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Need/Nursing Scientific Nursing Value

Objective Rationale Evaluation


Diagnosis/Cues Analysis Intervention Integration
Need: Sleep is required to After 6-8 hours Independent: After 6-8 hours
Physiologic need provide energy for of nursing of nursing
physical and mental intervention, the Evaluate patients response Establishes patients intervention, the
Nursing Diagnosis: activities. As persons patient will be to activity. capabilities or needs and patient was able
Disturbed sleep age the amount of able to: facilitates choice of interventions to:
pattern related to time spent in REM Reduces stress and excess
difficulty or laboured sleep diminishes. The a. demonstrate a Provide a quiet environment stimulation, promoting a. the patient was
breathing secondary to amount of sleep that measurable and limit visitors. rest. able to
disease process individuals require increase in demonstrate a
Cues: varies with age and tolerance in Elevate head and encourage These measures promote measurable
personal activity with frequent maximal inspiration. increase in
Subjective cues: characteristics. absence of position changes. tolerance in
Dili ko katulog kay Disruption in the dyspnea and activity with
maglisod ko ug individuals usual excessive absence of
Encourage deep Improve ventilation and
ginhawa, as diurnal pattern of fatigue. dyspnea and
breathing exercise. promotes optimal chest
verbalized by the sleep and excessive fatigue.
expansion.
patient. wakefulness may be b. Identify
temporary or chronic. negative factors b. Identified
Such disruptions may affecting activity Encourage adequate rest Facilitates healing process negative factors
Objective cues: result in both tolerance and balanced with moderate and enhances natural affecting activity
Frequent subjective distress eliminate or activity. Promote adequate resistance. tolerance and
and apparent reduce their nutritional intake. eliminate or
yawning
noticed impairment in effects when Assist patient with self-care Weakness may make reduce their
functional abilities. possible. needs. Keep bed in low activities of daily living effects when
Fatigue position and assist and ambulation difficult, possible.
c. Participate with ambulation. further assistance is
willingly in needed. c. Participated
Weak-looking
necessary / Dependent: Aids in reduction of willingly in
desired Provide supplemental shortness of breathe and necessary /
Dyspnea
activities. oxygen via nasal cannula as prevent hyperventilation. desired activities.
ordered by the physician.
Use of
accessory
muscles in
breathing

Restlessness

Number of
hours of
sleeping = 5
hours.

After rendering the nursing actions necessary for the patients health, the nurse was able to understand
and boost awareness towards self in relation to patient participation.