tag:blogger.com,1999:blog-63945968972410475272024-03-12T11:51:17.536+07:00Nursing Care PlansOffers nurse and student nurses a variety of Nursing Care Plans, nursing interventions and outcomes, which may be individualizedPri'ehttp://www.blogger.com/profile/12027499295412539384noreply@blogger.comBlogger62125tag:blogger.com,1999:blog-6394596897241047527.post-84249947104104175022012-02-02T15:53:00.009+07:002012-02-02T18:48:56.379+07:00We are moving the server as a step in our continuous work in improving our service. to Lifenurses.com<div style="text-align: center;"><br /><a href="http://www.lifenurses.com/" target="_blank"><br /><img src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhVTsusV04FddBsJt3PhIccOsSVScPegpKSQR03np9b14xeHYpcx6mwkUV1TgDiXqI-fqD1owy43Ytjd7fK9KEjScDFsKK2vOmB_bEibmKjaVJ5dzwMC4reIgWh7-56JjeyjeNuti-oTj_j/s200/move.jpg" width="368" height="247" border="2" style="border:2px solid black;" alt="moving to lifenurses.com!" /><br /></a><br /><br /><br /><div style="text-align: center;"><br /></div><br /><div class="fullpost" style="text-align: center;">We are moving the server as a step in our continuous work in improving our service. </div><div class="fullpost" style="text-align: center;">To <a href="http://www.lifenurses.com/">Lifenurses.com</a></div><div class="fullpost" style="text-align: center;"><br /></div><div class="fullpost" style="text-align: center;"><br /></div><div class="fullpost" style="text-align: center;">For Those Who Already Subscribe By Email Or Rss Feed, Feel Free To Update To New Site <a href="http://www.lifenurses.com/">Lifenurses.com</a></div><div class="fullpost" style="text-align: center;"><br /></div><br /></div>Pri'ehttp://www.blogger.com/profile/12027499295412539384noreply@blogger.com0tag:blogger.com,1999:blog-6394596897241047527.post-11069628785766461262011-04-26T10:43:00.000+07:002011-04-26T10:43:56.707+07:00NCP Nursing Care Plan for Viral hepatitis<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: justify;"><tbody>
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</tbody></table><div style="text-align: justify;">NCP Nursing Care Plan for Viral hepatitis. Hepatitis is a widespread inflammation of the liver that results in degeneration and necrosis of liver cells. Viral hepatitis is a fairly common systemic disease. It's marked by hepatic cell destruction, necrosis, and autolysis, leading to anorexia, jaundice, and hepatomegaly. In most patients, hepatic cells eventually regenerate with little or no residual damage, allowing recovery. However, old age and serious underlying disorders make complications more likely. The prognosis is poor if edema and hepatic encephalopathy develop</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Types Of Viral Hepatitis</b></div><div class="fullpost"><div style="text-align: justify;">The most common types are Hepatitis A, Hepatitis B, and Hepatitis C. </div><br />
<ul><li style="text-align: justify;">Type A (infectious or short-incubation hepatitis) is raising among people with immunosuppression. It's usually self-limiting and without a chronic form. About 40% of cases in the United States result from hepatitis A virus. Primarily transmitted by the fecal-oral route, by either person-to-person contact or consumption of contaminated food or water. Although viremia occurs early in infection and can persist for several weeks after onset of symptoms, bloodborne transmission of Hepatitis A virus HAV is uncommon. Hepatitis A virus HAV occasionally might be detected in saliva in experimentally infected animals, but transmission by saliva has not been demonstrated.</li>
<li style="text-align: justify;">Type B (serum or long-incubation hepatitis) is also increasing among HIV-positive individuals. Hepatitis B is considered a sexually transmitted disease because of its high incidence and rate of transmission by this route. Hepatitis B is caused by infection with the Hepatitis B virus (HBV). The incubation period from the time of exposure to onset of symptoms is 6 weeks to 6 months. HBV is found in highest concentrations in blood and in lower concentrations in other body fluids (e.g., semen, vaginal secretions, and wound exudates). HBV infection can be self-limited or chronic.</li>
<li style="text-align: justify;">Type C accounts for about 20% of all viral hepatitis cases and is primarily transmitted through blood and body fluids or obtained during tattooing. is most efficiently transmitted through large or repeated Percutaneous exposure to infected blood (e.g., through transfusion of blood from unscreened donors or through use of injecting drugs). Although much less frequent, occupational, perinatal, and sexual exposures also can result in transmission of HCV.</li>
<li style="text-align: justify;">Type D (delta hepatitis) is responsible for about 50% of all cases of fulminant hepatitis, which has a high mortality. Developing in 1% of patients, fulminant hepatitis causes unremitting liver failure with encephalopathy. It progresses to coma and commonly leads to death within 2 weeks. Hepatitis D virus which is an RNA virus structurally unrelated to the Hepatitis A, B, or C viruses. Hepatitis D, which can be acute or chronic, is uncommon in the United States. Hepatitis D virus HDV is an incomplete virus that requires the helper function of HBV to replicate and only occurs among people who are infected with the Hepatitis B virus. Hepatitis D virus is transmitted through Percutaneous or mucosal contact with infectious blood and can be acquired either as a coinfection with HBV or as superinfection in persons with HBV infection. There is no vaccine for Hepatitis D, but it can be prevented in persons who are not already HBV-infected by Hepatitis B vaccination.</li>
<li style="text-align: justify;">Type E (formerly grouped with type C under the name non-A, non-B hepatitis) occurs primarily in people who have recently returned from an endemic area (such as India, Africa, Asia, or Central America); it's more common in young adults and more severe in pregnant females. Hepatitis E is a serious liver disease caused by the Hepatitis E virus (HEV) that usually results in an acute infection. It does not lead to a chronic infection. While rare in the United States, Hepatitis E is common in many parts of the world. Transmission: Ingestion of fecal matter, even in microscopic amounts; outbreaks are usually associated with contaminated water supply in countries with poor sanitation</li>
<li style="text-align: justify;">Some older books and websites list additional hepatitis viruses. These are virus-like agents transmitted in blood that were once suspected of causing hepatitis but do not: Hepatitis G. Transfusion transmitted virus (TTV)</li>
</ul><br />
<div style="text-align: justify;"><b>Causes for Viral hepatitis</b></div><div style="text-align: justify;">The six major forms of viral hepatitis A, B, C, D, and E</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Complications for Viral hepatitis</b></div><div style="text-align: justify;">Life-threatening fulminant hepatitis the most feared complication develops in about 1% of patients, causing unremitting liver failure with encephalopathy</div><div style="text-align: justify;">Complications may be specific to the type of hepatitis:</div><br />
<ul><li style="text-align: justify;">Chronic active hepatitis may occur as a late complication of hepatitis B. During the prodromal stage of acute hepatitis B, a syndrome resembling serum sickness, characterized by arthralgia or arthritis, rash, and angioedema, may occur. This syndrome can lead to misdiagnosis of hepatitis B as rheumatoid <a href="http://nurse-thought.blogspot.com/2011/03/ncp-nursing-care-plan-for-gout-gouty.html">arthritis</a> or lupus erythematosus. Primary liver cancer may develop after infection with hepatitis B or C.</li>
<li style="text-align: justify;">Type D hepatitis can cause a mild or asymptomatic form of type B hepatitis to flare into severe, progressive chronic active hepatitis and <a href="http://nurse-thought.blogspot.com/2009/06/nursing-care-plans-for-cirrhosis.html">cirrhosis</a>.</li>
<li style="text-align: justify;">Other complications include a syndrome that resembles serum sickness (muscle and joint pain, rash, angioedema), as well as<a href="http://nurse-thought.blogspot.com/2009/07/cirrhosis-nursing-outcomes-nursing.html"> cirrhosis</a>, pancreatitis, <a href="http://nurse-thought.blogspot.com/2009/04/nursing-care-plans-for-cardiovascular.html">myocarditis</a>, <a href="http://nurse-thought.blogspot.com/2011/04/ncp-nursing-care-plans-for-aplastic.html">Aplastic anemia</a>, or peripheral neuropathy.</li>
