Nursing Diagnosis | Assessment Data | Goals and Outcome | Nursing Interventions | Rationale | Outcome Evaluation and Re-planning |
---|---|---|---|---|---|
First Diagnosis: | |||||
Risk of improper healthcare management | – Subjective: Patient is Mrs. Snyder, 56 years old, under treatment for hyperglycemia and uncontrolled diabetes. | Patient will report improvement in eating habits and personal health. | – Raise awareness about self-care management – Encourage diabetes self-monitoring at home – Teach insulin administration techniques | Education and self-monitoring vital for diabetes control | Assessment of glucose logs and lifestyle changes; medication adjustment if needed |
Risk of a consistent rise in diabetes | – Objective: Admitted to ED with sugar levels of 230-389, dyspnea, abdominal discomfort, malaise, urination problems, and HTN. – High consumption of cookies and snacks. | Patient will reduce weight in 3 months. Patient will control snacking habit in 1 month. | – Educate on lifestyle modifications – Teach insulin administration | Lifestyle changes crucial for diabetes management | Regular monitoring of weight and snacking habits; review after 1 and 3 months |
Second Diagnosis: | |||||
Higher domestic burden and difficulty in meal preparation | – Subjective: Patient experiences constant anxiety, depression, overwhelmed feeling, and weakness due to family responsibilities. – Husband provides validation, leading to neglect of personal health. | Patient will improve mental health and emotional well-being. | – Prescribe tolerable anxiolytics – Weekly counseling sessions (CBT) – Provide access to mindfulness and spiritual healing therapies | Pharmacological and psychotherapeutic approaches essential for anxiety control | Weekly assessment of anxiety level and adjustment of interventions as needed |
Third Diagnosis: | |||||
Ovarian Cancer | – Subjective: Patient fearful of chemotherapy, weak, and less immune. Fear of failing as caregiver for elderly mother. – Fear of acute pain, discomfort with surgery. Obesity and airway difficulty. | Patient will have multiple options for better care of her mother through facility placement. | – Refer to counselor for caregiver role – Find social worker for facility placement – Implement pain assessment thrice a day – Educate on nonpharmacological pain management | Ensure patient and caregiver support, pain relief, and improved quality of life | Regular assessment of pain and caregiving needs; adjust interventions accordingly |
References
Cancer. (2021, October 6). Managing diabetes when you have cancer. Cancer.net. https://www.cancer.net/navigating-cancer-care/when-cancer-not-your-only-health-concern/managing-diabetes-when-you-have-cancer
Carolina, C. M. (2019, October 16). Unlocking the full potential of self-monitoring of blood glucose. Uspharmacist.com. https://www.uspharmacist.com/article/unlocking-the-full-potential-of-selfmonitoring-of-blood-glucose
Goodtherapy. (2019, September 23). Therapy for self-love, therapist for self-love issues. Goodtherapy.org. https://www.goodtherapy.org/learn-about-therapy/issues/self-love
Heart. (2021, May 6). Living healthy with diabetes. Heart.org. https://www.heart.org/en/health-topics/diabetes/prevention–treatment-of-diabetes/living-healthy-with-diabetes
Hoyt, J. (2022, May 26). Assisted living
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