generic medical care plan

8/11/2019 Generic Medical Care Plan

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Generic Medical Care Plan for the HospitalizedAdult Client

This care plan (Level I) presents nursing diagnoses and collaborative problems that commonlyapply to clients (and their significant others) undergoing hospitalization for any medical disorder.

Nursing diagnoses and collaborative problems specific to a disorder are presented in the care plan (Level II) for that disorder.

DIAGNOSTIC CLUST ! Colla"orati#e Pro"le$sPC Cardiovascular !ysfunctionPC "espiratory InsufficiencyNursin% Dia%noses

#n$iety related to unfamiliar environment% routines% diagnostic tests% treatments% and loss of control

"is& for In'ury related to unfamiliar environment and physical and mental limitations secondaryto condition% medications% therapies% and diagnostic tests

"is& for Infection related to increased microorganisms in environment% ris& of person to persontransmission% and invasive tests and therapies

( pecify) elf Care !eficit related to sensory% cognitive% mobility% endurance% or motivation problems

"is& for Imbalanced Nutrition Less Than *ody "e+uirements related to decreased appetitesecondary to treatments% fatigue% environment% and changes in usual diet% and to increased

protein and vitamin re+uirements for healing"is& for Constipation related to change in fluid and food inta&e% routine% and activity level,

effects of medications, and emotional stress"is& for Impaired &in Integrity related to prolonged pressure on tissues associated -ith

decreased mobility% increased fragility of the s&in associated -ith dependent edema%decreased tissue perfusion% malnutrition% and urinary fecal incontinence

!isturbed leep Pattern related to unfamiliar% noisy environment% change in bedtime ritual%emotional stress% and change in circadian rhythm

"is& for piritual !istress related to separation from religious support system% lac& of privacy% or inability to practice spiritual rituals

Interrupted /amily Processes related to disruption of routines% change in role responsibilities% andfatigue associated -ith increased -or&load and visiting hour re+uirements

"is& for Compromised 0uman !ignity related to multiple factors (intrusions% unfamiliar procedures and personnel% loss of privacy) associated -ith hospitalization

"is& for Ineffective Therapeutic "egimen 1anagement related to comple$ity and cost of therapeutic regimen% comple$ity of health care system% shortened length of stay%insufficient &no-ledge of treatment% and barriers to comprehension secondary to

2 3445 6olters 7lu-er 0ealth 8 Lippincott 6illiams 9 6il&ins. /rom Carpenito 1oyet% L. :. Nursing care plans &documentation: Nursing diagnoses and collaborative problems (; th ed.).


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language barriers% cognitive deficits% hearing and or visual impairment% an$iety and lac& of motivation

Dischar%e Criteriapecific discharge criteria vary depending on the client


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against the arterial -alls.0ypertension (systolic pressureB?D4 mm0g% diastolic pressureBF; mm0g) may indicateincreased peripheral resistance%cardiac output% blood volume% or

blood viscosity. 0ypotensioncan result from significant bloodor fluid loss% decreased cardiacoutput% and certain medications.

d. &in (color% temperature%moisture) and temperature

d. &in assessment providesinformation evaluatingcirculation% body temperature%and hydration status.

e. Pulse o$imetry e. Pulse o$imetry is a noninvasivemethod (probe sensor onfingertip) for continuousmonitoring of o$ygen saturationof hemoglobin.

3. 1onitor respiratory statusa. "ate

b. "hythmc. *reath sounds

3. "espiratory assessment providesessential data for evaluating theeffectiveness of breathing and detectingadventitious or abnormal sounds% -hichmay indicate air-ay moisture%

narro-ing% or obstruction.

