Tuesday, January 31, 2012

Management / Treatment of Rheumatoid Arthritis

Management / Treatment of Rheumatoid Arthritis
Management / Treatment of Rheumatoid Arthritis

Therefore, the exact cause of rheumatoid arthritis is unknown, there is no causative treatment that can cure this disease. This should really be explained to patients so that it knows that the treatment is given aimed at reducing complaints / symptoms slow the progression of disease.
The main objective of the program management / treatment of Rheumatoid Arthritis, as follows:
  • To relieve pain and inflammation
  • To maintain joint function and the maximum capability of the patient
  • To prevent and or correct deformity that occurs in the joints
  • Maintain independence so it does not depend on others.
There are a number of ways that management deliberately designed to achieve the objectives mentioned above, namely:

1. Education
The first step of this management program is to provide adequate education about the disease to the patient, family and anyone associated with the patient. Education will include understanding the pathophysiology (disease course), the cause and the estimated trip (prognosis) of this disease, all components of program management including complex drug regimens, sources of help to overcome this disease and effective method of management provided by health team . This education process should be carried out continuously.

2. Rest
Is important because of rheumatism, usually accompanied by severe fatigue. Although fatigue may arise every day, but there are times where patients feel better or heavier. Patients should be split into several times a day time activity time, followed by a period of rest.

3. Physical exercise and Thermoterapy
Specific exercises can be helpful in maintaining joint function. This exercise includes active and passive movements in all joints are sore, at least two times a day. Medication for pain relief should be given before starting the exercise. Hot compresses on the sore and swollen joints may reduce pain. Exercise and Thermoterapy is best regulated by the health workers who have received special training, such as a physical therapist or occupational therapist. Excessive exercise can damage the structure supporting the joints that are already weakened by the disease.

4. Diet / Nutrition
Rheumatic Patients do not require a special diet. There are a number of ways giving a diet with a variety of variations, but all of which has not been proven true. The general principle for obtaining a balanced diet is important.

5. Drugs
Drug delivery is an important part of the program management of rheumatic diseases. Drugs used to reduce pain, relieve inflammation and to try to change the course of the disease.

Pathophysiology of Hypertension

Pathophysiology of Hypertension Pathway
Pathophysiology of Hypertension

Mechanisms that control the constriction and relaxation of blood vessels located in the vasomotor center, the medulla in the brain. Of the vasomotor center, the sympathetic nerve pathway begins, which continues down the spinal cord and the spinal cord out of the column to the sympathetic ganglia in the thorax and abdomen. Central vasomotor stimulation delivered in the form of impulse which moves downward through the sympathetic nervous system to the sympathetic ganglia. At this point, preganglionic neurons, releasing acetylcholine, which will stimulate post-ganglion nerve fibers to blood vessels, where the release of norepinephrine resulting in constriction of blood vessels. Various factors such as anxiety and fear can affect the response to stimuli vasoconstriction of blood vessels.

Individuals with hypertension is very sensitive to norepinephrine, although it is not clear why this could occur.

At the same time in which the sympathetic nervous system stimulates the blood vessels in response to emotional stimuli, the adrenal glands are also stimulated, resulting in additional vasoconstriction activity. Adrenal medulla secretes epinephrine, which causes vasoconstriction. Adrenal cortex to secrete cortisol and other steroids, which can strengthen the vasoconstrictor response of blood vessels. Vasoconstriction resulting in decreased flow to the kidneys, causing the release of renin. Renin stimulates the formation of angiotensin I is then converted into angiotensin II, a powerful vasoconstrictor, which in turn stimulates the secretion of aldosterone by the adrenal cortex. This hormone causes retention of sodium and water by kidney tubules, causing increased intra-vascular volume. All these factors tend to trigger a state of hypertension.

For consideration of Gerontology. Structural and functional changes in the peripheral vascular system are responsible for changes in blood pressure that occurs in the elderly. These changes include atherosclerosis, loss of elasticity of the connective tissue and a decrease in vascular smooth muscle relaxation, which in turn lowers the ability of distention and tensile strength of blood vessels. Consequently, the aorta and large arteries decreases its ability to accommodate the volume of blood pumped by the heart, resulting in decreased cardiac cheating and increased peripheral resistance. Pathophysiology of Hypertension (Brunner & Suddarth, 2002).

Hypertension Nursing Care Plan : Assessment, Diagnosis and Interventions

Acute Pain Nursing Care Plan for Pyelonephritis

Acute Pain Nursing Care Plan for Pyelonephritis


Pyelonephritis or a kidney infection usually caused by Escherichia Coli, a bacteria type that is found in the large intestine. This infection makes its way from the genital area through the urethra to the bladder, up the ureters and then it reaches the kidneys. Being more common in women than in men.

Pyelonephritis known that if a person has any physical obstruction to the flow of urine, like a kidney stone, an enlarged prostate, or the backflow of urine from the bladder into the ureters, it is very likely the risk of pyelonephritis to rise.

Persons with pyelonephritis might experience painful urination, tightly contraction of the abdomen muscles, one or both kidneys may be enlarged and tender, and cystitis symptoms can appear also. Usually, pyelonephritis starts suddenly, with pain in the lower part of the back on either side, fever, chills, nausea and vomiting, but very often, in children these symptoms are slight and difficult to recognize.

Nursing Care Plan for Pyelonephritis

Nursing Diagnosis for Pyelonephritis : Acute Pain related to inflammation and infection of the urethra, bladder and other urinary tract structures.

Evaluation criteria: no pain when urinating, no pain on percussion of the pelvis.

Nursing Interventions and Rational for Pyelonephritis

Independent

1. Monitor urine output to changes in color, odor and voiding pattern, input and output every 8 hours and monitor the results of repeated urinalysis.
Rational: To identify indications of progress or deviations from expected results.

2. Record the location, duration, intensity scale (1-10) the spread of pain.
Rational: To help evaluate the obstroksi and cause pain.

3. Provide comfort measures, such as back massage, environment, rest, sleep.
Rational: Increase relaxation, reduce muscle tension.

4. Help or encourage the use of focused relaxation breathing.
Rational: Helps to redirect attention and for muscle relaxation.

5. Give perianal care.
Rational: To prevent contamination of the urethra.

6. If mounted catheter, catheter care provided 2 times per day.
Rational: The catheter provides a way for bacteria to enter the bladder and up into the urinary tract.

Collaboration

1. Consul doctor if: previous urine yellow, ivory, yellow urine, dark orange, hazy or cloudy. Micturition pattern changes, frequent urination in small amounts, feeling the urge to urinate. Persistent pain or increasing pain.
Rational: These findings could signal further tissue damage and needs extensive examination.

2. Give analgesics as needed and evaluate its success.
Rational: Analgesic block the path of pain, thereby reducing pain.

3. Giving antibiotics. Create a variety of drink preparations, including fresh water. Provision of water to 2400 ml / day.
Rational: As a result of urine output makes it easy to urinate often and help flush urinary tract. 

Monday, January 30, 2012

Ineffective Airway Clearance Nursing Care Plan for Tetanus

Tetanus is caused by gram positive, obligate anaerobic bacteria: Clostridium tetani which affects skeletal muscles."Gram positive" means that the bacteria has a thick cell wall, while "obligate anaerobe" means that the bacteria can't survive in the presence of oxygen and survive using anaerobic respiration (without oxygen).

Causes:
Bacterium Clostridium tetani.
Contamination of a puncture wound, e.g.: a piercing.
Ear infections as bacteria may enter through ear.
Using unsterile equipment in surgery or other similarly invasive procedures such as tattooing and body piercing.

Ineffective Airway Clearance related to the accumulation of sputum in the trachea and the respiratory muscles spame

Characterized by:
Ronchi,
Cyanosis,
Dyspneu,
Ineffective cough accompanied by sputum or phlegm, lab test results, Abnormal Blood Gas Analysis (respiratory acidosis)

Objective: Airway clearance is effective

Criteria:

- Clients are not congested, mucus, or none sleam
- Respiratory 16 -18 x / minute
- No breathing nostril
- No additional respiratory muscle
- The results of laboratory examination of blood: Blood Gas Analysis in the normal range (pH = 7.35 to 7.45; PCO2 = 35-45 mmHg, pO 2 = 80-100 mmHg)

Nursing Interventions Ineffective Airway Clearance Nursing Care Plan for Tetanus:

1. Clear the airway by adjusting the position of head extension
Rational: The anatomy of the head position of the extension is a way to align the respiratory cavity so that the process of respiration remains smooth to get rid of airway obstruction.

