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Estelle Hatcher, 31yr-old, r/o appendicitis, 1st day post-op appendectomy; No known allergies (NKA); Vital signs -...

Estelle Hatcher, 31yr-old, r/o appendicitis, 1st day post-op appendectomy; No known allergies (NKA); Vital signs - Temp 101.2, BP 108/74, P 92, RR 20, SaO2 99%, alert and cooperative. Wound site clean, dry and intact NPO, NG-tube to low continuous suction. IV maintenance fluids with D5 1/2 NS with 20 KCL @ 125ml/hr in left forearm. Ambulates with minimal assistance. Family at beside.

Write a Nursing Care Plan Assessment, Diagnosis, Goal, Implement, Evaluation

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Expert Solution

ANSWER:

NURSING CARE PLAN ASSESSMENT,DIAGNOSIS,GOAL, IMPLEMENT AND EVALUATION:

  • FLUID DEPLETION IS PREVENTED BY IV MAINTENANCE FLUID AS THE BLOOD PRESSURE IS LOW (108/74 mm Hg).
  • ASSESSMENT OF INFECTION AS THE TEMPERATURE HAS BEEN INCREASED TO 101.2
  • SURGICAL INCISION SITE SHOULD BE CARED PROPERLY.AVOID TOUCHING THE SITE BEFORE WASHING HANDS .
  • ADVICE REGARDING AVOIDANCE OF STERNUOS EXERCISES AND STRAINING THE ABDOMINAL MUSCLES.
  • PREVENTION OF CONSTIPATION BY DRINKING PLENTY OF WATER.
  • PRACTICE OF SPLINTING WHICH MEANS APPLYING TIGHT PRESSURE OVER ABDOMEN WHILE COUGHING OR MOVING.

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