South University
Problem Focus Care Plan
Client’s Priority Basic Health Need:
1. Nursing Diagnosis: deficient knowledge regarding 3. Nursing interventions and corresponding rationale
disease R/T lack of information AEB development of
preventable complications.
2. Assessment Data Pertinent to above Nursing Dx 3a. Interventions:
1. Create an environment of trust by listening 1. Rapport and respect need to be established before
a. Subjective Assessment – pt states: to concerns, being available.
“I thought I was doing things the way I was
supposed to; I didn’t know I could get sick like this” 2. Work with client in setting mutual goals for 2. Participation in the planning promotes enthusiasm
learning.
3. Select a variety of teaching strategies; e.g.,
b. Objective Assessment – demonstrate needed skills and have client do
14 years old patient admitted to the hospital with return demonstration; incorporate new skills
diabetic ketoacidosis; according to her mother, into the hospital routine.
patient still doesn’t understand the importance of 4. Discuss reason for the ketoacidotic episode
taking her insulin. 5. Discuss acute and chronic complications of
the disease, including visual disturbances,
neurosensory and cardiovascular changes,
renal impairment, and hypertension.
4. Measurable and Realistic Outcomes 3c. Collaborative
4a. Short Term: by the end of my shift patient will 1. Review medication regimen, including
verbalize understanding of diabetes mellitus type I, onset, peak, and duration of prescribed insulin,
and its potential complications. as applicable with client.
2. Demonstrate fingerstick testing and have
client return demonstration until proficient.
Instruct client to check urine ketones if
4b.Long Term: In one week patient will correctly glucose is higher than 250mg/dL.
perform necessary procedures and explain reasons 3. Provide access information for contact
for the actions. person.
4. Identify community resources; e.g.,
American Diabetic Association, Internet
resources/online diabetes bulletin boards,
and diabetic instructor.
Student’s Name: Ana Moreira
Patient’s Initials: JD
3b. Scientific Rationale:
client will be willing to take part in the learning
process.
and cooperation with the principles learned.
3. Use of different means of accessing information
promotes learner retention.
4. Knowledge of the precipitating factors may help
avoid recurrences.
5. Awareness helps client to be more consistent with
care and may prevent/delay onset of complications
3d. Collaborative Rationale
1. Understanding all aspects of drug usage promotes
proper use.
2. Self monitoring of blood glucose four or more
times a day allows flexibility in self-care,
promotes tighter control of serum levels, and
may prevent/delay development of long-term
complications.
3. To answer questions/validate information
post-discharge.
4. Continued support is usually necessary to
sustain lifestyle changes and promote well-
being.
 5. Evaluation of Short and Long Term Outcomes:
Short Term Outcomes (4a)

Outcome met xx Not met Partially met Client behavior: patient was transfer to another unit before outcome could be met

Long Term Outcomes (4b)

Outcome met xx Not met Partially met Client behavior: patient was transfer to another unit before outcome could be met

Child Development

Sigmund Freud Stage 5: Genital (puberty-Adulthood) – “Time of turbulence when earlier sexual urges reawaken and are directed to an individual
outside the family circle. Unresolved prior conflicts surface during adolescence. Once the individual resolves conflicts, he or she is then capable of
having a mature adult sexual relationship”.

Erick Erikson Identity vs. Role Confusion – “Dramatic physiological changes associated with sexual maturation mark this stage. “Who am I?”
acquiring a sense of identity is essential for making adult decisions such as choice of vocation or marriage partner. There are new social demands,
opportunities, and conflicts that relate to the emergent mastery of this stage resulted in devotion and fidelity to others and to their own ideals”.

Jean Piaget Formal Operations – “The individuals thinking moves to abstract and theoretical subjects. Adolescents and young adults thinking
about such subjects as achieving world piece, finding justice, and seeking meaning in life. New cognitive powers allow the adolescent to do more for
reaching problem solving, including their futures and that of others. This thinking matures and the depth of understanding increases with experience. For
Piaget this stage marks the end of cognitive development”.