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</div><div style="text-align: justify;"><b>Nursing Assessment NCP Nursing Care Plan for Viral hepatitis</b></div><div style="text-align: justify;">Patient history. Question the patient about potential sources of transmission and risks: a history of blood dyscrasias, multiple blood or blood product transfusions, alcohol or drug abuse (sharing of needles), exposure to hepatotoxic chemicals or medications, and travel to third world countries or areas where the sanitation is poor. Since HAV transmission occurs in association with daycare centers, among male homosexuals, and among household contacts of persons with acute cases, inquire into these areas. Also ask about recent meals, because hepatitis A occasionally occurs from contaminated food or improper sewage treatment. Determine the patient’s occupation; teratogen exposure may cause a nonviral hepatitis.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Diagnostic tests for Viral hepatitis</b></div><br />
<ul><li style="text-align: justify;">Viral hepatitis serologies</li>
<li style="text-align: justify;">Liver function tests</li>
<li style="text-align: justify;">Liver scan: May be indicated for differential diagnosis, to identify underlying chronic liver disease, or for evaluating organ function.</li>
<li style="text-align: justify;">Liver biopsy: Considered if diagnosis is uncertain or if clinical course is atypical or unduly prolonged.</li>
<li style="text-align: justify;">Urinalysis: Checks the urine for bilirubin for the nonjaundiced client with suspected viral hepatitis.</li>
</ul><br />
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</div><div style="text-align: justify;"><a href="http://nurse-thought.blogspot.com/2009/03/complete-list-of-nanda-approved-nursing.html">Nursing diagnosis</a> NCP Nursing Care Plan for Viral hepatitis</div><br />
<ul><li style="text-align: justify;"><a href="http://nurse-thought.blogspot.com/2009/03/nursing-care-plans-for-activity.html">Activity intolerance</a></li>
<li style="text-align: justify;"><a href="http://nurse-thought.blogspot.com/2009/03/nursing-care-plans-for-anxiety.html">Anxiety</a></li>
<li style="text-align: justify;">Deficient knowledge (diagnosis and treatment)</li>
<li style="text-align: justify;">Fear</li>
<li style="text-align: justify;">Imbalanced nutrition: Less than body requirements</li>
<li style="text-align: justify;"><a href="http://nurse-thought.blogspot.com/2010/06/nursing-diagnosis-risk-for-infection.html">Risk for infection</a></li>
<li style="text-align: justify;">Risk for injury</li>
</ul><br />
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</div><div style="text-align: justify;">Nursing Key outcomes NCP Nursing Care Plan for Viral hepatitis</div><br />
<ul><li style="text-align: justify;">The patient will perform activities of daily living within the confines of the disease process, Extent of active management of energy to initate and sustain activity.</li>
<li style="text-align: justify;">The patient will identify strategies to reduce anxiety, Personal actions to eliminate or reduce feelings of apprehension and tension from an unidentifiable source.</li>
<li style="text-align: justify;">The patient and family will express an understanding of the disease process and treatment regimen Ability to acquire, organize, and use information. Verbalize understanding of condition/disease process and treatment.</li>
<li style="text-align: justify;">The patient will discuss fears and concerns, Acknowledge and discuss fears, recognizing healthy versus unhealthy fears.</li>
<li style="text-align: justify;">The patient will achieve adequate caloric and nutritional intake, Display normalization of laboratory values and be free of signs of malnutrition.</li>
<li style="text-align: justify;">The patient will remain free from signs and symptoms of infection, patient will Identify interventions to prevent/reduce risk of infection.</li>
<li style="text-align: justify;">The patient will avoid complications, Demonstrate behaviors, lifestyle changes to reduce risk factors and protect self from injury.</li>
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</div><div style="text-align: justify;"><b>Nursing interventions NCP Nursing Care Plan for Viral hepatitis</b></div><br />
<ul><li style="text-align: justify;">Activity Therapy: Prescription of and assistance with specific physical, cognitive, social, and spiritual activities to increase the range, frequency, or duration of an individual’s (or group’s) activity. Energy Management: Regulating energy use to treat or prevent fatigue and optimize function. Exercise Promotion: Facilitation of regular physical exercise to maintain or advance to a higher level of fitness and health</li>
<li style="text-align: justify;">Anxiety Reduction: Minimizing apprehension, dread, foreboding, or uneasiness related to an unidentified source or anticipated danger. Calming Technique: Reducing anxiety in patient experiencing acute distress</li>
<li style="text-align: justify;">Teaching Individual about disease, diagnosis and treatment. Learning Facilitation: Promoting the ability to process and comprehend information. Learning Readiness Enhancement: Improving the ability and willingness to receive information.</li>
<li style="text-align: justify;">Anxiety Reduction: Minimizing apprehension, dread, foreboding, or uneasiness related to an unidentified source or anticipated danger. Security Enhancement: Intensifying a patient’s sense of physical and psychological safety. Coping Enhancement: Assisting a patient to adapt to perceived stressors, changes, or threats that interfere with meeting life demands and roles</li>
<li style="text-align: justify;">Nutrition Management: Assisting with or providing a balanced dietary intake of foods and fluids. Weight Gain Assistance: Facilitating gain of body weight</li>
<li style="text-align: justify;">Infection Protection: Prevention and early detection of infection in a patient at risk. Infection Control: Minimizing the acquisition and transmission of infectious agents. Surveillance: Purposeful and ongoing acquisition, interpretation, and synthesis of patient data for clinical decision making</li>
<li style="text-align: justify;">Surveillance: Safety: Purposeful and ongoing collection and analysis of information about the patient and the environment for use in promoting and maintaining patient safety. Analysis of potential risk factors, determination of health risks, and prioritization of risk reduction strategies for an individual or group. Environmental Management Manipulation of the patient’s surroundings for therapeutic benefit</li>
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</div></div>Pri'ehttp://www.blogger.com/profile/12027499295412539384noreply@blogger.com0tag:blogger.com,1999:blog-6394596897241047527.post-14172513994057974982011-04-06T08:08:00.000+07:002011-04-06T08:08:04.801+07:00NCP Nursing Care Plans for Cerebral Palsy<div style="text-align: justify;"><a href="http://nurse-thought.blogspot.com/">NCP</a> Nursing Care Plans for Cerebral Palsy. Cerebral palsy the most common crippling disease in children includes several neuromuscular disorders resulting from prenatal, perinatal, or postnatal central nervous system damage. Cerebral palsy, a disorder that affects motor skills, muscle tone, and muscle movement, is a disorder which is most commonly due to damage during prenatal, perinatal, and postnatal periods during the pregnancy process. Although nonprogressive, these disorders may become more obvious as an affected infant grows older. </div><div style="text-align: justify;">Types of cerebral palsy:</div><ul><li style="text-align: justify;">Spastic cerebral palsy (affecting about 70% of children with cerebral palsy)</li>
<li style="text-align: justify;">Athetoid cerebral palsy (affecting about 20%)</li>
<li style="text-align: justify;">Ataxic cerebral palsy (affecting about 10%)</li>
<li style="text-align: justify;">Mixed cerebral palsy</li>
</ul><div style="text-align: justify;">Incidence of cerebral palsy is highest in premature neonates and in those who are small for gestational age. Cerebral palsy is slightly more common in boys than in girls and occurs more commonly in whites.</div><div class="fullpost"><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Causes for Cerebral Palsy</b></div><div style="text-align: justify;">About 40% of all cases, the cause for cerebral palsy is unknown. The most prevalent cause of cerebral palsy is prenatal factors. Cerebral palsy usually stems from conditions that result in cerebral anoxia, hemorrhage, or other damage. Conditions that cause these problems can occur before, during, or after birth. </div><div style="text-align: justify;"></div><ol><li>Prenatal causes include Rhesus (Rh) factor or ABO blood type incompatibility, maternal infection (especially rubella in the first trimester), maternal diabetes, irradiation, anoxia, toxemia, malnutrition, <a href="http://nurse-thought.blogspot.com/2009/04/nursing-care-plans-for-abruptio.html">abnormal placental attachment</a>, and isoimmunization.</li>
