Please help!! Problems with care plan interventions!

Nursing Students Student Assist

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Ok, I am at the point where my brain is dead! I have a care plan due tomorrow and I can't get the interventions right. I had done some previously but the instructor wrote a note on my paper that said work on outcomes and frequencies.

Pt is at risk for injury r/t falls AEB history of 1 -2 falls within the past 3 months.

Can someone please help me because I don't want to get an incorrect intervention again. Just need to be pointed in the right direction.

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how about allow time to dangle at bedside before standing, remove area rugs in home, allow extra time for ADLs as needed. Why is pt falling? Med related? Weather? Unsteady gait?

Think about WHY they are falling and how it can be prevented.

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Specializes in Informatics; Labor & Delivery; Med-Surg.

I am not a expert on these. But I know that with a risk diagnoses, there is not an AEB.

If im not mistaken. It could be Risk for injury r/t hx of falls. Or Risk for falls r/t hx of falls.

An outcome/goal could be Pt will remain free of falls during hospital stay.

An intervention could be to orient pt to environment. Place call light within reach, demonstrate how to use call bell if not use to it, make sure bed is in locked position.. You could routinely assist pt to restroom like q2hrs, which would reduce the risk.

I hope this helps a little.:idea:

Shawn

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Thanks guys. My brain is just frazzled right now. I have a pharmacology exam (first one) tomorrow and haven't even started studying for it yet because of this care plan!

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Specializes in med/surg, telemetry, IV therapy, mgmt.

you have more problems than getting correct interventions and outcomes here.

  1. you've diagnosed this incorrectly. the nursing diagnosis you should be using is risk for falls r/t history of falls. here is a website that has the nanda information (definition, risk factors, suggestions for outcomes, and nursing interventions) for this diagnosis:

[*]you are constructing your nursing diagnostic statement incorrectly. the information that follows the phrase "aeb" in a 3-part diagnostic statement is supposed to contain the signs and symptoms, or evidence, that the patient has that supports the diagnosis of an actual patient problem. a "risk for" diagnosis is only used for potential problems. potential problems are anticipatory, so if the patient has any actual symptoms of what you are thinking is a potential problem, then you've diagnosed it wrong. in your diagnostic statement risk for injury r/t falls aeb history of 1 -2 falls within the past 3 months the part thati underlined, and which you indicate is a symptom, is clearly an etiology, or cause, of the problem. however, "falls" are not a risk factor for the diagnosis of risk for injury (page 125, nanda-i nursing diagnoses: definitions & classification 2007-2008). this tells me that

  • you're not using a nursing diagnosis reference to check and verify the information of the diagnoses you are choosing
  • you're not understanding the difference between an actual and potential nursing diagnosis
  • you're not understanding the elements that go into the structure of a nursing diagnostic statement

please read the information and links on the thread below. construction of the 3-part nursing diagnostic statement is discussed on one of the links posted there:

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