Nursing Diagnosis #__: Anxiety related to stress Goal: To reduce level of anxiety experienced by the patient Expected Outcomes:

After 8 hours nurse-client interaction the client will be able to: 1. Verbalize decrease of level of anxiety experienced 2. Demonstrate anxiety reducing techniques Interventions Evaluation 1. Assess patients level of anxiety. 1. The patients anxiety level was Mild anxiety enhances patients awareness and ability to identify and solve problems. Moderate anxiety limits awareness of environmental stimuli. Problem solving can occur but maybe more difficult and patient may need help. Severe anxiety decrease patients ability to integrate information and solve problems. Panic is severe anxiety. Patient is unable to follow direction: Hyperactivity, agitation and immobilization may be observed. 2. Maintain a calm and tolerant manner while interacting with patient. Staffs anxiety may be easily perceived by patient. The patients feeling of stability increase in a calm and nonthreatening atmosphere. 2. The student nurses were calm and didnt show signs of distress or nervousness while asking questions and providing care to the patient. The client was less anxious. The client was smiling and joking. assessed. The level of anxiety is mild. The patient can still respond accurately to questions asked.

3. Assist in developing anxietyreducing skills. Utilizing anxietyreduction strategies enhances patients sense of personal mastery and confidence.

3. The patient was taught anxietyreducing techniques like deep breathing and positive visualization.

Nursing Diagnosis #__: Fluid Volume Deficit Goal: To increase fluid volume intake and maintain adequate fluid volume. Expected Outcomes: After 8 hours nurse-client interaction the client will be able to: 1. Show signs of hydration (intact skin, (-) chapped lips, (-) sunken eyes) 2. Maintain a balanced fluid volume intake Interventions Evaluation 1. Assess the patient for signs of 3. The patient showed negative dehydration. signs of dehydration. The patients skin was intact; her lips were not chapped and hey eyes were not sunken. 2. Monitor temperature. Febrile states decrease body fluid through perspiration and increased respiration. 3. Encourage the patient to drink or eat foods with high amounts of fluid like fruits. (watermelon, apple and popsicles) 4. Provide a breezy or cool environment. To lessen profuse sweating. Ideal Interventions: 1. Assess the input and output of the patient. 2. Assess the color of the urine and concentration. 6. The client used a hand-held fan to induce a cool airflow. 5. The patient drank water when the uterus is relaxed and not contracting. 4. The patients temperature was monitored from time to time and it was normal (36.5 36.6)

Nursing Diagnosis #__: Acute Pain Goal: To alleviate pain Expected Outcomes: After 30 minutes to 1 hour nurse-client interaction the client will be able to be: 1. Handle the pain. 2. Demonstrate use of new strategies to relieve pain. 3. Show negative signs of facial grimacing, crying and groaning. Interventions Evaluation 1. Assess clients level of pain by 1. The client was able to rater her both verbal and non-verbal indicators (pain scale) level of pain by using the pain scale. The client rated her pain 10 out of 10. 2. Teach the client breathing exercises or relaxation techniques. (backrub, deep breathing exercise) 2. The client was able to demonstrate and use the techniques taught effectively. The husband of the patient was taught to apply pressure on the clients back. The client and her husband were able to demonstrate the said techniques. The client showed signs that pain is manageable by smiling and responding to questions coherently. 3. Assess patients coping mechanisms. 3. The patient said that standing up is her relieves or alleviates the pain. Nursing Diagnosis #__: Impaired tissue integrity related to surgical procedure (episiotomy) as evidenced by laceration

Goal: To improve condition of impaired tissue Expected Outcomes: After 8 hours nurse-client interaction the client will be able to be: 1. Have decreased signs of tissue impairment such as reddening, swelling and pain on the lacerated tissue. Interventions 1. Assess the condition of tissue. The condition of the tissue is a sign of the bodys immune response to localized tissue trauma. 2. Assess temperature. An indication of infection. Ideal Interventions: 1. Educate the patient of proper care of the area of laceration. 2. Discourage rubbing or scratching.Can cause further injury and delay healing. 2. The patient didnt manifest any signs of hypothermia or hyperthermia. Evaluation 1. The patient was in pain which is a sign of the bodys immune response to localized tissue trauma.