<li>During parturition, conditions that can cause cerebral palsy include <a href="http://nurse-thought.blogspot.com/search/label/Trauma">trauma</a> during delivery, depressed maternal vital signs from general or spinal anesthesia, asphyxia from the cord wrapping around the neck, prematurity, prolonged or unusually rapid labor, and multiple births</li>
<li>Postnatal causes include infections, such as <a href="http://nurse-thought.blogspot.com/2011/03/ncp-nursing-care-plans-for-meningitis.html">meningitis</a> and <a href="http://nurse-thought.blogspot.com/2011/03/ncp-nursing-care-plan-for-encephalitis.html">encephalitis</a>, head trauma, poisoning, and any condition that results in cerebral thrombus or embolus.</li>
</ol><div style="text-align: justify;"><b>Complications for Cerebral Palsy</b></div><div style="text-align: justify;">• Cerebral palsy may produce complicating conditions, including </div><div style="text-align: justify;">• <a href="http://nurse-thought.blogspot.com/2009/01/nursing-care-plan-for-epilepsy.html">Seizure disorders</a></div><div style="text-align: justify;">• Language and perceptual deficits speech, vision, and hearing problems</div><div style="text-align: justify;">• Mental retardation</div><div style="text-align: justify;">• Dental problems </div><div style="text-align: justify;">• Respiratory difficulties, such as poor swallowing and gag reflexes.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Nursing Assessment <a href="http://nurse-thought.blogspot.com/">Nursing Care Plans</a> for Cerebral Palsy </b></div><div style="text-align: justify;">The patient's history and physical examination findings, including results of the neurologic assessment, confirm the diagnosis of cerebral palsy.</div><ul><li style="text-align: justify;">Patient history, maternal history often reveals the possible cause of cerebral palsy. Patients who have mixed forms of the disorder may display a combination of clinical findings</li>
<li style="text-align: justify;">Generally, inspection reveals a child with retarded growth and development. If you observe the patient eating, you may notice that he has difficulty chewing and swallowing. Other findings vary depending on the type of cerebral palsy.</li>
<li style="text-align: justify;">Neurologic examination may reveal hyperactive deep tendon reflexes and increased stretch reflexes, rapid alternating muscle contraction and relaxation, and weakness. Muscle contraction in response to manipulation with a tendency toward contractures also occurs.</li>
</ul><div style="text-align: justify;"><b>Diagnostic tests for Cerebral Palsy</b></div><div style="text-align: justify;">Appropriate tests are performed to diagnose conditions associated with cerebral palsy and to determine the degree of visual, auditory, and mental impairment.</div><ul><li style="text-align: justify;">Brain scans; Magnetic resonance imaging (MRI), Cranial ultrasound, Computerized tomography (CT)</li>
<li style="text-align: justify;">Electroencephalogram (EEG)</li>
<li style="text-align: justify;">Vision impairment tests</li>
<li style="text-align: justify;">Hearing impairment tests</li>
<li style="text-align: justify;">Speech delays or impairments tests</li>
<li style="text-align: justify;">Intellectual disabilities or mental retardation tests</li>
<li style="text-align: justify;">Other developmental delays tests</li>
</ul><div style="text-align: justify;"><b>Nursing diagnosis Nursing Care Plans for Cerebral Palsy</b></div><ul><li style="text-align: justify;">Chronic low self-esteem</li>
<li style="text-align: justify;">Compromised family coping</li>
<li style="text-align: justify;">Deficient knowledge (diagnosis and treatment)</li>
<li style="text-align: justify;">Delayed growth and development</li>
<li style="text-align: justify;">Disturbed body image</li>
<li style="text-align: justify;">Disturbed sensory perception: Visual, hearing</li>
<li style="text-align: justify;">Imbalanced nutrition: Less than body requirements</li>
<li style="text-align: justify;">Impaired physical mobility</li>
<li style="text-align: justify;">Impaired swallowing</li>
<li style="text-align: justify;">Interrupted family processes</li>
<li style="text-align: justify;">Risk for impaired parenting</li>
<li style="text-align: justify;">Risk for <a href="http://nurse-thought.blogspot.com/2010/09/nursing-diagnosis-impaired-skin.html">impaired skin integrity</a></li>
</ul><div style="text-align: justify;"><b>Nursing Key outcomes Nursing Care Plans for Cerebral Palsy</b></div><div style="text-align: justify;">Nursing Key outcomes Nursing Care Plans for Cerebral Palsy, Patient will:</div><ul><li style="text-align: justify;">Verbalize feelings related to self-esteem.</li>
<li style="text-align: justify;">Develop adequate coping mechanisms.</li>
<li style="text-align: justify;">Demonstrate knowledge of the condition and the treatment plan.</li>
<li style="text-align: justify;">Achieve age-appropriate growth, behaviors, and skills to the fullest extent possible.</li>
<li style="text-align: justify;">Express positive feelings about himself.</li>
<li style="text-align: justify;">Maintain optimal functioning within the limits of the visual or hearing impairment.</li>
<li style="text-align: justify;">Remain oriented to person, place, time, and situation.</li>
<li style="text-align: justify;">Consume adequate daily calories as required.</li>
<li style="text-align: justify;">Maintain joint mobility and ROM.</li>
<li style="text-align: justify;">Swallow without pain or aspiration.</li>
<li style="text-align: justify;">Family members will discuss how the patient's condition has affected the family's daily life.</li>
<li style="text-align: justify;">The parents will identify realistic goals according to the abilities of the child.</li>
<li style="text-align: justify;">Skin will show no signs of breakdown.</li>
</ul><div style="text-align: justify;"><b>Nursing interventions Nursing Care Plans for Cerebral Palsy</b></div><ul><li style="text-align: justify;">Self-Esteem Enhancement, Emotional Support, Body Image Enhancement: Assisting a patient to increase his/her personal judgment of self-worth. Provision of reassurance, acceptance, and encouragement during times of stress. Improving a patient’s conscious and unconscious perceptions and attitudes toward body</li>
<li style="text-align: justify;">Family Involvement Promotion, Family Support, Family Mobilization: Facilitating family participation in the emotional and physical care of the patient. Promotion of family values, interests, and goals. Utilization of family strengths to influence patient’s health in a positive direction</li>
<li style="text-align: justify;">Teaching Individual Planning, implementation, and evaluation of a teaching program designed to address a patient’s diagnosis and treatment. Learning Facilitation Promoting the ability to process and comprehend information Learning Readiness Enhancement Improving the ability and willingness to receive information.</li>
<li style="text-align: justify;">Developmental Enhancement Child, Developmental Care: Facilitating or teaching parents/caregivers to facilitate the optimal gross motor, fine motor, language, cognitive, social, and emotional growth of preschool and school-age children/of individuals during the transition from childhood to adulthood Structuring the environment and providing care in response to the behavioral cues and states of the preterm infant. Nutritional Monitoring: Collection and analysis of patient data to prevent or minimize malnourishment</li>
<li style="text-align: justify;">Self-Esteem Enhancement Assisting a patient to increase personal judgment of self-worth</li>
<li style="text-align: justify;">Communication Enhancement, Environmental Management: Hearing/Vision Deficit: Assistance in accepting and learning alternative methods for living with diminished hearing/vision, Manipulation of the patient’s surroundings for therapeutic benefit</li>
<li style="text-align: justify;">Nutrition Management, Weight Gain Assistance, Eating Disorders Management: Assisting with or providing a balanced dietary intake of foods and fluids, Facilitating gain of body weight.</li>
<li style="text-align: justify;">Exercise Therapy: Use of active or passive body movement to maintain or restore flexibility; use of specific activity or exercise protocols to enhance or restore controlled body movement.</li>
