ASSESSMENT SUBJECTIVE Masakit pa rin yung sugat ko sa tiyan OBJECTIVE o Temperature 36.
5 C o PR: 69bpm o RR: 20cpm o BP: 110/70 mmHg o Rated pain 8 out of 10 o Impaired physical mobility o Pain increases when moves vigorously o Guarding behavior o alert, conscious, coherent o With dry and intact surgical dressing on hypogastric area of the abdomen
DIAGNOSIS Acute pain secondary to surgical operation
INFERENCE CS and TAHBSO
PLANNING
INTERVENTION Independent: o Identify specific activity limitations. o Recommend planned or progressive exercise. o Schedule adequate rest periods. o Review importance of nutritious diets and adequate fluid intake. o Reposition as indicated. o Provide additional comfort measures like back rub. Dependent o Medication such as antibiotics and analgesics Collaborative o High-fiber diet
RATIONALE
EVALUATION
After 1 day of nursing interventions, patients pain will diminish Abdominal and perform incision and Uterine incision activities like sitting, standing and Alterations of walking. the Skin
o Prevents undue strain on operative site. o Promotes return of normal function and enhances feelings of general wellbeing. o Prevents fatigue and conserves energy for healing. o Provides elements necessary for tissue regeneration or healing and to avoid hypovolemic shock o May relieve pain and enhance circulation. o Improves circulation, reduces muscle tension and anxiety associated with pain o To prevent postoperative wound complication and relieve pain o To avoid constipation
After 1 day of nursing interventions , the patient pain was relieved or controlled and patient is able to ambulate.