Cues/Needs Nursing Goals and Interventions Rationale Evaluation

Diagnosis Objectives
Subjective: Risk for infection After 6 hours of After 6 hour of
“Kagagaling lang nursing _Assess signs and symptoms _Fever may indicate nursing
nga anak ko sa intervention, the of infection especially infection intervention, the
sakit, tapos ngayon patient’s support temperature patient ‘s
ngakasakit familywill identify support familily
nanaman.” As interventions to _Stress proper hand hygiene _A first line defense identified
verbalized by the prevent/ reduce by all caregivers between against health care- intervetnions to
patient’s mother risk of infection therapies/clients associated infections prevent/reduce
as evidenced by risk of infection
Objective: positive _Recommend routine body _To reduce bacterial as evidenced
_Weakness feedbacks. shower/scrubs when indicated colonization by poritive
_Pale looking feedbacks. The
_Clammy Skin _Emphasize necessity of _Premature dicontinuation mother stated
_Sunken eyebags taking antivirals/antibiotics as of treatment when client that she would
_Presence of directed begins to fell well may result ensure to
illness in return of infection and provide nutirous
potentiate drug-resistant foods for the
strains patient.
V/S
 P: 132 _Discuss importance of not _Unappropriate use can Goal Met
 R:48 taking antibiotics/using “leftover” lead to development of drug-
 T: 37 drugs unless specifically resistant strains/secondary
instructed by healthcare provider infections

_Encourage patient and _To boost immune system

patient’s support family to
consume nutirous foods and
refrain from sedentary lifestyle