DATE/ NEE NURSING OBJECTIVE OF NURSING

CUES IMPLEMENTATION EVALUATION

TIME D DIAGNOSIS CARE INTERVENTIONS
Subjective: Acute pain At the end of the o Assess the child’s pain 1
H related to nursing perception using an
E inflammation as intervention, the appropriate scale
Objective: A evidenced by patient will every 2 to 3 hours
- guarding L guarding appear relaxed R: Provides informarion
behaviour T behaviour of without guarding about the pain level of the
- grimaced face H painful joints as evidenced child
- red, swollen and redness. by: o Assess changes in 2
joints on wrists P a. Joints will behavior, such as
and elbows E not high-pitched cry,
- subcutaneous R become irritability,
nodules C inflamed, restlessness, refusal
- slightly raised, E red or to move, facial
painless rash P warm grimace aggressive or
- uncontrollable T dependent behavior.
body I R: Non-verbal pain
movements of O descriptions that are age-
hands and N related as child or infant
face may be unable to
P describe pain; fear and
A anxiety associated with
T pain cause changes in
T behavioral responses.
E o Examine affected 3
R joints, degree of joint
N pain, and level of joint
movement.
R: Provides data about
pathologic changes in
joints; reversible joint
involvement usually
affecting large joints,
such as knees, hips,
wrists, and elbows; an
increase in numbers of
affected joints occurs
over a period of time.

o Elevate involved 4
extremities above
heart level.
R: Improves circulation to
the heart to alleviate
edema.
o Maintain bed rest 5
during the acute stage
of the disease.
R: Promotes relief of joint
pain caused by
movement.
o Apply bed cradle 6
under outside covers
over painful joints.
R: Avoids pressure on
painful parts.
o Assist in gentle 7
handling and
supporting of body
parts.
R: Prevents extra pain to
affected parts.
o Provide toys, games 8
for quiet, sedentary
play.
R: Provides diversionary
activity to distract from
the pain.
o Stress the importance 9
of limited activity or
amount of joint
movement allowed.
R: Prevents increase or
exacerbation of pain.
o Educate parents in 10
proper body
positioning and
handling of affected
parts.
R: Promotes comfort and
avoids pain and
contractures during bed
rest.