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Cues Nursing Diagnosis Background Knowledge Planning Intervention Rationale Evaluation Subjective Data

The patient presented with fever and abdominal rose spots. Their temperature was 38.7C. A nursing diagnosis of hyperthermia related to typhoid fever was made. Over 7 days the nurse monitored the patient's temperature and symptoms, administered antipyretics and antibiotics as prescribed, and provided supportive care like sponge baths. By the end of the 7 days, the patient's temperature was within normal range and they were free from chills.

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Jordz Placi
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1K views

Cues Nursing Diagnosis Background Knowledge Planning Intervention Rationale Evaluation Subjective Data

The patient presented with fever and abdominal rose spots. Their temperature was 38.7C. A nursing diagnosis of hyperthermia related to typhoid fever was made. Over 7 days the nurse monitored the patient's temperature and symptoms, administered antipyretics and antibiotics as prescribed, and provided supportive care like sponge baths. By the end of the 7 days, the patient's temperature was within normal range and they were free from chills.

Uploaded by

Jordz Placi
Copyright
© © All Rights Reserved
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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NURSING BACKGROUND

CUES PLANNING INTERVENTION RATIONALE EVALUATION


DIAGNOSIS KNOWLEDGE
SUBJECTIVE Hyperthermia Typhoid fever After 7 days of 1. Monitored patient 1. Fever pattern may After 7 days of
DATA: related to caused by bacterial nursing temperature aids in diagnosing rendering
“Mainit ang increase salmonella typhi interventions, degree and underlying disease. nursing
pakiramdam metabolic rate, transmitted through the patient will pattern. interventions,
the 7F’s
ko” as illness. demonstrate 2. Observed for 2. Chills often precede The patient was
verbalized by temperature shaking chills and during high temp. and able to
Exposure from
the patient. Poor sanitation within normal profuse in presence of demonstrate
around the range and free diaphoresis. generalized infection. temperature
OBJECTIVE community. chills. 3. Washed hands 3. Reduce cross within the
DATA: with anti bacterial contamination and normal range
Flushed skin, Bacteria enters the soap before and prevent the spread of and free from
warm to touch. stomach through after care of each infection. chills.
+ rose spots on oral-fecal route and activity and
abdomen invades the Peyer’s encourage proper
patches of the hygiene.
intestinal wall in
V/S taken as 4. Provide tepid 4. May help reduce
the small intestine
follows: sponge bath and fever. That use of ice,
where it is attached.
BP:120/70 avoid use of ice water and alcohol
RR: 17 cpm Enters the water and may cause chills and
PR 96 bloodstream via alcohol. may elevate temp.
Temp: 38.7C lymphatic (Payer’s 5. Monitor for signs 5. May reflect
patches) of deterioration of inappropriate abx
condition or therapy.
Inject toxin known failure to improve
as the effoctor with the therapy.
protein in the COLLABORATI
intestinal cells and VE
interrupts with the 6. Administered 6. Used to reduce fever
cellular proteins antipyretics as by it’s central action
and lipids and
prescribed. on the hypothalamus.
manipulate its
Paracetamol 500
function.
Bacteria induce mg 1 tab po for
macrophages fever q4hours
apoptosis, breaking PRN
out into the blood
stream and cause 7. Administered abx
systemic infection. as prescribed. 7. To control the spread
Chloramphenicol 3-4 of infection.
gms per day po in 4
Fever divided doses.
.

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