Nursing Care Plan for Appendectomy - NCP
2
Student Nurses’ Community NURSING CARE PLAN Appendectomy ─ ASSESSM ENT DIAGNO SIS INFERENC E PLANNI NG INTERVENT ION RATIONA LE EVALUATI ON SUBJECTIVE : “Sumasakit ang sugat ng opera ko.” (I feel pain aroun t!e in"ision site# as $er%ali&e %' t!e patient. BJECTIVE: • )uaring %e!a$ior in t!e a%omen • *a"ial mask of pain • +istra"tion %e!a$iors • V,S taken as follo-s: T : /.0 1C 2: 0 3: 45 B2: 446,06 7"ute pain ma ' %e relate to istention of intestinal ti ssue %' in8ammat ion an presen"e of surgi"al in"ision. Appendect omy is t!e remo$a l of t!e in8ame appe ni9. In an open "on$entional an un"ompli"at e appene"to m' t!e surgeon remo$es t!e appeni9 t!roug! an in"ision appro9imate l' in "!es long in t!e lo -er rig !t ;uarant. T!e in"ision is larger if t!e appe ni9 is in a t'pi "a l position or if peri tonit is is present. 7fter 4 !our of nursing inter$enti ons t!e patient -ill report pain is relie$e or "ontrolle an appear to %e rela9e a%le to sleep an rest appropriat el'. Inepenent • 7ssess pain noting lo"atiosn "!ara"terist i"s an se$eri t' (6 to 46 s"ale#. In$estigate an repor t "! anges in pain as appropriate. • 2ro$ie a""urate !onest information to patient or signi<"ant ot!ers. • =eep at rest in semi> *o-ler?s position. • Useful in monitorin g e@e"ti$en ess of mei"atio n an progressi on of !ealing. C!anges in "!ara"ter isti" of pain ma' ini"ate e$elopin g a%s"ess or peritoniti s re;uiring prompt mei"al e$aluatio n an inter$enti on. • Being informe a%out t!e progress of situation pro$ies emotiona l 7fter 4 !our of nursing inter$entio ns t!e patient -as a%le to report pain is rel ie$e or "ontrolle an appear to %e rela9e a%le to sleep an rest appropriate l' .
Transcript of Nursing Care Plan for Appendectomy - NCP
7/25/2019 Nursing Care Plan for Appendectomy - NCP
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Student Nurses’ Community
NURSING CARE PLAN Appendectomy ─
ASSESSM
ENT
DIAGNO
SIS
INFERENC
E
PLANNI
NG
INTERVENT
ION
RATIONA
LE
EVALUATI
ONSUBJECTIVE
:
“Sumasakit
ang sugat
ng opera
ko.” (I feel
pain aroun
t!e in"ision
site# as$er%ali&e
%' t!e
patient.
BJECTIVE:
• )uaring
%e!a$ior
in t!e
a%omen
• *a"ial mask
of pain
• +istra"tion
%e!a$iors
• V,S taken
as follo-s:
T: /.0 1C2: 03: 45B2:
446,06
7"ute
pain ma'
%e relate
to
istention
of
intestinal
tissue %'
in8ammat
ion anpresen"e
of surgi"al
in"ision.
Appendect
omy is t!e
remo$al of
t!e in8ame
appeni9. In
an open
"on$entional
an
un"ompli"at
eappene"to
m' t!e
surgeon
remo$es t!e
appeni9
t!roug! an
in"ision
appro9imate
l' in"!es
long in t!e
lo-er rig!t
;uarant.
T!e in"ision
is larger if
t!e
appeni9 is
in a t'pi"al
position or if
peritonitis is
present.
7fter 4
!our of
nursing
inter$enti
ons t!e
patient
-ill report
pain is
relie$e
or"ontrolle
an
appear to
%e
rela9e
a%le to
sleep an
rest
appropriat
el'.
Inepenent
• 7ssess pain
noting
lo"atiosn
"!ara"terist
i"s an
se$erit' (6
to 46
s"ale#.
In$estigatean report
"!anges in
pain as
appropriate.
• 2ro$ie
a""urate
!onest
information
to patient
or
signi<"ant
ot!ers.
• =eep at rest
in semi>
*o-ler?s
position.
• Useful in
monitorin
g
e@e"ti$en
ess of
mei"atio
n an
progressi
on of
!ealing.C!anges
in
"!ara"ter
isti" of
pain ma'
ini"ate
e$elopin
g a%s"ess
or
peritoniti
s
re;uiring
prompt
mei"al
e$aluatio
n an
inter$enti
on.
• Being
informe
a%out t!eprogress
of
situation
pro$ies
emotiona
l
7fter 4
!our of
nursing
inter$entio
ns t!e
patient -as
a%le to
report pain
is relie$e
or"ontrolle
an appear
to %e
rela9e
a%le to
sleep an
rest
appropriate
l'.
7/25/2019 Nursing Care Plan for Appendectomy - NCP
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support
!elping
to
e"rease
an9iet'.
• )ra$it'
lo"ali&es
in8amma
tor'
e9uates
into lo-er
a%omina
l tension.
g
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