Ncp 3 Mam Dela Cruz

Assessment CUES Subjective:

“parang masusuka ako pagkatapos ko uminom ng gamut. Sumakit din ang tiyan ko ” as verbalized by the patient.

Objective: -aversion toward food -increased swallowing -sour taste in mouth -abdominal pain

NURSING DIAGNOSIS Problem: Nausea Etiology: Related to gastric irritation and unpleasant taste Signs and symptoms: -aversion toward food -increased swallowing -sour taste in mouth

RATIONALE

PLANNING

NURSING INTERVENTIONS

Nausea is the body's way of reacting to an infection or condition such as gastric

Long term: After 4 hours of nursing intervention the patient will be able To prevent frequent nausea.

INDEPENDENT

irritation and unpleasant taste.

It is accompanied by other severe symptoms such as abdominal pain, jaundice, fever, or bleeding.

Short term: After 30 minutes of nursing intervention the patient will be able to know how to manage nausea.

RATIONALE

1. Assess for presence of conditions of the gastro intestinal tract.

Dietary changes may be sufficient.

2. note systemic conditions that may result in nausea(cancer)

Help to determine appropriate interventions need for treatment of underlying condition.

3. Check vital signs and note signs of dehydration

Nausea may occur in the presence of Postural hypotension or fluid volume deficit

4.monitor response to medication used to treat underlying cause of nausea

Older client are more prone to side effect of antiemetic and anti anxiety or anti psychotic medications.

5. Have client dry foods such as toast, crackers before arising or throughout the day.

To prevent feeling of nausea

6. Encourage to eat small but frequent

So stomach does not feel excessively

EVALUATION

Long term: After 4 hours of nursing intervention the patient prevents frequent nausea. -fully met. Short term: After 30 minutes of nursing intervention the patient knows how to manage nausea. -fully met