2. Physical examination by auscultation listening to breath sounds (there Ronchi) every 2-4 hours.
Rational: Ronchi indicate a problem caused by upper respiratory fluids or secretions that covered most of the respiratory tract that is necessary to issue, to optimize the airway.

3. Clean the mouth and airways of secretions and mucus by suction
Rational: Suction is an act of assistance to remove secretions, thus simplifying the process of respiration.

4. oxygenation
Rationale: The provision of oxygen in adequat can supply and provide backup oxygen, thus preventing the occurrence of hypoxia.

5. Observation of vital signs every 2 hours
Rational: Dyspneu, cyanosis is a sign of breathing disorder which is accompanied by decreased cardiac work and capilary tachycardia arising refill time prolonged / long.

6. Observation of the onset of respiratory failure.
Rational: The inability of the body in the process of respiration required critical interventions using tools breathing (mechanical ventilation)

7. Collaboration in drug delivery thinning secretions
Rational: Drug-thinning secretions could dilute the thick secretions that facilitate spending and prevent viscosity.

Wednesday, January 25, 2012

How to Make Easy Flat Stomach

Got a flat stomach not only unsightly but also good for health. At least there are 7 easy ways to create a flat stomach that can be done while relaxing at home. What? Stomach average indicates the metabolic and cardiovascular work systems (circulatory system) works well. In contrast, protruding belly fat accumulation often keep problems that lead to various diseases .
Here are 7 easy ways to flatten the stomach:

1. Drinking enough water when drinking enough water, you provide free food intake of calories. Another additional benefit is to provide a lubricant to facilitate the body's metabolism so as to accelerate the burning of fat and avoid the buildup in the abdomen.


2. Stay away from cocktails Cocktails is a kind of alcohol-free drinks and refreshing. But the cocktails are usually high in calories yan, may even lead to the emergence of the hormone cortisol, a stress hormone that helps the body to store fat.


3. Sit properly position crouching or bending will make the lump. Whereas when you sit with your spine straight, the muscles will be toned stomach.


4. Move your hips back to the activity when you were kids, which is playing hula hoop. Playing the hula hoop can burn fat at the waist and hips, so that helps make the stomach was flat.


5. Working in the garden planting activity, lifting pots and watering can help burn fat as much as 350 calories in one hour.


6. Walk in the park relaxing in the park Walking to the green not only makes your mind relax, but also can burn fat, including fat in the body.


7. Lift the foot on the bed Lie on the bed, lift your legs and stick on the wall. Slowly move back and shoulders away from the bed and towards the knee. After that, slowly lower your upper body into position. Repeat 10 to 20 times for 2 to 3 times a week.

Source : http://tipshealthdaily.blogspot.com/2011/08/human-brain-need-vacation.html

Monday, January 16, 2012

Auditory Hallucinations Definition Causes and Symptoms




Definition of Auditory hallucinations

Auditory hallucinations are false sensory perception of external stimuli that are not able to hear in the identification.

Auditory hallucinations are the hearing of individual sensory perception in the absence of real external stimuli.


Signs and symptoms of Auditory hallucinations

Patients the observed behavior is as follows

1. Eyes glanced to the left and right like to find who or what he was talking.

2. Listening attentively to others who are not speaking or to inanimate objects such as furniture, walls etc..

3. Involved conversations with inanimate objects or with someone who does not appear.

4. Move the mouth like he was speaking or being the voice replied.


Causes of Auditory hallucinations

Social isolation withdrawn

1. understanding

Pulling himself a nuisance by withdrawing and others are on the mark with self isolation (withdrawing) and self-care is lacking.

2. cause

a. development

Touch, attention, warmth of the family that resulted in solitary individual, the ability to relate to inadequate client ended by withdrawing.

b. Low self esteem

Signs and symptoms of Auditory Hallucinations

Signs symptoms of withdrawal can be viewed from various aspects, among others

a. physical aspects

1) Appearance self-less.

2) Sleep less.

3) Courage less.

b. aspects of emotion

1) Talk is not clear.

2) Feeling ashamed.

3) Easy to panic.

c. social aspects

1) Sit outs

2) There was daydreaming

3) No matter the environment

4) Avoidance of others

d. aspects of intellectual

1) Feeling hopeless

2) Lack of confidence

4 Steps To Treat Gastroenteritis


Sometimes we as humans fail to health of our bodies, so it can not shy away from unhygienic food of all kinds of seeds and disease germs. If we are not hygienic food then we could be attacked by digestive disease that one result is gastroenteritis or diarrhea. Besides gastroenteritis can be caused by chemicals in food poisoning, colds, dehydration (lack of body fluids) and others.

Gastroenteritis is a condition in which a person defecate many times in one day which exceeds the normal limits and the stool or feces that comes out of a thin or thick with wind / fart from the stomach.

Here below are the 4 Steps To Treat Gastroenteritis:

1. Drink Plenty of Water White
Frequently drinking lots of water because of the frequent bowel movements the body will lose a lot of fluid that should always be replaced with new fluid. Each after defecation drink one or two glasses of water or mineral water is clean and has been cooked. Drink oral rehydration salt sugar solution which is to assist the formation of energy and withstand gastroenteritis / diarrhea after bowel movement out. Avoid drinking coffee, tea, etc. are able to stimulate gastric acid.

2. Eating Special Foods
Avoid eating fibrous foods such as gelatin, vegetable and fruit because fibrous foods will only prolong the gastroenteritis. Fibrous food is only good for people with a bowel obstruction. For patients with gastroenteritis should eat foods low in fiber and smooth like rice or rice porridge with toppings salted eggs. Here the rice will become sugar to provide energy, while the salted egg will provide protein and salts for diarrhea and as an agent holding a body builder. Avoid eating out at random and spicy foods containing chillies and pepper.

3. Enough Rest
It is inevitable that people who waste water will taste weak, weak, lethargic, less passionate, and so on. For that for those of you who already feel very weak should ask the permission of the school or office to avoid the possibility of the worst or embarrassing in public places.
Sleep as much as possible but do not forget the time eating food and drugs should be regularly, drinking lots, worship and pray and others.

4. Drinking Drugs With the Right Dose
There is a good idea to consult with your doctor and ask for the right medicine for you, because everyone has the characteristics of each in drug selection. Hospitals, physician practices, health centers or clinics other appropriate department of health license is the right choice because it has a good doctor with good medicine too. If you doubt just go to another doctor to get more information.
After getting the medicine medicinal drink according to the dose specified time. Usually the doctor will prescribe mules, diarrhea medications, vitamins and antibiotics. For drug mules and diarrhea should be taken if the stomach pains and gastro enteritis alone and stop if it stops mules and gastroenteritis. As for the antibiotics must be spent so that germs and other germs and do not form a death total resistance. For the vitamin up to you want to spend or not, but it would not hurt if spent because the vitamin is good for you as long as not excessive.

Thursday, January 12, 2012

Imbalanced Nutrition Less Than Body Requirements Nanda Nursing Diagnosis for Hyperemesis Gravidarum

Imbalanced Nutrition Less Than Body Requirements Nanda Nursing Diagnosis for Hyperemesis Gravidarum

Imbalanced Nutrition Less Than Body Requirements Definition: Intake of nutrients insufficient to meet metabolic needs.

Hyperemesis Gravidarum

Hyperemesis Gravidarum (HG) is a very severe form of morning sickness. It is described as extreme vomiting, dehydration, nutritional deficiencies, and electrolyte imbalances combined with a first trimester weight loss of aproximately 10% of normal body weight.

Morning sickness is a normal part of early pregnancy and it can also continue through out the pregnancy in some cases. But extreme pregnancy nausea can cause distressing effects for the mother and can also be harmful for your baby.

There are numerous theories regarding the etiology of HG, however, none are conclusive as of yet. The most commonly held belief is that the increase in HCG and estrogen hormones in early pregnancy is the cause.


Hyperemesis Gravidarum


Nursing Intervention - Imbalanced Nutrition Less Than Body Requirements - Hyperemesis Gravidarum


1. Restrict oral intake until the vomiting stops.
Rationale: Maintaining electrolyte balance fluid and prevent further vomiting.

