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PATIENTS INITIALS: __________ SEX: __________ AGE: _______

NURSING CARE PLAN

STUDENTS NAME: ____________________ DATE: __________ UNIT: __________

MEDICAL DIAGNOSIS: _____________________________

ASSESSMENT Subjective & Objective Data

ANALYSIS Nursing Diagnosis Validation of Patients Needs

PLANNING Short & Long Term Goals

Subjective: F.S was admitted to hospital by her daughter for the condition of Atrial Fibrillation and Hemiplegia unspecified. Patient Cried and said , She is in pain. Patient said ,She wants to do her work herself.

Nursing Dx: Risk for impaired skin integrity related to Hemiplegia or immobility NANDA Definition: Altered Epidermis and/or dermis.

STG # 1: Patient will be put under the protocol for turning and positioning q2h. STG # 2: Patient will not show signs of infection or worsening of skin breakdown such as redness or swelling within two weeks. LTG # 1: Patient will remain free of any skin breakdown by discharge.

ASSESSMENT Subjective & Objective Data

ANALYSIS Nursing Diagnosis Validation of Patients Needs

PLANNING Short & Long Term Goals

PATIENTS INITIALS: __ F.M________ NURSING CARE PLAN STUDENTS NAME: Lucy Trivedi SEX: __F________ AGE: _63______ DATE: __________ UNIT: B-758 MEDICAL DIAGNOSIS: _Atrial Fibrillation, Hemiplegia unspecified. ASSESSMENT Subjective & Objective Data

Nursing Diagnosis Validation of Patients Needs PATIENTS INITIALS: __ F.M________ NURSING CARE PLAN STUDENTS NAME: Lucy Trivedi SEX: __F________ AGE: _63______ DATE: __________ UNIT: B-758 MEDICAL DIAGNOSIS: _Atrial Fibrillation, Hemiplegia unspecified. ASSESSMENT Subjective & Objective Data

ANALYSIS Nursing Diagnosis Validation of Patients Needs ANALYSIS Nursing Diagnosis Validation of Patients Needs PLANNING Short & Long Term Goals PLANNING Short & Long Term Goals Subjective: Ms. F.M was admitted to hospital by her daughter for the condition of Atrial Fibrillation and Hemiplegia unspecified. Subjective: Ms. F.M was admitted to hospital by her daughter for the condition of Atrial

Ms. F.M Cried and states, She is in pain. Ms. F.M states, She wants to do her work herself. Objective: B/P = 108/68 T=97 F P= 87 b/min Resp = 18 *Patient is physically immobile and unable to get out of bed. *Patient is incontinent of her bowls, which leads to moisture on skin. Nursing Dx: Risk for impaired skin integrity related to Hemiplegia or immobility NANDA Definition: Altered Epidermis and/or dermis. Etiology : Impaired skin integrity related to Hemiplegia.

Fibrillation and Hemiplegia unspecified. Ms. F.M Cried and states, She is in pain. Ms. F.M states, She wants to do her work herself. Objective: B/P = 108/68 T=97 F P= 87 b/min Resp = 18 *Patient is physically immobile and unable to get out of bed. *Patient is incontinent of her bowls, which leads to moisture on skin. Nursing Dx: Risk for impaired skin integrity related to Hemiplegia or immobility NANDA Definition: Altered Epidermis and/or dermis. Etiology : Impaired skin integrity related to Hemiplegia.

STG # 1: Patient will be put under the protocol for turning and positioning q2h. STG # 2: Patient will not show signs of infection or worsening of skin breakdown such as redness or swelling within two weeks.

STG # 1: Patient will be put under the protocol for turning and positioning q2h. STG # 2: Patient will not show signs of infection or worsening of skin breakdown such as redness or swelling

LTG # 1: Patient will remain free of any skin breakdown by discharge. LTG # 2: Patient will not develop any debitus ulcer. ASSESSMENT Subjective & Objective Data

within two weeks. LTG # 1: Patient will remain free of any skin breakdown by discharge. LTG # 2: Patient will not develop any debitus ulcer. ASSESSMENT Subjective & Objective Data

ANALYSIS Nursing Diagnosis Validation of Patients Needs ANALYSIS Nursing Diagnosis Validation of Patients Needs PLANNING Short & Long Term Goals Ms. F.M. cried and states , she wants to go home and wants to live normal life again. Ms. F.M states, If she would have son , he might keep her with him. PLANNING Short & Long Term Goals Ms. F.M. cried and states , she wants to go home and wants to live normal life again. Ms. F.M states, If she would have son , he might keep her with him. Nursing Dx.: Risk for depression related to decrease socialization. Nanda definition: STG 1# : Encourage patient to attend group therapy. Nursing Dx.: Risk for depression related to decrease socialization. Nanda definition: STG 1# : Encourage patient to attend

STG 2 #: Encourage patient to ventilate her fear and refer to psychiatry LTG 1#: Patient will accept her condition. LTG:2 # : Patient will be able to socialize appropriate.

group therapy. STG 2 #: Encourage patient to ventilate her fear and refer to psychiatry LTG 1#: Patient will accept her condition. LTG:2 # : Patient will be able to socialize appropriate.

IMPLEMENTATION Strategies to achieve Goals Intervention

IMPLEMENTATION Strategies to achieve Goals Intervention SCIENTIFIC RATIONALE EVALUATION(S)

Provider of Care:

IMPLEMENTATION Strategies to achieve Goals Intervention SCIENTIFIC RATIONALE EVALUATION(S)

Manager of Care:

IMPLEMENTATION Strategies to achieve Goals Intervention SCIENTIFIC RATIONALE EVALUATION(S)

Member of the Discipline: