QuestionAnswered step-by-stepThis patients is in the hospice for multiple health complications and their main complication relates to decreased cardiac output. Client Outcomes:Demonstrate adequate cardiac output as evidenced by blood pressure, pulse rate, and rhythm within normal parameters for clientsStrong peripheral pulsesMaintained level of mentationLack of chest discomfort or dyspneaAdequate urinary outputAn ability to tolerate activity without symptoms of dyspnea, syncope, or chest painRemain free of side effects from the medications used to achieve adequate cardiac outputExplain actions and precautions to prevent primary or secondary cardiac disease.Suggested NOC OutcomesCardiac Pump EffectivenessCirculation statusTissue perfusionAbdominal organsPeripheralVital SignsMedical Diagnosis: Decreased cardiac output related to impaired contractility.Clostridium difficile infectionType 2 diabetes mulitas without complication Nursing Diagnosis: AnxietyRestlessnessAdventitious breath soundsClammy skinDecrease in peripheral pulsesOliguriaProlonged capillary refillDecrease in gross motor skillsAlteration in gaitPostural instabilitySpastic movement Vital Signs: Diet: NPOBP: 124/74Pulse: 86Resp: 2202 set: 95Temp: 98.1Lab: Albumin: 3.4.Alk Phosphatase: 46BUN: 7Calcium: 8.5Chloride: 98C02: 21.0Patient Medication:Sodium Chloride 5ml FlushLorazepam (ATIVAN) 2mg/ml Inj.Morphine Sulfate INJ 10mg/1mlCefazolin (ANCEF) 1gm vial 2 gmLactated Ringers 1000ml (938) 100ml/hr.Normal Saline 0.9% 100ml (943)Nausea/EmesisPatient is resting in bed with her TV on, she is requesting to watch a movie. Denies any pain currently. Tuesday, the patient respirations are even and unlabored. Will continue to monitor. Assessment Data (Include at least three-five subjective and/or objective pieces of data that lead to the nursing diagnosis) Goals & Outcome (Two statements are required for each nursing diagnosis. Must be Patient and/or family focused; measurable; time-specific; and reasonable.) Nursing Interventions (List at least three nursing or collaborative interventions with rationale for each goal & outcome.) Rationale (Provide reason why intervention is indicated/therapeutic; provide references.) Outcome Evaluation & Replanning(Was goal met? How would you revise the plan of care according the patient’s response to current plan ?)1. 2. 3. Statement #1 Statement #2 1. 2. 3. 1. 2. 3. 1. 2. 3. 1. 2. 3. Outcome #1 Outcome #2 Nursing Care Plan FormPatient Medical Diagnosis: Nursing Diagnosis:Assessment Data (Include at least three-five subjective and/or objective pieces of data that lead to the nursing diagnosis) Goals & Outcome (Two statements are required for each nursing diagnosis. Must be Patient and/or family focused; measurable; time-specific; and reasonable.) Nursing Interventions (List at least three nursing or collaborative interventions with rationale for each goal & outcome.) Rationale (Provide reason why intervention is indicated/therapeutic; provide references.) Outcome Evaluation & Replanning(Was goal met? How would you revise the plan of care according the patient’s response to current plan ?)1. 2. 3. Statement #1 Statement #2 1. 2. 3. 1. 2. 3. 1. 2. 3. 1. 2. 3. Outcome #1 Outcome #2 List patient mediations, indications, and nursing considerations for this patientMedication, Dose, Route Indications for Medication Nursing Consideration for Patient/ Side Effects List Patient abnormal lab values, normal ranges, and why they are altered.Abnormal Lab Value Normal Range Cause of Abnormal Lab Value List all Patients Nursing Diagnosis in priority Order and explain why.Nursing Diagnosis Explanation Health ScienceScienceNursingNURSING NSG221Share Question
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