Question aboutt interventions

i don't recall if i have answered any care plan questions for you before. however, there are plenty of my previous posts around where i explain care planning to help you.

• https://allnurses.com/forums/f50/help-care-plans-286986.html - assistance - help with care plans (in the general nursing discussion forum)
  

diagnosis: activity intolerance r/t decreased hemoglobin and lung capacity aeb shortness of breath on exertion.

• shortness of breath on exertion

• the patient is able to sit in wheel chair for 30 minutes then wants to go to bed due to fatigue
  
  
• the patient becomes extremely short of breath when he is assisted to the bathroom

is there a book of interventions that i can buy?

ah, ha! the cancer and the chemotherapy add a lot more information. the chemo explains the low hemoglobin. did this guy have lung cancer or lung surgery?

we would all like to see patients get better, go home and live forever. but the reality is that they don't. one thing that hits you in the face when you work as a hospital nurse is that patients do three things:

• improve
  
• stabilize
  
• deteriorate
  

while we would all like patients to improve and get well, the facts are that some will not. it is perfectly kosher to care plan for all three types of outcomes. deteriorating patients are probably the hardest for some nurses to care for. hospice nurses have it down to a science. i've seen enough respiratory patients to know that you just can't push them, particularly a cancer patient with compromised hemoglobin.

this patient is probably not going to improve. all you are going to do with your interventions is maintain his current level of functioning as safely as you can. in other words, supportive care only. pushing for improvement is probably not an option here.

some of the interventions you can do are monitor the patient for the signs and symptoms of activity intolerance when they are engaged in physical activity. watch for syncope. plan for the patient to do as many of their independent adls as possible in short periods of time with rest periods in between provided. evaluate for and incorporate the use of assistive devices. monitor pulse ox.

nursing interventions are of four types:

• assess/monitor/evaluate/observe (to evaluate the patient's condition)
  
• care/perform/provide/assist (performing actual patient care)
  
• teach/educate/instruct/supervise (educating patient or caregiver)
  
• manage/refer/contact/notify (managing the care on behalf of the patient or caregiver)
  

you can knock yourself out developing several of each type!

minimize cardiovascular deconditioning by positioning the client in an upright position several times daily isn't an ideal way to write an intervention. i would say "have patient sit in an upright position three times a day for meals for at least 20 minutes." why? (1) it doesn't sound like i copied it directly from a book. (2) the scenario told me that the patient was able to sit in a wheel chair for 30 minutes then wanted to go to bed due to fatigue. he should be able to tolerate 20 minutes of sitting up. three times a day can be coordinated with meal times. that is how you customize the plan of care.

no more trips to the br because of the sob. he gets a bedside commode, starts using w/c transfer or using urinal or bedpan.

what comes after interventions in the care planning (nursing) process?

1. assessment
   
2. determination of the patient's problem(s)/nursing diagnosis
   
3. planning
   
4. implementation
   
5. evaluation

the interventions are implemented and then evaluated to see if the care plan is successful or needs changing.