Desired Outcomes

1. Pain
Patient will rate pain 5/10 or
below

2. Impaired Mobility
Patient performs physical
activity within limitations of
prescribed mobility
restrictions

3. Constipation
Patient will have regular
bowel movement pain free

4. Deficient Knowledge
Patient will demonstrate
understanding of hip
precautions and medications

5. Impaired Skin
Integrity/Risk for Infection
Patient will be free of
infection in surgical wound

6. Relocation Stress
Syndrome
Patient maintains orientation
and safety in new environment

Interventions
1. Administer
analgesics/opioids
2. Assessments of patients
pain & effectiveness after
medications
3. Maintain proper position
of operated extremity
1. Assess the level of
understanding of
postoperative restriction
2. Encourage ROM within
precaution limits
3. Maintain weight bearing
status as tolerated

Evaluation
Patient continued to report
pain at lowest 7/10 when
asked. Would be sleeping at
times despite subjective pain
report. Outcome was not
met

1. Evaluate laxative use and

administer if needed
2. Encourage proper fluid
and fiber intake
3. Encourage
activity/exercise
1. Assess willingness and
motivation to learn
2. Determine patients
learning style
3.Give clear, thorough
explanations and
demonstrations
1. Assess for presence of
swelling, redness, or
drainage
2. Monitor WBC levels
3. Perform proper hand
washing and contact
precautions

Patient had first bowel

movement in 5 days with
use of rectal suppository.
Following day did now have
bowel movement. Outcome
partially met
Patient was reminded of hip
precautions and kept
abductor pillow between
legs. Was interested in
medications but needed to
be reminded of effects.
Outcome partially met
Proper precautions were
taken. Wound VAC dressing
over surgical site remained
dry and intact with no
swelling or redness or
drainage. WBC lab levels
remained within normal
limits
Patient was AOx3, didnt
want to be in hospital
anymore and wanted to
return home due to being
extremely lonely in hospital.
Remained safe in
environment. Outcome was
met

1. Assess patients
orientation
2. Seek to understand the
patients perspective of the
event
3. Arrange situations to
encourage the patients
autonomy

Patient transferred from bed

to bedside commode with
moderate assistance.
Refused transfer to chair for
dinner after encouragement.
Outcome partially met

7. Impaired Gas
Exchange/Tissue Perfusion
Patient will keep O2 saturation
about 94% with capillary refill
<3 seconds and palpable
pulses

1. Assess and compare status

of affected limb with
unaffected limb, checking
CMS
2. Use pulse oximetry and
monitor oxygen saturation
3. Administer low-flow
oxygen therapy as indicated
4. Administer
bronchodilators as ordered
1. Arrange case manager
2. Assess support at home
3. Assess patients
knowledge of rationale for
personal support and home
safety

Patients oxygen saturation

went at lowest 93% but
+CMS with cap refill less
than 3 seconds. Outcome
partially met

Case manager is working

with patient and
rehabilitation facilities.
Patient states has help back
home in Samoa but visiting
niece says theres no one,
only his children who are
scattered among the
mainland. Outcome was
partially met
Gulanick, M., & Myers, J.L. (2011). Nursing care plans: Nursing diagnoses, interventions and
outcomes, (7th ed.). St Louis: Mosby.
8. Impaired Home
Maintenance
Patient will identifies
available resources

Discharge Plan/Patient Teaching

Patient will be discharged to rehabilitation facility from hospital. Patient states he has
support and family at home, but niece who comes to visit states there is no one in Samoa and the
children wish to take care of him at their homes. There are 7 children who are located all around
the mainland. He requires moderate assistance with gait, transfers, and bed mobility. He is able
to perform self-hygiene and minimal help with dressing. He is continent with urinal. Will
require equipment such as walker and possible d/c with wound VAC that rehabilitation facility
will help with.
Patient prefers verbal and visual teaching. He has learning barriers due to his dementia
and cultural relocation from Samoa. Topics of teaching include the following:
- Surgical procedure education
o Hip precautions
- Wound care
- Pain management
- Nutrition
- Medications
- Fall precautions
- When to notify physician
- Discharge instructions