Vous êtes sur la page 1sur 1

DIAGNOSIS SCIENIFIC NURSING

EXPLANATION CARE PLAN PLANNING


by BSN4E1 INTERVENTIONS RATIONALE EVALUATION
Subjective: Electrolyte Short term Outcome Independent: Short term
Patient Name: R.M Chief Complaint: Fever, frequent vomiting and diarrhea
‘Madalas akong Imbalance related to Acute Gastroenteritis is After 4 hours of -Provide -It serves as Outcome
Age: 45
magtae at magsuka’ frequent vomiting inflammation of the Medical Diagnosis:
thoroughAcute Gastroenteritis
nursing continuous baseline for future Acieved:
as verbalized by the and persistent gastrointestinal tract, involving intervention, the client assessment by comparison After 4 hours of
patient. diarrhea as both the stomach and the small will be able to: doing an accurate thorough
evidenced by intestine and resulting in acute a) reduce vomiting intake and output, nursing
Objective: +hyponatremia diarrhea. The inflammation is by promoting an daily weights, intervention,
-frequent vomiting +hypokalemia caused most often by infection environment mental status the client was
-persistet diarrhea +hypochloremia with certain viruses, less often conducive for examination, able to reduce
-Na level of by bacteria or their toxins, doing ADL’s electrolyte levels vomiting by
115mEq/L parasites, or adverse reaction to b) improve skin and vital signs. promoting an
(135-145mmol/L) something in the diet or turgor of the environment
-K level of medication patient from poor -Assess cardiac -changes in cardiac conducive for
2.6mEq/L to fair. status, ECG status indicates doing ADL’s
(3.5-5.5 mEq/L) monitoring potassium and improved
-Cl level of imbalances skin turgor of
92mEq/L the patient
(96-106mEq/L) from poor to
-decrease skin turgor fair.

-hypotension Long term Outcome: - Promote a well- – To avoid the Long term
-muscle twitching After 1 week of ventilated occurrence of Outcome
and convulsion thorough environment Vomiting achieved:
-fatigue nursing intervention, conducive for After 1 week of
-anorexia the client will be able eating. thorough
-excessive thirst to: nursing
Cold clammy skin a) Maintain body -Provide frequent – To prevent injury intervention,
-hyperactive bowel fluid levels. oral and skin from dryness the client was