!elated Ph'sician(Prescri"ed Inter#entions!ependent on the underlying pathology

Docu$entation/lo- records

Pulse rate and rhythm*lood pressure"espiratory assessmentProgress notes#bnormal findingsInterventions



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Nursin% Dia%noses

An)iet' !elated to Unfa$iliar n#iron$ent* !outines* Dia%nostic Tests*

Treat$ents* and Loss of Control

NOC #n$iety Control% Coping% Impulse Control

GoalThe client -ill communicate feelings regarding the condition and hospitalization.Indicators> Herbalize% if as&ed% -hat to e$pect regarding routines and procedures.> $plain restrictions.

NIC #n$iety "eduction% Impulse Control Training% #nticipatory =uidance

Inter#entions !ationales?. Introduce yourself and other members

of the health care team% and orient theclient to the room (e.g.% bed controls%call bell% bathroom).

?. # smooth% professional admission process and -arm introduction can puta client at ease and set a positive tonefor his or her hospital stay.

3. $plain hospital policies and routinesa. Hisiting hours

b. 1ealtimes and availability ofsnac&s

3% E. Providing accurate information canhelp decrease the client


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D. $plain any scheduled diagnostic tests%covering the follo-inga. !escription

b. Purposec. Pretest routines

DA@. Teaching the client about tests andtreatment measures can help decreasehis or her fear and an$iety associated-ith the un&no-n% and improve his orher sense of control over the situation.

d. 6ho -ill perform the procedureand -here

e. $pected sensationsf. Posttest routinesg. #vailability of results

;. !iscuss all prescribed medicationsa. Name and type

b. Purposec. !osaged. pecial precautionse. ide effects

@. $plain any prescribed dieta. Purpose

b. !urationc. #llo-ed and prohibited foods

J. Provide the client -ith opportunities toma&e decisions about his or her care

-henever possible.

J. Participating in decision ma&ing canhelp give a client a sense of control%

-hich enhances his or her copingability. Perception of loss of control canresult in a sense of po-erlessness% thenhopelessness.

F. Provide reassurance and comfort.pend time -ith the client% encourage

him or her to share feelings andconcerns% listen attentively% and conveyempathy and understanding.

F. Providing emotional support andencouraging sharing may help a clientclarify and verbalize his or her fears%allo-ing the nurse to get realisticfeedbac& and reassurance.

5. Correct any misconceptions and

inaccurate information the client maye$press.

5. # common contributing factor to fear

and an$iety is incomplete or inaccurateinformation, providing ade+uate%accurate information can help allayclient fears.



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?4. #llo- the client Identify factors that increase ris& of in'ury.> !escribe appropriate safety measures.

NIC /all Prevention% nvironmental 1anagement afety% 0ealth ducation%urveillance afety% "is& Identification

Inter#entions !ationales?. rient the client to his or her

environment (e.g.% location of bathroom% bed controls% call bell).Leave a light on in the bathroom atnight.

?. rientation helps provide familiarity, alight at night helps the client find his orher -ay safely.

3. Instruct the client to -ear slippers -ithnons&id soles and to avoid ne-ly-ashed floors.

3. These precautions can help prevent footin'uries and falls from slipping.

E. Teach him or her to &eep the bed in thelo- position -ith side rails up at night.

E. The lo- position ma&es it easier for theclient to get in and out of bed.

D. 1a&e sure that the telephone%eyeglasses% and fre+uently used

D. 7eeping ob'ects at hand helps preventfalls from overreaching and



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personal belongings are -ithin easyreach.

overe$tending.

;. Instruct the client to re+uest assistance-henever needed.

;. =etting needed help -ith ambulationand other activities reduces a client


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;. Teach a client -ith an ind-ellingcatheter in place to do the follo-inga. #void pressure on the catheter.

b. 6ipe from front to bac& after a bo-el movement.

;. Catheter movement can cause tissuetrauma% predisposing to inflammation./eces can readily contaminate anind-elling catheter.

