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    NCP1 1

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    NCP1 1

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    NCP1-1

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    NCP1 1

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    Health Assessment - Activity 1: GROUP 1

    PLANNING,
    ASSESSMENT NURSING CLIENT GOAL, NURSING RATIONALE EVALUATION
    DIAGNOSIS DESIRED INTERVENTION
    OUTCOMES

    Subjective cues: Acute pain related to After 24-48 hours Independent: After 24-48 hours
    biological injury as of meticulous of meticulous
    evidenced by diaphoretic, nursing - Pain should be compared to the nursing
    • Severe avoidance of eye contact, intervention the - Take note of any reports client's previous encounters with intervention the
    abdominal pain dry mouth, strained expected of pain including location, pain. By comparing the patient:
    expression, autonomic outcomes will be: duration, intensity (0-10 development of complications, this
    •“My mouth is so responses, request for scale), and other signs comparison may help diagnose the 1. The patient is
    dry” information, and abnormal 1. Patient will be such as changes in vital etiology. free from severe
    vital signs. free from signs. abdominal pain.
    •“I'm so uptight I abdominal pain - Minimizes pain and discomfort by
    will be never able - Aid the patient to perform reducing joint stiffness. *GOAL MET
    to sleep tonight” Priority problem no.1 2. Patient will passive and active range-
    verbalize the of-motion exercises. - By providing thorough information 2. Patient
    – as verbalized by Anxiety reduction of the regarding the diagnostic test, the verbalized the
    the patient. pain within one - Provide therapeutic patient may feel at ease, which reduction of the
    Priority problem no.2 hour of communication regarding helps decrease the patient’s pain within.
    Objective cues: intervention. diagnostic tests and anxiety.
    address the patient's *GOAL MET
    3. Patient will be anxiety by offering - Monitoring fluid balance of the
    • Abdominal pain able to feel emotional support. patient is crucial to prevent 3. Patient is able
    comfortable on complications such as dehydration to feel
    their own. - Monitor and maintain and electrolyte imbalances in comfortability on
    • Diaphoretic
    fluid balance of the patients. its own.
    patient.
    • Skin is cool to
    touch -Intravenous (IV) therapy is *GOAL MET
    administering fluids directly in the
    veins. Since taking food may cause
    • Abnormal Vital
    distress to the digestive tract of the
    Signs, P 104, R client, IV fluids help replenish lost
    Dependent:
    30, BP 180/96 fluids and avoid complications as it
    - IV fluids as ordered by provides the right amount of fluids
    the physician. and electrolytes in the body.

    - May be a narcotic of choice to


    relieve acute pain and reduce
    - Pain relief medication peristaltic pain activity.
    ordered by the physician.

    REFERENCES:
    Doengers M.E., Moorhouse M.F, & Gerss;er-Murr A.C. (2002). Nursing care plans-guidelines for individualizing patient care 6th edition, Philadelphia:
    F.A Davis Company.

    Ccm, M. W. B. R. (2023, May 24). Abdominal Pain: Nursing Diagnoses, Care Plans, Assessment & Interventions | NurseTogether. NurseTogether.

    https://www.nursetogether.com/abdominal-pain-nursing-diagnosis-care-plan/

    Sterns, R.H. (2023). Etiology, Clinical Manifestations, and Diagnosis of Volume Depletion.

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