Make a nursing care plan  Acute pain related to post operative surgery as evidenced by guarding and facial grimace Subjective Cues Objective cues Scientific Analysis Situational Analysis Goals and Objective Short term Goal Cognitive Goal Affective Goal Psychomotor Goal Implementation Independent nursing interventions Dependent Nursing Intevention Collaborative Nursing Intervention Rationale Evaluation   Chief Complaints: Hypogastric pain    history of present illness2 months prior to consultation the patient complained of abdominal pain associated with discomfort, she was admitted to the ER but was discharged with unrecalled medications. 1 month prior to consultation the patient had moderate to severe dysmenorrhea, a whole abdominal ultrasound was performed and the results indicated the patient to have myoma in her uterus.     2 weeks prior to admission the attending physician was consulted due to the results of the whole abdominal ultrasound hence her admission for a total abdominal hysterectomy bilateral salpingo-oophorectomy. past health history    Patient underwent a total thyroidectomy Diagnosis: Myoma Uterine

Comprehensive Medical Assisting: Administrative and Clinical Competencies (MindTap Course List)
6th Edition
ISBN:9781305964792
Author:Wilburta Q. Lindh, Carol D. Tamparo, Barbara M. Dahl, Julie Morris, Cindy Correa
Publisher:Wilburta Q. Lindh, Carol D. Tamparo, Barbara M. Dahl, Julie Morris, Cindy Correa
Chapter5: The Therapeutic Approach To The Patient With A Life-threatening Illness
Section: Chapter Questions
Problem 6CR
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Make a nursing care plan 

Acute pain related to post operative surgery as evidenced by guarding and facial grimace


Subjective Cues

Objective cues

Scientific Analysis

Situational Analysis

Goals and Objective

Short term Goal

Cognitive Goal

Affective Goal

Psychomotor Goal

Implementation

Independent nursing interventions

Dependent Nursing Intevention

Collaborative Nursing Intervention

Rationale

Evaluation

 

Chief Complaints: Hypogastric pain   

history of present illness
2 months prior to consultation the patient complained of abdominal pain associated with discomfort, she was admitted to the ER but was discharged with unrecalled medications. 
1 month prior to consultation the patient had moderate to severe dysmenorrhea, a whole abdominal ultrasound was performed and the results indicated the patient to have myoma in her uterus. 
    2 weeks prior to admission the attending physician was consulted due to the results of the whole abdominal ultrasound hence her admission for a total abdominal hysterectomy bilateral salpingo-oophorectomy.

past health history
    Patient underwent a total thyroidectomy


Diagnosis: Myoma Uterine

 

 

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