Episiotomy Wound N 58n3f

ASSESSMENT

NURSING

INFERENCE

GOAL

INTERVENTIONS

RATIONALE  To avoid possible

Subjective:

DIAGNOSIS Impaired skin

Altered epidermis

After 30 mins. of

1) Emphasize

“May tahi ako”, as

integrity related to

due to episiotomy

nursing intervention,

principles of

verbalized by the

episiotomy wound

wound.

the patient will

hand washing

patient.

secondary to post

understand the

2) Keep the area

Objective:

NSD

importance of caring

clean and dry

 Presence of

the incision site and

secretions

be able to manage

3) Instruct

 Incision on

situation.

patient to

right mediolateral

infection  Moistures harbors microorganisms for infection

nursing intervention, understood the importance of caring the incision site and was able to managed situation.

 Long and rough

dry clothes

nails increases

4) Instruct

risk of further

patient to clip

impaired skin

nails regularly

integrity  To increase

5) Inform

After 30 mins. of the patient

 To decrease risk

maintain clean,

EVALUATION

compliance

patient the purpose of selfcare practices  To promote wound

6) Advise patient to eat foods high in protein such as lean meat, fish, etc

healing