2. Give the anti-emetic drugs are prescribed with a low dose.
Rationale: To prevent vomiting and to maintain fluid and electrolyte balance

3. Maintain fluid therapy can be saved.
Rational: Correction of hypovolemia and electrolyte balance.

4. Record intake and output.
Rationale: Determining hydration fluid through vomiting and spending.

5. Encourage to eat small meals but often
Rational: Can adequate intake of nutrients body needs.

6. Advise to avoid fatty foods
Rational: can stimulate nausea and vomiting

7. Recommended to eat a snack such as biscuits
Rational: snack can reduce or prevent nausea, vomiting, excessive excitatory

8. Record intake, if oral intake can not be given within a certain period.
Rational: To maintain a balance of nutrients.

9. Inspection of irritation on the mouth.
Rationale: To determine the integrity of the oral mucosa.

10. Assess oral hygiene and personal hygiene and the use of cleaning fluids mouth as often as possible.
Rational: To maintain the integrity of the oral mucosa

11. Monitor hemoglobin and hematocrit levels.
Rationale: Identify presence of anemia and potential decline in the capacity of oxygen carrier mothers. Clients with Hb levels <12 mg / dl or low hematocrit levels considered anemic in the first trimester.

12. Test urine of acetone, albumin and glucose
Rationale: Establish baseline data; done routinely to detect potential high-risk situations such as inadequate intake of carbohydrate, ketoacidosis diabetic and hypertension due to pregnancy.

13. Measure the enlargement of the uterus
Rational: maternal malnutrition affects fetal growth and aggravate the decline of complement in fetal brain cells, resulting in deterioration of fetal development and the possibilities further.

Physical, Mental, Psychosocial and Spiritual Changes In Elderly

Physical Changes in Elderly




Physical Changes in Elderly


(1) Cells: fewer but larger size, reduced intra and extra cellular fluid.

(2) Nervous System: rapid decrease neural connections, slow in response time to react, diminishing the nervous system senses of hearing, presbiacusis, tympanic membrane atrophy, due to the increased occurrence of serum collection ceratin.

(3) Vision System: sclerosis arising pupillary sphincter and loss of response to the synapse, the cornea is more shaped speris, cloudy lens, increasing the threshold of observation of light, loss of accommodation, decreased visual field.

(4) Cardiovascular System. : Heart valves thicken and become stiff, the heart's ability to pump blood decreases 1% every year after age 20 years, causing contraction and decline in volume, loss of elasticity of blood vessels, blood pressure rises.

(5) Respiration System : respiratory muscles become stiff so that causes decreased activity of cilia. Lungs lose their elasticity so that the residual capacity increases, breath heavy. Depth of breathing decreased.

(6) Gastrointestinal System: loss of teeth, causing malnutrition, decreased sense of taste because of the mucous membrane and atrophy of the senses of taste up to 80%, then the loss of nerve sensitivity of taste for sweet and salty taste.

(7) Genitourinary System: kidney nephron shrink and become atrophic so that blood flow to the kidneys decreased to 50%, GFR decreased to 50%. Renal threshold for glucose is enhanced. Urinary vesicles, the muscles become weaker, its capacity is decreased to 200 cc so difficult urinary-derived vesicles in elderly men would result in retensia urine. Enlarged prostate, 75% experienced by men over 55 years. In the vulva occurs vaginal atrophy are going dry mucous membranes, decreased tissue elasticity, and reduced secretion becomes alkaline.

(8) Endocrine System: endocrine system on almost all hormone production decreases, whereas the parathyroid function and secretion did not change, decreased thyroid activity resulting in lower basal metabolic rate (BMR). Porduksi decreased sex cells such as progesterone, estrogen and testosterone.

(9) Integumentary System: skin becomes wrinkled due to loss of fat tissue, scalp and thinning hair becomes gray, whereas in the ear and nose hair thickened. Become hard and brittle nails.

(10) Musculoskeletal System: bones lose density and become more fragile kiposis, height is reduced vertebral discusine called thinning, the tendon fibers shrink and atrophy - muscle fibers, so that the elderly be slow moving. muscle cramps and tremors.

Mental Changes in Elderly

Factors that affect the mental changes are:
  • First of all the physical changes, particularly the organs of taste
  • Health
  • The level of education
  • Heredity
  • Environment

Psychosocial Changes



Psychosocial Changes In Elderly


 Retirement: a value measured by productivity, identits associated with a role in job
 Sensing or aware of the death
 The change in the way of life, ie moving into a nursing home is more narrow.
• Impaired self-concept due to loss of losing office.
• The series of losses, namely loss of relationships with friends and family.
• Loss of physical strength and sturdiness, changes to the self-image, self-concept changes.

Spiritual Change

Religion or belief increasingly integrated in the life (Maslow, 1970) Elderly more mature in their religious life, this is seen in thinking and acting in everyday (Murray and Zentner, 1970)

Theory of Aging Process

Theory of Aging Process


  1. Biological Theories

    (1) Genetic Theory And Mutation (Somatic Mutatie Theory)
    According to this theory, aging is genetically programmed for certain species. Aging occurs as a result of biochemical changes that are programmed by the molecules / DNA and every cell in time will be the mutation. As a typical example is a mutation of sex cells (a decrease in functional ability of cells).

    (2) Use and Damage
    Excess effort and stress causes the body's cells are tired (damaged).

    (3) Reaction of Immune Self (Auto Immune Theory)
    In the process of metabolism, one time produced a special substance. There are certain tissues that are not resistant to these substances so that the tissues of the body becomes weak and ill.

    (4) The theory of "Imunology Slow Virus Theory"
    Imune system to be effective with increasing age and entry of virus into the body can cause organ damage.

    (5) Theory of Stress
    Aging occurs due to loss of cells commonly used by the body. Tissue regeneration can not maintain a stable internal environment, the extra effort and stress causes the body cells tired unused.

    (6) Free Radical Theory
    Free radicals can be formed in the wild, unstable free radicals (groups of atoms) of oxygen resulting in oxidation of organic materials such as carbohydrates and proteins. These free radicals can cause the cells can not regenerate.

    (7) Cross Chain Theory
    The cells are old or obsolete, the chemical reaction causes a strong bond, particularly the collagen network. This causes a lack of elastic bonding, chaos and loss of function.

    (8) Theory Courses
    Organism's ability to set the number of cells that divide after the cells die.
  2. Theory of Social Psycho

    (1) Activity Theory
    • The provision will increase to a decrease in the number of activities directly. This theory states that the elderly are successful are those who are active and participate in many social activities.
    • The optimum size (lifestyle) continued in the way of life of elderly.
    • Maintaining the relationship between social systems and individuals to remain stable from middle age to elderly.

    (2) Personality Continues (Continuity Theory) Basic personality or behavior does not change in elderly patients. This theory is a combination of the above theory. In this theory states that the changes that occur in the elderly person is strongly influenced by the type of personality they have.

    (3) Disengagement Theory

    This theory states that with increasing age, a person gradually began to break away from social life. This situation resulted in decreased elderly social interaction, both in quality and quantity so often lose terjaadi double (triple loss), namely:
    • Losing Role
    • Barriers of Social Contacts
    • Reduction Commitment Contacts
  3. Theory of Psychology

    (1) Theory Development Task

    Havigurst (1972) stated that the developmental tasks in old age include:
    • Adjusting to decline in physical strength and health
    • Adjusting to retirement and reduced income
    • Adjusting to the death of a spouse
    • Establish a relationship with people own age
    • Establish a satisfactory physical living arrangements
    • Adjusting to the social roles flexibly

    In addition to the above developments tasks, there are specific developmental tasks that may arise as a result of demands:
    • Physical Maturity
    • Expectations and cultural community
    • The individual's personal values ​​and aspirations
    According to this theory, every individual has a hierarchy of the self, the needs that motivate all human behavior (Maslow 1954).

Nursing Assessment for Dizziness Vertigo

Dizziness is classified into three categories-vertigo, syncope, and nonsyncope nonvertigo. Each category has a characteristic set of symptoms, all related to the sense of balance. In general, syncope is defined by a brief loss of consciousness (fainting) or by dimmed vision and feeling uncoordinated, confused, and lightheaded. Many people experience a sensation like syncope when they stand up too fast. Vertigo is the feeling that either the individual or the surroundings are spinning. This sensation is like being on a spinning amusement park ride. Individuals with nonsyncope nonvertigo dizziness feel as though they cannot keep their balance. This feeling may become worse with movement.

