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Care Plan

Rasmussen College



Author Note

This paper is being submitted on December 12, 2016, for Professor Cowherd NUR3177 Health Assessment course.
Based on the Developmentally Appropriate Comprehensive Health Assessment Summary (week 6 assignment), Formulate a Comprehensive Care Plan.


Include each of the following elements using the Care Plan Template:

1. Identify a minimum of three NANDA Nursing Diagnoses, from the highest priority to the lowest priority (20 points).
2. Identify a minimum of three expected outcomes in the total care plan (Remember, there are 3 care plans, so you should have 9 goals overall...3 for each care plan. 20 points)
3. List patient-centered nursing implementation for the nursing diagnoses to meet the expected outcomes (20 points)
4. Provide an evidence-based rationale to support the nursing implementation, using national clinical guidelines (20 points)
5. Provide evaluation strategies for the three expected outcomes, and if you cannot evaluate, describe the strategies you would use to evaluate and when (20 points)

Comprehensive Care Plan Template

|NANDA Nursing Diagnosis |Expected Outcomes | |Rationale |Evaluation |
|(List from highest priority to |Need to be behaviorally measureable, |Implementation |(Should cite evidence-based rationale|(If you cannot evaluate, describe the |
|lowest using Maslow's Hierarchy)|reasonable, and time specific. |These are your interventions as a nurse. |to support the nursing |strategies you would use to evaluate and |
| |Minimum of three for each care plan |What will you do to help your client |implementation, using national |when) |
| |(Can have more if you choose) |achieve his/her goals? |clinical guidelines) | |
| | |(Should be evidence-based, according to | | |
| | |clinical guidelines) | | |
|Care Plan #1 |
| | 1. Client will identify three |1. Assess the causes of poor perfusion | 1. Guidelines indicate that tobacco| 1. Client identified smoking cessation, |
|Ineffective tissue perfusion |lifestyle modifications he can make |such tobacco use participating in regular |cessation, control of hypertension, a|exercise, and maintaining cholesterol and|
|related to interruption of |to increase his circulation by the |exercise, eat a diet with reduced trans fat|diet to reduce cholesterol, and |blood pressure levels within recommended |
|arterial flow as evidenced by |end of the educational session |and saturated fat, and take prescribed |physical activity is considered |ranges as lifestyle modifications to |
|weak pedal pulse (Skyscape, |(Skyscape, 2015). |medications for hypertension and high |secondary prevention (National |improve peripheral circulation. |
|2015) |2. Client will identify two |cholesterol (American Heart Association, |Institute for Health and Care |2. Client identified not crossing his |
| |positional requirements to prevent |2016) Refer the client to a dietitian to |Excellence (NICE), 2012) |legs and not sitting for long periods of |
| |worsening of circulation problems |establish a well balanced heart healthy |2. According to St. Mary Medical |time as ways to prevent worsening his |
| |this educational session (Skyscape, |diet (Skyscape, 2015). |Center (2016), positional changes can|circulation problems. |
| |2015). |2. Teach the client proper foot care as it |be considered as treatment for |3. I will have the client will obtain a |
| |3. Client will demonstrate increased|is important to prevent ulcerations. Teach |peripheral vascular disease. |pedometer to utilize when walking. The |
| |activity tolerance at follow-up visit|the client to avoid long periods of sitting|3. Guidelines suggest a overseen |client will keep a log of how many steps |
| |in three months. |or standing. Have the client avoid |physical fitness program (NICE, |and how many minutes he is able to walk |
| |(Skyscape, 2015) |crossing his legs and elevate legs when |2016). |before experiencing excessive pain. The |
| | |sitting (Skyscape, 2015). | |client will present the walking log at |
| | |3. Instruct the client on an exercise | |his follow-up visit in three months. |
| | |program that alternates exercise and rest | | |
| | |to increase the distance and time he can | | |
| | |walk before experiencing pain (American | | |
| | |Heart Association, 2016). | | |
|Care Plan #2 |
|Caregiver role strain related to|1. Client will identify at least | 1. Identify resources available to | 1. Studies indicate that the | 1. Client identified three additional |
|years of caregiving and lack of |three additional resources to assist |caregivers such as the Community Care for |greater prepared the caregiver is the|resources (CCE, OAA, and Senior |
|family support as evidenced by |with care giving requirements by the |the Elderly (CCE) Program, Older Americans |less strain they experience this |Companion) available to caregivers. |
|client stating ineffective |end of the educational session |Act (OAA), Respite for Elders Living in |includes lack of resources (Burns, & |2. The client identified two changes |
|coping (Skyscape, 2015). |(Skyscape, 2015). |Everyday Families (RELIEF), and Senior |Stewart, 1993). |(having stepdaughters assist with house |
| |2. Client will identify two changes |Companion (Department of Elder Affairs, |2. According to Collins and Swartz |hold tasks and sharing his feelings about|
| |to assist with coping with the role |2011). |(2011), support groups, counseling, |caregiving with his daughter) to assist |
| |strain at the end of this educational|2. Explore potential changes the client |training, and education pertaining to|with coping with is role as a caregiver. |
| |session (Skyscape, 2015). |can take to assist with coping such as |the care receivers condition is |3. Strategies to assess a decrease in |
| |3. The client will indicate an |having the client request assistance from |recommended. |the client's caregiver role strain |
| |increase in his ability to cope with |the care receiver's local family to assist |3. Caregivers often experience |include assessment for depression or |
| |his position as caregiver at his |with household chores and give the client |anxiety and depression, and it is |anxiety. Also, the client identifying new|
| |follow-up visit in three months |an occasional break. Encourage the client |recommended that seek out healthy |methods of coping with strain, client |
| |(Skyscape, 2015). |to discuss his feelings, concerns, and |methods of coping (Burns, & Stewart, |participating in support groups, client |
| | |frustration with care giving. Assist the |1993). |utilizing provided resources can be an |
| | |client with identifying how to meet his | |indication of improvement in his ability |
| | |wife's requirements. Encourage attending a | |to cope. This evaluation will be |
| | |caregiver educational program or joining a | |conducted within three months of initial |
| | |support group (Skyscape, 2015). | |visit. |
| | |3. Have the client explore coping outlets | | |
| | |such as hobbies, exercise, and support | | |
| | |groups, meditation. Assess for depression | | |
| | |and provide referral to psychiatry if | | |
| | |required (Skyscape, 2015). | | |
|Care Plan #3 |
|Risk for bleeding related to |1. Client will identify three signs | 1. Instruct the client on signs of active| 1. Providing the client with an | 1. Client provided three signs of active|
|medication side effects |of active bleeding by the end of this|and excessive bleeding and when the client |understanding of excessive bleeding |bleeding (red or brown urine, blood in |
|(warfarin and clopidogrel) |educational session (Skyscape, 2015).|should seek assistance with bleeding. Signs|and bleeding management can assist in|stools, and a cut that does not quit |
|(Skyscape, 2015) | |of bleeding include blood in stools, |the prevention of significant blood |bleeding) by the end of the educational |
| |2. Client will explain home testing |coughing up blood, red vomit, oozing from |loss. |session. |
| |procedures for testing his INR, and |skin or mucous membranes and blood in urine|2. Performing INR testing correctly |2. Client was able to demonstrate the |
| |he will state the expected INR levels|(Skyscape, 2015). |identifies INR levels so the provider|use of his INR home testing equipment and|
| |by the end of this educational |2. Instruct the client on use of his INR |can adjust the level of anticoagulant|was able to indicate a therapeutic INR |
| |session (Skyscape, 2015) |home testing equipment with a therapeutic |therapy. |level (2-3) at the end of the training |
| |3. Client will describe activities he|INR range between 2 and 3 (Skyscape, 2015).|3. Identifying activities that place|session. |
| |participates in that place him at | |an individual at a greater risk for |3. The client identified that he would |
| |risk for increased bleeding, and he |3. Review with the client activities that |hemorrhage provides the ability to |switch to using an electric razor and a |
| |will develop a plan to prevent |increase risk for bleeding such as using |practice prevention strategies. |soft bristled toothbrush immediately. |
| |bleeding (Skyscape, 2015) |hard bristled toothbrushes, knives, |(Agency for Healthcare Research and |The client also indicated that he would |
| | |scissors, razors, and saws. Recommend the |Quality, n.d.) |start utilizing protective equipment such|
| | |client utilize protective equipment while | |as protective eye glasses, gloves, and |
| | |doing yard and woodwork. Avoid injections,| |durable shoes while participating in lawn|
| | |rectal medications and procedures, and | |care and hobbies. |
| | |increasing in leafy green vegetables | | |
| | |(Skyscape, 2015). | | |


