Introduction To Nursing Assignment
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Healthcare systems elements (continued) ALLERGIES:
Introduction To Nursing Assignment
Medications: List all medications, dosages, classifications and the rational for the medications prescribed for this patient include major considerations for administration and the possible negative outcomes associated with this medication.
DEFINE 1: What the medications does to the body to the cellular level AND 2: Why the patient is taking the medication?
Medication/dose Classification Indication/ Rationale SE’s/Nursing Considerations Client Education Text Reference
Triamcinolone acetonide ointment
Aspirin chewable table
Hydroxyzine oral syrup
Ibuprofen
CON CEPT MAP
Pathophysiology – (Alagille Syndrome)
Medical Diagnosis
Alagille Syndrome
Signs & Symptoms/Clinical Manifestations (all data subjective and objective: labs, radiology, all diagnostic studies) (What symptoms does your client present with?)
Complications
Introduction To Nursing Assignment
Treatment (Medical, medications, intervention and supportive)
Causes/Risk Factors (chemical, environmental, psychological, physiological and genetic)
Nursing Diagnosis
Problem statement: (NANDA)
Related to: (What is happening in the body to cause the issue?)
Manifested by: (Specific symptoms)
REMEMBER THAT THE EXPECTED OUTCOMES MUST BE MEASURABLE. THE INTERVENTIONS ARE WHAT YOU DO TO ASSURE THE OUTCOME AND THE CLIENT’S RESPONSE IS SPECIFICALLY HER RESPONSE.]
PLAN OF CARE: Use your top two priorities
NANDA NURSING DIAGNOSIS use NANDA definition
Expected outcomes of care (Goals)
Interventions
Patient response
Goal evaluation
NRS DX:
Problem Statement:
R/T: (What is the cause of the symptom)
Manifested by: (Specific symptoms)
Short term goal : Create a SMART goal that relates to hospital stay/shift/day.
Long term goal : Create a SMART goal that is appropriate for discharge.
Introduction To Nursing Assignment
This is specific to the patient that you are caring for. A list of planned actions that will assist the patient to achieve the desired goal. (i.e. obtain foods that the patient can eat/ likes)
Interventions for short-term goal:
1.
2.
3.
Interventions for longterm goal:
1.
2.
3.
Identify what the patients response or “outcome is to the goal or care that you have provided. i.e. patient ate 45% of lunch)
Reassess for short-term goal:
1.
2.
3.
Reassess for long-term goal:
1.
2.
3.
Was it met or not met there is no partially met.
Introduction To Nursing Assignment
NANDA NURSING DIAGNOSIS use NANDA definition
Expected outcomes of care (Goals)
Interventions
Patient response
Goal evaluation
NRS DX:
Problem Statement:
R/T: (What is the cause of the symptom?)
Manifested by: (specific symptoms)
Short term goal: Create a SMART goal that relates to hospital stay.
Long term goal: Create a SMART goal that is appropriate for discharge.
This is specific to the patient that you are caring for. A list of planned actions that will assist the patient to achieve the desired goal. (i.e. obtain foods that the patient can eat/ likes)
Identify what the patients response or “outcome is to the goal or care that you have provided. i.e. patient ate 45% of lunch)
Was it met or not met there is no partially met.
Introduction To Nursing Assignment Essay
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