@. Instruct the client to -atch for andreport immediately any signs andsymptoms of inflammationa. "edness or pain at the catheter

insertion site

@. Nosocomial infections occur in ;A@Mof all hospitalized clients. arlydetection enables prompt interventionto prevent serious complications and a

prolonged hospital stay.

b. *ladder spasms and cloudy

urine (for a client -ith anind-elling urinary catheter)

c. /eelings of -armth and malaise

Docu$entation/lo- records

Catheter and insertion site careProgress notes

#bnormal findings1ultidisciplinary client education record

-Specif'. Self(Care Deficit !elated to Sensor'* Co%niti#e* Mo"ilit'* ndurance* orMoti#ational Pro"le$s

NOC ee elf Care *athing% elf Care 0ygiene% elf Care ating% elf Care!ressing% elf Care Toileting% and or elf Care Instrumental #ctivities of !aily Livingfor N C

Goal

The client -ill perform self care activities (feeding% toileting% dressing% grooming% bathing)% -ithassistance as needed.Indicators> !emonstrate optimal hygiene after care is provided.> !escribe restrictions or precautions needed.



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NIC ee /eeding% *athing% !ressing% and or Instrumental elf Care !eficit for NIC

Inter#entions !ationales?. Promote the client


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eat them easily.3. Promote the client


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!is+ for I$"alanced Nutrition& Less Than /od' !e0uire$ents !elated to DecreasedAppetite Secondar' to Treat$ents* 1ati%ue* n#iron$ent* and Chan%es in UsualDiet* and to Increased Protein and 2ita$in !e0uire$ents for Healin%

NOC Nutritional tatus% Teaching Nutrition

GoalThe client -ill ingest daily nutritional re+uirements in accordance -ith activity level% metabolicneeds% and restrictions.Indicators> "elate the importance of good nutrition.> "elate restrictions% if any.

NIC Nutrition 1anagement% Nutritional 1onitoring

Inter#entions !ationales?. $plain the need for ade+uate

consumption of carbohydrates% fats% protein% vitamins% minerals% and fluids.

?. !uring illness% good nutrition canreduce the ris& of complications andspeed up recovery.

3. Consult -ith a nutritionist to establishappropriate daily caloric and food typere+uirements for the client.

3. Consultation can help ensure a diet that provides optimal caloric and nutrientinta&e.

E. !iscuss -ith the client possible causesof his or her decreased appetite.

E. /actors such as pain% fatigue% analgesicuse% and immobility can contribute toanore$ia. Identifying a possible causeenables interventions to eliminate or minimize it.

D. ncourage the client to rest beforemeals.

D. /atigue further reduces an anore$icclient


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the client usually feels most li&e eating. calories and protein.5. Ta&e steps to promote appetite

a. !etermine the client


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1ultidisciplinary client education record!iet instructionKse of assistive devices

!is+ for Constipation !elated to Chan%e in 1luid or 1ood Inta+e* !outine* orActi#it' Le#el3 ffects of Medications3 and $otional Stress

NOC *o-el limination% 0ydration% ymptom Control

GoalThe client -ill maintain pre hospitalization bo-el patterns.Indicators> tate the importance of fluids% fiber% and activity.> "eport difficulty promptly.

NIC *o-el 1anagement% /luid management% Constipation Impaction 1anagement

Inter#entions !ationales?. #uscultate bo-el sounds. ?. *o-el sounds indicate the nature of

peristaltic activity.3. Implement measures to eat a balanced

diet that promotes regular eliminationa. ncourage increased inta&e of

high fiber foods% such as freshfruit -ith s&in% bran% nuts andseeds% -hole grain breads andcereals% coo&ed fruits andvegetables% and fruit 'uices.(Note If the client


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of fresh fruit and a large salad daily to promote regular bo-elmovements.

E. Promote ade+uate daily fluid inta&ea. ncourage inta&e of at least 3

liters (F to ?4 glasses) per day%unless contraindicated.

E. #de+uate fluid inta&e helps maintain proper stool consistency in the bo-eland aids regular elimination.

b. Identify and accommodate fluid preferences% -henever possible.

c. et up a schedule for regular fluid inta&e.