<li style="text-align: justify;">Swallowing Therapy, Aspiration Precautions: Facilitating swallowing and preventing complications of impaired swallowing. Prevention or minimization of risk factors in the patient at risk for aspiration</li>
<li style="text-align: justify;">Family Process Maintenance, Family Integrity Promotion, Normalization Promotion: Minimization of family process disruption effects. Facilitating family participation in the emotional and physical care of the patient. Assisting parents and other family members of children with chronic diseases or disabilities in providing normal life experiences for their children and families</li>
<li style="text-align: justify;">Skin Surveillance, Pressure Management, Pressure Ulcer Prevention: Collection and analysis of patient data to maintain skin and mucous membrane integrity. Minimizing pressure to body parts. Prevention of pressure ulcers for a patient at high risk for developing them</li>
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</div></div>Pri'ehttp://www.blogger.com/profile/12027499295412539384noreply@blogger.com0tag:blogger.com,1999:blog-6394596897241047527.post-69898655668788237322011-04-04T06:34:00.000+07:002011-04-04T06:34:51.256+07:00NCP Nursing Care Plans For Aplastic Anemia<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="http://www.umm.edu/graphics/images/en/19725.jpg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="256" src="http://www.umm.edu/graphics/images/en/19725.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Image courtesy of umm.edu</td></tr>
</tbody></table><div style="text-align: justify;">NCP <a href="http://nurse-thought.blogspot.com/">Nursing Care Plans</a> For Aplastic <a href="http://www.lifenurses.com/anemia/">Anemia</a>. Aplastic, or hypoplastic, anemia is a bone marrow failure that is characterized by a decrease in all formed elements of peripheral blood and its bone marrow. If all elements are suppressed resulting in loss of production of healthy erythrocytes, platelets, and granulocytes the condition is known as pancytopenia. Onset is often insidious and may become chronic; however, onset may be rapid and overwhelming when the cause is a myelotoxin. Aplastic and hypoplastic anemia are potentially fatal, commonly used interchangeably with other terms for bone marrow failure, aplastic anemia correctly refer to pancytopenia resulting from the decreased functional capacity of a hypoplastic, fatty bone marrow. These disorders usually produce <a href="http://nurse-thought.blogspot.com/2011/03/ncp-nursing-care-plan-for-abdominal.html">fatal bleeding</a> or infection, particularly when they're idiopathic.</div><div class="fullpost"><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b><a href="http://www.lifenurses.com/causes-and-complications-of-anemia/">Causes</a> For Aplastic Anemia</b></div><div style="text-align: justify;">Injury or damage to the stem cells that inhibit red blood cell (RBC) production.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Complications For Aplastic Anemia</b></div><div style="text-align: justify;"><a href="http://nurse-thought.blogspot.com/2011/03/ncp-nursing-care-plans-for-stroke.html">Life-threatening hemorrhage</a> from the mucous membranes is the most common complication of aplastic or hypoplastic anemias because affected patients develop alloimmunization, which can make platelet transfusions ineffective. Immunosuppression can lead to secondary opportunistic infections.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Nursing Assessment <a href="http://www.lifenurses.com/nursing-care-plans-for-anemia/">Nursing Care Plans For Anemia</a></b></div><div style="text-align: justify;">The patient's history may not help to establish disease onset because the symptoms usually develop insidiously. The patient may report signs and symptoms of anemia (progressive weakness and fatigue, shortness of breath, and headache) or signs of thrombocytopenia (easy bruising and bleeding, especially from the mucous membranes [nose, gums, rectum, vagina]).</div><div style="text-align: justify;">Inspection may reveal pallor if the patient is anemic, and ecchymosis, petechiae, or retinal bleeding if thrombocytopenia is present. You may note alterations in the level of consciousness and weakness if bleeding into the central nervous system has occurred.</div><div style="text-align: justify;">Auscultation may reveal bibasilar crackles, tachycardia, and a gallop murmur if severe anemia results in heart failure.</div><div style="text-align: justify;">The patient may also have signs and symptoms of an opportunistic infection (most commonly, a bacterial infection). Fever, oral and rectal ulcers, and sore throat may indicate the presence of an infection but without characteristic inflammation due to leukopenia.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Diagnostic tests For Aplastic Anemia</b></div><br />
<ul><li style="text-align: justify;">Complete blood count</li>
<li style="text-align: justify;">Serum iron; coagulation tests; bone marrow biopsy; hemoglobin electrophoresis;</li>
<li style="text-align: justify;">transaminase; bilirubin; lactic dehydrogenase; blood urea nitrogen; creatinine;</li>
<li style="text-align: justify;">hepatitis testing; peripheral smear.</li>
</ul><br />
<div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b><a href="http://www.lifenurses.com/anemia-nursing-diagnosis/">Nursing diagnosis</a> Nursing Care Plans For Aplastic Anemia</b></div><br />
<ul><li style="text-align: justify;"><a href="http://nurse-thought.blogspot.com/2009/03/nursing-care-plans-for-activity.html">Activity intolerance</a></li>
<li style="text-align: justify;">Acute <a href="http://nurse-thought.blogspot.com/2009/06/pain-nursing-care-plan.html">pain</a></li>
<li style="text-align: justify;"><a href="http://nursing-concept.blogspot.com/2010/06/nursing-diagnosis-fatigue.html">Fatigue</a></li>
<li style="text-align: justify;">Fear</li>
<li style="text-align: justify;"><a href="http://nursing-concept.blogspot.com/2009/02/nursing-care-plans-for-impaired-oral.html">Impaired oral mucous membrane</a></li>
<li style="text-align: justify;">Ineffective thermoregulation</li>
<li style="text-align: justify;">Risk for deficient fluid volume</li>
<li style="text-align: justify;"><a href="http://nurse-thought.blogspot.com/2010/06/nursing-diagnosis-risk-for-infection.html">Risk for infection</a></li>
</ul><br />
<div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Nursing outcomes Nursing Care Plans For Aplastic Anemia</b></div><div style="text-align: justify;">Nursing Key outcomes Nursing Care Plans For Aplastic Anemia, Patient will;</div><br />
<ul><li style="text-align: justify;">State the need to increase activity level gradually and the importance of rest periods.</li>
<li style="text-align: justify;">Express feelings of comfort and decreased pain.</li>
<li style="text-align: justify;">Identify measures to prevent or reduce fatigue.</li>
<li style="text-align: justify;">Verbalize fears and concerns.</li>
<li style="text-align: justify;">Oral mucous membranes will remain intact.</li>
<li style="text-align: justify;">Maintain a normal body temperature.</li>
<li style="text-align: justify;">Maintain adequate fluid balance.</li>
<li style="text-align: justify;">Free from signs and symptoms of infection</li>
</ul><br />
<div style="text-align: justify;"><b>Nursing interventions Nursing Care Plans For Aplastic Anemia</b></div><br />
<ul><li style="text-align: justify;">To identify causative/precipitating factors. Assist client to deal with contributing factors and manage activities within individual limits. Activity Therapy Prescription of and assistance with specific physical, cognitive, social and spiritual activities to increase the range, frequency, or duration of an individual’s or group are activity. Energy Management Regulating energy use to treat or prevent fatigue and optimize function</li>
<li style="text-align: justify;">Pain Management Alleviation of pain or a reduction in pain to a level of comfort that is acceptable to the patient. Analgesic Administration Use of pharmacologic agents to reduce or eliminate pain. Environmental Management Manipulation of the patient’s surroundings for promotion of optimal comfort</li>
<li style="text-align: justify;">Energy Management regulating energy use to treat or prevent fatigue and optimize function. Exercise Promotion Facilitation of regular physical exercise to maintain or advance to a higher level of fitness and health. Nutrition Management Assisting with or providing a balanced dietary intake of foods and fluids</li>
