Bladder Cancer - Nursing Diagnosis : Imbalanced Nutrition and Deficient Knowledge

Nursing Care Plan for Bladder Cancer

1. Imbalanced Nutrition: Less Than Body Requirements
related to:

hyper-metabolic-related cancer, the consequences of chemotherapy, radiation, surgery (anorexia, gastric irritation, lack of sense of taste, nausea), emotional distress, fatigue, inability to control pain


characterized by:

• inadequate intake,
• loss of sense of taste,
• loss of appetite,
• weight down to 20% or more below the ideal,
• decreased muscle mass and subcutaneous fat,
• constipation,
• abdominal cramping.

Goal:

• Showed a stable weight, normal laboratory results and no sign of malnutrition.
• Stated understanding of the need for adequate intake.
• Participate in the management of diet-related illness.

Interventions :

• Monitor food intake every day, whether eating in accordance with the needs of the client.
• Measure weight, triceps size and observed weight loss.
• Assess pale, slow wound healing and parotid gland enlargement.
• Encourage clients to consume high-calorie foods with adequate fluid intake. Instruct too little food to clients.
• Control of environmental factors such as foul odors or noise. Avoid foods that are too sweet, fatty and spicy.
• Create a pleasant dining atmosphere for example, a meal with friends or family.
• Encourage relaxation techniques, visualization, moderate exercise before eating.
• Encourage open communication about anorexia problems experienced by clients.

Collaboration:

• Observe laboratory studies such as total lymphocytes, serum transferrin and albumin.
• Give treatment as indicated.
• Attach a nasogastric tube for enteral feeding, balanced with infusion.

Rational:

• Provide information about nutritional status.
• Provides information about the addition and weight loss.
• Showed very poor nutritional state.
• Calories are energy sources.
• Prevent nausea and vomiting, excessive distension, dyspepsia which causes a decrease in appetite and reduce harmful stimulus which can increase anxiety.
• In order for the client to feel like being at home alone.
• To induce a feeling of wanting to eat / arouse appetite.
• In order to overcome together (with a dietitian, nurse and client).
• To determine / establish the occurrence of nutritional deficiencies as a result of the course of disease, treatment and care of the client.
• Facilitate the intake of food and beverages with maximum results and right as needed.

2. Deficient Knowledge about the disease, prognosis and treatment
related to:

• lack of information,
• misinterpretation,
• cognitive limitations.

characterized by:

• often asked,
• stating the problem,
• statement misconceptions, is not accurate in mengikiuti instruction / prevention of complications.

Goal:

• Can accurately say about diagnosis and treatment at the level of proximity ready.
• Following the procedure well and explain the reasons to follow those procedures.
• Having the initiative of changing lifestyles and participate in treatment.
• In cooperation with the furnisher.

Interventions:

• Review understanding of the client and family about the diagnosis, treatment and consequences.
• Determine the client's perception about cancer and its treatment, tell the client about the experience of other clients who have cancer.
• Give accurate and factual information. Answer the questions specifically, avoid unnecessary information.
• Provide guidance to client / family before following the treatment procedure, the old therapy, complications. Be honest with the client.
• Encourage clients to provide verbal feedback and correct misconceptions about the disease.
• Review client / family about the importance of optimal nutrition status.
• Encourage clients to assess the oral mucous membranes regularly, note the presence of erythema, ulceration.
• Encourage clients to maintain the cleanliness of the skin and hair.

Rational:

• Avoid duplication and repetition of the client's knowledge.
• Lets do justification to errors as well as errors of perception and conception of understanding.
• Assist the client in understanding the disease process.
• Assist clients and families in making treatment decisions.
• Knowing the extent of understanding the client and client's family about the disease.
• Increasing knowledge of the client and family regarding adequate nutrition.
• Reviewing the development of the processes of healing and signs of infection and problems with oral health can affect the intake of food and beverages.
• Improving the integrity of the skin and head.

Source : http://nursing-care-plan.blogspot.com/2014/01/imbalanced-nutrition-and-knowledge.html

Imbalanced Nutrition Less Than Body Requirements - NCP for Typhoid Fever

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Gastritis - Imbalanced Nutrition Less Than Body Requirements

Nursing Diagnosis for Gastritis Imbalanced Nutrition Less Than Body Requirements related to anorexia, vomiting

Nursing Interventions for Gastritis:

1. Allow clients to choose foods (low-calorie foods are not allowed)
2. Make mealtime structure with a time limit (eg 40 minutes)
3. Eliminate distractions (eg conversation, watching television) during the meal.
4. Specify the time to eat, serve food, and eating time limit; inform the client that if the food is not eaten during the time that has been provided, will be the replacement of other feeding methods.
5. When food is not eaten, do feeding through a tube, NGT to order.
6. Perform a replacement feeding method each time the client refuses to eat by mouth.
7. Keep your attention during the meal if the client refuses to eat.
8. Reduce attention while eating.

Behavior Modification Therapy

1. Clients achieve increased body weight every day because of the desire of the client.
2. Separation from family for some time would be very helpful.
3. Switch on a fun activity.
4. Nursing interventions are technical limitations.
5. Social isolation.
6. Useful communication.
7. Give the award to the client only when he is likely to gain weight.
8. Consistent action should be maintained.
9. Each staff member must have a final report per shift on a decision
10. Measure weight accurately;

Expected outcome:

1. Clients indicate hydration, necessary to adequately.
2. Balance between inputs and outputs.

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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.




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.

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Imbalanced Nutrition Less Than Body Requirements Nursing Care Plan for Peritonitis

Nursing Diagnosis for Peritonitis : Imbalanced Nutrition, Less Than Body Requirements related to anorexia and vomiting.

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

Characteristics :

• Loss of weight
• Lack of interest in food
• Pale conjunctiva and mucous membranes
• Poor muscle tone
• Amenorrhea
• Poor skin turgor
• Edema of extremities
• Electrolyte imbalances
• Weakness
• Constipation
• Anemias

Goals

• Client will gain 2 pounds per week for the next 3 weeks.
• Client will exhibit no signs or symptoms of malnutrition by time of discharge from treatment (e.g., electrolytes and blood counts will be within normal limits; a steady weight gain will be demonstrated; constipation will be corrected; client will exhibit increased energy in participation in activities).

Nursing Interventions Imbalanced Nutrition, Less Than Body Requirements for Peritonitis

Independent:

1. Monitor bow NG tube, and note the presence of vomiting or diarrhea.
Rational: The large number of gastric aspiration and vomiting or diarrhea is suspected bowel obstruction, requiring further evaluation.

2. Measure body weight each day.
Rationale: Loss of or increase in early showed further changes in hydration but loss is suspected nutritional deficit.

3. Auscultation bowel sounds, record sounds nothing or hyperactive.
Rationale: Although there is no frequent bowel sounds, bowel inflammation or irritation may accompany intestinal hyperactivity, decreased water absorption, and diarrhea.

4. Record the required calorie needs.
Rational: The calories (energy sources) will accelerate the healing process.

5. Monitor Hb and albumin
Rational: Indications adequate protein to the immune system.

6. Assess abdomen with frequent return to the gentle sound, the appearance of normal bowel sounds, flatus smooth dam.
Rationale: Indicates the return to normal bowel function.

Collaboration:

1. Collaborative installation NGT if the client can not eat and drink orally.
Rational: In order to keep the client nutrients are met.

2. Collaboration with a dietitian in your diet.
Rational: A healthy body is not easy for infection (inflammation).

3. Provide information about the food substances which are very important to balance the body's metabolism
Rationale: Clients can strive to meet the needs of eating nutritious food.

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