Help with care plan

fab4fan · Oct 30, 2003

Mito: I didn't say there was anything wrong with your post; I just thought that flowerchild did a good job of explaining without giving specific answers, and I wanted to pay her a compliment.

Having gotten plenty of careplans back full of red ink in my early student days, I learned plenty about writing them. I think I learned more by correcting the mistakes and rewriting the careplans.

meownsmile, BSN, RN · Oct 30, 2003

I was confused as to what she was really asking when she posted this on another thread too. I wonder if your instructor is really wanting care plans or is she wanting you to find rationals for why these things were ordered for your patient?

If it is rationals,, i would suggest you ask yourself questions about why these things would be done.

1. foley to gravity,,,,, Why would the patinet need a foley?

To check hourly urine output, why would the patients output be low after surgery?,, To observe for blood in the urine from possible trauma to the bladder during surgery?, Did the patient have a spinal block, would she need the foley until feeling returns and she was able to roll onto a bedpan more easily since she is 300+ pounds?

2. ambulate with assistance. Is there any reasons this patient couldnt ambulate safely by herself?

3. Ice to incision,, what does ice do? Why do we put ice on wounds? To decrease bleeding? swelling? soreness?

4. Routine vitals,,, why would they only want routine vitals? Is the patient getting a iv antibiotic? what kind is it? What would justify getting vitals more frequently? What would we watch for to justify getting them more frequently?

If it is truely care plans she is looking for you to do, the other suggestion and explainations are great.

Vsummer1 · Oct 30, 2003

Remember the nursing process: ADPIE.

Since assessment is first, I would not be able to write a post and get the answers for my careplans. The assessment is every minute detail including resources of the patient! No one can really help you with this, as it is INDIVIDUAL to each patient. You see, I can think it out and write it out,

BUT I HAVE TO HAVE REFERENCES for each rationale.

You should be able to integrate theory (what is taught in class) with your patient. That requires READING THE BOOK to find the rationale.

There is an index at the back of the book. What you do is think about what the patient requires most BASED ON THE ASSESSMENT then go for the diagnoses, look it up, write it out, then reference it. There have been MANY times where I KNEW what to do, but could not incorporate it into a careplan because I couldn't find the reference. So, I moved on to another item. Usually just READING the material pertinent to my patient (though this often took HOURS) gave me the information I needed.

We can't help you without having YOUR book. My careplans take a MINIMUM of 4 hours. But, because I look the stuff up, think long and hard about the patient and the patient's needs, I get the grades. ASKING someone else to help you work it out might be fine to give you ideas, but without an assessment (the "A" in ADPIE) of the patient it would be impossible for me to offer guidance.

So, my guidance is: Start at the beginning, think it out, and spend many, many hours on it.

P.S. A doctor's order is NOT a nursing action, so don't try to use that as an action. I got dinged for that! For example, don't say you will give the med, because that is an MD order. You can say that you will check the apical pulse prior to administering a med like dig though, because that is a nursing action. Better yet, teach the patient to take their pulse prior to taking their dig because teaching is always a nursing action. You can reference your drug book with that one...

Editorial Team / Admin · Oct 30, 2003

Sometimes I need a good example or two to get the idea, then I can take off on my own. Perhaps this is what T-bell was looking for also, from seasoned professionals.

We all give and take. :)

Warisose · Feb 7, 2006

Hi all! I just want to say that I too am a nursing student in the hospital. I am also a student having some problems with care plans! I have turned two in so far and talk about red ink!!

However, my instructor is wonderful. When she writes in red ink she writes suggestions and where to find clues. She is there to help us think critically. She is our instructor and mentor. We are not taking a test to see what we learned, we are in the process of learning.

We students need to take it easy. Nothing will come to us as long as we are so upset. A good instructor won't give you answers, but will help you or tell you where to go to find what you need.

Do the care plan as best as you know how. Use the resources you have and find more! Go ahead! Turn it in. Your instructor will show what needs to be included or omitted on the next one. I was so freaked out last quarter that I made myself ill. I learned to meditate!

Anyway, use what you have, seek more info and turn it in. Look at the red marks as learning tools. Curious, are you graded on these? We are not thank goodness. But the care plans affect our overall grade. I don't know what I would do if they were graded each time!

Hey, what care plan manual are you using? We are using Ulrich's. I am not sure I like it. I have ordered another care plan manual at Barnes and Noble.com.