+) [4 tl 43% @ 4:24 p.m. @ OQ — @ =scribd.com/doc/14976 = §3 SCRIBD Assessment] Diagnosis | Planning | Intervention] Rationale | Evaluation ~Maintainin Subjective: Goal: gclean, dry | ~the goal is May mga | ~Impaired | Afier the ~Demonstrated | skin provides | met. sugat ako.” as | skin integrity } nursing 3 days | good skin a barrier to verbalized by | related to intervention | ion gy, fimfistion, | Because the the patient. | inflammatory | the client will client is able response | beableto | wash to display secondary to | display improvement Objective: | infection. improvement | *horoughly and in wound Disruption of in wound pat dry healing as skin surface at healing carefully) , evidence by the right upper 3 ~Wound | minimized am Objective: | ~provideand | dressings _| presence of “presence of ~the wound apolied protectthe | wound. pain will be lessen ee woundand | ~there sa nthe wound is in diameter wound the absent of 3mm in there will be surrounding. | itching distance an absent of dressing tissues ~absent of -there has a erythema carefully | ~ Improved _| pain presence of the presence | _prashag nutrition and | ~several part erythema of wound will |~Emphasized | hydration | of wound had “presence of be minimize importance | will improve | dried up itchiness in the ~absence of ofadeqate | Kin surrounding of itchiness condition, the wound nuttition and fluid intake. |. the -clean the wound will . be not wound with | 20 disinfectant and avoid using dirty dressing Scribd «kee Books, audiobooks, and more. x Get our free app