<li style="text-align: justify;">Anxiety Reduction Minimizing apprehension, dread, foreboding, or uneasiness related to an unidentified source or anticipated danger. Security Enhancement Intensifying a patient’s sense of physical and psychological safety. Coping Enhancement Assisting a patient to adapt to perceived stressors, changes, or threats that interfere with meeting life demands and roles</li>
<li style="text-align: justify;">Oral Health Restoration, Oral Health Maintenance, Promotion of healing for a patient who has an oral mucosa or dental lesion. Maintenance and promotion of oral hygiene and dental health for the patient at risk for developing oral or dental lesions. Promotion of oral hygiene and dental care for a patient with normal oral and dental health</li>
<li style="text-align: justify;">Temperature Regulation: Attaining and/or maintaining body temperature within a normal range. Fever Treatment Management of a patient with hyperpyrexia caused by nonenvironmental factors</li>
<li style="text-align: justify;">Fluid Monitoring Hemodynamic Regulation Bleeding Precautions Collection and analysis of patient data to regulate fluid balance Optimization of heart rate, preload, afterload, and contractility Reduction of stimuli that may indicate bleeding or hemorrhage in at risk patients</li>
<li style="text-align: justify;">Infection Protection Infection Control and Surveillance Prevention and early detection of infection in a patient at risk, Minimizing the acquisition and transmission of infectious agents, Purposeful and ongoing acquisition, interpretation, and synthesis of patient data for clinical decision making</li>
</ul><br />
<div style="text-align: justify;"><br />
</div></div>Pri'ehttp://www.blogger.com/profile/12027499295412539384noreply@blogger.com0tag:blogger.com,1999:blog-6394596897241047527.post-78824088029561005892011-03-22T09:11:00.001+07:002011-03-22T09:11:53.121+07:00NCP Nursing Care Plan for Abdominal Aortic Aneurysm<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="http://myhealth.ucsd.edu/library/healthguide/en-us/images/media/medical/hw/h5550970.jpg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="208" src="http://myhealth.ucsd.edu/library/healthguide/en-us/images/media/medical/hw/h5550970.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 115%;">Image courtesy of myhealth.ucsd.edu<o:p></o:p></span></div></td></tr>
</tbody></table><div style="text-align: justify;">NCP <a href="http://nurse-thought.blogspot.com/">Nursing Care Plan</a> for Abdominal Aortic Aneurysm. Abdominal aortic aneurysm (AAA) is a localized outpouching abnormal dilation in the arterial wall that generally occurs in the aorta between the renal arteries and the iliac branches. Nearly 98% of all abdominal aneurysms are located in the infrarenal aorta. These aneurysms can be fusiform (spindle shaped) or saccular (pouchlike) and develop slowly.</div><div style="text-align: justify;">First, a focal weakness in the muscular layer of the aorta (tunica media), resulting from degenerative changes, allows the inner layer (tunica intima) and outer layer (tunica adventitia) to stretch outward (often caused by plaque and cholesterol deposits) and degenerative changes occur. The inner and outer layers of the arterial wall are stretched, and as the pulsatile force of the blood rushes through the aorta, the vessel wall becomes increasingly weak, and the aneurysm enlarges. Abdominal aneurysms can be fatal. More than half of people with untreated aneurysms die of aneurysm rupture within 2 years.</div><div class="fullpost"><div style="text-align: justify;"><b><br />
</b></div><div style="text-align: justify;"><b>Causes for Abdominal Aortic Aneurysm</b></div><div style="text-align: justify;">The most common cause of Abdominal Aortic Aneurysm is atherosclerosis or arteriosclerosis; the rest, from cystic medial necrosis, trauma, syphilis, and other infections.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Complications for Abdominal Aortic Aneurysm</b></div><div style="text-align: justify;">Hemorrhage and shock from aneurysmal rupture </div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Nursing Assessment Nursing Care Plan for Abdominal Aortic Aneurysm</b></div><br />
<ul><li style="text-align: justify;">Patient History most of abdominal aortic aneurysm are asymptomatic and are found incidentally. When the aorta enlarges and compresses the surrounding structures, patient complaints may include flank and back pain, epigastric discomfort, or altered bowel elimination. The pain may be deep and steady with no change if the patient shifts position. If the patient reports severe back and abdominal pain, rupture of the abdominal aortic aneurysm may be imminent</li>
<li style="text-align: justify;">Inspection of the patient with an intact abdominal aneurysm usually reveals no significant findings. However, if the patient isn't obese, you may notice a pulsating mass in the periumbilical area. If the aneurysm has ruptured, you may notice signs of hypovolemic shock, such as skin mottling, decreased level of consciousness, diaphoresis, and oliguria. The abdomen may appear distended and an ecchymosis or hematoma may be present in the abdominal, flank, or groin area</li>
<li style="text-align: justify;">Palpation of the abdomen may disclose some tenderness over the affected area. A pulsatile mass may be felt; however, avoid deep palpation to locate the mass because this may cause the aneurysm to rupture. Palpation of the peripheral pulses may reveal absent pulses distal to a ruptured aneurysm</li>
</ul><br />
<div style="text-align: justify;">Watch for signs that may indicate impending aneurysm rupture. Note subtle changes such as a change in the characteristics and quality of peripheral pulses, changes in neurological status, and changes in vital signs such as a drop in blood pressure, increased pulse, and increased respirations. An abdominal aneurysm can impair flow to the lower extremities and cause what are known as the five Ps of ischemia: pain, pallor, pulselessness, paresthesias, and paralysis</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Diagnostic tests for Abdominal Aortic Aneurysm</b></div><div style="text-align: justify;">• Abdominal ultrasonography or echocardiography</div><div style="text-align: justify;">• Anteroposterior and lateral X-rays of the abdomen</div><div style="text-align: justify;">• Computed tomography scan</div><div style="text-align: justify;">• Aortography</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Nursing diagnosis Nursing Care Plan for Abdominal Aortic Aneurysm</b></div><div style="text-align: justify;">Common nursing diagnosis found in Nursing Care Plan for Abdominal Aortic Aneurysm</div><br />
<ul><li style="text-align: justify;">Deficient fluid volume</li>
<li style="text-align: justify;"><a href="http://www.lifenurses.com/pain-nursing-management/">Acute pain</a></li>
<li style="text-align: justify;"><a href="http://nurse-thought.blogspot.com/2009/03/nursing-care-plans-for-anxiety.html">Anxiety</a></li>
<li style="text-align: justify;">Decreased cardiac output</li>
<li style="text-align: justify;"><a href="http://nurse-thought.blogspot.com/2010/07/nursing-diagnosis-impaired-gas-exchange.html">Impaired gas exchange</a></li>
<li style="text-align: justify;">Impaired physical mobility</li>
<li style="text-align: justify;"><a href="http://nurse-thought.blogspot.com/2010/09/nursing-diagnosis-impaired-skin.html">Impaired skin integrity</a></li>
<li style="text-align: justify;">Ineffective tissue perfusion: Renal, cardiopulmonary</li>
<li style="text-align: justify;">Risk for fluid volume deficit related to hemorrhage</li>
</ul><br />
<div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Nursing outcomes</b> <b><a href="http://www.lifenurses.com/category/nursing/nursing-care-plans/">Nursing Care Plan</a> for Abdominal Aortic Aneurysm</b></div><div style="text-align: justify;">Nursing Key outcome NCP <b>Nursing Care Plan for Abdominal Aortic Aneurysm, </b>Patient Will:</div><br />
<ul><li style="text-align: justify;">Express feelings of increasing comfort and decreased pain.</li>
<li style="text-align: justify;">Verbalize strategies to reduce his anxiety level.</li>
<li style="text-align: justify;">Maintain adequate cardiac output.</li>
<li style="text-align: justify;">Maintain adequate fluid volume.</li>
<li style="text-align: justify;">Maintain adequate ventilation and oxygenation.</li>
<li style="text-align: justify;">Maintain joint mobility and muscle strength.</li>
<li style="text-align: justify;">Patient's skin will remain intact.</li>
<li style="text-align: justify;">Pulses will remain palpable distal to the aneurysm site.</li>
<li style="text-align: justify;">Maintain adequate urine output (output will be equivalent to intake).</li>
