Sunteți pe pagina 1din 2

Assessmen t Subjective: sumasakit ang tahi ko pag gumagalaw ako as verbalized by the patient

Diagno sis Activity Intolera nce related to postsurgical incision as evidenc ed by Objective: report of pain Body Weakn while moving. ess Fatigu e Limite d ROM Slow move ments Pain scale of 7 out of 10 V/S taken as follows : BP:13 0/90 PR:10 8bpm RR:24 bpm Temp: 36.7

Inferen ce Pain Body weakne ss Decreas e of muscle strength impaire d ability to maintai n activity Inability to perform activity Activity intolera nce

Plannin g After 8 hours of nursing intervent ions will be able to achieved measura ble increase in activity tolerance as evidence d by reduced fatigue and weaknes s and by vital signs within acceptab le limits.

Intervention Establish Rapport Monitor vital signs Assess for signs and sympto ms of activity intoleran ce Assess patient's level of mobility.

Rationale

To gain trust To obtain baseline data

This aids in defining what patient is capable of, which is necessar y before setting realistic goals Activity stimulate increase d vasculari zation and the pulsation of the reproduc tive organs, but can affect postoper ative wound c onditions and reduced

Evaluati on After 8 hours of nursing intervent ions will achieved measura ble increase in activity tolerance as evidence d by reduced fatigue and weaknes s and by vital signs within acceptab le limits.

Assess the influence of activity on wound condition and general body condition

energy. Provide adequat e rest Teach patient about progress ive activities such as perfor ming range of motion. Teach relaxatio n techniqu es eg. Deep breathin g exercise Encoura ge to maintain positive attitude To prevent fatigue To prevent p atient from over exer ting

To divert the pain

To enhance sense of wellbeing