D. stablish a regular routine for eliminationa. Identify the client


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sounds% use a room deodorizer.d. Provide ade+uate comfort%

reading material as a diversion%and a call bell for safetyreasons.

@. Teach the client to assume an optimal position on the toilet or commode(sitting upright% leaning for-ardslightly) or bedpan (head of bedelevated to put the client in high/o-ler


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NIC Pressure 1anagement% Pressure Klcer Care% &in urveillance% Positioning

Inter#entions !ationales?. &in assessment

a. Assessment . #ll clients -ill beassessed upon admission for ris& factors that predispose tos&in brea&do-n. These ris& factors include% but are notlimited to% the follo-ing

?. To prevent pressure ulcers% individualsat ris& must be identified so that ris& factors can be reduced throughintervention.

> #ltered level of consciousness

> Poor nutrition hydration> Impaired mobility> Impaired sensation

(paralysis)> Incontinence> 1ultisystem failure> teroid or

immunosuppressivetherapy

> #ge over @; b. Inspection. Kpon admission%

bony prominences and s&in

folds -ill be inspected for evidence of redness or s&in

brea&do-n.c. Documentation. 6ithin F hours

of admission% document thefollo-ing information on thes&in section of the Nursing#dmission 0istory> Indicate by chec&ing

appropriate bo$es-hether the client is atris& for s&in brea&do-nand the ris& factors

present.> !escribe e$isting areas

of brea&do-n andindicate their location on



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the body.3. Prevention protocol 3.

a. Pressure relief > Change client The critical time period for tissue changes due to pressure is

bet-een ? and 3 hours% after

-hich irreversible changes canoccur.

> Post position changeschedule ( turn cloc&O)at bedside.

> Ktilize prevention modeon specialty beds.

> The turn cloc&O alerts the nurseto recommended positionchanges and appropriate timeintervals for turning.

> Kse foam -ith cushionin chair, no donuts.

b. Limit shearing forces friction> 7eep the head of the bed

at or belo- E4 degrees-henever possible.

> #void dragging theclient in bed. Kse liftsheet or overheadtrapeze.

> Kse elbo- protectors.

"emove to inspect atevery shift.> #pply transparent film

dressing (Tegaderm)over bony prominences%as appropriate.

> The ris& of developing a pressure ulcer can bediminished by reducing themechanical loading on thetissue. This can beaccomplished by using pressurereducing devices. !onuts are&no-n to cause venouscongestion and edema. # studyof at ris& clients found that ringcushions are more li&ely to

cause pressure ulcers than prevent them. The donutrelieves pressure in one area butincreases pressure in thesurrounding areas.

> Clinically% shear is e$erted on



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the body -hen the head of the bed is elevated. In this position%the s&in and superficial fasciaremain fi$ed against the bedlinens -hile the deep fascia ands&eleton slide do-n to-ard thefoot of the bed. #s a result of shear% blood vessels in the sacralarea are li&ely to becomet-isted and distorted and tissuemay become ischemic andnecrotic (Porth% 344;).

> /riction in'uries to the s&inoccur -hen it moves across a

coarse surface such as bedlinens. 1ost friction in'uries can be avoided by using appropriatetechni+ues -hen movingindividuals so that their s&in isnever dragged across the bedlinens.

> Holuntary and involuntarymovements by the individualsthemselves can lead to friction

in'uries% especially on elbo-sand heels. #ny agent thateliminates this contact or decreases the friction bet-eenthe s&in and the bed linens -illreduce the potential for in'ury.

