Question

Write a NURSING CARE PLAN for a pateint with UTI , chronic Atrial fibrillation and coronary artery disease.

Answer 1

NURSING CARE PLAN FOR UTI.

ASSESSMENT	NURSING DIAGNOSIS	PLANNING AND GOALS	IMPLEMENTATION WITH RATIONALE	EVALUATION
Subjective data * pain in the groin,lower abdomen or pelvis. * foul smelling urine. * frequent urination. * persistent urge to urinate. Objective data. * cloudy urine. * Weakness * Fever. * blood in urine or dark urine.	* Acute pain in the urethra related to UTI. * Impaired urinary elimination due to inflammation caused by bacteria. * Anxiety related to discomfort produced by the urinary problem.	* Planning and set major goals include * Reduce pain level. * Maintain normal urine elimination pattern. * Reduce anxiety level.	Acute pain * Increase fluid intake of patient which help to dilute urine and flush out bacteria. * Avoiding use of irritant foods like caffine,soft drinks and alcohol to reduce irritation and pain. * Give analgesics as per doctors order. * Hot water bag application over lower abdominal area to reduce pain. Impaired urinary elimination. * Assess the intake and output level and give fluids orally or IV to maintain normal urine elimination pattern. * Use of antibiotic therapy as per physicians order for control urinary infection to maintain normal elimination pattern. Reduce Anxiety    * Give psychological support to reduce stress level. * Provide a peaceful environment in the hospital to reduce anxiety. * Allow family members to participate in care to reduce stress level.	*Evaluate the pain level of patient. * Evaluate the urinary elimnation pattern. * Evaluate the anxiety level.

NURSING CARE PLAN FOR CHRONIC ATRIAL FIBRILLATION.

ASSESSMENT	NURSING DIAGNOSIS	PLANNING AND GOALS.	IMPLEMENTATION	EVALUATION.
Subjective data. * Heart palpitations and chest pain. * Shortness of breath. * Anxiety * Dizziness. Objective data * Weakness. * Low oxygen saturation. * Arrythmias in ECG.	* Decreased cardiac output related to cardiac arrythmias. *Acute chest pain related to heart problems. * Ineffective breathing pattern related to blood accumulate in the lung due to chronic atrial fibrillation.	* Maintain normal cardiac function. * Reduce the pain level. * Maintain normal breathing pattern.	Restore cardiac function. * Administer antiarrythmic medications as per doctors order (eg; diltizem) to restore normal rhythm and function of heart. * Continous cardiac monitoring to detect sudden changes in heart rate and rhythm to continue treatment. * Prepare for cardioversion or catheter ablation as per physicians order to restore normal heart function. Acute pain. * Provide upright position to improve comfort and reduce pain. * Give analgesics as per doctors order. Ineffective breathing pattern. * Provide oxygen therapy to maintain normal respiratory pattern. * Provide fowler's position to improve breathing pattern.	* Evaluate the heart rate and rhythm of patient. * Evaluate pain level. * Evaluate respiratory rate and oxygen saturation.

NURSING CARE PLAN FOR PATIENT WITH CORONARY ARTEWRY DISEASE.

ASSESSMENT	NURSING DIAGNOSIS	PLANNING AND GOALS	IMPLEMENTATION AND RATIONALE	EVALUATION
Subjective data * Chest pain. * shortness of breath. * nausea. Objective data * Dysrhythmias in ECG. * Weakness. * Myocardial infarction findings in ECG. * Cool,pale,moist skin.	* Acute chest pain related to coronary artery disease. * Ineffective cardiac tissue perfusion related to reduced coronary blood flow. * Anxiety related to inability to do self care activities	* Reduce pain level. * Maintain normal cardiac tissue perfusion. * Reduce anxiety level.	Acute chest pain * Administer supplemental oxygen to relieve chest discomfort due to shortness of breath which help to reduce chest pain. * Give coronary vasodilators and analgesics as per doctors order to relieve pain. Ineffective cardiac tissue perfusion. * Circulatory support include vasodilators,antihypertensive drugs to maintain cardiac tissue perfusion. * Oxygen supplementation with the help of ventilator if needed to maintain normal cardiac tissue perfusion. * Fluid administration to restore fluid volume in the body for effective cardiac tissue perfusion. * Provide nutritional suppoert for normal functioning of heart. Reduce anxiety * Provide a good therapeutic environment to reduce stress level. * Give psychological support to reduce anxiety. * Assist in daily activities of the patient to reduce stress level.	* Evaluate the pain level. * Evaluate the cardiac function. * Evaluate the anxiety level.