References

Agency for Healthcare Research and Quality. (n.d.). Blood thinner pills: Your guide to using them safely. Retrieved from http://www.ahrq.gov/patients-consumers/diagnosis-treatment/treatments/btpills/btpills.html

American Heart Association. (2016, October). Prevention and treatment of PAD. Retrieved from http://www.heart.org/HEARTORG/Conditions/VascularHealth/PeripheralArteryDisease/Prevention-and-Treatment-of-PAD_UCM_301308_Article.jsp#

Burns, C., & Stewart, B. (1993). New diagnosis: Caregiver role strain. Nursing Diagnosis, 4(2), 70-76. Retrieved from http://www.academia.edu/19260060/New_Diagnosis_Caregiver_Role_Strain

Collins, L. G., & Swartz, K. (2011, June 1). Caregiver care. American Family Physician, 83(11), 1309-1317. Retrieved from http://www.aafp.org/afp/2011/0601/p1309.html

Department of Elder Affairs. (2011). Bureau of community and support services. Retrieved from http://elderaffairs.state.fl.us/doea/bureau_css.php

National Institute for Health and Care Excellence. (2012, August). Peripheral arterial disease: Diagnosis and management. Retrieved from https://www.nice.org.uk/guidance/cg147/chapter/1-Guidance

Skyscape. (2015). Skyscape Medical Resources (Version 2.5.2.2) [Mobile Application Software]. Retrieved from http://itunes.apple.com/

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Keywords: care plan example, care plan template, care plan for hypertension, care plan for fever, care plan medicare, care planner, care plan for diabetes, care plan meaning

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