Nursing Assessment Nursing Care Plan for Dizziness Vertigo

1. Activity / Rest
  • Fatigue, weakness, malaise
  • limitation of motion
  • Eye strain, difficulty reading
  • Insomnia, waking in the morning, accompanied by headache.
  • Severe headaches when changes in posture, activity (work) or because the weather changes.

2. Circulation
  • History of hypertension
  • Vascular pulsations, eg temporal region.
  • Pale, flushed face.

3. Ego Integrity
  • Emotional stress factors / specific environment
  • Changes in disability, despair, hopelessness depression
  • Worries, anxiety, receptors for headaches.

4. Food and Fluid
  • Nausea / vomiting, anorexia (for pain)
  • Weight loss

5. Neuro-Sensory
  • Dizziness, disorientation (for headache)
  • History of seizures, head injury had just happened, trauma, stroke.
  • Aura; facial, olfactory, tinnitus.
  • Visual changes, sensitive to light / sound harsh, epistaxis.
  • Parastesia, progressive weakness / paralysis one side tempore
  • Changes in the patterns of speech / thought patterns
  • Easily aroused, sensitive to the stimulus.
  • Decreased deep tendon reflexes
  • Papilledema.

6. Pain / Comfort
  • Characteristics of pain depends on the type of headache, eg migraine, muscle tension, cluster, brain tumors, post-traumatic, sinusitis.
  • Pain, redness, pale in the face.
  • The focus narrows
  • Focus on own
  • Emotional responses / behaviors like crying undirected, anxiety.
  • The muscles also tighten the neck area, frigidity vocals.

7. Security
  • History of allergy or allergic reactions
  • Fever (headache)
  • Gait disturbance, parastesia, paralysis
  • Purulent nasal drainage (sinus headache disorders).

8. Social Interaction
  • Changes in responsibility / role of social interaction associated with the disease.

9. Guidance / learning
  • History of hypertension, migraine, stroke, illness in family
  • Use of alcohol / other drugs, including caffeine. Oral contraceptives / hormone, menopause.

Nanda Nursing Diagnosis for Dizziness Vertigo

Nanda Nursing Diagnosis for Dizziness Vertigo

Dizziness Vertigo

Dizziness is the Third Most Frequent Reason People Seek Medical Attention

Dizziness is one thing, vertigo is another. Both involve potential feelings of unsteadiness and possible faintness, but vertigo will often also include disorientation. Both conditions can persist to be point of becoming disabling.

There are many reasons for causing dizziness. Infection in viral system is the main cause of dizziness which affects the air flow to the head or the ear. The low blood pressure can also cause dizziness due to reduction of blood supply to the brain. Mental anxiety and panic attacks, can lead to dizzy condition. Sudden low blood sugar is another possible cause, and is easily treated by taking some sugary foods.

The dizziness can be recognized with the following symptoms
  • Being fainted at the sight of blood or with emotional upset 
  • Fainting in standing up too quickly or standing still too long 
  • Weakness during a illness 
  • Seasickness or motion sickness 
  • Queasiness, nausea, or vomiting 
  • Confusion in thinking 
  • Fatigue feelings, tiredness or daytime sleepiness 
  • Clumsy movement
Vertigo is usually due to an imperfection of the equilibratory apparatus of the semicircular canals of the ear. There may also be associated problems with the vestibule, 8th nerve, the semicircular canals, the eyes, or in the brainstem. Any of these structures can be affected by a variety of diseases and disorders, such as: otitis media, labyrinthitis, osteosclerosis, an obstruction of the Eustachian tube, or external auditory canal. Avery important element that may result in vertigo, is a disease called " Meniere's syndrome.


Nanda Nursing Diagnosis for Dizziness Vertigo

1. Pain (acute / chronic)

related to: stress and tension, irritation / nerve pressure, increased intracranial
characterized by : pain states that are influenced by such factors, changes in position, changes in sleep patterns, anxiety.

2. Ineffective individual coping

related to: inadequate relaxation, coping methods are not adequate, excess workload.

3. Deficient knowledge : (needs to learn) about the condition and treatment needs

related to : cognitive limitations, are not familiar information and less to remember.
characterized by the request information, Inadequate follow the instructions.

Nursing Assessment Nursing Care Plan for Dizziness Vertigo

Wednesday, January 11, 2012

Self-Care Deficit Nursing Care Plan for Stroke

Self-Care Deficit Nursing Nanda Diagnosis Definition:

Impaired ability to perform or complete activities of daily living, Such as feeding, dressing, bathing, toileting.

The nurse may encounter the patient with a self-care deficit in the hospital or in the community.

Stroke Definition :

That stroke is a disease affects the blood vessels That blood supply to the brain. Without blood to supply oxygen and Nutrients and to remove waste products, brain cells begin to die Quickly. Stroke is Sometimes Called a "brain attack. Stroke is a medical emergency and can cause permanent neurological damage or even death if not promptly diagnosed and treated.

The cause of stroke is an interruption in the blood supply, with a resulting depletion of oxygen and glucose in the affected area. This reduces or abolishes IMMEDIATELY neuronal function, and also initiates the ischemic cascade the which Causes neurons to die or Be Seriously Damaged, Further impairing brain function.

Nanda Nursing Diagnosis Self-Care Deficit

related to weakness, neuromuscular disorders, decreased muscle strength, decreased muscle coordination, depression, pain, damage to the perception

Goal: The ability to care for self-rising

Expected outcomes:

a. Demonstrating changes in lifestyle to meet the needs of daily living

b. Perform self-care according to ability

c. Identify and utilize sources of aid


Nursing Interventions Self-Care Deficit Nursing Care Plan for Stroke

1. Monitor the client's skill level in caring for themselves

2. Provide assistance to the needs that really need it

3. Create an environment that allows clients to perform ADLs independently

4. Involve the family in helping clients

5. Client's motivation to perform ADLs according to ability

6. Provide aids themselves when possible

7. Collaboration: plug the DC if necessary, consultation with a occupational or physiotherapy.

Ineffective Airway Clearance Stroke Nursing Care Plan

Ineffective Airway Clearance Definition:

Inability to clear secretions or obstructions from the respiratory tract to maintain airway patency.

Stroke

Stroke is also Referred to as a brain attack, and it Occurs Pls a blood vessel leading to the brain ruptures or gets blocked due to plaque deposits. When plaque accumulates on the wall of arteries, it is known as arthrosclerosis.

Nanda Nursing Diagnosis Ineffective Airway Clearance

related to the buildup of sputum (due to weakness, loss of cough reflex)

Goal: Patient is able to maintain a patent airway.

Expected outcomes:

a. Vesicular breath sounds

b. Normal respiratory rate

c. No signs of cyanosis and pallor

d. There is no sputum

Nursing Interventions :

1. Auscultation of breath sounds

2. Measure vital signs

3. Give the semi-Fowler position in accordance with the requirements (not conflict with other nursing problems)

4. Perform the exploitation lenders and pairs of OPA if decreased consciousness

5. When it is possible to do chest physiotherapy and breathing exercises in

6. Collaboration:
  • Provision of oxygenation
  • Laboratory: blood gas analysis, complete blood etc.
  • Giving medication as needed

Basic Steps to Prevent Cancer

One third of all cancer cases in the United States, China and the United Kingdom each year could be prevented if only people would do the basic steps for cancer prevention.

Prevention of cancer should not be anything complicated, some simple decisions in your daily life effectively enough to fend off the attack of cancer. But the point is to keep us stay on course a healthy lifestyle.
The American Institute for Cancer Research and the World Cancer Research Fund stated that cancer deaths could be prevented if we keep the weight remains the ideal, healthy and varied diet, physical activity and quitting smoking.

World Health Organization (WHO) declared lack of exercise are risk factors for breast cancer and colon cancer, 27 percent of causing diabetes and 30 percent of the causes of heart disease worldwide. WHO also recommends exercising at least 150 minutes per week, equivalent to walking or cycling for 30 minutes every day.

"There is no magic bullet to prevent cancer but we've got the opportunity and obligation to protect themselves from cancer as much as possible," said Peter Baldini from the World Lung Foundation.

source : http://health.kompas.com

Monday, January 9, 2012

Acute Pain Nursing Care Plan for Hepatitis

Hepatitis is characterized by the destruction of a number of liver cells and the presence of inflammatory cells in the liver tissue caused by excessive alcohol drinking, disorders of the gall bladder or pancreas, including medication side effects, and infections.

