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    Risk

    Uploaded by

    Henry Roque Tagalag
    The client presented with headache, dizziness, limited motion, warm feeling in the eye, and abnormal vital signs of temperature of 37°C, respiratory rate of 28 breaths per minute, and blood pressure of 150/100 mmHg. This places the client at risk for injury due to factors such as hypertension, loss of balance, and inability to protect himself. The nurse's goals are to keep the client free of injury and lessen risk factors through safety measures like monitoring vitals and providing injury prevention materials. Interventions include assessing the client's status and environment for risk of injury and promoting safety.

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    Risk

    Uploaded by

    Henry Roque Tagalag
    140 views1 page
    The client presented with headache, dizziness, limited motion, warm feeling in the eye, and abnormal vital signs of temperature of 37°C, respiratory rate of 28 breaths per minute, and blood pressure of 150/100 mmHg. This places the client at risk for injury due to factors such as hypertension, loss of balance, and inability to protect himself. The nurse's goals are to keep the client free of injury and lessen risk factors through safety measures like monitoring vitals and providing injury prevention materials. Interventions include assessing the client's status and environment for risk of injury and promoting safety.

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    The client presented with headache, dizziness, limited motion, warm feeling in the eye, and abnormal vital signs of temperature of 37°C, respiratory rate of 28 breaths per minute, and blood pressure of 150/100 mmHg. This places the client at risk for injury due to factors such as hypertension, loss of balance, and inability to protect himself. The nurse's goals are to keep the client free of injury and lessen risk factors through safety measures like monitoring vitals and providing injury prevention materials. Interventions include assessing the client's status and environment for risk of injury and promoting safety.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    140 views1 page

    Risk

    Uploaded by

    Henry Roque Tagalag
    The client presented with headache, dizziness, limited motion, warm feeling in the eye, and abnormal vital signs of temperature of 37°C, respiratory rate of 28 breaths per minute, and blood pressure of 150/100 mmHg. This places the client at risk for injury due to factors such as hypertension, loss of balance, and inability to protect himself. The nurse's goals are to keep the client free of injury and lessen risk factors through safety measures like monitoring vitals and providing injury prevention materials. Interventions include assessing the client's status and environment for risk of injury and promoting safety.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 1

    Risk For Injury

    CUES

    NURSING DIAGNOSIS

    SCIENTIFIC EXPLANATION

    PLANNING

    SELECTED INTERVENTION

    IMPLEMENTED INTERVENTIONS

    RATIONALE

    EVALUATION

    OBJECTIVE: -Needs assistance in ambulation -Headache -dizziness -limited motion -feeling of warm specially in the eye -VS taken as follows: T-37 C RR-28 cpm BP-150/100 mmhg

    Risk for injury r/t multiple factors (Headache, dizziness, limited motion, feeling of warm specially in the eye, V/S T-37 c, RR- 28 cpm, BP150/100 mmhg)

    The Increase o f BP and RR will result to hypertension which may affect the clients lost of balance, in relation to limitation of movements the client is unable to gain his balance and protect his self that leads to possible injury.

    Short term Goal: At the end of Nursing intervention, the client will be free from any signs of injury. Long Term Goal: after nursing intervention the risk factors of client from pain will be lessen. After nursing intervention , the client will verbalized understanding of individual factors that may contribute to possibility of injury.

    Assess general status of the client Assess mood coping abilities, personality style that may result in carelessness Assess environmental factors that may lead to injury Promoting clients Safety by: Monitoring V/S Providing materials for injury prevention

    Assessed general status of the client. Assessed mood coping abilities, personality style that may result in carelessness. Assessed environmental factors that may lead to injury. Promoted clients Safety by: Monitored V/S Provided materials for injury prevention

    To determined clients condition that may cause injury To determine the level of cooperation To determine causes of injury To lessen the risk for injury, safe environment and Promote clients comfort.

    GOAL: The client was free of any signs of injury.

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