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COMMUNITY HEALTH NURSING CARE PLANS, DIAGNOSIS AND INTERVENTION

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COMMUNITY HEALTH NURSING CARE PLANS, DIAGNOSIS AND INTERVENTION

  1. 1. COMMUNITY HEALTH NURSING CARE PLANS, DIAGNOSIS AND INTERVENTIONS By: ROMMEL LUIS C. ISRAEL III
  2. 2. ADPIE CARE PLAN FOR COMMUNITY HEALTH PROBLEMS References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health-nursing-diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie-nursing-process/. 2
  3. 3. ADPIE : THE 5 STAGES OF THE NURSING PROCESS References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health- nursing-diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie-nursing-process/. 3 ASSESSMENT DIAGNOSIS PLANNING IMPLEMENTATION EVALUATION
  4. 4. ASSESSMENT INCLUDES THE FOLLOWING: • Vital Signs taking • Head-to-Toe Assessment • Patient's Medical History • Subjective complaints and objective Physical observation from a patient References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health- nursing-diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie-nursing-process/. 4
  5. 5. ASSESSMENT References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health- nursing-diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie-nursing-process/. 5 1. DATA COLLECTION • Interview patients and/or family members having a keen observation of their behavior and conducting a physical examination • Concentrates on relevant data collection, evidence validation, and recording the noted abnormalities
  6. 6. ASSESSMENT References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health- nursing-diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie-nursing-process/. 6 2. OBJECTIVE VERSUS SUBJECTIVE DATA • Objective data are the pieces of information that you can see, hear, feel, smell, and measure. Includes body temperature, Blood Pressure, Heart Rate, tremors, pallor, diaphoresis, weight and height. We often refer to this data as "signs." • Subjective data are pieces of information that are immeasurable. They are spoken information such as emotion, level of pain, itchiness, tinnitus, and others which are often referred to as "symptoms."
  7. 7. DIAGNOSIS References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health- nursing-diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie-nursing-process/. 7 Nurses establish nursing diagnosis to aid the patient in their current or potential health problems Nurses can identify patient's response to disease and modify nursing care plans to meet the patient's needs. Nursing diagnosis also helps in facilitating better communication between medical team members. The comprehensive judgement of nurses, which are evidenced based, could determine the actual and potential health risks to their patients.
  8. 8. DIAGNOSIS References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health- nursing-diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie-nursing-process/. 8 1. NANDA • The taxonomy created by the North American Nursing Diagnosis Association (NANDA) is where the nursing diagnoses as based • Example for Pain, use impaired comfort or acute pain as the nursing diagnosis. • After the diagnosis is established, identified risk that may cause harm or complications to the patient must be placed in order. • Life-threatening risks shall be listed as top priority followed by other risks in descending order with the most minor as the lowest priority
  9. 9. DIAGNOSIS References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health- nursing-diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie-nursing-process/. 9 2. ABRAHAM MASLOW'S HEIRARCHY OF NEEDS • The bottom level needs to be met before an individual can move on to the next level of the pyramid. • Develop by Abraham Maslow, an American Psychologist
  10. 10. DIAGNOSIS 2. ABRAHAM MASLOW'S HEIRARCHY OF NEEDS • The bottom level needs to be met before an individual can move on to the next level of the pyramid. • First Level – Basic Physiological Needs • Second Level - Safety and Security Needs • Third Level - Love and Belongingness Needs • Fourth Level - Self-Esteem Needs • Fifth Level - Self-Actualization Needs References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health- nursing-diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie-nursing-process/. 10
  11. 11. DIAGNOSIS References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health- nursing-diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie-nursing-process/. 11 FIRST LEVEL: BASIC PHYSIOLOGICAL NEEDS • This is the level at the bottom part of the pyramid • Includes air, water, food, shelter, rest, clothing, reproduction, and elimination • These are the highest priority and the most basic human survival needs • The concept of ABC (Airway, Breathing, Circulation) in nursing belongs to the highest priority. It has the most vital role in the prioritization of care and nursing diagnosis.
  12. 12. DIAGNOSIS References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health- nursing-diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie-nursing-process/. 12 SECOND LEVEL: SAFETY AND SECURITY NEEDS • This pertains to protection from violence or theft, emotional stability and well-being, health and financial security • In the hospital setting, nurses provides instruction on using guard rails and call lights to prevent falls, the importance of hygiene, and frequent handwashing to prevent infection, to name a few. How about in the community setting? • Making a patient feel safe and secure before a surgical operation or when facing serious medical situation is also part of this level
  13. 13. DIAGNOSIS References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health- nursing-diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie-nursing-process/. 13 THIRD LEVEL: LOVE AND BELONGINGNESS NEEDS • This social needs involve human interaction. • Friendships and family relationship are among these needs. • The need of the individual to accept themselves and to also feel accepted by the family, friends, friends, and colleagues. • Nurses support this by actively listening to their patients and encouraging them in an activity that keeps them from avoiding social isolation.