A person can develop hepatitis if they contract one of the viruses that can cause liver inflammation, or as a result of exposure to substances that can cause hepatitis. There are two ways that can lead to hepatitis: it can either occur as a result of infections or from autoimmune processes.

Hepatitis can be divided into two subgroups:

1. Acute Hepatitis
Acute hepatitis caused by the below in result of inflammation that causes damaging to the liver's normal function and lasting less than six months. People having a weakened immune system and weaken liver, making them more susceptible to be infected by hepatitis.
a) Infectious viral hepatitis such as hepatitis A, B, C, D, E.
b) Inflammation of liver caused by Epstein-Barr virus and cytomegalovirus.
c) Inflammation of liver caused by other bacteria.
d) Medication overdose causing damage to liver tissues and cells such as tranquilizers, chemotherapeutic agents, antibiotics and anesthetics.
e) Excessive alcohol drinking.

2. Chronic Hepatitis:
Chronic hepatitis means active, ongoing inflammation of the liver persisting for more than six months. Chronic hepatitis, although much less common than acute hepatitis, can persist for years, even decades. In most people, it is quite mild and does not cause significant liver damage. It may be caused by hepatitis B and C viruses, drugs and excessive alcohol drinking. It can also result in cirrhosis, with an enlarged spleen and fluid accumulation in the abdominal cavity. In some people, continued inflammation slowly damages the liver, eventually resulting in severe scarring of the liver, liver failure and sometimes liver cancer.

In addition to common and everyday body aches that many people experience, Hepatitis patients also suffer from the virus's discomforting symptoms, such as headaches, liver pain and joint pain.

Prior to attempting pain management, it is imperative that you discuss your symptoms and available options with your doctor. A knowledgeable physician will be able to give sound advice in regard to which analgesic may be best for you. The manufacturer, as well as a doctor, can provide appropriate dosing recommendations.

Rather then self-treating pain with over-the-counter medications and possibly harming an already overexerted liver, many Hepatitis patients instead turn to non-medication options. Massage therapy, heat packs, topical pain relievers, and gentle stretching are some safe alternatives for pain management. Getting enough sleep is yet another safe way to aid in pain reduction.

Nursing Diagnosis Nursing Care Plan for Hepatitis

Acute Pain related to swelling of the inflamed liver and portal vein dam

Expected results:

Show signs of physical pain and behavior in pain (not to wince in pain, crying intensity and location)

Nursing Interventions Nursing Care Plan for Hepatitis

a. Collaboration with individuals to determine the method can be used to reduce the intensity of pain

R / pain associated with hepatitis very uncomfortable, because stretching the capsule of the liver, through the approach to individuals who experience pain comfort changes are expected to more effectively reduce the pain.

b. Indicate the client's acceptance of the client's response to pain
  • Acknowledge the pain
  • Listen attentively client's expression of pain

R / clients who have tried to convince health providers that he was experiencing pain

c. Provide accurate information
  • Explain the causes of pain
  • Indicate how long the pain will end, if known

R / clients are prepared to experience the pain through the explanation of the real pain will tend to be more peaceful than clients who receive an explanation less / not an explanation.

d. Discuss with your doctor the use of analgesics that do not contain hepatotoxic effects

R / likelihood of pain already can not be limited to techniques for reducing pain.

Sunday, January 8, 2012

Pathophysiology of CHF - Congestive Heart Failure

Congestive heart failure is a condition in which the heart becomes an inefficient or weak pump.

This heart condition is a long-term and chronic condition, which typically involves both sides of the heart. However, the condition may affect only the right side of the heart (right-sided heart failure) or the left side (left-sided heart failure). The condition occurs when your heart muscles are weak and cannot pump the blood out of the heart effectively (systolic heart failure) or when your heart muscles are stiff and do not fill up with blood easily (diastolic heart failure).

Pathophysiology of CHF - Congestive Heart Failure

Heart failure is often separated into two classifications: right sided or left-sided failure. In right-sided failure, the right ventricle is unable to pump blood into the pulmonary artery, resulting in less blood being oxygenated by the lungs and increased pressure in the right atrium and systemic venous circulation. Systemic venous hypertension causes edema on the extremities. In left-sided failure, the left ventricle is unstable to pump blood into the systemic circulation, resulting in increased pressure in the left atrium and pulmonary veins. The lungs become congested with blood, causing relevated pulmonary pressures and pulmonary edema.
Although, each type produces different systemic/pulmonary artery alterations, clinically it is unusual to observe solely right-or left-sided failure. Since both sides of the heart are dependent on adequate function of the other side, failure of one chamber causes a reciprocal change in the opposite chamber. For example, in left-sided failure increase in pulmonary vascular congestion will cause increased pressure in the right ventricle, resulting in right ventricular hypertrophy, decreased myocardial efficiency, and eventually pooling of blood in the systemic venous circulation.

Physical Examination for Congestive Heart Failure (CHF)

Congestive heart failureor Heart failure is inability of the heart to pump an adequate amount of blood to the systemic circulation to meet the body's metabolic demands.

In most cases, heart failure is a process that occurs over time, when an underlying condition damages the heart or makes it work too hard, weakening the organ. Heart failure is characterized by shortness of breath (dyspnea) and abnormal fluid retention, which usually results in swelling (edema) in the feet and legs.

Common symptoms of congestive heart failure include:
  • Shortness of breath with exertion or when lying down
  • Cough
  • Swelling in legs, feet and ankles (pooling of blood)
  • Swelling of the abdomen
  • Weight gain
  • Loss of appetite, indigestion
  • Irregular or rapid pulse
  • Low blood pressure
  • Weakness and fatigue
  • Heart palpitations (feeling the heart beat)
  • Difficulty sleeping
  • Other symptoms may include:
  • Decreased in alertness or ability to concentrate
  • Decreased urine production
  • Nighttime urination (the need to get out of bed to go to the bathroom)
  • Nausea and vomiting
Physical Examination for Congestive Heart Failure (CHF)

GENERAL SITUATION
Obtained good or composmentis awareness and change according to the level of perfusion disorders involving the central nervous system

Breathing
  • Visible shortness
  • Frequency of breathing exceeds the normal
Bleeding
  • Inspection: the scar, complaints of physical weakness, edema of the extremities.
  • Palpation: weak peripheral pulses, thrill
  • Percussion: Shifting boundaries of heart
  • Auscultation: decreased blood pressure, extra heart sounds
BRAIN
  • Awareness is usually composmentis
  • Peripheral cyanosis
  • The face grimacing, crying, moaning, stretched and stretched.
Bladder
  • Oliguria
  • Extremity edema
Bowel
  • Nausea
  • Vomiting
  • Decrease in appetite
  • Weight loss
BONE
  • Weaknesses
  • Fatigue
  • Unable to sleep
  • Sedentary lifestyle
  • Schedule regular exercise could not
PSYCHOSOCIAL
  • The integrity of the ego: denial, fear of dying, anger, worry.
  • Social interaction: stress due to family, work, difficulties of economic cost, difficulty coping.

    Ineffective Airway Clearance Nursing Care Plan for Epistaxis

    Epistaxis is defined as acute bleeding from the nostril, nasal cavity or nasopharynx. Anterior nosebleeds occur when the source of bleeding originates from Kiesselbach's plexus (Little's area) which is present in the anterior part of the nasal canal. Anterior epistaxis usually occurs in children and young adults.

    However, posterior nosebleeds originates from the sphenopalatine artery which is present in the posterior part of the nasal canal. Posterior epistaxis usually presents in old individuals.

    First-Aid at Home for Epistaxis

    • Remember to stay calm. Most nose bleeds are benign and will stop with simple measures.
    • Sit upright and lean your head forward. Tilting your head backward will cause you to swallow the blood.
    • Pinch your nose for about 10 minutes. This simple application of pressure should stop most bleeds.
    • Once the bleeding has stopped, try to prevent any further irritation to the nose for the next 24 hours. Avoid sneezing, blowing your nose, picking your nose or straining.
    • Avoid prolonged exposure to dry air. Using a humidifier and avoiding air-conditioned environments will help keep the nasal mucosa from drying out and triggering more bleeding.

    Nursing Diagnosis Nursing Care Plan for Epistaxis

    Ineffective Airway Clearance

    Goal: to be effective airway clearance

    Expected Outcomes: Frequency of normal breathing, no additional breath sounds, do not use additional respiratory muscles, dyspnoea and cyanosis does not occur.