E. Nutritional assessment> 1onitor inta&e and consider

consultation -ith physiciandietary if the client

> ats less than ;4M of meals for E or more days

> Is NP or on a clear li+uid diet for ; days

> 0as a serum albumin of E.;

> Place on inta&e and output. If

E. Nutritional deficit is a &no-n ris& factor for the development of pressureulcers. Poor general nutrition isfre+uently associated -ith loss of

-eight and muscle atrophy. Thereduction in subcutaneous tissue andmuscle reduces the mechanical padding

bet-een the s&in and the underlying bony prominences% thus increasingsusceptibility to pressure ulcers. Poor nutrition also leads to decreased



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inta&e is less than 3444 mL 3Dhours% force fluids unlesscontraindicated.

resistance to infection and interferes-ith -ound healing.

> "ecord actual -eight onadmission and -ee&lythereafter.

> "e+uest multivitamin mineralsupplement and or dietarysupplements (*urnsha&es%

nsure) if indicated.> #ssess lab values

> C*C> #lbumin> 0emoglobin hematocrit

D. &in care

> Inspect s&in at least daily during bath for reddened areas or brea&do-n. Chec& bony prominences for redness -itheach position change.

> 7eep s&in clean and dry. =entlyapply moisturizers such as

ucerin% Lubriderm% or -eenCream% as needed.

> #void massage over bony prominences.

D. &in inspection is fundamental to any

plan for preventing pressure ulcers.&in inspection provides the

information essential for designinginterventions to reduce ris& and for evaluating the outcomes of thoseinterventions.> /or ma$imum s&in vitality%

metabolic -astes andenvironmental contaminantsthat accumulate on the s&inshould be removed fre+uently. Itis prudent to treat clinical signsand symptoms of dry s&in -itha topical moisturizer.

> There is research evidence to



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suggest that massage over bony prominences may be harmful.

;. Incontinence care ;.> #ssess the cause of

incontinence0istory of incontinenceChange in medications#ntibiotic therapyClient disoriented at night

> Chec& client for incontinenceevery ? to 3 hours.

> Ta&e client to bathroom or offer bedpan every 3 hours -hilea-a&e and at bedtime

> If diapers are used% chec& every3 hours and prn for -etness.

> If plastic protectors are used% place inside lift sheet% never indirect contact -ith the client 1oist s&in due to incontinenceleads to maceration% -hich canma&e the s&in more susceptibleto in'ury. 1oisture from urine or fecal incontinence also reducesthe resistance of the s&in to

bacteria. *acteria and to$ins inthe stool increase the ris& of s&in brea&do-n.

> Plastic pads hold moisture ne$tto the s&in. They are notabsorbent and serve only as

bed protectors.O Never use plastic pads unless they arecovered -ith smooth linen toabsorb moisture.

> Cleanse perineal area after eachincontinent episode% follo-ed

by the application of a moisture barrier ointment (!esitin%Haseline% # 9 ! intment%*aza.)

> # moisture barrier is a petrolatum based ointment that repels urine andfecal material and moisturizes the s&into assist in healing reddened% irritatedareas resulting from incontinence.

Docu$entation/lo- record

Turning and repositioning&in assessment



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Distur"ed Sleep Pattern !elated to an Unfa$iliar* Nois' n#iron$ent* a Chan%e in/edti$e !itual* $otional Stress* and a Chan%e in Circadian !h'th$

NOC

"est% leep% 6ell *eing

GoalThe client -ill report a satisfactory balance of rest and activity.Indicators> Complete at least four sleep cycles (?44 min) undisturbed.> tate factors that increase or decrease the +uality of sleep.

NIC nergy 1anagement% leep nhancement% nvironmental 1anagement

Inter#entions !ationales?. !iscuss the reasons for differing

individual sleep re+uirements%including age% life style% activity level%and other possible factors.

?. #lthough many believe that a personneeds F hours of sleep each night% noscientific evidence supports this.Individual sleep re+uirements varygreatly. =enerally% a person -ho canrela$ and rest easily re+uires less sleepto feel refreshed. 6ith age% total sleeptime usually decreases (especially tage

IH sleep) and tage I sleep increases.3. Institute measures to promoterela$ationa. 1aintain a dar&% +uiet

environment.