  14. 14. DIAGNOSIS References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health- nursing-diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie-nursing-process/. 14 FOURTH LEVEL: SELF ESTEEM NEEDS • The primary concept is self-respect and self- confidence • The belief of being valuable and confident and being capable of personal growth and accomplishments. • Hospitalized patients who are dependent on others or sometimes feel not useful are difficult to attain this level. Hence, nurses should listen and encourage the patient to feel significant to the lives of their family, friends and their workplace. • For patients who may not be able to return to work, the nurse can gather information about personal achievements and focus on them. These patients can feel delighted and encouraged to feel good about themselves.
  15. 15. DIAGNOSIS References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health- nursing-diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie-nursing-process/. 15 FIFTH LEVEL: SELF-ACTUALIZATION NEEDS • This is the highest spot in the pyramid. • All the other levels must be met before they can be fulfilled. • Involves the fulfillment of full potential as a person. • There are cases where in this level cannot be reached at all. • Nurses should assist the patients to reach their other goals to reach their maximum potential in time.
  16. 16. DIAGNOSIS References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health- nursing-diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie-nursing-process/. 16 FIFTH LEVEL: SELF-ACTUALIZATION NEEDS • This is the highest spot in the pyramid. • All the other levels must be met before they can be fulfilled. • Involves the fulfillment of full potential as a person. • There are cases where in this level cannot be reached at all. • Nurses should assist the patients to reach their other goals to reach their maximum potential in time.
  17. 17. PLANNING References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health- nursing-diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie-nursing-process/. 17 Developing for a plan on how to achieve the desired goal /s for the patient. The goal should always be S.M.A.R.T.: SPEFICIC MEASURABLE ATTAINABLE REALISTIC/RELEVANT TIME-BOUND
  18. 18. PLANNING References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health- nursing-diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie-nursing-process/. 18 Example of S.M.A.R.T. Plans: A patient who has mobility problem should have a nursing care plan that can allow them to move from the bed to a chair at least 3x a day and sit there for a certain amount of time. A patient diagnosed by a nursing professional with a lack of adequate nutrition may have a plan that entails eating several small meals a day instead of 3 large meals.
  19. 19. PLANNING • Aside from creating SMART goals, a nursing care plan and intervention strategies must be developed and communicated to the patient and the rest of the medical team, as a part of the treatment. This will surely help in achieving the success of the goals. 19
  20. 20. IMPLEMENTATION References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health- nursing-diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie-nursing-process/. 20 It is commonly executed using a combination of direct care and indirect care. 1. DIRECT CARE • The provision of hands-on care to help the patient meet their goals. • Carrying out of nursing interventions such as wound care, administering medications or oxygen, applying a cardiac monitor, repositioning or assisting in a patient's ambulation. • Includes the patients working individually. The nurse provides feedback about the patient's development and discuss modification in the care plan for them to meet the desired goals.
  21. 21. IMPLEMENTATION References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health- nursing-diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie-nursing-process/. 21 It is commonly executed using a combination of direct care and indirect care. 1. INDIRECT CARE • Involves monitoring the other health care staffs to make sure that they are working harmoniously to carry out the goals of the nursing care plan. • It is anything that transpired in the patient care that is completed while the nurse is away from the patient.
  22. 22. IMPLEMENTATION 22
  23. 23. EVALUATION The Health Care Professional weighs the outcome of the nursing actions done in the implementtain stage . Did the plans work successfully? Did the plans are still in the process of being effective? Did the plans failed and therefore need to be changed? 23
  24. 24. EXAMPLE OF ADPIE: Patient with Osteomyelitis References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health-nursing- diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie-nursing-process/. 24
  25. 25. ASSESSMENT References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health- nursing-diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie-nursing-process/. 25 OBJECTIVE DATA: Fever (39.5C) and Flushed Skin Erythema, swelling, warmth on the left arm Compromised mobility of the affected site and limb and Range of Motion (ROM) Complete Blood Count showing elevated White Blood Cell (WBC) SUBJECTIVE DATA: 10/10 level of pain as verbalized by the patient
  26. 26. PLANNING (Expected Outcome) Tient will verbalize an acceptable pain level of 5or less on a 0 to 10 pain scale, as confirmed by normal signs, and relaxing effect, and body posture. The patient will sustain a normal body temperature measurement of less than 39C, dry skin and normal respiration rate. References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health-nursing- diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. 26
  27. 27. IMPLEMENTATION References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health- nursing-diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie-nursing-process/. 27 FOR ACUTE PAIN RELATED TO INFECTIOUS PROCESS AND SWELLING: Assess the patient's pain level being 10 as the highest and 0 as the lowest pain. Note the characteristics of pain. Monitor vital signs at least every 4 hours or as ordered by the physician Administer pain medication according to the physician's orders. Encourage bed rest to lessen the movement of the affected area and alleviate the pain.