    Independent
    • Assess the sound or the depth of breathing and chest movement.
      Rational: Decreased breath sounds may lead to atelectasis, Ronchi, and wheezing showed accumulation of secretions.
    • Note the ability to remove mucous / coughing effectively
      Rational: bright lumpy or bloody sputum may result from damage to lungs or bronchial injury.
    • Give Fowler's or semi-Fowler position.
      Rational: Positioning helps maximize lung expansion and reduce respiratory effort.
    • Clean secretions from the mouth and trachea
      Rational: To prevent obstruction / aspiration.
    • Maintain a fluid inclusion at least as much as 250 ml / day unless contraindicated.
      Rational: Helping dilution of secretions.

    Collaboration
    • Give medication in accordance with the indications mucolytic, expectorant, bronchodilator.
      Rational: Mucolytic to reduce cough, expectorant to help mobilize secretions, bronchodilators reduce bronchial spasms and analgesics are given to reduce discomfort.

    Deficient Fluid Volume Nursing Care Plan for Peritonitis

    Deficient Fluid Volume Nursing Care Plan for Peritonitis

    Nursing Diagnosis for Peritonitis Deficient Fluid Volume related to active fluid volume loss.

    Deficient Fluid Volume NANDA Definition: Decreased intravascular, interstitial, and/or intracellular fluid. This refers to dehydration, water loss alone without change in sodium

    Characteristics
    • Decreased urine output
    • Concentrated urine
    • Output greater than intake
    • Sudden weight loss
    • Decreased venous filling
    • Hemoconcentration
    • Increased serum sodium
    • Hypotension
    • Thirst
    • Increased pulse rate
    • Decreased skin turgor
    • Dry mucous membranes
    • Weakness
    • Possible weight gain
    • Changes in mental status

    Goal:
    To identify interventions to improve the balance of fluid and minimize the inflammatory process to improve comfort.

    Expected outcomes:
    • Adequate urine output with normal specific gravity,
    • Stable vital signs
    • Mucous membranes moist
    • Good skin turgor
    • The capillary rise
    • Weight within the normal range.

    Nursing Interventions Deficient Fluid Volume Nursing Care Plan for Peritonitis

    Independent:

    1. Monitor vital signs, note the presence of hypotension (including postural changes), tachycardia, tachypnea, fever. Measure CVP if any.
    Rational: To assist in the evaluation of the degree of fluid deficit / effectiveness of fluid replacement therapy and response to treatment.

    2. Maintain adequate intake and output and then connect with the body weight daily.
    Rationale: Demonstrates overall hydration status.

    3. Rehydration / resuscitation fluid
    Rationale: To meet the need of fluid in the body (homeostasis).

    4. Measure specific gravity of urine
    Rationale: Demonstrates changes in hydration status and renal function.

    5. Observation of skin / mucous membranes for dryness, turgor, note peripheral edema / sacral.
    Rational: Hypovolemia, fluid displacement, and lack of nutrition aggravate skin turgor, adding tissue edema.

    6. Eliminate the danger signs / smells from environment. Limit intake of ice cubes.
    Rational: Lowering the gastric stimulation and vomiting response.

    7. Change positions frequently give skin care with often, and keep the bed dry and free of folds.
    Rational: tissue edema and circulatory disturbance tends to damage the skin.

    Collaboration:

    1. Monitor laboratory examinations, eg Hb / hematocrit, electrolytes, protein, albumin, BUN, creatinine.
    Rationale: Provides information about hydration and organ function.

    2. Give the plasma / blood, fluids, electrolytes.
    Rational: Charge / maintain circulating volume and electrolyte balance. Colloid (plasma, blood) to help move the water into the area by increasing intravascular osmotic pressure.

    3. Keep fasting with nasogastric aspiration / intestinal
    Rational: Lowering intestinal hyperactivity, and loss from diarrhea.

    The number 1 killer in the United States and how you can beat it

    Do you know what the number one killer in much of the developed world and especially the United States is? The answer is heart disease. With all the junk food that is available nowadays heart disease has turned in to the biggest killer today. So how can we beat this serial killer and add a few more years to our lives you ask? The answer is simple. We just need to eat healthier and the risk or contracting any sort of heart problem is greatly reduced. In fact you can add about 15 years to your life by just changing a few things in your diet.

    The answer is really eating more raw foods and mostly vegetable foods. Raw vegetable foods contain zero cholestrol which is what causes heart disease in the first place.The reason people in the past sought to cook food so much is that it was often dirty and it would make us sick if we tried to consume it as it was. In African villages, people that do not have running water must go to the rivers and get it from there. Of course it is not clean so what do they do? They boil it first to kill the germs and then let it cool and then they will drink it. Nowadays the food we get from the stores is basically edible when we get it. We also wash the food at home so it is very safe for us to consume already. That means we are not taking any risks if we go raw with out diets, or at least replace some of our unhealthy eating habits with raw food.

    Some people might be asking what is the main difference between raw and cooked food? Well the thing is when food is being cooked, the temperatures get so high that most of the nutrients present in the food will be destroyed! That means that we are not getting in as many nutrients as we would be led to believe. Many diseases that are prevalent today come about because people do not get as many nutrients as they should from the food they are eating.

    When you eat raw clean food, you can rest assured that you will not miss out on any essential nutrients inside the food. Some people may also ask what the nutrients can do for them? Well the biggest thing is that they can easily prevent you from contracting any annoying niggling illnesses. Many people who have gone raw have not had any slight sign of the flu or cold in many years. Some even say it has been more than 15 years since they were last sick!

    With all the advances in science and medicine, people in the developing world now have a life expectancy which is very high. Sometimes it is over 80 years old and that is despite people eating all of this unhealthy food. How many more years can we add to this if we all went raw? Maybe another 15 years! Japan has so many people living to an old age, probably because they eat so much raw food such as sushi, that it is actually becoming a huge problem for them!

    Now going raw is a process and it is not going to happen overnight, but you have to take responsibility for your health. There are so many raw food recipes for beginners out there that you can try and they are very tasty. In fact you can save money and time because you do not have to stand around cooking food for so long. The many raw food recipes for beginners are easy to prepare and you will not regret as least incorporating a bit of raw food in your diet. There are also many other benefits you can get from raw food.

    by: Anthony Muzonzini

    The Risks Presented By GBS and Meningitis For Newborns

    According to the Center For Disease Control (CDC), Group B Strep is the major prevalent cause of sepsis and meningitis (a severe infection of the fluid of the spinal cord and the fluid surrounding the brain) in newborns. Group B Strep is a bacterial infection that may affect an infant if the mother is is colonized with the bacteria and transmits it during childbirth.

    The bacteria normally germinates in the vagina and/or the lower intestine. It is found in about 1 out of every 4 adult women. However, it usually does not lead to an active infection or lead to symptoms. Transmission from expecting mother to the baby generally occurs during labor and delivery. The child may be exposed to group b strep, for instance, if the bacteria moves up from the mother's vagina into the uterus after the membranes (bag of water) rupture. The newborn may also come in contact with GBS while moving down through the birth canal. In this time, the newborn can swallow or inhale the bacteria.

    Around 75% of cases of Group b strep in newborns take place during the seven days of life, and the majority show up inside of a few hours following birth. This is called "early onset." The rest develop a GBS infection at anytime from one week to several months after birth. This is called as "late onset." Statistically, approximately fifty percent of instances of late onset can be related to the baby's mother having had the bacteria. In the other cases of late onset, the cause of the infection is unknown.

    After the infant is exposed to the bacteria, it may travel to the infant's bloodstream. This may induce sepsis (overpowering infection throughout the body), pneumonia, or meningitis. These are all severe conditions which can progress rapidly and leave the infant with lifelong disabilities or may even cause the newborn's death. Among the typical possible disabilities are: brain damage, cerebral palsy, blindness, deafness, and seizures.

    The most common symptoms of meningitis include: a high fever, lethargy, unusual irritability, trouble feeding, stiffness, vomiting, and rashes. Since the infection can advance quickly quick treatment is needed to avoid significant harm to the newborn. For bacterial based meningitis (such as that caused by Group B Strep), treatment calls for the immediate administration of intravenous IV and antibiotics. A diagnosis of meningitis is established through a sample of spinal fluid through a spinal tap and growing the bacteria for correct identification. This is important so as to determine the right antibiotic for use. The outcome of the test might take several hours. In the time it takes for the results, the infection can result in lasting damage or kill the child. Because of the immediacy required, treatment normally begins ahead of a confirmed diagnosis if meningitis is a possible explanation for the baby's symptoms. Penicillin is the most commonly administered treatment.

