PLEASE help me! :(

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I have looked all over the board about care plans and I find everything BUT the one thing I am looking for. It seems most care plans involve Maslow but mine does not, it involves OREM. I really have no idea where blood pressure, temperature, and pulses go. Also, I really get the feeling that my teachers are doing way more with our care plan than the other ones I'm reading about which honestly upsets me because it's already hard enough without making it so detailed and lengthy! I am just over this whole thing already. :(

Another thing is, for each nursing diagnosis, we have to have 3 goals and 3 interventions for each nursing diagnosis. With the goals, they want us to put the self care agency, expected outcomes, and broad goals. Then put a nurse agency/system and include whether the nursing actions are independent or interdependent and include rationales as well as A JOURNAL ARTICLE and highlight in the NCP (I dont understand this at all!)

Then we have to evaluate and modify.....

The problem is....my patient was from same day surgery and then was admitted so I never was able to see her discharge papers or find out what happened with her because by the time my shift was over, her records still weren't up on the computer. I am just so unbelievably frustrated. I have a good majority of the info but these two areas are torturing me!

Please Help!!! :( (Thank you Daytonite for trying to help, I appreciate it....I looked through all the info but didn't see anything on OREM or the specificity of the goals with everything my instructor is asking for)

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i put in a search for orem here on allnurses and found many posts discussing orem. if you have already looked on allnurses maybe they are not what you are looking for.

a google search for orem revealed the following. you might try a google search with specific words found in these documents and maybe you will get better results.

here is a website for a book about orem

http://books.google.com/books?id=id3oxx2h5poc&pg=pa132&dq=orem+nursing+care+plans&lr=&as_brr=0&ei=edvfsqflbjpwzatn9mghbw#v=onepage&q=&f=false

here is a power point about orem

faculty.ucc.edu/nursing-gervase/orem%5b1%5d.pps

below is some of the content from the power point.

orem’s self care agency

l definition: the individual’s ability to perform self-care activities

l consists of two agents:

– self-care agent - person who provides the self-care

– dependent care agent - person other than the individual who provides the care (such as a parent)

orem’s nursing system theory

l refers to a series of actions a nurse takes to meet a patient’s self-care needs

l is determined by the patient’s self-care needs

l is composed of three systems:

– wholly compensatory

– partly compensatory

supportive-educative

i did not have to use orem and not sure what you are looking for exactly. try different search terms in google.

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

if you have a copy of taber's cyclopedic medical dictionary you will find a nice breakdown of orem's theory in the appendix.

are you in a bsn program? it sounds like it. i was and they were just as specific with our care plans. so specific in fact that we had a 3 credit unit class that we had to take before we even got into our clinical classes where all this stuff was explained in detail. are you sure this care plan business wasn't explained to you in previous lectures or handouts? it sounds too specific for it not to have been. have you discussed this with fellow classmates?

my bsn program wanted us to assess patients and base our care plans on the work of two specific theorists and their work was drummed into us. if we failed to follow their theories in presenting any work, whether it was a care plan or a term paper, we lost valuable grade points.

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We did receive a handout for the nursing diagnosis which uses the issue of constipation to explain each one. So it says NANDA: constipation related to prolonged immobility as manifested by decreased frequency of stools, lack of appetite, c/o headache and abdominal pain. For the NOC: it says BOWEL ELIMINATION. The goal is: The patient will return to a normal pattern of bowel elimination. The NOC Indicators/expected outcome says: The patient will drink 2000ml in each 24 hr period.

My problem is I don't know how to apply this to Anxiety. My three issues are: Ineffective breathing pattern, Pain, and Anxiety. I understand the PES format and have mine finished but I am unsure how to make an Anxiety goal more specific. I put:

GOAL: The patient's anxiety level will decrease. Expected Outcome: The patient will demonstrate some ability to reassure self upon discharge.

Is this right?

I wasn't really sure how to make a decreased level of anxiety specific without making it an intervention. Then in addition they want rationales supported by a journal article. And the problem with all this is they just gave us our care plan patient last Friday, so I have only had a week to do this in addition to doing a research project and studying for exams.

Unfortunately they did not have us take a class on this. We did get a powerpoint packet on the nursing diagnosis but not a detailed one that really explains what we need. Our teacher handed us a guideline for nursing care plan which is an outline and states one sentence under each topic.

For the nursing diagnosis, it states:

A. select one problem and state a nursing diagnosis using the PES format. (I understand PES) Come up with 3 diagnoses for each care plan.

B. Self-care agency - include clients expected outcomes and broad goals

EX: fluid volume deficit - nursing diagnosis/ Goal: The client demonstrates evidence of adequate hydration.

Each outcome must have a subject, verb, and indicate the action performed with measurable terms expected of the client. Include a time frame.

C. Nurse agency - nursing actions

1. choose appropriate nursing system (THIS I UNDERSTAND)

2. state whether nursing actions are independent or dependent (THIS I UNDERSTAND)

3. Include rationale to justify nursing actions

4. use a journal article and highlight in NCP

5. identify the source and page number for each action and rationale

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Daytonite and TLC.....I just wanted to thank you both for caring and trying to help me. I really do appreciate it so much! Daytonite, you reminded me of a sheet I had on OREM from last semester. I am going to try and dig it up and hopefully I still have it. I know the basics for each one and some of the topics that go under each one, it's just the specifics which I am unclear about.

Thank you again. If you have time and read the goal/expected outcome I listed and can tell me if that sounds okay, that would be wonderful!

Thank you!!!!

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Here is a website to view an Anxiety care plan. This may help you get ideas for how to write yours.

http://www.rncentral.com/nursing-library/careplans/anx

Copy the above address and paste it in your address bar.

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

my problem is i don't know how to apply this to anxiety.

when care planning for a medical diagnosis you start by breaking this down into its component symptoms. this is step #1 of the nursing process, assessment. you always assess the patient first looking for the abnormal assessment data. the signs and symptoms of the medical diagnosis of anxiety are what you have to work with in determining what the person's nursing problems are going to be. think about how the person with the signs and symptoms of anxiety are going to
respond
to this medical condition and perform their adls. that is how you determine their nursing problems. the signs and symptoms of their nursing diagnoses may be the same, similar or different than the medical diagnosis of anxiety.

every nursing diagnosis has a definition, defining characteristics and related factors that nanda has already worked out for you. that is what your instructors supplied for you as an example when they gave you the information on constipation.

constipation

(related factor) related to prolonged immobility

(defining characteristics) manifested by decreased frequency of stools, lack of appetite, c/o headache and abdominal pain.

noc (outcome, goal) link: bowel elimination

for ineffective breathing pattern, acute pain and anxiety you will find this information on these webpages:

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hello people, Im doing my nursing degree. How do i answer the question which asks for critically examining the back ground to the development of orems theory. Describe the key concepts and how the theory contributes to nursing knowledge

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