Foundations of Nursing Practice: Mrs. Palmer's Care Plan, NUR1299

This document presents a detailed nursing care plan for Mrs. Denise Palmer, a 47-year-old patient admitted to USQ Hospital with multiple health concerns, including lower back pain, a skin tear, and a history of cardiovascular disease. The care plan, developed for a NUR1299 assignment, includes comprehensive assessments, identification of patient problems (e.g., decreased mobility, hygiene deficit, risk of pressure injury, disturbed sleep pattern, self-care deficit, ineffective coping), and planned interventions. These interventions encompass physical therapy, education on mobility and DVT prevention, hygiene assistance, wound care, sleep management strategies, dietary considerations, and support for her family situation. The plan also incorporates evaluations of the interventions' effectiveness and references to support clinical decision-making, demonstrating a strong understanding of the nursing process and patient-centered care. The plan addresses Mrs. Palmer's physical, psychological, and social needs to promote her recovery and well-being while in the hospital.

STUDENT NAME NUMBER 1
NURSING CARE PLAN
Name:
Institutional affiliation:

STUDENT NAME NUMBER 2
Assessment / Cues Problem Planning/ implementation Evaluation
Mrs Denise Palmer complains of
lower back pain
BMI of 30
Fall at home
Decreased mobility related to
lower back pain resulting from a
fall
The nurse collaborates with the
physiotherapist to provide
musculoskeletal exercise.
The nurse educates the patient to
educate their lower extremities to
prevent deep venous thrombosis.
The nurse educates and ensures
that Mrs Palmer can use anti-
embolic stockings appropriately
(Rae, 2016)
Ensure Mrs Palmer is turned
every two hourlies to relieve
pressure from the bony
prominences.
In collaboration with the
Mrs Denise Palmer lives a near
normal life while encouraging
independence and mobility.

STUDENT NAME NUMBER 3
Mrs Denise Palmer is under
instructions of strict bedrest
Lower back pain
Hygiene deficit related to
decreased mobility, lower back
pain and strict bedrest
nutritionist the nurse encourages
a high fibre diet which decreases
the risk of constipation while
encouraging easy bowel
movement.
The nurse should encourage Mrs
Palmer to use a pillow in between
her knees to ease the back pain
The nurse ensures the bed rails
are in place to prevent falls as
Mrs Palmer has poor vision
The nurse provides Mrs Palmer
with warm water for a bed bath.
The nurse provides Mrs Palmer
Mrs Denise Palmer maintains
high standards of hygiene while
encouraging her to perform
activities independently.

STUDENT NAME NUMBER 4
with warm water to brush her
teeth.
The bath water should have soap
and an absorbable bathing towel
The nurse conducts a general
head to toe assessment especially
observing the skin.
There should be
privacy/screening when Mrs
Palmer is having the bed bath.
She should feel comfortable.
The nurse encourages Mrs Palmer
to massage pressure areas and
apply massage oil.
The nurse ensures the linen is
changed to avoid wetness which

STUDENT NAME NUMBER 5
Braden risk of 9
Skin tear on lower legs (Break in
skin)
Risk of pressure injury related to
break in skin and BMI of 30.
may contribute to pressure sores.
The nurse performs 2 hourly
turning of the patient to relieve
the pressure of the bony
prominences (Jocelyn Thiara,
Lopez & Shorey, 2018).
Daily dressing of the wound by
aseptic technique according to the
physician’s instructions
Educate patient regarding their
obesity and the necessity to cut
down weight through various
means.
Head to toe assessment of the
Mrs Palmer maintains skin
integrity free of pressure ulcers
and wound heals without delay.

STUDENT NAME NUMBER 6
Difficulty in sleeping due to the
noise in the ward
Disturbed sleep pattern related to
environmental noise
evidenced by difficulty in
sleeping
bony prominences while
performing bed bath to assess risk
(Chamblee et.al 2018)
The nurse ensures the linen is
changed to prevent wetness
which may contribute to pressure
sores.
Educate patient on relaxation
technique which she can use to
sleep calmly (Rodriguez,
Dzierzewski & Alessi, (2015).
Ensure all the distractions are
removed for example switching
off lights and noisy areas such as
the nursing station and procedure
Mrs Denise Palmer should
demonstrate a normal sleeping
pattern of 8 hours.