    If an infant died or suffers from permanent disabilities that were avoidable except for the failure on the part of a physician to diagnose GBS meningitis or to provide immediate treatment that doctor might be liable for malpractice. The mothers and fathers of children thus injured by GBS meningitis should consult with a birth injury attorney immediately as the law permits just a limited amount of time to pursue a birth injury claim.

    by: Joseph Hernandez

    Saturday, January 7, 2012

    Hyperthermia Nanda Nursing Diagnosis - Dengue Fever

    Nanda Nursing Diagnosis for Dengue Fever : Hyperthermia

    Dengue hemorrhagic fever is an acute infectious disease manifested initially with fever. Dengue fever is one of the contagious viral diseases spread through the mosquito bite. The female Aedes aegypti mosquitoes thrive in stagnant water of surroundings and become the carriers of the virus. The disease is characterized by mild to high fever, headache, joint and muscle pains and rashes.

    Signs and Symptoms
    • Mild to high fever about 105 F
    • Severe pain in the bone joints 
    • Intense headache and backache
    • Loss of appetite
    • Appearance of rashes all over the body
    • Nausea followed by vomiting
    Home Remedies for Dengue

    1. One should reduce the exposure to mosquitoes as far as possible and not venture out in the dawn or dusk, when the mosquitoes are most prevalent.

    2. Mosquito nets, mosquito repellant ointments and coils must be regularly used while sleeping at night, to prevent the mosquito bite.

    3. Holy basil leaves are very useful in preventing and treating dengue. Drinking a decoction of basil leaves and cardamom powder, adding little salt and milk helps in reducing high fever.

    4. Juice extracted from two raw papaya leaves helps in preventing Dengue.

    5. Drinking few cups pf herbal tea prepared from basil leaves, ginger and cardamom powder is very effective in reducing the fever.

    6. Orange juice is widely used for treating Dengue fever. Drinking orange juice helps in proper digestion to fight against the disease.

    7. Plenty of water or diluted fruit juice must be administered to the patient to maintain the required water balance of the body.


    Nursing Diagnosis and Interventions for Dengue Fever 

    Nursing Diagnosis Hyperthermia

    related to :

    the disease (viremia)

    Goal :
    • Normal body temperature (36-37 C).
    • Patients were free from fever.

    Nursing Interventions and Rational for DHF :
    1. Assess the onset of fever.
    Rational: to identify patterns of fever patients.

    2. Observation of vital signs (temperature, pulse, blood pressure, respiration) every 3 hours.
    Rational: vital signs is a reference to determine the patient's general condition.

    3. Instruct patient to drink plenty
    Rationale: Increased body temperature resulting in increased evaporation of the body so it needs to be balanced with a lot of fluid intake.

    4. Give a warm compress.
    Rational: With vasodilation can increase evaporation which accelerate the decline in body temperature.

    5. Advise not to wear a thick blanket and clothing.
    Rational: thin clothing helps reduce the evaporation of the body.

    6. Give intravenous fluid therapy and medications according to physician programs.
    Rational: infusion of fluids is very important for patients with a high temperature.

    Impaired Skin Integrity Nanda Nursing Diagnosis - Stevens-Johnson Syndrome (SJS)

    Stevens Johnsons Syndrome is a dangerous problem of the skin. It is thought to be a hypersensitivity complex affecting the skin and the mucous membranes.

    Stevens Johnson Syndrome (SJS) is a severe and deadly allergic reaction to certain drugs, some proscription and some over the counter, which causes the severe burning of skin and mucosal membranes from the inside out. 15% of people who develop Stevens Johnson Syndrome will die as a direct result. Many drugs which have been known to cause SJS do not have warning labels notifying users about the very real danger of Stevens Johnson Syndrome.

    The skin rash of SJS consists of erythematous (red) papules, vesicles, bullae. There may also be iris lesions. The mucosal lesions include conjunctivitis as well as oral and genital ulcers. The most frequent complications of SJS are keratitis, uveitis, and perforation of the globe of the eye all of which may result in permanent visual impairment.

    Nanda Nursing Diagnosis : Impaired skin integrity related to inflammatory dermal and epidermal

    Expected Outcomes:

    Shows the skin and skin tissue intact.

    Intervention:

    1. Observation of skin turgor circulation daily notes and sensory as well as other changes that occur.
    Rational: determining a baseline by which changes in status can be compared and appropriate intervention

    2. Use a thin clothing and soft loom.
    Rational: reduce irritation and pressure from the suture line of clothes, leave the incision open to air increases the healing process and reduce the risk of infection

    3. Keep loom is used.
    Rationale: to prevent infection

    Intellectual Disability Causes and Signs

     Doctors have found many causes of intellectual disabilities. The most common are:
    • Genetic conditions. Sometimes an intellectual disability is caused by abnormal genes inherited from parents, errors when genes combine, or other reasons. Examples of genetic conditions are Down syndrome, fragile X syndrome, and phenylketonuria (PKU).
    • Problems during pregnancy. An intellectual disability can result when the baby does not develop inside the mother properly. For example, there may be a problem with the way the baby’s cells divide as it grows. A woman who drinks alcohol or gets an infection like rubella during pregnancy may also have a baby with an intellectual disability.
    • Problems at birth. If a baby has problems during labor and birth, such as not getting enough oxygen, he or she may have an intellectual disability.
    • Health problems. Diseases like whooping cough, the measles, or meningitis can cause intellectual disabilities. They can also be caused by extreme malnutrition (not eating right), not getting enough medical care, or by being exposed to poisons like lead or mercury.

    An intellectual disability is not a disease. You can’t catch an intellectual disability from anyone. It’s also not a type of mental illness, like depression. There is no cure for intellectual disabilities. However, most children with an intellectual disability can learn to do many things. It just takes them more time and effort than other children.

    Signs of Intellectual Disability

    There are many signs of an intellectual disability. For example, children with an intellectual disability may:
    • sit up, crawl, or walk later than other children;
    • learn to talk later, or have trouble speaking,
    • find it hard to remember things,
    • not understand how to pay for things,
    • have trouble understanding social rules,
    • have trouble seeing the consequences of their actions,
    • have trouble solving problems, and/or
    • have trouble thinking logically.

    Pediatric Nursing Care Plan - Mental Retardation

    Pediatric Nursing Care Plan - Mental Retardation Nursing Assessment

    Assessment can be done through:
    1. Neuroradiology can find abnormalities in the structure of the cranium, such as classification or increased intracranial pressure.
    2. Echoencephalography can show the tumor and hematoma.
    3. A brain biopsy is only useful on a small number of children retardasii mentally. Not easy for parents to accept the role in brain tissue making even small amounts because they add to the brain damage is inadequate.
    4. Bio-chemical research to determine the metabolic rates of various materials which are known to affect brain tissue if not found in large quantities or small, such as hyperglycemia in preterm neonates, accumulation of glycogen in muscles and neurons, fat deposits in the brain and high levels of phenylalanine.

    Or can perform the following assessments:
    • Assessment of physical
    • Assessment for growing up
    • Family history assessment, especially regarding mental retardation and hereditary disorders in which mental retardation is one of the main species.
    • Medical history to obtain evidence of trauma to prenatal, perinatal, postnatal, or physical injury.
    • Prenatal maternal infection (eg, rubella), alcoholism, drug consumption.
    • Inadequate nutrition.
    • Environmental deviations.
    • Psychiatric disorders (eg, Autism).
    • Infections, particularly those involving the brain (eg, meningitis, encephalitis, measles) or high body temperature.
    • Chromosome abnormalities.
    • Assist with diagnostic tests such as: analysts chromosomes, metabolic dysfunction, radiography, tomography, electro ensephalography.
    • Perform or assist with intelligence tests. Stanford Binet, Wechsler intellence, Scale, American Assiciation of Mental Retardation Adaptive Behavior Scale.
    • Observation of an early manifestation of mental retardation:
      • Not responsive to contact.
      • Poor eye contact during breastfeeding.
      • Decrease in spontaneous activity.
      • Decreased awareness of sound vibrations.
      • Sensitive stimuli.
      • Breast-feeding is slow.