</ul><br />
<div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Nursing interventions</b> <b>Nursing Care Plan for Abdominal Aortic Aneurysm</b></div><br />
<ul><li style="text-align: justify;">Fluid Management: Promotion of fluid balance and prevention of complications resulting from abnormal or undesired fluid levels</li>
<li style="text-align: justify;">Hypovolemia Management: Reduction in extracellular and/or intracellular fluid volume and prevention of complications</li>
<li style="text-align: justify;">Shock Management: Volume: Promotion of adequate tissue perfusion for a patient with severely compromised intravascular volume.</li>
<li style="text-align: justify;">Pain Management: Alleviation of pain or a reduction in pain to a level of comfort that is acceptable to the patient</li>
<li style="text-align: justify;">Analgesic Administration: Use of pharmacologic agents to reduce or eliminate pain</li>
<li style="text-align: justify;">Environmental Management: Comfort: Manipulation of the patient’s surroundings for promotion of optimal comfort</li>
<li style="text-align: justify;">Anxiety Reduction: Minimizing apprehension, dread, foreboding, or uneasiness related to an unidentified source or anticipated danger</li>
<li style="text-align: justify;">Calming Technique: Reducing anxiety in patient experiencing acute distress</li>
<li style="text-align: justify;">Hemodynamic Regulation: Optimization of heart rate, preload, afterload, and contractility</li>
<li style="text-align: justify;">Cardiac Care: Limitation of complications resulting from an imbalance between myocardial oxygen supply and demand for a patient with symptoms of impaired cardiac function</li>
<li style="text-align: justify;">Circulatory Care: Mechanical Assist Devices: Temporary support of the circulation through the use of mechanical devices or pumps</li>
<li style="text-align: justify;">Respiratory Monitoring: Collection and analysis of patient data to ensure airway patency and adequate gas exchange</li>
<li style="text-align: justify;">Oxygen Therapy: Administration of oxygen and monitoring of its effectiveness</li>
</ul><br />
<div style="text-align: justify;"><br />
</div></div>Pri'ehttp://www.blogger.com/profile/12027499295412539384noreply@blogger.com0tag:blogger.com,1999:blog-6394596897241047527.post-53728767853097108812011-03-18T07:44:00.002+07:002011-03-18T08:52:56.190+07:00NCP Nursing Care Plan for Acute Respiratory Failure<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: justify;"><tbody>
<tr><td style="text-align: center;"><a href="http://www.umm.edu/graphics/images/en/9248.jpg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="256" src="http://www.umm.edu/graphics/images/en/9248.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><div class="MsoNormal" style="line-height: normal; margin-bottom: 0.0001pt; text-align: center;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt;">Image courtesy of umm.edu<o:p></o:p></span></div></td></tr>
</tbody></table><div style="text-align: justify;">NCP Nursing Care Plan for Acute Respiratory Failure. When the lungs can't adequately maintain arterial oxygenation or eliminate carbon dioxide (CO2), acute respiratory failure occurs. If not checked and treated, the condition leads to tissue hypoxia. In patients with essentially normal lung tissue, acute respiratory failure usually produces a partial pressure of arterial CO2 (PaCO2) greater than 50 mm Hg and a partial pressure of arterial oxygen (PaO2) less than 50 mm Hg.</div><div style="text-align: justify;">These limits, however, don't apply to patients with <a href="http://nurse-thought.blogspot.com/2009/06/nursing-care-plan-for-patient-with-copd.html">chronic obstructive pulmonary disease COPD</a>. </div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Causes for Acute Respiratory Failure</b></div><div class="fullpost"><div style="text-align: justify;">Acute respiratory failure may develop from COPD, Other causes of acute respiratory failure include:</div><br />
<ul><li style="text-align: justify;">Central nervous system depression due to <a href="http://www.lifenurses.com/cerebral-contusion/">head trauma</a> or injudicious use of sedatives, opioids, tranquilizers, or oxygen</li>
<li style="text-align: justify;">Cardiovascular disorders (myocardial infarction, heart failure, or pulmonary emboli)</li>
<li style="text-align: justify;">Airway irritants, such as smoke or fumes</li>
<li style="text-align: justify;">Endocrine or metabolic disorders, such as myxedema or metabolic acidosis</li>
<li style="text-align: justify;">Thoracic abnormalities, such as chest trauma, pneumothorax, or thoracic or abdominal surgery</li>
<li style="text-align: justify;">Noncompliance with prescribed bronchodilator or corticosteroid therapy.</li>
</ul><br />
<div style="text-align: justify;"><b>Complications for Acute Respiratory Failure</b></div><br />
<ul><li style="text-align: justify;">Tissue hypoxia,</li>
<li style="text-align: justify;">Metabolic acidosis.</li>
<li style="text-align: justify;">Respiratory and cardiac arrest.</li>
</ul><br />
<div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Nursing Assessment Nursing Care Plan for Acute Respiratory Failure</b></div><br />
<ul><li style="text-align: justify;">Inspection, note cyanosis of the oral mucosa, lips, and nail beds; nasal flaring; and ashen skin. You may observe the patient yawning and using accessory muscles to breathe. He may appear restless, anxious, depressed, lethargic, agitated, or confused. Additionally, he usually exhibits tachypnea, which signals impending respiratory failure.</li>
<li style="text-align: justify;">Palpation may reveal cold, clammy skin and asymmetrical chest movement, which suggests <a href="http://www.lifenurses.com/pneumothorax/">pneumothorax</a>. If tactile fremitus is present, notice that it decreases over an obstructed bronchi or pleural effusion but increases over consolidated lung tissue.</li>
<li style="text-align: justify;">Percussion especially in patients with <a href="http://www.lifenurses.com/nursing-care-plans-chronic-obstructive-pulmonary-disease-copd/">COPD</a> reveals hyperresonance. If acute respiratory failure results from atelectasis or pneumonia, percussion usually produces a dull or flat sound.</li>
<li style="text-align: justify;">Auscultation typically discloses diminished breath sounds. In patients with <a href="http://www.lifenurses.com/nursing-care-plans-pneumothorax/">pneumothorax</a>, breath sounds may be absent. In other cases of respiratory failure, you may hear such adventitious breath sounds as wheezes and rhonchi . If you hear crackles, suspect pulmonary edema as the cause of respiratory failure.</li>
</ul><br />
<div style="text-align: justify;"><br />
</div><div style="text-align: justify;">Diagnostic tests for Acute Respiratory Failure</div><br />
<ul><li style="text-align: justify;">ABG analysis</li>
<li style="text-align: justify;">Chest X-rays</li>
<li style="text-align: justify;">Electrocardiography (ECG)</li>
<li style="text-align: justify;">Pulse oximetry.</li>
<li style="text-align: justify;">Blood tests such as a white blood cell count low hematocrit and decreased hemoglobin levels signal blood loss, which indicates decreased oxygen-carrying capacity.</li>
<li style="text-align: justify;">Serum electrolyte</li>
<li style="text-align: justify;">Pulmonary artery</li>
<li style="text-align: justify;">Blood culture and sputum culture to identify the pathogen.</li>
</ul><br />
<div style="text-align: justify;"><b>Nursing diagnosis Nursing Care Plan for Acute Respiratory Failure</b></div><div style="text-align: justify;">Common Nursing diagnosis found in patient with Acute Respiratory Failure</div><br />
<ul><li style="text-align: justify;">Anxiety</li>
<li style="text-align: justify;">Decreased cardiac output</li>
<li style="text-align: justify;">Fatigue</li>
<li style="text-align: justify;">Fear</li>
<li style="text-align: justify;"><a href="http://nurse-thought.blogspot.com/2010/07/nursing-diagnosis-impaired-gas-exchange.html">Impaired gas exchange</a></li>
<li style="text-align: justify;">Impaired physical mobility</li>
<li style="text-align: justify;">Impaired verbal communication</li>
<li style="text-align: justify;"><a href="http://nurse-thought.blogspot.com/2010/07/nursing-diagnosis-ineffective-airway.html">Ineffective airway clearance</a></li>
<li style="text-align: justify;">Ineffective coping</li>
<li style="text-align: justify;">Ineffective tissue perfusion: Cardiopulmonary</li>
<li style="text-align: justify;">Risk for<a href="http://nurse-thought.blogspot.com/2010/09/nursing-diagnosis-impaired-skin.html"> impaired skin integrity</a></li>
