ASSESSMENT DIAGNOSIS PLANNING INTERVENTION EVALUATION

Subjective: Activity Short term: Independent: ♦ Patient reveals

intolerance After 8 hours of ♦ Assess patient’s an increase in
“Nabghihina siya related to nursing interventions ability to perform activity
kadalasan”as imbalance the patient will: normal task or tolerance,
verbalized by the between oxygen activities of daily demonstrating a
mother’s patient. supply (delivery) ♦ Report an living. reduction in
and demand increase in physiological
Objective: activity tolerance signs of
♦ Fatigue including ♦ Recommend quiet intolerance and
activities of daily atmosphere, bed rest laboratory
♦ Greater need living. if indicated. values within
for sleep and ♦ Elevate the head of normal range.
rest. the bed as tolerated.
Long term: ♦ Provide or
After months of recommend
nursing interventions, assistance with
the patient: activities or
♦ Is free form ambulation as
weakness and necessary, allowing
risk for patient to do as much
complications has as possible.
been prevented.
ASSESSMENT DIAGNOSIS PLANNING INTERVENTION EVALUATION
Subjective: Impaired Gas General: ♦Assess patient’s Goals: Partially met
“Namumutla at Exchange related to - To facilitate the respirations: Rate, as evidence by:
maputi ang mga low RBC count as maintenance of rhythm, depth and - Increase
daliri ng anak ko. evidenced by pallor oxygen to all body and breathing effort
Nanghihina din on the face and cells ♦Monitor vital signs, hemoglobin
sya” as fingers, and dyspne note for changes in level after
verbalized by the After 1 day of cardiac rhythm blood
mother of the effective nursing ♦Recommend quiet transfusion
patient. interventions the atmosphere and - Return of
patient will be able bed rest if indicated
Objective: to: ♦Recommend pinkish color
• on both
Irritability 1. Display mother to stimulate hands and
• laboratory values the baby to cry face
Pallor on face within acceptable once in a while
and fingers on range Collaborative:
both extremities ♦Monitor Hb levels
2. Manifest glow on ♦Administer packed
the face and return of RBCs or exchange
color on the fingers