Planning

Planning A deliberative Systematic phase Decision making Problem solving Develop goals, desired outcomes and nursing interventions to prevent, reduce, or alleviate the client’s health problem.

Types of planning Initial (admission) Ongoing (Beginning of the shift) Discharge (needs after discharge)

A 75-year-old patient who has had elective surgery to replace an arthritic hip. The patient was admitted directly to the surgery unit and is now back to his room on orthopedic floor several hours after being discharged from recovery room. Which type of planning performed during this first post-op shift?

Nursing Care Plans Informal Formal Standardised (for groups of patients with common needs) Individualised (meet specific needs)

Planning Process

Setting Priorities Pain Dry skin Nausea Constipation Potential for wound infection

Establishing goals/desired outcomes Subject Verb Conditions or modifiers Criterion of desired performance Realistic Client response (not nurse activity) (maintain client hydration)…..(Client will drink 100 cc of water per hour) Derived from nursing Dx.

Goals /Desired outcomes Client performs leg ROM exercises as taught Q 8 hrs time. Client administers correct insulin dose using aseptic technique

Risk for impaired skin integrity r/to immobility, dry skin and surgical incision represents which of the following goals: Change position Q 2 hrs Applying lotions and skin barrier creams Not develop skin break down during hospitalisation Use a pressure-reducing mattress.

Selecting Nursing Interventions and activities Independent interventions/ nurse licensed to practice (Physical care, teaching, ongoing assessment, emotional support, making referrals( Dependent (medication prescription, diagnostic tests)

Writing nursing order Date Action verb Content area Time element 22/02/2008 : Instruct the patient to avoid drinking liquids with meals if nausea occurs in evening shift. Saleh.M, RN

“ 21/02/2008 : Measure client’s fluid intake and output. Sara. F, RN