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    NCP for Imperforate Anus

    Uploaded by

    Kyla Euste

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    © All Rights Reserved
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    NCP for Imperforate Anus

    Uploaded by

    Kyla Euste
    15 views1 page

    Copyright

    © © All Rights Reserved

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    © All Rights Reserved
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    Download as docx, pdf, or txt
    15 views1 page

    NCP for Imperforate Anus

    Uploaded by

    Kyla Euste

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
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    IMPERFORATE ANUS

    ASSESSMENT NURSING DIAGNOSIS PLANNING INTERVENTION RATIONALE EVALUATION


    Subjective Data: Impaired skin integrity After Nursing Independent Independent After Nursing
    “Mainit at namamaga related to the colostomy Interventions the  Monitor Vital Signs  For baseline data Interventions the
    ang parte kung saan as evidenced by existence patient will be;  Established rapport  To gain trust and patient was;
    siya inoperahan tapos of the incision, stitching  Achieving pink with the patient or SO cooperation
    may sugat din” as drain, irritation, swelling dry and  Keep sterile dressing  A sterile technique  Achieved pink
    verbalized by the SO and redness, skin around damage-free technique around reduces the risk of dry and
    the colostomy wet and no skin around the wound care infection in impaired damage-free
    Objective Data: drainage. colostomy  Check for every two tissue integrity. This skin around the
     Affected area is  Incision free of hours for proper involves the use of a colostomy
    hot redness, no placement of casts sterile procedure
     Skin and tissue swelling and and assess skin field, sterile gloves,  Incision free of
    color changes drainage tissue integrity sterile supplies and redness, no
    (red, purplish, Collaborative dressing, sterile swelling and
    black)  Instruct SO in the instruments. drainage
     Swelling around proper care of the  Mechanical damage
    the wound wound, including hand to skin and tissues
     Presence of washing, wound (pressure, friction or
    moist and lesion cleansing, dressing shear) is often
    in the area changes and associated with
     High-pitched cry application of topical external devices.
    medications Collaborative
     Accurate
    information
    increases the
    ability to manage
    therapy and
    reduces the risk
    for infection.

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