IV.

ACTIVITIES OF DAILY LIVING

Activities Before Hospitalization
NUTRITION  The patient is frequently on
high cholesterol diet. He also
likes to eat sweets.
 Patient is a truck driver and
does not drink a lot of water
during when on a trip. He
usually drinks 2-4 glasses of
water a day.
During Hospitalization Interpretation Nursing Responsibilities
 The patient is on NGT for High fat diet Ensure proper nutrition by
Parenteral Nutrition. ↓ consulting with physician for
 The patient is required to Sedentary lifestyle enteral feedings, preferably an
receive 1800 kcal per day. ↓ NGT tube in most cases.
Imbalanced nutrition:
more than body
requirements

Usual diet
Breakfast:
2 slices of bread with spread: 133kcal
1 cup of Coffee with Creamer: 43 kcal

Lunch:
2 cups of rice: 410 kcal
160g of Pork Sinigang: 914kcal
208g of cooked vegetables: 90kcal
1 bottle of coke: 150kcal

12
Snacks:
5 pcs candies: 120kcal
250mL of water: 0kcal

Dinner:
2 cups of rice: 410 kcal
241g of Pork Adobo: 254kcal
250mL of water: 0kcal

Total kcal: 2,524kcal

Breakfast:
2 slices of bread with spread: 133kcal
1 cup of Coffee with Creamer: 43 kcal

Lunch:
2 cups of rice: 410 kcal
1 serving nilagang baboy: 622kcal
208g of cooked vegetables: 90kcal
1 bottle of coke: 150kcal

Snacks:

13
5 pcs candies: 120kcal
250mL of water: 0kcal

Dinner:
2 cups of rice: 410 kcal
1 cup of Kare kare: 478kcal
250mL of water: 0kcal

Total Calories: 2,456 kcal

Breakfast:
1 pack pancit canton: 290 kcal
1 cup of Coffee with Creamer: 43 kcal

Lunch:
2 cups of rice: 410 kcal
2 cups of Dinuguan: 510 kcal
208g of cooked vegetables: 90kcal
1 bottle of coke: 150kcal

Snacks:
5 pcs candies: 120kcal

14
250mL of water: 0kcal

Dinner:
2 cups of rice: 410 kcal
1 cup Menudo: 478 kcal
250mL of water: 0kcal

Total Calories: 2501 kcal

15
ELIMINATION  Patient approximately urinates  The patient is on indwelling Malignant Right MCA  Assessing hydration
500-1000 mL per day. folly catheter. Infarction status and measuring
 He defecates 1-2 times a day,  Urine is Amber in color ↓ fluid balance can
usually in the morning before Urine Input and Output Hospitalization ensure optimal
going to work. May 15, 2019 ↓ hydration
2-6: Left-sided body weakness  Encourage and help the
Oral 300 ↓ patient develop a daily
Parenteral: 400 Bed Rest bowel program based
Total: 700 ↓ on the patients wants
6-2: Decreased peristalsis and needs.
Oral: 300 ↓
Parenteral: 400+100 No bowel movement
Total: 800 ↓
Total Input: 1500 Altered bowel elimination
Total Output: 1300
Fluid Balance: +200

May 22, 2019

2-6:
Oral: ------
Parenteral: 480
Total: 480

16

EXERCISE  He cannot do exercise daily
because he was a truck driver.
After a long drive, he just
stretches his body and arms.
6-2:
Oral: 300
Parenteral: 480
Total: 780
Total Input: 1260
Total Output: 1000
Fluid Balance: +260
The patient is currently taking
lactulose. Lactulose will be placed
on hold if the patient’s bowel
movement amounts to 3 times or
more per day.
The patient doesn’t have a normal Malignant Right MCA Gradually increase activity
activity and exercise because he only Infarction with active range-of-motion
stays in bed all day. ↓ exercises in bed, increasing to
Hospitalization sitting and then standing.
↓
Left-sided body weakness
↓
Bed rest
↓
17

HYGIENE  He usually takes a bath before
and after he got home from
driving because when he’s
driving it is too hot and full of
dust in the road.
 He also brushes his teeth after
breakfast in the morning and
before bed time.
SLEEP AND  He usually sleeps5-6 hours at
REST night, He wakes up early for
work and sleeps late at night
after coming from work.
 During resting hours, he takes a
nap and uses his phone to relax.
Activity Intolerance
Patient is currently confined at NSU Malignant Right MCA Promote independence, but
and cannot take a bath. His wife visits Infarction intervene when the patient is
the NSU to wash his face and body. ↓ not able to carry out self-care
Hospitalization activities.
↓
Left-sided body weakness
↓
Inability to perform hygiene
↓
Self-care Deficit
The patient sleeps at around 4 hours Malignant Right MCA Assess patient’s sleep
a day. He doesn’t have a normal Infarction disturbances that are associated
sleeping pattern. ↓ with the environment.
Hospitalization
↓
Disturbed sleep due to
getting of vital signs
18

SEXUAL Patient is having an intercourse with
ACTIVITY his wife at least once a week.
SUBSTANCE The patient occasionally drinks
USE alcohol. He also smokes to relieve
stress and consumes 30 pack annually,
at approximately 1 and ½ stick per
day.
Disturbed Sleeping Pattern
The patient doesn’t have any sexual
activity to the length of his
hospitalization.
Left-sided body weakness
 The patient is currently
taking/have taken the
following medications:
Aspirin, Clopidogrel,
Ranitidine, Ceftriaxone,
Humulin, Amlodipine,
Omeprazole, Atorvastatin,
Lactulose, and Mannitol.
 The patient is currently on
PNSS 1L IV line.
↓
Malignant Right MCA Assess patient’s sexual
Infarction interest, desire, effect of health
↓ status on sexuality, and
psychosocial factors affecting
↓ sexual function.
Lack of privacy
↓
Sexual Dysfunction
Increased level of  Assess for Hemoglobin
Hemoglobin/Hematocrit and Hematocrit.
↓  Monitor level of
Aspirin/Clopidogrel cholesterol.
 Monitor level of
Increased intracranial Intracranial pressure.
pressure  Check for bowel
↓ movements.
Mannitol  Monitor glucose level.
19
Increased level of cholesterol  Monitor vital signs
↓ (BP)
Atorvastatin

Impaired bowel movement

↓
Lactulose

Increased Blood Pressure

↓
Amlodipine

Increased level of glucose

↓
Humulin

20