Cues Nursing Inference Objective Nursing Intervention Rationale Evaluation

Diagnosis

Subjective Short-term Goal Independent

♥”Sumasakit at ♥ Acute Pain r/t ♥ Acute pain is After 6 days of nursing ♥ vital signs were monitored Q15 ♥ Alterations from normal ♥ Pain is
kumikirot ang surgery AMB described as an intervention, the patient: minutes until stable & dressing was may be signs of infection. reduced/controlled
inoperahan sakin,” incision on L arm unpleasant sensory or checked. Moistened dressings are to a tolerable extent
♥ verbalizes methods that as verbalized.
as verbalized emotional experience favorable site for
associated with actual provide relief microorganism to culture. Relieving methods
Objective or potential tissue & relaxation
♥ demonstrates use of ♥ assessed LOC & turned Q2 hours,
♥ one must be conscious & techniques are
♥ c incision on the damage or injury as relaxation skills & to unoperative side only
awake in order to feel understood &
L arm (ORIF- lasting from seconds diversional activities as pain. Turning of positions demonstrated.
treated D/3 radius to 6 months. In cases indicated for his situation prevent bed sores.
L with bone of fracture, pain is
continuous & Long-term Goal
grafting) ♥ this is to prevent
increasing in severity ♥ adjusted constricting bandage & diminished circulatory &
♥ c posterior cast After months of nursing
until bone fragments advised to elevate L arm nerve function & control
intervention, the patient:
& bandage on L are immobilized. In swelling of the site.
arm this type of fracture, ♥ is free of pain in the
the main medical surgical site ♥ Instructed to do activities such as ♥ to reduce swelling &
♥ c swelling on the prevent stiffness, the
management is open deep breathing exercise, coughing
L arm
reduction with internal exercise, dorsiflexion of foot & sitting stated activities must be
♥ c pale pink nail fixation (ORIF), exercises done. Decreased lung
beds @ L hand wherein the fracture capacity & decreased
fragments are reduced cough efficiency are
♥ BP= 120/90 & internal fixation predisposing factors to
mmHg devices are used to respiratory infections.
hold the bone
fragment in position ♥ noted to avoid weight bearing until
until solid bone allowed
healing occurs.
♥ encourage to void freely
♥ enough rest and sleep is also
advised
Dependent
♥ intake of pain reliever such as
mefenamic acid & antibacterial
medications such as amoxicillin as
per doctor’s order & advice
♥ to prevent from
complication of the
incision site, activities that
may extend the cut must
be avoided.
♥ this is advised in order to
prevent constipation &
fecal impaction.
♥ this promotes healing by
reducing basal metabolic
rate & allowing oxygen &
nutrients to be utilized for
tissue growth, healing &
regeneration.
♥ NSAID activity includes
modulation of T-cell
function, inhibition of
inflammatory cell
chemotaxis, decreases
release of superoxide
radicals, or increased
scavenging of these
compounds at
inflammatory sites.
Antibiotics treat and
prevent infections.