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NURSING CARE PLAN
    ASSESSMENT            DIAGNOSIS            INFERENCE             PLANNING            INTERVENTION              RATIONALE           EVALUATION
                                                                                     Independent:
Subjective:           •    Acute pain      •   Caesarean         •   After 8 hours   • Evaluate pain           •   Provides            •   After 8
                           related to          delivery is the       of nursing         regularly noting           information             hours of
“Masaki yung tahi          disruption of                             interventions      characteristics,           about need for          nursing
                                               surgical
ko” as verbalized          skin, tissue,                             , the patient      location, intensity        or effectiveness        intervention
by patient.                and muscle
                                               removal of the        pain will be       (0-10 scale).              of interventions.       s, the
                           integrity.          infant from the       relieved or     • Identify specific       •   Prevents undue          patient pain
Objective:                                     uterus through        controlled.        activity                   strain on               was relieved
                                               an incision                              limitations.               operative site.         or
•    Facial mask of                            made in the                           • Recommend               •   Promotes                controlled.
     pain.                                     abdominal wall                           planned or                 return of normal
                                               and the uterus.                          progressive                function and
•    Guarding                                  Size and                                 exercise.                  enhances
     behavior.                                 location of the                                                     feelings of
                                               incision vary,                                                      general well
•    Narrowed                                  but abdominal                                                       being.
     focus.                                    and uterine                           •    Schedule             •   Prevents
                                                                                          adequate rest            fatigue and
                                               incisions of
•    V/S taken as                                                                         periods.                 conserves
     follows:
                                               choice are low                                                      energy for
                                               and horizontal.                                                     healing.
     T: 37.3                                   Vertical                              •    Review               •   Provides
     P: 80                                     incisions may                              importance of            elements
     R: 18                                     be necessary                               nutritious diets         necessary for
     Bp: 110/90                                for quicker                                and adequate             tissue
                                               procedures, the                            fluid intake.            regeneration or
                                               presence of                                                         healing.
                                               adhesions and                         •    Reposition as        •   May relieve
                                               other                                      indicated.               pain and
                                               complications.                                                      enhance
                                                                                                                   circulation.
                                                                                     •    Provide additional   •   Improves
                                                                                          comfort                  circulation,
                                                                                          measures like            reduces muscle
                                                                                          back rub.                tension and
                                                                                                                   anxiety
                                                                                                                   associated with
                                                                                                                   pain.
•   Encourage use of    •   Relieves
    relaxation              muscle and
    technique like          emotional
    deep breathing          tension.
    exercises.

Collaborative:
• Administer            •   To relieve mild
    analgesics or non       or moderate
    steroidal anti-         pain.
    inflammatory
    drugs as
    prescribed.

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Nursing crib.com+ +nursing+care+plan+cesarian+delivery

  • 1. NURSING CARE PLAN ASSESSMENT DIAGNOSIS INFERENCE PLANNING INTERVENTION RATIONALE EVALUATION Independent: Subjective: • Acute pain • Caesarean • After 8 hours • Evaluate pain • Provides • After 8 related to delivery is the of nursing regularly noting information hours of “Masaki yung tahi disruption of interventions characteristics, about need for nursing surgical ko” as verbalized skin, tissue, , the patient location, intensity or effectiveness intervention by patient. and muscle removal of the pain will be (0-10 scale). of interventions. s, the integrity. infant from the relieved or • Identify specific • Prevents undue patient pain Objective: uterus through controlled. activity strain on was relieved an incision limitations. operative site. or • Facial mask of made in the • Recommend • Promotes controlled. pain. abdominal wall planned or return of normal and the uterus. progressive function and • Guarding Size and exercise. enhances behavior. location of the feelings of incision vary, general well • Narrowed but abdominal being. focus. and uterine • Schedule • Prevents adequate rest fatigue and incisions of • V/S taken as periods. conserves follows: choice are low energy for and horizontal. healing. T: 37.3 Vertical • Review • Provides P: 80 incisions may importance of elements R: 18 be necessary nutritious diets necessary for Bp: 110/90 for quicker and adequate tissue procedures, the fluid intake. regeneration or presence of healing. adhesions and • Reposition as • May relieve other indicated. pain and complications. enhance circulation. • Provide additional • Improves comfort circulation, measures like reduces muscle back rub. tension and anxiety associated with pain.
  • 2. Encourage use of • Relieves relaxation muscle and technique like emotional deep breathing tension. exercises. Collaborative: • Administer • To relieve mild analgesics or non or moderate steroidal anti- pain. inflammatory drugs as prescribed.