Planning

Planning
The planning phase of the nursing process is when you will decide which care measures are appropriate for your patient. Each nursing diagnosis listed in your text will have a corresponding list of interventions and rationales. Planning care involves carefully reading though each listed intervention and asking yourself if that intervention can or should be carried out with your patient. For example, an intervention listed underImpaired Gas Exchange reads as follows: “If the patient is obese or has as cites, consider positioning in reverse Trendelenberg’s position at 45 degrees for short periods as tolerated” (Ackley & Ladwig, 2006, p.439).
Now, if your patient is not obese and does not have ascites, this intervention is not indicated and should not be included in your plan of care. To reiterate, include only those care measures which are relevant to your patient.
It is very important that you learn, early on, how to make yourinterventions specific to your patient. Trust me when Itell you that you will likely save
2yourself a lot of time, and possibly avoid having your care plan returned to you forrevisions, if you are conscientious about doing this. As an illustration, suppose you have a diagnosis of Acute Pain and one of the listed interventions is
“administer analgesics, as needed.” What you will need to do is look at your patient’s available medications for pain relief and write the intervention as follows: “administer Dilaudid, 2 mg,IV q 4 hours@0800 and 1200.” Notice that the medication, dose,route, and schedule is listed and that the times are specific to the shift when you will be caring forthe patient. Also, be cognizant of the use of pronouns in yourinterventions. Use he orshe where appropriate. This lets yourinstructor know that you are tailoring your care to your patient. You will see more examples of specificity as you look at the sample care plans in this manual. Each of the interventions you plan has a corresponding rationale; a scientific explanation for why that nursing care measure is appropriate. Beginning in your second semester you will be required to list a rationale for each of your interventions. Many students find this to be a tedious and somewhat superfluous step. I urge you to examine each rationale carefully, as it is an important component of yourlearning. As nurses, it is essential that we understand not only how we do things, but why we do things. Rationales reflect what research has proven to be best‐practice.