ASSESSMENT Explanation of OBJECTIVES NURSING RATIONALE EXPECTED

the problem INTERVENTION OUTCOMES

S> A break in the Short term: Dx> assess and >in order to Short term:
body’s primary Within the monitor presence/ detect any
O> Patient or secondary shift, pt will be absence/ changes change in The patient was able to
manifested: defences able to in assessment status. perform ways in how to
>+ edema predisposes a enumerate at findings prevent infection such as
>discoloration of patient to least 2 ways of proper hand washing and
sclerae infection. When preventing >stressed the >a first line by having adequate
>weak in the body’s infection such importance of defense nutrition.
appearance immune system as proper hand proper hand against cross
becomes weak washing and washing contamination. Long term:
DX> Risk for or is adequate techniques.
infection r/t inadequate, nutrition. > The patient manifest no
presencence of pathogenic Tx>Established >to gain signs and symptoms of
microorganism in microorganisms Long term: rapport cooperation infection such as elevated
the body and cause infection Within 3 days body temperature and
inadequate of duty, pt will >maintained >to avoid other s/sx of infection.
primary and not manifest adequate bladder
secondary signs and hydration, distention.
symptoms of encouraged to
infection such void, catheterize if
as elevated necessary.
body
temperature >Provided personal >to avoid skin
and other s/sx hygiene. Keep skin breakdown
of infection. dry. and prevent
skin infection.
>regulate intake of >to promote
fluids to 1L/day as urine flow
ordered.

>provided oral To help

hygiene as needed minimize the
risk of oral
contamination
and
colonization to
keep tissues
healthy and
intact.

Edx>encourage to >to boost

eat foods rich in immune
vitamin C like system
orange and
pineapple juice