PROBLEM NURSING DIAGNOSIS OBJECTIVE INTERVENTION/RATIONALE EVALUATION

Anxiety Anxiety related to knowledge To allay patients anxiety -I will explain the condition to the Patient has been provided with
deficit evidenced by patient asking in 24 hours of nursing patient and relatives in simple terms adequate information and the
many question. intervention to help patient acquire knowledge on anxiety has be allied evidenced by
the condition. patient is come and not asking a lot
-I will involve the family of C.M to of questions
make him feel loved.
-I will encourage the patient to
adhere to medication so as to get
better soon.

Risk of altered Risk of altered nutrition less than Patient nutrition status -I will provide my patient with small Patient nutrition status is
nutrition body required evidenced by will be maintained frequent meals to promote appetite maintained throughout
patient loss of weight through out -I will provide a lot of fluids to hospitalization evidenced by
hospitalization prevent constipation and patient gaining weight from 55 kg
dehydration. to 58 kg.
-I will provide food rich in vitamins
such as fruits, vegetables to boost the
immunity my patient.
-I will weigh the patient daily to see if
he is improving or not.
Self Self-care deficit related to patient Patient self-care will be 1. I will encourage client to be Patients self-care has improved
Care change in normal behavior improved within 2 to 3 performing normal activity of daily within 2 – 3 hours of
Deficit evidenced by inability to perform days of hospitalization living to his or her level of ability. hospitalization manifested by
activities of daily living Because this enhances self-esteem. patient performing the activities of
2. I will Offer recognition and daily living on her own.
positive reinforcement for
independent accomplishments
because encourages repetition of
desirable behaviors.
3. I will Show client, how to
perform activities with which he or
she is having difficulty. E.g. If client is
not eating, place spoon in his or her
 hand, scoop some food into it, and
say, “Now, eat a bite of mashed
potatoes).” Because concrete thinking
prevails.
4.. If client is not eating because of
suspiciousness and fears of being
poisoned, I will provide canned foods
to allow client open the food and eat.

PROBLEM NURSING DIAGNOSIS OBJECTIVE INTERVENTION/RATIONALE EVALUATION

Risk Risk for self-directed or other- The client will not injure 1. I will Maintain low level of Patient sleeping patterns has
for directed violence related to herself or others stimuli in client’s environment such improved manifested by patient
self-directed patient been irritable or agitated throughout her hospital as few people and low noise level in having enough time to sleep.
or stay. order to prevent the patient from
other-directed becoming suspicious and perceive
injury others as threatening.
2. I will Remove all dangerous
objects from client’s environment so
that in her agitated, confused state
client may not use them to harm
herself or others.
3. I will try to redirect the
violent behavior with physical outlets
for the client’s anxiety (e.g., punching
bag). Because physical exercise is a
safe and effective way of relieving
pent-up tension.
4. I will ensure sufficient staff
available to indicate a show of
strength to client if it becomes
necessary. This provides evidence of
control over the situation and
provides some physical security for
staff
 PROBLEM NURSING DIAGNOSIS OBJECTIVE INTERVENTION/RATIONALE EVALUATION

Imbalance Imbalance nutrition less than body Patient nutrition status 1. I will provide the patient with Patients’ nutrition status has improved
nutrition less requirements related to patient will be improved within 2 “Finger foods” a client can eat while within 2 – 3 hours of hospitalization
than body being too busy without having - 3 days of hospitalization moving around in order to improve manifested by patient gaining weight.
requirements time to eat evidenced by patient nutrition status.
losing weight. 2. I will provide the food to the
patient that is high in calories and
protein as possible in order to
improve the nutrition status.
3. I will ensure that things like
snacks are available between meals,
so that clients can eat whenever
possible.
4. I will continue observing and
supervising the client at meal times in
order to prevent the client from
taking food from others.