Assessment Nursing Scientific Planning Nursing Rationale Expected Outcome

Diagnosis Explanation Intervention

S> “ Masakit Acute pain r/t Incision on the left Short Term: Independent: Short Term:
surgery as side of the head
yung sugat evidence by cause the activation After 3 hours of >Asses vital sign. > Change vital is After 3 hours of
facial grimace of nocireceptors or nursing indicated acute pain nursing intervention,
ko sa ulo” intervention, the and discomfort. the patient verbalize
and incision on pain receptors
the left side of patient will > Provide pain is relieve or
verbalize pain is > Improve controlled. Pain
the head additional comfort circulation reduce
O relieve or measures e.g., scale from 6/10 to
controlled. Pain muscle tension and 9/10.
> Incision on back rub, heat and anxiety associated
scale from 6/10 to cold.
9/10. with pain.
the left side

the head
>Encourage and >Deep breathing for
> Facial assist the client to relaxation is easy to
do deep breathing learn and
Grimaces
exercise. contributes to relief,
> Pain Scale: reduce and/or
control pain by
7/10
reducing muscle
tension.

>To prevent fatigue

>Encourage
adequate periods
of rest and sleep
>Encourage
divisional
activities like >To divert attention
reading from pain
newspapers or
book, socialization
with SO or others
etc.

Dependent:

> Non steroidal

> Use to mild and
anti- inflammatory
moderate pain as
drug( NSAID)
adjunct to opioid
therapy when pain
is moderate to
severe.