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risk for infection

Assssme Nursing goal & expected Intervention Rationales Evaluation


nt Diagnosis outcomes

Subjectiv problem Goal 1.Aseptic Monitor the


e data risk for Mr. Wong will remain free 1.Keep sterile technique vital sign of
infection of infection with stable dressing minimize the Mr.Wong
pain eitiology vital sign on 10/3/2019 replacement the by 10/3/2019
score is Surgiacal and wound transmitting
8/10 on wound Mr. Wong will able to risk of Ask Mr.Wong
care (Vera ,
3/3/2019 perform hand washing pathogens to
2019)
sign & technique on 6/3/2019 2.increase demonstrate
pain symptoms https://nursesla the hand washing
score is Mr. Wong will report pain bs.com/risk-for- immunity technique by
4/10 on pain score score below 4/10 on infection/ 3. 6/3/2019
3/3/2019 is 8/10 on 7/3/2019 2.Encourage handwashin
3/3/2019 Expected outcomes Mr Wong to eat g reduces Ask Mr.Wong
food which is the risk of to report pain
Objective pain score Mr. Wong was able to rich in protein spreading score by
data is 4/10 on remain free of infection and calorine of pathogen 7/3/2019
3/3/2019 with stable vital sign by (Vera ,2019) between
Stage II 10/3/2019 patients
3.Teach Mr
colorectal Stage II and others
Wong to wash
carcinom colorectal Mr. Wong was able to 4.postopera
a carcinoma perform hand washing hands tive pain
technique by 6/3/2019 frequently(Vera leads to
open open ,2019) arteriolar
colostom colostomy Mr. Wong was able to 4.manage vasoconstri
y has has been report pain score below postoperative ction and
been done 4/10 on 7/3/2019 pain decreases
done (Vera ,2019) circulations
enternal required for
enternal feeding is wound
feeding is used recovery.
used

Disturbed body image


https://nurseslabs.com/disturbed-body-image/
Accessment Nursing goal & Intervention Rationales Evaluation
Diagnosis expected
outcomes

Subjective problem goal 1.Accept the 1.Accepting Ask Mr


data disturbed body Mr. Wong will expression negative Wong how
image able to merge of negative emotions as a does he
Mr.Wong changes into feelings from normal feel about
expressed self-concept Mr.Wong like response to himself
worries on eitiology without denying depression, the changed with the
caring self-esteem by dependence, body image stoma bag.
colostomy surgery 8/3/2019 anger helps solve
(Wayne, the problem. Ask Mr.
Objective Mr Wong will 2017) Wong if he
data sign & able to 2.The accept his
symptoms verbalize that 2.Supports expression of body
Stoma is Mr.Wong he accept his verbal sensation can image with
created expressed body image by expressions strengthen stoma bag
worries on 8/3/2019 of feelings coping and stoma
caring about the method of Mr
colostomy Mr Wong will loss of Wong Ask Mr
able to map out normal body Wong
Stoma is plans for the structure. 3. Positive what is the
created future by (Wayne, feedback in future plan
8/3/2019 social for his
2017)
environment daily
expected 3.Help accelerate activites
outcome Mr.Wong in adaptation of and job.
accepting body image.
Mr. Wong was body
avle to merge structural 4.A good
changes into changes into communicatio
self-concept Activity of n provides
without denying daily life and support for
self-esteem by occupational clientt and
8/3/2019 activities. family.
(Wayne,
Mr Wong was 2017) 5.Involving in
able to 4.Encourage self-care and
verbalize that family planning
he accept his interaction promotes
body image by with positive
8/3/2019 rehabilitation handling the
team. altered body
Mr Wong was (Wayne, image.
able to map out 2017)
plans for the 6.Discover
future by 5.Educate personal
8/3/2019 Mr.Wong of attributes and
the health strength
problem and allows the
mangement client to look
of stoma bag into his unique
character
(Arcangelo which help
et al., 2011) him focus the
whole concept
of self instead
6.Discover
of changed
Mr.Wong’s
body part.
strength and
resources
(Arcangelo
et al., 2011)

Vera, M. (2019). Risk for infection. Retrieved from https://nurseslabs.com/risk-for-infection/


Wayne, G ( 2017 ). Disturbed Body Image. Retrieved from https://nurseslabs.com/disturbed-body-image/
NURSING DIAGNOSIS Application to Cliniacal Practice FIFTEENTH EDITION
Wolters Kluwer

Arcangelo, V. , Bhatti , J. , Bohnenkaup, S. , Davis, H. , Galambos, C. , Gwen,


G. ,...Garner, L. (2011). NURSING DIAGNOSIS Application to Cliniacal Practice
(15th ed .). Disturbed body image in (pp.695-697). Publish City. Wolters Kluwer.

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