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FDARs

This document contains nursing care plans for 4 patients with different health focuses: 1) A female surgery patient at risk for falls and infection. Nursing actions included safety precautions and hygiene instructions. 2) An MS ward patient with impaired mobility. Nursing actions included exercises and positioning to prevent further weakness. 3) An MS ward patient at risk for skin impairment. Nursing actions included skin care and cast management to prevent disruption. 4) A female surgery patient at risk for infection. Nursing actions included monitoring, hygiene, and infection precautions.

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Makki Marcos
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107 views2 pages

FDARs

This document contains nursing care plans for 4 patients with different health focuses: 1) A female surgery patient at risk for falls and infection. Nursing actions included safety precautions and hygiene instructions. 2) An MS ward patient with impaired mobility. Nursing actions included exercises and positioning to prevent further weakness. 3) An MS ward patient at risk for skin impairment. Nursing actions included skin care and cast management to prevent disruption. 4) A female surgery patient at risk for infection. Nursing actions included monitoring, hygiene, and infection precautions.

Uploaded by

Makki Marcos
Copyright
© © All Rights Reserved
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
Download as docx, pdf, or txt
Download as docx, pdf, or txt
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Focus:

Focus: Risk for fall and injury


(Female Surgery)

Focus: Risk for infection


(Female Surgery)

Focus: Impaired physical


mobility
(MS Ward)

Focus: Risk for impaired skin


integrity
(MS Ward)

Focus: Risk for infection


(Female Surgery)

Data:
Action:
Response:
Data: Seen bedridden; Lighting is not good; s/p Omaya shunt
reservoir insertion; Has recent experience of blurring of vision and
dizziness
Action: Instructed the relative no to leave the patient
unattended
Raised side rails up, as permitted by patient
Maintained the lights switched on
Placed pillows on sides
Response: Relatives and patient were amenable to teachings.
Maintained patients safety
Data: s/p Omaya shunt reservoir insertion; With JP drain; T-36.6;
Takes Unasyn 750mg
Action: Instructed patient to report signs of discomfort (e.g.
febrile, pain, headache)
Taught patient strict proper hygiene especially when eating
Continuous monitoring of incision site and drain site keeping dry
and clean
Response: No signs & symptoms of infection within the shift
Data: Movement restriction of lower extremities; Anxiety in
attempting to move; Hip x-ray; Incomplete trochanteric fracture of R
femur
Action: Positioned in proper body alignment
Encouraged isometric exercise on the unaffected extremities
every 10mins, as tolerated
Encouraged flexion and extension of unaffected extremities, as
tolerated
Encouraged deep breathing exercise
Response: No further loss of motion and weakness of the
extremities
Data: Moisture on the cast; Pressure from prolonged supination;
Immobilization of the right lower extremity; Dry skin
Action: Cleansed skin with water & small amount of soap
Taught not to apply alcohol affecting wide area of the skin
Encouraged and assisted the relative to massage unaffected
extremities
Encouraged gradual reposition about 10mins of upper torso and
upper extremities, as tolerated
Promoted cast drying exposing it to air while being supported
with pillow
Response: No disruption/impairment of skin surfaces
Data: Paracentesis site at the right lower quadrant; 37.7 temp at
12pm; 37.5 recent temp; With drain
Action: Encouraged increase fluid intake

Continuous monitoring of temperature


Strict monitoring and keeping the paracentesis site free from
contamination
Instructed to report symptoms of discomfort especially on the
surgical site
Taught strict proper hygiene by using antisepsis/disinfectant
Response: No signs and symptoms of infection noted

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