - 'he client was lying on the bed all the time and it was observed that he cannot walk around the area without assistance with limited range of motion. Maslo !s 'he problem is on the safety and security. "egree of Problem 'he problem is moderately prioriti ed because the problem needs immediate action yet it isn.t life threatening. Inter#retation 'his is moderately prioriti ed because this is an actual problem. 'he nurse or the health care provider has the necessary resources to solve this problem such as time( skills( knowledge and money. )liminating this problem may help to prevent further complications and completely eliminate the actual problem. Maslo !s 'he problem is physiologic needs. on the

/isk for infection Subjective' r/t tissue - *gb - ++.,- g/dl destruction on the left foot with Objective increased - broken skin due to cellulitis and environmental I0/in1ection sites e!posure to - tissue destruction2 increased pathogens. environmental e!posure to pathogens - #$% cellulitis on the left leg/foot

"egree of Problem 'he problem is least prioriti ed because the problem doesn.t needs immediate action yet it isn.t life threatening. Inter#retation 'his is least prioriti ed because this is a potential problem. 'he nurse or the health care provider has the necessary resources to solve this problem such as time(

skills( knowledge and money. )liminating this problem may help to prevent further complications and completely eliminate the actual problem. 3eficient Subjective knowledge in - 'he client stated that he still eats diabetes mellitus high cholesterol foods even management r/t though it is contraindicated to his noncompliance of condition the treatment. - 4 years ago nungnadiagnosedna may diabetes siya. 5aturuannaman kami ngmgabawalsakanya. Meron pa ngakaming booklet eh. 6aya langmgaisangbuwanlangsigurong nasunodyun. as verbali ed by the wife of the client. - 7he also added( Matigaskasiangulonyan eh. Alam nan gang bawalsakanyaangalak( sige pa din. Objective - obese Maslo !s 'he problem is on the safety and security. "egree of Problem 'he problem is not life threatening yet it needs an immediate attention for reinforcement of the previous health teaching is needed to prevent further complications. Inter#retation 7upposedly( this is another highly prioriti ed problem because this is the underlying cause of all the problems mentioned above. )liminating this problem may help to prevent further complications and completely eliminate the actual problem as well as the possible problems that the client may.