Careplan

NURSING DIAGNOSES
Constipation r/t weakness
of muscles, inadequate
fluid intake, decreased
autonomic nervous system
activity AEB Parkinsons
Disease, pt drinking only
720 mL of fluid in 8 hours
despite being reminded, pt
stated my legs get sore
easily, and pt not
defecating in over 24
hours.
EXPECTED PATIENT ASSESSMENT interventions:
OUTCOMES (S. M. A. R. T.)
Pt will increase fluid intake -Assess usual pattern of
by drinking 1.5 to 2 L of defecation, including time of
water daily while awake for 7 day, amount, consistency and
days ending on 11/01/2017. frequency of stool.
-Evaluate all the medications
pt is taking in order to
determine if one could have
adverse effect of constipation
and monitor pts water jug
level in room to see how much
they usually are drinking.
Monitor pt fluid intake during
meals too.
ACTION interventions: TEACHING interventions:
-Nurse will provide pt -Teach pt to eat a
with 100g of prune healthy diet with
juice daily to adequate intake of whole
incorporate fiber, grains and fiber.
sorbitol, and
polyphenol into pts -Teach pt keep a 7-day
diet and promote a diary of bowel habits to
laxative effect. include date/time, length
of time on toilet,
-Encourage pt to do consistency,
physical activity like amount/frequency of
walking the halls and stool, and any straining
doing waist twists. to promote pt adherence
and understanding.
-Nurse will
administer laxative or -Teach pt how to adopt
BRC bowel protocol the best posture for
drugs PRN. defecationkeep knees
slightly higher than hips,
feet flat on the floor, and
lean forward with elbows
on knees.

Risk for injury r/t tremors
in hands and legs, fatigue
after therapy
sessions/walking the
hallways, slowed reactions
while using RW assistive
device, and altered gait
(Parkinsons Disease).
Pt stand up and hold onto
Rolling Walker while doing
twisting side stretches/
reaches for a minimum of 2
minutes three times a day at
0930, 1300, and 2030 for 7
days ending on 11/01/2017.
-Monitor pts ability to
tolerate activity and use all 4
extremities noting pulse, skin
color, and B/P before and
after PT sessions and while
doing independent transfers.
-Assess pt room for any
possible hazards in the
environment ie. room clutter,
bed position, if the overhead
lights work, or if furniture is
blocking pts walking
pathway.
-Nurse will monitor -Teach pt to do deep
the pt while breathing exercises to
performing her help with lung expansion
standing and and to help relieve pts
stretching exercise anxiety/ tremor intensity/
for 2 minutes three fatigue when ambulating.
times a day to ensure
pt performs task. -Teach pt to stand up
Nurse will execute slowly using the RW and
passive and active to sit down slowly
ROM exercises on making sure to grab arm
pts legs to avoid
rests on chairs before
muscle fatigue and
lowering themself to add
cramping.
extra support and to
-Nurse will monitor avoid lightheadedness.
for orthostatic
hypotension while pt
is moving and
transferring.

References
Ackley, B. J., Ladwig, G. B., & Makic, M. B. (2017). Nursing diagnosis handbook: An evidence-based
guide to planning care (11th ed.). St. Louis, MO: Elsevier.
Lewis, S. L., Bucher, L., Heitkemper, M. M., & Harding, M. M. (2017). Medical-surgical nursing:
Assessment and management of clinical problems(10th ed.). St. Louis, MO: Elsevier, Inc.