STUDENT NAME NUMBER 7
Strict bed rest
Hyperlipidaemia
History of cardiovascular disease
in the family.
Hypertension
Self-care deficit regarding
nutrition and toileting due to bed
rest.
rooms
The nurse can liaise with the
senior nurse so she can be given a
room of her own
If possible, relaxing music can be
played at low volumes
The nurse should liaise with the
physician to advocate for use of
melatonin which can help her
sleep.
The nurse should discourage Mrs
Palmer from sleeping during the
day which may affect her sleep
routine.
The nurse collaborates with the
Mrs Palmer should have an
adequate nutritional balance and
able to eliminate properly.

STUDENT NAME NUMBER 8
nutritionist to plan Mrs Palmer
meals which include a low fat,
high fibre, high protein and low
salt diet (Tietge, 2018).
The nurse encourages and
educates Mrs Palmer regarding
their diet which is tailored
regarding to her conditions.
The nurse administers
antihypertensive as ordered by
the physician
The nurse encourages a high fibre
diet and high-water consumption
to decrease the risk of
constipation.
The nurse provides Mrs Palmer

STUDENT NAME NUMBER 9
Mrs Denise Palmer is a single
mum of five children
She has two children with special
needs.
Ineffective individual coping
related to situational crisis of
being hospitalized whilst she has
a family to take care of
with a bed pan when required for
her to meet her elimination needs.
The nurse auscultates for bowel
sounds to ensure there is active
bowel movement.
The nurse provides Mrs Palmer
with privacy when she is using a
bedpan
At night Mrs Palmer should use a
diaper which is changed as soon
as possible to avoid wetness.
Any wet linen from urine or
faecal soil should be changed.
The nurse should organize with
the counsellor and physician to
Mrs Palmer should demonstrate
proper coping skills regarding her
health condition whilst in
hospital.

STUDENT NAME NUMBER 10
hold a family conference whereby
Mrs Palmer will discuss her
health condition with her sister
and other members (Pranis,
2017).
The nurse encourages Mrs Palmer
to voice her needs and perceived
threats and she/he listens to her
Her sister is encouraged to visit
Mrs Palmer in hospital to provide
consolation and inform her about
the welfare of the children.
The spiritual welfare of Mrs
Palmer is encouraged by allowing
the fellow Catholic Church
members to visit her and console

STUDENT NAME NUMBER 11
with her (Sajja & Puchalski,
2017).
The nurse engages with the
occupational therapist who will
engage Mrs Palmer in activities
she enjoys distracting her.
The nurse educates Mrs Palmer
regarding her conditions and the
progression of the disease to
ensure she adheres to her
medication even after discharge.
The nurse should be empathetic
while communicating with Mrs
Palmer.
Encourage relaxation techniques
such as listening to music which

STUDENT NAME NUMBER 12
may help her calm down.
Engage the social workers who
will ensure they follow up on the
welfare of her children and her
medical bills.
Necessary consultation with the
counsellor who may be skilled in
handling situational and mental
crisis.
REFERENCES
Chamblee, T. B., Pasek, T. A., Caillouette, C. N., Stellar, J. J., Quigley, S. M., & Curley, M. A. (2018). CE: How to Predict Pediatric Pressure
Injury Risk with the Braden QD Scale. AJN The American Journal of Nursing, 118(11), 34-43.
Jocelyn Chew, H. S., Thiara, E., Lopez, V., & Shorey, S. (2018). Turning frequency in adult bedridden patients to prevent hospital‐acquired
pressure ulcer: A scoping review. International wound journal, 15(2), 225-236.

STUDENT NAME NUMBER 13
Pranis, K. (2017). Conferencing and the community. In Family Group Conferencing (pp. 40-48). Routledge.
Rae, L. M. H. S. M. (2016). How can the pressure in anti-embolism stockings be. Journal of Phlebology, 6(1), 9-14.
Rodriguez, J. C., Dzierzewski, J. M., & Alessi, C. A. (2015). Sleep problems in the elderly. The Medical clinics of North America, 99(2), 431.
Sajja, A., & Puchalski, C. (2017). Healing in modern medicine. Annals of palliative medicine, 6(3), 206-210.
Tietge, U. J. (2018). PURE and simple? A new perspective on the impact of diet on hyperlipidemia and cardiovascular risk. Current opinion in
lipidology, 29(3), 273-274.