Short / long term goals

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i have two diagnosis that i am having trouble making a short term/ long term goal can i please get some help.

#1. Risk for falls r/t elevated blood glucose level as evidenced by patient fainting and being found on the floor of their home with no recollection of the incidence.

#2. Ineffective coping r/t death of spouse as evidenced by patient crying, appearing withdrawn, poor appetite, high blood pressure, and patient stating she would like to "be left alone".

Here is the case study scenario:

Mrs. D. is a 73-year-old recently widowed female with a history of CAD, MI- 5 years ago, NIDDM- 7 years, and fairly good health. She was brought into the ER by her daughter, who because she could not reach the patient by phone went to the patient's apartment and found the patient on the floor with no recollection of how she got there. The patient has been admitted with a diagnosis of syncope. Vitals signs: 148/94, 93- irregular, 24, 97.8 F, blood sugar 317.

The physical assessment shows no signs of injury or bruises and the patient is able to move all extremities without any pain. At present Mrs. D. is quiet, answers questions appropriately with short replies, is withdrawn, states that she wants to "be left alone", and has been see crying. Her appetite is poor, color is pale, and she cannot remember the last time she had "a decent" meal and "could care less".

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Specializes in Med/Surg, Ortho, ASC.

You can get some help if you first show your thinking on your care plans. Most of us will not just give you answers but we are happy to critique your thoughts and help you move forward.

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A care plan book would help with these short- and long-term goals. Do you have one? I used Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care. It has outcomes/goals and interventions along with everything else you would need!

For outcomes/goals use the acronym SMART

Specific – What needs to be accomplished?

Measurable – How will the nurse, patient, and/or family know that the goal has been met?

Attainable – Can the goal be met with the resources available?

Realistic – Does the patient and/or family have the physical, emotional, and mental capacity to meet the goal?

Timed – When will the goal be achieved by?

For example

For ineffective airway clearance a short-term goal could be the pt correctly demonstrates turning, coughing, and deep breathing by end of shift on 11/26.

This is specific. It states exactly what the pt will demonstrate - turning, coughing, and deep breathing.

This is measurable. You can watch the pt complete it to ensure the pt is learning and doing it appropriately.

This is attainable. It is possible to teach the pt proper turning, coughing, and deep breathing, and it is possible for the pt to learn it and do it properly.

This is realistic. The pt has the ability to meet this goal by the specified time.

This is timed. This goal is to be achieved by 11/28

One way to identify expected outcomes/goals is to convert the nursing diagnosis into a positive statement. For example, the nursing diagnosis impaired physical mobility r/t fracture of right hip. The expected outcome/goal might be – the pt will ambulate independently before discharge.

You also want to identify a target time or date for when the expected outcomes/goals should be achieved. These expected outcomes/goals will be what you will use to evaluate your nursing interventions.

Keep in mind that each expected outcome has to be stated in measurable terms.

So, what are you thinking for you pt that are attainable for your pt, fit the SMART acronym, and fit your nursing diagnoses. What interventions would you do for these nursing diagnoses? Based on those interventions, what do you want to pt to achieve from them? (e.g., you have a nursing diagnosis of risk for falls. An intervention might be to teach pt and family factors r/t the pts condition that increase potential for falling. What would be an outcome related to that? Maybe that the pt and/or family learn and repeat 5 factors r/t pts condition that increase potential for falling)

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#1. Risk for falls r/t elevated blood glucose level as evidenced by patient fainting and being found on the floor of their home with no recollection of the incidence.

Short Term Goal:

1. Patient will be free from falls by the end of shift.

2. Patient will have decreased blood sugar by end of shift.

Long Term Goal:

1. Client will make necessary physical changes in environment to ensure safety within first week of returning home.

2. Client will maintain blood glucose within the recommended target range

#2. Ineffective coping r/t death of spouse as evidenced by patient crying, appearing withdrawn, poor appetite, high blood pressure, and patient stating she would like to "be left alone".

Short Term Goal:

1. Patient will report increased appetite within 24 hours.

2. Blood pressure decrease by end of shift

3. Patient communicates needs and negotiates with others to meet need

Long Term Goal: 1. patient will sustain proper dietary needs

2. blood pressure will be maintained within recommended target range

3. Patient uses available resources and support systems

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btf4 said:
#1. Risk for falls r/t elevated blood glucose level as evidenced by patient fainting and being found on the floor of their home with no recollection of the incidence.

Short Term Goal:

1. Patient will be free from falls by the end of shift.

2. Patient will have decreased blood sugar by end of shift.

Long Term Goal:

1. Client will make necessary physical changes in environment to ensure safety within first week of returning home.

2. Client will maintain blood glucose within the recommended target range

#2. Ineffective coping r/t death of spouse as evidenced by patient crying, appearing withdrawn, poor appetite, high blood pressure, and patient stating she would like to "be left alone".

Short Term Goal:

1. Patient will report increased appetite within 24 hours.

2. Blood pressure decrease by end of shift

3. Patient communicates needs and negotiates with others to meet need

Long Term Goal: 1. patient will sustain proper dietary needs

2. blood pressure will be maintained within recommended target range

3. Patient uses available resources and support systems

Very good. Except for your ineffective coping diagnosis:

  • Maybe state an acceptable BP level for the pt for the short-term goal
  • You definitely want to state that recommended target range for your pt
  • For your 3rd short-term goal, you didn't list a time when the pt needs to meet that goal. For example, pt will communicate needs and negoatiate with others to meet needs within 2 days.
  • You didn't list a specific time for any of your long-term goals. Maybe have the pt sustain proper dietary needs within 1 week of discharge, maintain BP within recommended target range within 3 weeks of discharge, and use available resources and support systems within 1 week of discharge
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I like where you are headed. One minor point - is she a client or a patient? In today's healthcare world, you could make an argument for either, but do be consistent.

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ProperlySeasoned said:
I like where you are headed. One minor point - is she a client or a patient? In today's healthcare world, you could make an argument for either, but do be consistent.

Very good point! Half of my textbooks used "client" and the other half used "patient." My instructor's didn't seem to care which one we used but we had to be consistent

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