Question

Mrs. Franklin is an 89-years-old Black female who lives at Riverside, a long-term care facility. She has been a resident for eight years. She moved to the retirement community when her husband passed away. She has been living in the skilled nursing facility for the past two years because of medical illnesses and increased need for assistance with ADLs due to her poor vision. She has a son and a daughter who both live in the area and six grandchildren, all of whom visit often. Mrs. Franklin is a devout Baptist who attends the chapel services at Riverside every Sunday.care plan • Pain • Dyspnea (air hunger) • Fatigue and weakness • Ano rexia (loss of appetite) and cachexia (weight loss) • Edema and ascities • Skin breakdown

Answer 1

Careplan for pain

Assessment	Nursing Diagnosis	Objective	Planning	Rationale	Implematation	Evaluation
To be done in practial setting.	Chronic pain.related to physiological and anatamical changes secondary to aging process as evidenced by facial expression and verbalization of the patient.	Pain will be reduced to some extend.	1.assess pain status 2.teach active and passive excercise 3.encourage in diversional therapy 4.porvide mild anagesics as per physician order. 5.avoid doing vigorous activities	1.provide information about patient pain 2.promote circulation and prevent pain due to immobility 3.soothen the mind 4.reduce pain. 5.prevent pain stimulation.	To be done in practial setting.	To be done in practial setting.

Careplan for Dyspnea (air hunger)

Assessment	Nursing Diagnosis	Objective	Planning	Rationale	Implematation	Evaluation
To be done in practial setting.	Imapaired breathing pattern related to physiological and environmental changes as evidenced by laboured breathing,patient's vebalization.	Patient will maintain normal breathing pattern.	1.assess patient breathing pattern 2.maintain fowler's position 3.teach deep breathing and coughung exercise 4.avoid exposure to pollutants 5.avoid exposure to unfavourable climate 6.maintain adequate ventilation 7.avoid overcrowding 8.restrict visitors	1.provides baseline information 2.helps to expand lungs as thoracic cavity space increases insitting posture. 3.removes secretions and maintain patency of the airway. 4.prevent respiratoy infections 5.climatic changes may trigger the breathing problem 6.increase oxygen supply in air and prevent suffocation. 7.overcrowding may increase breathing problems as oxygen level decreses. 8.increase in no of visitors may cause increased chance for infection	To be done in practial setting.	To be done in practial setting.

Careplan for Fatigue and weakness

Assessment	Nursing Diagnosis	Objective	Planning	Rationale	Implematation	Evaluation
To be done in practial setting.	Fatigue related to aging process and environmental changes as evidenced by patient's decreased level of activities.	Patient will maintain normal activity level to some extent.	1.assess patient's general condition 2.provide nutrious foods. 3.increase fluid intake as per physician advise. 4.encourage to do mild exercise.	1.provides baseline information. 2.increase energy level. 3.prevent dehydration and related weakness. 4.increases circulation and improves energy level.	To be done in practial setting.	To be done in practial setting.

Careplan for Ano rexia (loss of appetite) and cachexia (weight loss)

Assessment	Nursing Diagnosis	Objective	Planning	Rationale	Implematation	Evaluation
To be done in practial setting.	Imbalanced nutrional status less than body requirements related to aging parocess and changes in the environment as evidenced by reduced food intake and reduction in body weight.	Patient will maintain normal nutritional status .	1.assess patient's nutritional status. 2.know patient's likes and dilikes. 3.provide small and frequent foods. 4.provide pleasant environment. 5.include fruits ,vegetables and protien.	1.provides baseline information for planning care. 2.helps to provid meal according to the preference of patient. 3.increases intake of patient. 4.increases food intake. 5.provide nutrients to cope up with body requirements.	To be done in practial setting.	To be done in practial setting.

Careplan for Edema and ascities

Assessment	Nursing Diagnosis	Objective	Planning	Rationale	Implematation	Evaluation
To be done in practial setting.	Fluid volume excess related to physiological and structural changes secondary to the aging process as evidenced by edema and ascities.	Patient will maintain normal fluid level to some extent .	1.assess patient's skin turgor and general condition 2.include fruits and vegetables 3.maintain intake out put chart 4.reduce intake of salt and salt containing foods. 5.restrict fluid intake as per physician advice.	1.provides baseline information for planning care. 2.helps to maintan healthy body by meeting its nutrional requirement. 3.provide information about patient's nutritional status. 4.salt causes fluid retension. 5.prevents fluid retension	To be done in practial setting.	To be done in practial setting.

Careplan for Skin breakdown

Assessment	Nursing Diagnosis	Objective	Planning	Rationale	Implematation	Evaluation
To be done in practial setting.	Imapaired skin integrity related to aging process as evidenced by skin breakdown.	Patient will maintan normal skin integrity to som extent.	1.assess patient's skin turgor and general condition 2.include fruits and vegetables. 3.maintain fluid intake as per physician advise. 4.encourage and assist in maintaining personal hygiene. 5.provide wound care if needed. 6.encourage toavoid same position for long period.	1.provides baseline information for planning care. 2.increases skin health. 3.helps to maintain good skin turgor. 4.prevents infection and heals skin breakdown. 5.prevents infection and improve the skin condition. 6.prevents skin damage due to pressure from maintaining same position for long.	To be done in practial setting.	To be done in practial setting.

Note:Assessment ,implementation and evaluation can be made from real clinical setting as per the patient's verbalization,nurse's observation and progress of the patient as per the care planned given.