    Pediatric Nursing Care Plan Mental Retardation Nursing Diagnosis and Interventions 

    1. Altered Growth and Development related to damage to cognitive function.

    Expected results:
    • Children and families actively involved in infant stimulation program. 
    • Families applying these concepts and continue the child care activities at home. 
    • Children perform activities of daily living at optimal capacity. Family ~ find out about educational programs. 
    Nursing interventions :
    • Involve children and families in early infant stimulation program. Rational: to help maximize growth in children.
    • Assess the progress of the child's development with regular intervals, for which detailed records to distinguish subtle changes in function. Rational: so the treatment plan can be repaired as needed.
    • Help families set goals for the child's reality. Rationale: to encourage the successful achievement of goals and self-esteem.
    • Provide positive reinforcement / specific tasks to the behavior of children. Rational: as this can improve motivation and learning.
    • Provide information on adolescent social practices and codes of behavior that is concrete and well defined. Rational: because of the ease and lack of assessment of the child persuasion can make children are at risk of dangerous.

    2. Altered family processes related to having a child with mental retardation.

    Expected results:
    • Family expresses feelings and concerns about the birth of a child with mental retardation and its implications.
    • Family members indicate acceptance of the child.
    • Family members indicate acceptance of the child.

    Nursing Interventions:
    •  Provide information on the family as soon as possible during or after birth. Rational: In order for families able to receive the actual circumstances.
    •  Encourage both parents to be present at the conference giving information. Rational: In order for parents to get lots of information about mental retardation.
    •  Discuss with family members about the benefits of home care, give them a chance to investigate all residential alternatives before making a decision. Rationale: So that they can take the best decision for them and their children.
    • Encourage the family to meet with other families who have the same problem. Rational: so they can receive additional support.

    Self-Care Deficit Nanda Nursing Diagnosis

    Self-care deficits

    When an individual is very unable to meet their own self-care requisites, a "self-care deficit" occurs. It is the job of the Registered Nurse to determine these deficits, and define a support modality.

    Self-care deficit nursing theory is a grand nursing theory that was developed between 1959 and 2001 by Dorothea Orem. It is also known as the Orem model of nursing. It is particularly used in rehabilitation and primary care settings where the patient is encouraged to be as independent as possible.

    Self-Care Deficit

    Bathing/Hygiene; Dressing/Grooming; Feeding; Toileting

    Defining Characteristics:
    • Inability to feed self independently
    • Inability to dress self independently
    • Inability to bathe and groom self independently
    • Inability to perform toileting tasks independently
    • Inability to transfer from bed to wheelchair
    • Inability to ambulate independently
    • Inability to perform miscellaneous common tasks such as telephoning and writing
    Related Factors :
    • Neuromuscular impairment, secondary to cerebrovascular accident (CVA)
    • Musculoskeletal disorder such as rheumatoid arthritis
    • Cognitive impairment
    • Energy deficit
    • Pain
    • Severe anxiety
    • Decreased motivation
    • Environmental barriers
    • Impaired mobility or transfer ability
    Expected Outcomes
    • Patient safely performs (to maximum ability) self-care activities.
    • Resources are identified which are useful in optimizing the autonomy and independence of the patient.

    NOC Outcomes (Nursing Outcomes Classification)
    Suggested NOC Labels
    • Self-Care: Eating
    • Self-Care: Bathing
    • Self-Care: Dressing
    • Self-Care: Grooming
    • Self-Care: Hygiene
    • Self-Care: Toileting

    NIC Interventions (Nursing Interventions Classification)
    Suggested NIC Labels
    • Self-Care Assistance: Bathing/Hygiene
    • Self-Care Assistance
    • Dressing/Grooming
    • Self-Care Assistance: Feeding
    • Self-Care Assistance: Toileting
    • Environment Management

    Impaired Physical Mobility Nanda Nursing Diagnosis

    Nanda Definition:

    Impaired physical mobility a nursing diagnosis approved by the North American Nursing Diagnosis Association, defined as the state in which an individual has a limitation in independent, purposeful physical movement of the body or of one or more extremities.


    Alteration in mobility may be a temporary or more permanent problem. Most disease and rehabilitative states involve some degree of immobility (e.g., as seen in strokes, leg fracture, trauma, morbid obesity, and multiple sclerosis). With the longer life expectancy for most Americans, the incidence of disease and disability continues to grow. And with shorter hospital stays, patients are being transferred to rehabilitation facilities or sent home for physical therapy in the home environment.

    Mobility is also related to body changes from aging. Loss of muscle mass, reduction in muscle strength and function, stiffer and less mobile joints, and gait changes affecting balance can significantly compromise the mobility of elderly patients. Mobility is paramount if elderly patients are to maintain any independent living. Restricted movement affects the performance of most activities of daily living (ADLs). Elderly patients are also at increased risk for the complications of immobility. Nursing goals are to maintain functional ability, prevent additional impairment of physical activity, and ensure a safe environment.

    Impaired physical mobility - Related factors arising from within the person include pain or fear of discomfort, anxiety or depression, and physical limitations due to neuromuscular or musculoskeletal impairment. External factors include enforced rest for therapeutic purposes, as in the case of immobilization of a fractured limb. The human body is designed for motion; hence, any restriction of movement will take its toll on every major anatomic system.

    Defining Characteristics:
    • Inability to move purposefully within physical environment, including bed mobility, transfers, and ambulation
    • Reluctance to attempt movement
    • Limited range of motion (ROM)
    • Decreased muscle endurance, strength, control, or mass
    • Imposed restrictions of movement including mechanical, medical protocol, and impaired coordination
    • Inability to perform action as instructed
    NOC Outcomes (Nursing Outcomes Classification)
    Suggested NOC Labels
    • Ambulation: Walking
    • Joint Movement: Active
    • Mobility Level

    NIC Interventions (Nursing Interventions Classification)
    Suggested NIC Labels
    • Exercise Therapy: Ambulation
    • Joint Mobility
    • Fall Precautions
    • Positioning
    • Bed Rest Care
    Expected Outcomes
    • Patient performs physical activity independently or with assistive devices as needed.
    • Patient is free of complications of immobility, as evidenced by intact skin, absence of thrombophlebitis, and normal bowel pattern.

    Friday, January 6, 2012

    Imbalanced Nutrition More than Body Requirements Nanda Nursing Diagnosis

    Imbalanced Nutrition More than Body Requirements Definition :


    Imbalanced nutrition : more than body requirements refers to a caloric intake / excess of daily energy requirements, resulting in storage of energy in the form of adipose tissue. As the amount of stored fat increases, the individual becomes overweight or obese. A person is said to be overweight when BMI is between 25 and 29.9 kg/m2 and obese when BMI is >30 kg/m2 . Factors that affect weight gain include genetics, sedentary lifestyle, and emotional factors associated with dysfunctional eating. Medical conditions associated with this problem are as follows: diabetes mellitus, severe hypertension, and Cushing’s syndrome. Cultural or ethnic background also influences eating habits. Overall nutritional requirements of geriatric patients are similar to those of younger patients, except that calories should be reduced because of their leaner body mass. The major goals for this problem is to maintain or restore optimal nutrition status, promote healthy nutritional practices, prevent complication associated with malnutrition and decrease weight.


    Related Factors :
    • Cultural preferences
    • Excessive intake in relation to metabolic need
    • Lack of knowledge of nutritional needs, food intake, and/or appropriate food preparation
    • Metabolic disorders
    • Poor dietary habits
      • Psychosocial factors
    • Sedentary lifestyle
      • Socioeconomic status
    • Use of food as coping mechanism

    Nursing Interventions Classification (NIC)
    • Nutrition Counseling
    • Nutritional Monitoring
    • Weight Reduction Assistance


    Nursing Outcomes Classification (NOC)
    • Nutritional Status: Food and Fluid Intake
    • Weight Control
    • Knowledge: Diet


    Goal and Objectives
    • Patient will articulate actions essential to attain weight reduction.
      • Patient will cemonstrate change in eating patterns and participation in individual exercise program.
    • Patient will commence an appropriate program of exercise.
    • Patient will demonstrate proper selection of meals or menu planning toward the goal of weight reduction.
    • Patient will exhibit weight loss with optimal continuation of health.
      • Patient will recognize inappropriate behaviors and consequences related with overeating or weight gain.

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