PLEASE HELP<< CARE PLANS

  1. Hello I am struggling with these care plans I have the nursing dx that i need to do but I am having trouble gathering plans and my goals for these, I have bought several books and they are great except these are for a well baby newborn and I have confused my self on as what to use for my plans .. our instructor adviced us to be very specific..
    the nursing dx that i have to use are:
    ]
    Risk for ineffective airway clearance R/t increased mucus production
    risk for fluid volume deicit R/t poor suck
    risk for altered thermoregulation r/t large body surface area and cool environment
    risk for injury (misidentification) r/t helpless infant

    please if someone has done these or has any plans in mind for these it would be very helpful>>>>>> thank you kem
    •  
  2. 7 Comments

  3. by   ShelleyERgirl
    Hey Kem,
    I hope this helps, I don't start my OB rotation until next week, but I do have my book, and I found an example of a care plan for your nursing dx for ineffective airway clearance R/T excessive mucus production.... My text book is " Maternity Nursing" sixth edition by Lowdermilk and Perry, page 505. Good luck to you!
  4. by   KolkataMomRN
    Risk For Fluid Volume Deficit R/T poor suck
    Goal: Pt. will not demonstrate signs and symptoms of dehydration
    Interventions: Monitor weight, body temperature, moisture in oral cavity
    and urine volume and concentration
    Offer appealing forms of fluids

    Risk For Ineffective Airway Clearance R/T increased mucus production
    Goal: Pt. will not experience aspiration
    Interventions: Position to prevent aspiration
    Suction secretions from airway as needed
    Provide humidified atmosphere
    Rrisk For Altered Thermoregulation r/t large body surface area and cool environment

    Goal: The infant will have a temp. between 97.5 F and 98.6 F
    Interventions: Warp in two blankets
    Put on head cap
    Limit time in contact with wet clothing or blankets
    Warm all articles for care

    Risk For Injury (misidentification) r/t helpless infant
    Goal: Pt will not be misidentified.
    Interventions: Frequent checks to ensure identification is intact
    Ensure identification is intact on bed

    Hope these help.......
    Tammy
  5. by   Lys
    Kem,

    I had *major* troubles with my ND's too...but thankfully have found the light *lol* This article may help you wrap your head around differences between interventions and goals (which is what I had the most difficulty with).

    Tribulski, Jean A. (1988). Nursing diagnosis: waste of time or valued tool? Registered Nurse Dec 1988, pp 30-34.

    In a nutshell just in case you cant' get the article anywhere:
    Example: Fluid volume excess related to excess sodium intake.

    Condition (nursing diagnosis) = patient goals.
    i.e. fluid volume excess = goals, weight loss, no pulmonary edema, choose low sodium items from menu.

    Etiology (related to factors) = interventions
    i.e. excess sodium intake = interventions, weight QAM, monitor I & O, assess breath sounds...etc.

    Best of luck with the ones that your instructor gave you, KolkataMom hit the nail on the head for you!!
  6. by   KolkataMomRN
    KolkataMom hit the nail on the head for you!![/QUOTE]


    Thanks Lys!! I actually have had a lot of trouble with nursing care plans in school. I was looking at them the wrong way and making them way too complicated.

    It finally hit me one day, that the goal it is the outcome that the PATIENT will do. While the interventions are something the NURSE will do to help the patient reach the goal. I know, I know they told me this in class, but for some reason it just was not clicking

    So with airway clearance, the ultmate goal is for the pt. to not aspirate. So what can I do, while with the pt., to help him/her not do this (interventions)............... I think some instructors make them sound way to complicated. Kem, forget fancy wording, keep it simple, and you will prgress with them.
  7. by   bangkay
    quick nemonics
    NCP:

    Assessment Nsg DX Goals Objective Nsg Implementation Evaluation
    Cues Problem How,Able? Doing,Action Did it work?
    Subjective Etiology SMART Documenting Goalmet
    Objective ManifestationShort/long term

    SMART- Subjective, Measurable, Attainable, Realistic, Time bounded
    Hope this will help
    Last edit by bangkay on Mar 27, '04
  8. by   kem7
    thank you so vey much this was very helpful cit R/T poor suck
    Goal: Pt. will not demonstrate signs and symptoms of dehydration
    Interventions: Monitor weight, body temperature, moisture in oral cavity
    and urine volume and concentration
    Offer appealing forms of fluids

    Risk For Ineffective Airway Clearance R/T increased mucus production
    Goal: Pt. will not experience aspiration
    Interventions: Position to prevent aspiration
    Suction secretions from airway as needed
    Provide humidified atmosphere
    Rrisk For Altered Thermoregulation r/t large body surface area and cool environment

    Goal: The infant will have a temp. between 97.5 F and 98.6 F
    Interventions: Warp in two blankets
    Put on head cap
    Limit time in contact with wet clothing or blankets
    Warm all articles for care

    Risk For Injury (misidentification) r/t helpless infant
    Goal: Pt will not be misidentified.
    Interventions: Frequent checks to ensure identification is intact
    Ensure identification is intact on bed

    Hope these help.......
    Tammy[/QUOTE]
  9. by   KolkataMomRN
    You are quite welcome!! Was good practice for me







    [QUOTE=kem7]thank you so vey much this was very helpful

close