3. leep is difficult -ithout rela$ation.The unfamiliar hospital environmentcan hinder rela$ation.

b. #llo- the client to choose pillo-s% linens% and covers% asappropriate.

E. chedule procedures to minimize thetimes you need to -a&e the client at

night. If possible% plan for at least t-ohour periods of uninterrupted sleep.

E. In order to feel rested% a person usuallymust complete an entire sleep cycle (J4

to ?44 min) four or five times a night.

D. $plain the need to avoid sedative andhypnotic drugs.

D. These medications begin to lose their effectiveness after a -ee& of use%re+uiring increased dosages and leadingto the ris& of dependence.

;. #ssist - ith usual bedtime routines as ;. # familiar bedtime ritual may promote



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necessary% such as personal hygiene%snac&% or music for rela$ation.

rela$ation and sleep.

@. Teach the client sleep promotingmeasures

@. These practices may help promotesleep.

a. ating a high protein snac& (such as cheese or mil&) before

bedtime

a. !igested protein producestryptophan% -hich has a sedativeeffect.

b. #voiding caffeine b. Caffeine stimulates metabolismand deters rela$ation.

c. #ttempting to sleep only -henfeeling sleepy

c. /rustration may result if theclient attempts to sleep -hennot sleepy or rela$ed.

d. Trying to maintain consistentnightly sleep habits

d. Irregular s leeping patterns candisrupt normal circadianrhythms% possibly leading to

sleep difficulties.J. $plain the importance of regular

e$ercise in promoting good sleep.J. "egular e$ercise not only increases

endurance and enhances the ability totolerate psychological stress% but also

promotes rela$ation.

Docu$entationProgress notes"eports of unsatisfactory sleep

!is+ for Spiritual Distress !elated to Separation fro$ !eli%ious Support S'ste$*Lac+ of Pri#ac'* or Ina"ilit' to Practice Spiritual !ituals

NOC 0ope% piritual 6ell *eing

GoalThe client -ill maintain usual spiritual practices not detrimental to health.Indicators> #s& for assistance as needed.

> "elate support from staff as needed.

NIC piritual =ro-th /acilitation% 0ope Instillation% #ctive Listening% Presence%motional upport% piritual upport

Inter#entions !ationales?. $plore -hether the client desires to ?. /or a client -ho places a high value on



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engage in an allo-able religious or spiritual practice or ritual. If so% provideopportunities for him or her to do so.

prayer or other spiritual practices% these practices can provide meaning and purpose and can be a source of comfortand strength.

3. $press your understanding andacceptance of the importance of theclient


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Indicators> Identify signs of family dysfunction.> Identify appropriate resources to see& -hen needed.

NIC /amily Involvement Promotion% Coping nhancement% /amily IntegrityPromotion% /amily Therapy% Counseling% "eferral

Inter#entions !ationales?. #pproach the family and attempt to

create a private and supportiveenvironment.

?. #pproaching a family communicates asense of caring and concern.

3. Provide accurate information usingsimple terms.

3. 1oderate or high an$iety impairs theability to process information. implee$planations impart useful information

most effectively.E. $plore the family members Physician Prolonged interval bet-eentrauma or illness and

presentation for medical care> Conflicting or implausible

accounts regarding in'uries or incidents

> 0istory of 1! shopping or " shopping

#ocial indicators:> #ge

Qoung (chronologically or developmentally)

lder > pouse intimate partner is

forced by circumstances to carefor client -ho is un-anted

> pouse intimate partner inappropriately -ill not allo-you to intervie- the client alonedespite e$planation

> Client spouse intimate partner socially isolated or alienated

> Client spouse intimate partner



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demonstrates poor self image> /inancial difficulties> Client claims to have been

abused $ehavioral indicators:

> Client spouse intimate partner presents vague e$planationregarding in'uries -ithimplausible stories

> Client spouse intimate partner isvery evasive in providinge$planations

> Client has difficulty maintainingeye contact and appearsshameful about in'uries

> Client appears very fearful% possibly trembling

> Client e$presses ambivalenceregarding relationship -ithspouse intimate partner

> Client +uic&ly blameshimself herself for in'uries

> Client is very passive or -ithdra-n

> pouse intimate partner appears

overprotectiveO> Client appears fearful of spouse intimate partner

"efer for counseling if necessary.?J. !irect the family to community

agencies and other sources of emotionaland financial assistance% as needed.