<li style="text-align: justify;"><a href="http://nurse-thought.blogspot.com/2010/06/nursing-diagnosis-risk-for-infection.html">Risk for infection</a></li>
</ul><br />
<div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Nursing outcomes Nursing Care Plan for Acute Respiratory Failure</b></div><div style="text-align: justify;"><b><span class="Apple-style-span" style="font-weight: normal;">Patient will</span><span class="Apple-style-span" style="font-weight: normal;"> :</span></b></div><br />
<ul><li style="text-align: justify;">Express feelings of reduced anxiety.</li>
<li style="text-align: justify;">Remain hemodynamically stable.</li>
<li style="text-align: justify;">Verbalize the importance of balancing activity with adequate rest periods.</li>
<li style="text-align: justify;">Discuss fears or concerns.</li>
<li style="text-align: justify;">Maintain adequate ventilation and oxygenation</li>
<li style="text-align: justify;">Maintain joint range-of-motion and muscle strength.</li>
<li style="text-align: justify;">Use alternate means of communication.</li>
<li style="text-align: justify;">Maintain a patent airway.</li>
<li style="text-align: justify;">Use support systems to assist with coping.</li>
<li style="text-align: justify;">Maintain adequate cardiopulmonary perfusion.</li>
<li style="text-align: justify;">Maintain skin integrity.</li>
<li style="text-align: justify;">Remain free from signs or symptoms of infection.</li>
</ul><br />
<div style="text-align: justify;">Nursing Interventions Nursing Care Plan for Acute Respiratory Failure</div><br />
<ul><li style="text-align: justify;">Anxiety Reduction: Minimizing apprehension, dread, foreboding, or uneasiness related to an unidentified source or anticipated danger</li>
<li style="text-align: justify;">Calming Technique: Reducing anxiety in patient experiencing acute distress</li>
<li style="text-align: justify;">Hemodynamic Regulation: Optimization of heart rate, preload, afterload, and contractility</li>
<li style="text-align: justify;">Cardiac Care: Limitation of complications resulting from an imbalance between myocardial oxygen supply and demand for a patient with symptoms of impaired cardiac function</li>
<li style="text-align: justify;">Circulatory Care: Mechanical Assist Devices: Temporary support of the circulation through the use of mechanical devices or pumps</li>
<li style="text-align: justify;">Energy Management: Regulating energy use to treat or prevent fatigue and optimize function</li>
<li style="text-align: justify;">Exercise Promotion: Facilitation of regular physical exercise to maintain or advance to a higher level of fitness and health</li>
<li style="text-align: justify;">Nutrition Management: Assisting with or providing a balanced dietary intake of foods and fluids</li>
<li style="text-align: justify;">Anxiety Reduction: Minimizing apprehension, dread, foreboding, or uneasiness related to an unidentified source or anticipated danger</li>
<li style="text-align: justify;">Security Enhancement: Intensifying a patient’s sense of physical and psychological safety</li>
<li style="text-align: justify;">Coping Enhancement: Assisting a patient to adapt to perceived stressors, changes, or threats that interfere with meeting life demands and roles</li>
<li style="text-align: justify;">Respiratory Monitoring: Collection and analysis of patient data to ensure airway patency and adequate gas exchange</li>
<li style="text-align: justify;">Oxygen Therapy: Administration of oxygen and monitoring of its effectiveness</li>
<li style="text-align: justify;">Airway Management: Facilitation of patency of air passages</li>
<li style="text-align: justify;">Exercise Therapy: [specify]: Use of active or passive body movement to maintain or restore flexibility; use of specific activity or exercise protocols to enhance or restore controlled body movement, etc.</li>
<li style="text-align: justify;">Pain Management: Alleviation of pain or a reduction in pain to a level of comfort acceptable to the patient</li>
<li style="text-align: justify;">Communication Enhancement: Speech Deficit: Assistance in accepting and learning alternative methods for living with impaired speech</li>
<li style="text-align: justify;">Communication Enhancement: Hearing Deficit: Assistance in accepting and learning alternative methods for living with diminished hearing</li>
<li style="text-align: justify;">Active Listening: Attending closely to and attaching significance to a patient’s verbal and nonverbal messages</li>
<li style="text-align: justify;">Airway Management: Facilitation of patency of air passages</li>
<li style="text-align: justify;">Respiratory Monitoring: Collection and analysis of patient data to ensure airway patency and adequate gas exchange</li>
<li style="text-align: justify;">Cough Enhancement: Promotion of deep inhalation by the patient with subsequent generation of high intrathoracic pressures and compression of underlying lung parenchyma for the forceful expulsion of air</li>
<li style="text-align: justify;">Coping Enhancement: Assisting a patient to adapt to perceived stressors, changes, or threats that interfere with meeting life demands and roles</li>
<li style="text-align: justify;">Decision-Making Support: Providing information and support for a person who is making a decision regarding healthcare</li>
<li style="text-align: justify;">Fluid/Electrolyte Management: Promotion of fluid/electrolyte balance and prevention of complications resulting from abnormal or undesired fluid/serum electrolyte levels</li>
<li style="text-align: justify;">Cerebral Perfusion Promotion: Promotion of adequate perfusion and limitation of complications for a patient experiencing or at risk for inadequate cerebral perfusion</li>
<li style="text-align: justify;">Cardiac Care: Limitation of complications resulting from an imbalance between myocardial oxygen supply and demand for a patient with symptoms of impaired cardiac function</li>
<li style="text-align: justify;">Circulatory Care: Arterial/Venous Insufficiency: Promotion of arterial/venous circulation</li>
<li style="text-align: justify;">Skin Surveillance: Collection and analysis of patient data to maintain skin and mucous membrane integrity</li>
<li style="text-align: justify;">Pressure Management: Minimizing pressure to body parts</li>
<li style="text-align: justify;">Pressure Ulcer Prevention: Prevention of pressure ulcers for a patient at high risk for developing them</li>
<li style="text-align: justify;">Infection Protection: Prevention and early detection of infection in a patient at risk</li>
<li style="text-align: justify;">Infection Control: Minimizing the acquisition and transmission of infectious agents</li>
<li style="text-align: justify;">Surveillance: Purposeful and ongoing acquisition, interpretation, and synthesis of patient data for clinical decision making</li>
</ul><br />
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</div></div>Pri'ehttp://www.blogger.com/profile/12027499295412539384noreply@blogger.com0tag:blogger.com,1999:blog-6394596897241047527.post-68867244767812268462011-03-18T07:44:00.001+07:002011-03-18T07:44:19.324+07:00NCP Nursing Care Plan For Encephalitis<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="http://www.umm.edu/graphics/images/en/17110.jpg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="256" src="http://www.umm.edu/graphics/images/en/17110.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt;">Image Courtesy Of umm.edu</span></td></tr>
