Self Care Deficit: Dressing and Grooming
(_)Actual (_) Potential
| (_)
Neuromuscular impaitment:___________________________ (_) Impaired visual actuity (_) Immobility (_) Weakness (_) Decreased level of consciousness (_) Other:___________________________________________ ___________________________________________________ ___________________________________________________ |
| Major:
(Must be present) |
(_)
Impaired ability to put on or take off clothing. (_) Unable to obtain or replace article of clothing. (_) Unable to fasten clothing. (_) Unable to groom self satisfactorily |
| Date & Sign. |
Plan and Outcome [Check those that apply] |
Target Date: |
Nursing Interventions [Check those that apply] |
Date Achieved: |
| The
patient will: (_) Demonstrate increased ability to dress/groom self. (_) Demonstrate ability to cope with the necessity of having someone else assist him/her in performing the task. (_) Demonstrate ability to learn how to use adaptive devices to facilitate optimal independence in the task of dressing/grooming. (_) Other: |
(_)
Allow sufficient time for dressing and undressing, since
the task may be tiring, painful, and difficult. (_) Promote independence in dressing through continual and unaided practice. (_) Choose clothing that is loose fitting, with wide sleeves and pant legs, and front fasteners. (_) Lay clothes out in the order in which they will be needed to dress. (_) Avoid placing clothing to blind side if patient has field cut, until patient is visually accommodated to surroundings; encourage patient to turn head to scan entire visual field. (_) Consult/refer to PT/OT for teaching application of prosthetics. (_) Provide dressing aids as necessary (dressing stick, swedish reacher, zipper pull, button-hook, long handled shoehorn, shoe fasteners adapted with elastic laces, velcro closures, flip back tongues). (_) Plan for person to learn and demonstrate one part of an activity before progressing further. (_) Make consistent dressing/grooming routine to provide a structured program to decrease confusion. (_)
Other:________________ |
__________________________
Patient/Significant other signature
__________________________
RN signature
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