Assessment Subjective Cues

:

Nursing Diagnosis

Scientific Analysis Absence or deficiency of cognitive information related to specific topic.

Planning

Intervention

Rationale

Evaluation Goal: Met

Short term goal: Independent: Knowledge deficit related to surgical “Hindi niya procedure of the right masyadong alam inguinal area as ang mga operasyon manifested by na ginagawa sa inability to kanya” as understand verbalized by the information on the client’s son. procedure, different perception about the surgical procedure, Objective Cues: and inability to follow healthcare • Inability to needs and precautions understand post operatively. information on the procedure • Different perception of the surgical procedure • Inability to follow healthcare needs and precautions post operatively Measurements: Vital Signs: BP= 130/70 PR= 77 bpm RR= 18 cpm T = 36.5 C Psychomotor: After10 minutes of nursing care, client will be able to participate in the learning process about the client’s disorder and its surgical procedure Affective: After 10 minutes of nursing care, client can verbalize understanding of the surgical procedure. Cognitive: After 10 min. of nursing care client will be able to understand the surgical procedure involved in the disorder. Determine client’s ability and barriers to learning. Individual may not be physically, emotionally or mentally capable at this time May need to help caregivers to learn

Assess the level of the client’s capabilities and the possibilities of the situation Explain the procedure to the client’s support person Provide information relevant to the situation Discuss client’s perception needs

After 10 minutes of nursing care, patient has able to demonstrat e and understand the information regarding the surgical procedure.

Provide information of the procedure and its complications To provide reality based facts Client will feel competent and respected

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