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Assessment Nursing Planning Nursing Intervention Rationale Evaluation

Diagnosis
SUBJECTIVE: • Risk for prone • After 8 hours of INDEPENDENT: After 8 hours of nursing
“Bakit kaya behavior nursing • Define and state the limits • Provides basis for interventions, the patient
madalas sumsaskit related to lack interventions, the of desired BP. Explain understanding elevations was able to verbalize
ulo ko at of knowledge patient will hypertension and its effect of BP, and clarifies understanding of the
nahihilo?” as about the verbalize on the heart, blood vessels, misconceptions and also disease process and
verbalized by the disease. understanding of kidney, and brain. understanding that high treatment regimen.
patient. the disease BP can exist without
process and symptom or even when
OBJECTIVE: treatment feeling well.
• Request for regimen. • Assist the patient in • These risk factors have
information. • identifying modifiable risk been shown to contribute
• Agitated factors like diet high in to hypertension.
behavior sodium, saturated fats and
• Inaccurate cholesterol.
follow through • Reinforce the importance • Lack of cooperation is
of instructions. of adhering to treatment common reason for failure
regimen and keeping of antihypertensive
• V/S taken as
follow up appointments. therapy.
follows:
• Suggest frequent position • Decreases peripheral
T: 36.3
changes, leg exercises venous pooling that may
P: 82
when lying down. be potentiated by
R: 21
vasodilators and
BP: 140/90
prolonged sitting or
standing.
• Help patient identify • Two years on moderate
sources of sodium intake. low salt diet may be
sufficient to control mild
hypertension.
• Encourage patient to • Caffeine is a cardiac
decrease or eliminate stimulant and may
caffeine like in tea, coffee, adversely affect cardiac
cola and chocolates. function.
• Stress importance of • Alternating rest and
accomplishing daily rest activity increases
periods. tolerance to activity
progression.

DEPENDENT:
• Give due medications • Refer to drug study.