?J. #dditional resources may be needed tohelp -ith management at home.

?F. #s appropriate% e$plore -hether theclient and family have discussed endof life decisions, if not% encourage themto do so.

?F. Intense stress is e$perienced -henfamilies and health care providers arefaced -ith decisions regarding either initiation or discontinuation of lifesupport systems or other medicalinterventions that prolong life (e.g.%nasogastric tube feeding). If the client


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by the health care providers% or viceversa.

?5. 6hen appropriate% instruct the client or family members to provide thefollo-ing informationa. Person to contact in the event of

emergency b. Person -hom the client trusts

-ith personal decisionsc. !ecision -hether to maintain

life support if the client -ere to become mentally incompetent

d. #ny preference for dying athome or in the hospital

e. !esire to sign a living -illf. !ecision on organ donationg. /uneral arrangements, burial%

cremation

?5. !uring an episode of acute illness%these discussions may not beappropriate. Clients and families should

be encouraged to discuss their directions to be used to guide futureclinical decisions% and their decisionsshould be documented. ne copyshould be given to the persondesignated as the decision ma&er in theevent the client becomes incapacitatedor incompetent% -ith another copyretained in a safe deposit bo$ and one

copy on the chart.

Docu$entationProgress notes

Interactions -ith family#ssessment of family functioning

nd of life decisions% if &no-n#dvance directive in chart



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!is+ for Co$pro$ised Hu$an Di%nit' !elated to Multiple 1actors -Intrusions*Unfa$iliar n#iron$ent and Personnel* Loss of Pri#ac'. Associated 6ithHospitalization

NOC #buse Protection% Comfort Level% 7no-ledge Illness Care% elf steem%!ignified !ying% piritual 6ell *eing% Information Processing

GoalThe individual -ill report respectful and considerate care.Indicators> "espect for privacy> Consideration of emotions> #s&ed for permission> =iven options> 1inimization of body part e$posure

NIC Patient "ights Protection% #nticipatory =uidance% Counseling% motional upport%Preparatory ensory Information% /amily upport% 0umor% 1utual =oal etting%Teaching Procedure Treatment% Touch

Inter#entions !ationales?. !etermine if the agency hospital has a

policy for prevention of compromisedhuman dignity (Note This type of

policy or standard may be titleddifferently Re.g.% 1ission tatementS).

?. #gency policies can assist the nurse

-hen problematic situations occur.0o-ever% the moral obligation to

protect and defend the dignity of clientsand their families does not depend onthe e$istence (or lac&) of a policy.

3. "evie- the policy. !oes it include(6alsh 9 7o-an&o% 3443)> Protection of privacy and

private space> #c+uiring the client


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> Clear guidelines regarding thenumber of personnel (e.g.%students% nurses% physiciansRresidents% internsS) that can be

present -hen confidentialand or stressful information isdiscussed% or -hen proceduresthat leave a client e$posed needto be done.

E. 1inimize e$posure of the client


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9 7o-an&o% 3443).5. *e a role model and an advocate for the

preservation of the client


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D. $plain and discuss -ith client andfamily caregiver (-hen possible)a. !isease process

b. Treatment regimen(medications% diet% procedures%e$ercises% e+uipment use)

c. "ationale for regimend. ide effects of regimene. Lifestyle changes neededf. /ollo- up care neededg. igns or symptoms of

complicationsh. "esources and support available

D. !epending on client


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a. Provide printed material (inclient

generic medical care plan

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