ENCOPRESIS IHP Student's Name * First Middle Last Suffix This field is required. Please complete the following fields: First,Last. PhotoAccepted file types: jpg, gif, png, jpeg, Max. file size: 100 MB.DoB Month Incorrect Value for Month field Day Incorrect Value for Month field Year Incorrect Value for Month field Please enter a valid date. GR/LevelDaycareEEPKKN010203040506070809101112Post-GraduateWould you like to add the student's ID number? Yes No ID Campus/Building Would you like to add the student's homeroom number and teacher's name? 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Yes No ContactContact Name Add RemoveRelationship Add RemoveContact Phone Number Add RemoveContact Phone Type Add RemoveContact Phone Number Add RemoveContact Phone Type Add RemoveContact Name RelationshipChoose one:ParentGuardianOtherContact Phone Number Contact Phone TypeChoose OneHomeMobileWorkFaxContact Phone Number Contact Phone TypeChoose OneHomeMobileWorkFax Add More Treating Physician Add RemovePhysician Phone Number Add RemovePhysician Fax Number Add RemoveTreating Physician Physician Phone Number Physician Fax Number Add More Preferred Hospital City MEDICAL DIAGNOSIS(ES)Add a medication or procedure? Yes No MEDICATIONS/PROCEDURES Medication/Procedure Strength Dose ModeChoose one:OralTopicalInhaledIntranasalSQNebulizerSublingualRectalIMIVSched/PRN?Choose OneScheduledPRNTime Frequency If PRN, administer for Medication/Procedure Add RemoveStrength Add RemoveDose Add RemoveMode Add RemoveSched/PRN? Add RemoveTime Add RemoveFrequency Add RemoveIf PRN, administer for Add Remove Add More MEDICAL HISTORYASSESSMENT NursingList InterventionList OutcomesList Nursing Diagnosis: Potential for recurring episodes of bowel incontinence and/or episodes of constipation or diarrhea Related to neuromuscular impairment Interventions The school nurse will identify type of bowel elimination program student requires - diapering or bowel cleansing program. The school nurse will obtain physician's orders and assist student with elimination needs. The school nurse will establish a plan for monitoring bowel patterns while at school and maintain a daily toileting diary. The school nurse will establish a daily toileting schedule. The school nurse will obtain permission for an unrestricted restroom pass. The school nurse will work with student's teachers to assign seating next to classroom exit. Expected Outcomes The student will establish a normal pattern of bowel functioning while at school, with no soiling incidents. The student will report to clinic or designated restroom for daily toileting. Nursing Diagnosis: Knowledge deficit Related to disease process and management of exacerbations Interventions The school nurse will provide health teaching about disease process. The school nurse will provide parent with a list of available community resources. The school nurse will educate about the importance of daily compliance to plan of care and established action plan The school nurse will provide written instructions for reinforcement and future reference. The school nurse will administer medication/treatments as ordered. Expected Outcomes The student and parent will voice and demonstrate exacerbation "triggers" and signs/symptoms of impending exacerbation. The student and parent will effectively manage disease process. Nursing Diagnosis: Potential for infection Related to lack of knowledge. Interventions The school nurse will teach/monitor self-cleansing program. The school nurse will observe for s/s of UTI such as frequent urination, pain, blood in urine, or foul order. The school nurse will recommend good hand-washing and perineal care. The school nurse will encourage adequate fluid and fiber intake Expected Outcomes The student will not experience bladder or kidney infections due to transfer of bacteria. Nursing Diagnosis: Potential for skin breakdown Related to imbalanced nutrition, recurring episodes of incontinence, and/or improper hygiene. Related to lack of knowledge. Interventions The school nurse will develop a standard clean-up procedure that student can perform independently. The school nurse will provide soap, towels, and cleansing wipes in a private, accessible place. The school nurse will remind parent to provide a change of clothes available at school. The school nurse will monitor skin for signs/symptoms of breakdown. Expected Outcomes The student will adequately clean perineal area after each soiling incident. The student and parent will be able to identify s/s of impending skin breakdown. Nursing Diagnosis: Potential for altered nutritional status Related to imbalanced nutrition and/or impaired intestinal absorption. Interventions The school nurse will provide counseling about nutritional guidelines and healthy food choices. The school nurse will discuss student's food preferences, food intolerances, and nutritional alternatives. The school nurse will educate on the importance of daily high-fiber foods and the importance of drinking an adequate amount of fluids during the school day. The school nurse will obtain permission for use of water bottle in the classroom. The school nurse will modify and/or supplement school lunches to provide adequate intake. Expected Outcomes The student will exhibit no signs/symptoms of impaired nutritional status. The student and caregiver will voice and demonstrate compliance to daily dietary requirements Nursing Diagnosis: Potential for low self-esteem Related to recurring episodes of incontinence and/or disturbed body image Interventions The school nurse will encourage student to identify their strengths. The school nurse will teach coping strategies. The school nurse will monitor student for signs of isolation, anxiety, or depression. The school nurse will allow student to express feelings related to school - frustration, isolation, social struggles, etc. The school nurse will identify student's strengths and reinforce examples of those strengths. The school nurse will provide support, encouragement, and comment of appropriate behaviors. The school nurse will obtain in-school counseling, if needed. Expected Outcomes The student will participate in daily social activities with appropriate peer groups. The student will feel comfortable with discussing issues related to disease process. Would you like to add another nursing diagnosis? Yes No Nursing DiagnosisNursing DiagnosisAdd your own nursing diagnosisInterventionsAdd your own nursing interventionsExpected OutcomesAdd your own expected outcomesNursing Diagnosis Add RemoveInterventions Add RemoveExpected Outcomes Add Remove Add More EVALUATIONNOTESIHP Developed ByName First Last Title Date Month Day Year Please enter a valid date. Do you want to include physician and parent signature lines? Yes Download IHP Clicking this button will download this IHP to your computer and return you to the blank IHP. Return Clicking this button will return you to the IHP to make changes.