  28. 28. IMPLEMENTATION FOR ACUTE PAIN RELATED TO INFECTIOUS PROCESS AND SWELLING: • Be considerate during wound care and use appropriate timing through administration and wound care during peaks of pain medication. • Elevate the involved area to reduce the swelling and ease the pain. • Provide hot and cold packs if not contraindicated by the attending physician. • Provide activities to help with distractions such as listening to music, reading books, or watching television. References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health-nursing-diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie-nursing-process/. 28
  29. 29. IMPLEMENTATION FOR HYPERTHERMIA RELATED TO INFLAMMATORY RESPONSE TO INFECTION: • Monitor the patient's temperature at appropriate times and as clinically specified. • Obtain temperature measurement from the same site and with the same tool for more accurate results. • Administer antipyretics as ordered to reduce fever for some time. • Remove warm clothing and adjust the room temperature which affects the patient's body temperature. • Offer sponge bath and provide temperature lowering measurements such as fan or cold clothe to the forehead. References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health-nursing- diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. 29
  30. 30. EVALUATION 1. T patient verbalizes an acceptable pain level of 5 at the end of the shift. 2. The patient maintains a normal body temperature as evidenced by consistent temperature measurement of 37.5C, a cool and dry skin. References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health-nursing- diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. 30
  31. 31. ADPIE CARE PLAN FOR COMMUNITY HEALTH PROBLEMS References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health-nursing- diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie-nursing-process/. 31
  32. 32. THE NURSING PROCESS IN THE COMMUNITY • The nursing process in the community involves health planning. • It is a continuous social process in which data in a certain area is collected and analyzed in order to establish a strategy for generating new ideas , meeting identified requirements, resolving health issues and guiding changes in the delivery of health care. • Community health nurses are required to design strategies and actions for the entire community health needs, not just for the health of a single person. • It involves the process of problem solving which is centered on a certain group of people. References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health- nursing-diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie-nursing-process/. 32
  33. 33. THE NURSING PROCESS IN THE COMMUNITY • Assessments in the community are made, needs and problems are prioritized. • Goals are set and methods for achieving them are developed. • When planning care for a group or a population, the term program planning is frequently used to refer to the process of planning care for a community. • CHNurses conduct health assessments that collect a broader range of data than nurses in other fields: information on both the individuals and families within the community. References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health- nursing-diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie-nursing-process/. 33
  34. 34. THE NURSING PROCESS IN THE COMMUNITY • CHNurses look at the data to see if it can be utilized to determine a population's health, resources or needs. • They also look into how a range of community factors affect the health of the people who live there. • Collaborating with the members of the community to to validate nursing diagnosis based on the assessment and enlisting community members' support and cooperation and accomplishing change are all essential tasks References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health- nursing-diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie-nursing-process/. 34
  35. 35. THE NURSING PROCESS IN THE COMMUNITY • The program may not be successful if the community is not involved from the start. • Incorporate the community in the assessment and planning phases. References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health- nursing-diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie-nursing-process/. 35
  36. 36. COMMUNITY HEALTH NURSING DIAGNOSIS References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community- health-nursing-diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie- nursing-process/. 36
  37. 37. COMMUNITY HEALTH NURSING CARE PLAN ALTERED HEALTH-SEEKING BAHAVIORS ASSESSMENT: The older adults are expanding rapidly in ABC community, a sub-urban community. According to the records, there is only one taxicab service in the area, which causes limited public transportation. References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health- nursing-diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie-nursing-process/. 37
  38. 38. COMMUNITY HEALTH NURSING CARE PLAN ALTERED HEALTH-SEEKING BAHAVIORS NURSING DIAGNOSIS: Altered health-seeking behaviors related to insufficient transport services for senior citizens. References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health- nursing-diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie-nursing-process/. 38
  39. 39. COMMUNITY HEALTH NURSING CARE PLAN ALTERED HEALTH-SEEKING BAHAVIORS DESIRED OUTCOME: The community, particularly the senior citizens, will improve their health-seeking behaviors through participation in organized health activities and programs. References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health- nursing-diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie-nursing-process/. 39
  40. 40. COMMUNITY HEALTH NURSING CARE PLAN References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health-nursing- diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie-nursing-process/. 40 COMMUNITY HEALTH NURSING INTERVENTIONS RATIONALE Conduct a comprehensive review of the health records in the community Establishing a baseline makes it easier to set realistic goals which are the basis for effective planning. Coordinate with the health care organizations and community leaders. Collaboration with relevant organizations is necessary to have the resources required to putc up health programs and activities.
  41. 41. COMMUNITY HEALTH NURSING CARE PLAN References: Community Health Nursing Diagnosis and Nursing Care Plan. (2022, February 20). NurseStudy.net. https://nursestudy.net/community-health-nursing- diagnosis/ and NurseStudy.net (2022). ADPIE Nursing Process. [online] NurseStudy.net. Available at: https://nursestudy.net/adpie-nursing-process/. 41 COMMUNITY HEALTH NURSING INTERVENTIONS RATIONALE Arrange Home Visits to selected Senior Citizens and identify the most significant health concerns that need to be addressed as soon as possible. Home visits can put an individual's mind at ease and make them feel important in society. It will be expected that they will want to participate in the health activities that will be launched. Identifying the most pressing health issues might assist the CHNurses in prioritizing health related problems and activities.

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