</tbody></table><div style="text-align: justify;">NCP <a href="http://nurse-thought.blogspot.com/">Nursing Care Plan</a> For Encephalitis. Encephalitis is a severe inflammation of the brain characterized by intense lymphocytic infiltration of brain tissues and the leptomeninges. This process causes cerebral edema, degeneration of the brain's ganglion cells, and diffuse nerve cell destruction. Viruses transmitted by arthropods are arboviruses (arthropod-borne). Transmission by means other than arthropod bites may occur through ingestion of infected goat's milk and accidental injection or inhalation of the virus. Eastern equine encephalitis may produce permanent neurologic damage and is commonly fatal.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Causes For Encephalitis</b></div><div class="fullpost"><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">Encephalitis usually results from infection frequently caused by enteroviruses (coxsackievirus, poliovirus, and echovirus). Other causes include herpesvirus, mumps virus, adenoviruses, and demyelinating diseases after measles, varicella, rubella, or vaccination</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Complications For Encephalitis</b></div><div style="text-align: justify;">Potential complications associated with viral encephalitis include:</div><div style="text-align: justify;">• Bronchial pneumonia,</div><div style="text-align: justify;">• Urine retention</div><div style="text-align: justify;">• Urinary tract infection</div><div style="text-align: justify;">• Pressure ulcers.</div><div style="text-align: justify;">• Coma. </div><div style="text-align: justify;">• Epilepsy, parkinsonism, and mental deterioration may also occur</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Nursing Assessment Nursing Care Plan For Encephalitis</b></div><div style="text-align: justify;">Depending on the severity of the disease, all forms of viral encephalitis have similar clinical features. The severity of arbovirus encephalitis may range from subclinical to rapidly fatal necrotizing disease. Herpes encephalitis also produces signs and symptoms that vary from subclinical to acute and often fatal fulminating disease.</div><div style="text-align: justify;"><b>Patient History</b>. Obtain a history of recent illnesses, which may include an upper respiratory infection or a minor systemic illness that caused headache, muscle ache, malaise, sore throat, and runny nose. Note if the patient has other sites of infection, such as a recent skull fracture or head injury, middle ear infection, or sinus infection. Ask if the patient has had a recent immunization, exposure to mumps or hsv, animal bites, recent travel, or exposure to epidemic outbreaks or mononucleosis. Ask if a child has been playing in a rural area where exposure to ticks or mosquitoes was possible</div><div style="text-align: justify;"><b>Neurologic examination</b>, The patient appears acutely ill with an altered mental status that may range from mild confusion to delirium and coma. Tremors, cranial nerve palsies, exaggerated deep tendon reflexes, absent superficial reflexes, and paresis or paralysis of the extremities. The patient may complain of a stiff neck when the head is bent forward.Vital signs usually reveal fever.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Diagnostic tests For Encephalitis</b></div><div style="text-align: justify;">The following tests help establish a diagnosis.</div><br />
<ul><li style="text-align: justify;">Blood analysis or,</li>
<li style="text-align: justify;">Rarely, cerebrospinal fluid (CSF) analysis</li>
<li style="text-align: justify;">Serologic studies in herpes encephalitis.</li>
<li style="text-align: justify;">Lumbar puncture CSF analysis</li>
<li style="text-align: justify;">EEG.</li>
<li style="text-align: justify;">Computed tomography scanning</li>
<li style="text-align: justify;">Magnetic resonance imaging.</li>
</ul><br />
<div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Nursing diagnosis Nursing Care Plan For Encephalitis</b></div><br />
<ul><li style="text-align: justify;">Acute pain</li>
<li style="text-align: justify;">Anxiety</li>
<li style="text-align: justify;">Disturbed thought processes</li>
<li style="text-align: justify;">Hyperthermia</li>
<li style="text-align: justify;">Imbalanced nutrition: Less than body requirements</li>
<li style="text-align: justify;">Impaired gas exchange</li>
<li style="text-align: justify;">Impaired physical mobility</li>
<li style="text-align: justify;">Risk for deficient fluid volume</li>
<li style="text-align: justify;">Risk for impaired skin integrity</li>
</ul><br />
<div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Nursing outcomes Nursing Care Plan For Encephalitis</b></div><div style="text-align: justify;">Nursing outcomes Nursing Care Plan For Encephalitis The patient will:</div><br />
<ul><li style="text-align: justify;">Express feelings of comfort and relief of pain.</li>
<li style="text-align: justify;">Identify strategies to reduce anxiety.</li>
<li style="text-align: justify;">Remain oriented to person, place, time, and situation.</li>
<li style="text-align: justify;">Exhibit fluid balance within normal limits.</li>
<li style="text-align: justify;">Consume adequate daily calories as required</li>
<li style="text-align: justify;">Maintain adequate ventilation and oxygenation.</li>
<li style="text-align: justify;">Maintain joint mobility and muscle strength.</li>
<li style="text-align: justify;">Exhibit temperature within normal limits.</li>
<li style="text-align: justify;">Maintain intact skin with no signs of breakdown.</li>
</ul><br />
<div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Nursing interventions Nursing Care Plan For Encephalitis</b></div><br />
<ul><li style="text-align: justify;"><a href="http://nurse-thought.blogspot.com/2009/06/pain-nursing-care-plan.html">Pain Management</a>: Alleviation of pain or a reduction in pain to a level of comfort that is acceptable to the patient</li>
<li style="text-align: justify;">Analgesic Administration: Use of pharmacologic agents to reduce or eliminate pain</li>
<li style="text-align: justify;">Environmental Management: Comfort: Manipulation of the patient’s surroundings for promotion of optimal comfort</li>
<li style="text-align: justify;">Anxiety Reduction: Minimizing apprehension, dread, foreboding, or uneasiness related to an unidentified source or anticipated danger</li>
<li style="text-align: justify;">Provision of a modified environment for the patient who is experiencing a chronic confusional state</li>
<li style="text-align: justify;">Calming Technique: Reducing anxiety in patient experiencing acute distress</li>
<li style="text-align: justify;">Delusion Management: Promoting the comfort, safety, and reality orientation of a patient experiencing false, fixed beliefs that have little or no basis in reality</li>
<li style="text-align: justify;">Environmental Management: Safety: Manipulation of the patient’s surroundings for therapeutic benefit</li>
<li style="text-align: justify;">Temperature Regulation: Attaining and/or maintaining body temperature within a normal range</li>
<li style="text-align: justify;">Fever Treatment: Management of a patient with hyperpyrexia caused by nonenvironmental factors</li>
<li style="text-align: justify;">Nutrition Management: Assisting with or providing a balanced dietary intake of foods and fluids</li>
<li style="text-align: justify;">Weight Gain Assistance: Facilitating gain of body weight</li>
<li style="text-align: justify;">Eating Disorders Management: Prevention and treatment of severe diet restrictions and over exercising or binging and purging of foods and fluids</li>
<li style="text-align: justify;">Respiratory Monitoring: Collection and analysis of patient data to ensure airway patency and adequate gas exchange</li>
<li style="text-align: justify;">Oxygen Therapy: Administration of oxygen and monitoring of its effectiveness</li>
<li style="text-align: justify;">Airway Management: Facilitation of patency of air passages</li>
<li style="text-align: justify;">Exercise Therapy: Use of active or passive body movement to maintain or restore flexibility; use of specific activity or exercise protocols to enhance or restore controlled body movement</li>
<li style="text-align: justify;">Fluid Monitoring: Collection and analysis of patient data to regulate fluid balance</li>
<li style="text-align: justify;">Hemodynamic Regulation: Optimization of heart rate, preload, afterload, and contractility</li>
<li style="text-align: justify;">Skin Surveillance: Collection and analysis of patient data to maintain skin and mucous membrane integrity</li>
<li style="text-align: justify;">Pessure Management: Minimizing pressure to body parts</li>
<li style="text-align: justify;">Pressure Ulcer Prevention: Prevention of pressure ulcers for a patient at high risk for developing them</li>
</ul><br />
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</div></div>Pri'ehttp://www.blogger.com/profile/12027499295412539384noreply@blogger.com0tag:blogger.com,1999:blog-6394596897241047527.post-69677185986736118182011-03-18T07:43:00.000+07:002011-03-18T07:43:54.468+07:00NCP Nursing Care Plans For Sudden Infant Death Syndrome SIDS<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="http://scopeblog.stanford.edu/SleepingBaby.jpg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="213" src="http://scopeblog.stanford.edu/SleepingBaby.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><div class="MsoNormal" style="line-height: normal; margin-bottom: .0001pt; margin-bottom: 0cm; mso-layout-grid-align: none; text-autospace: none;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt;">Image courtesy of </span>scopeblog.stanford.edu<span style="font-family: 'Times New Roman', serif; font-size: 12pt;"><o:p></o:p></span></div></td></tr>
</tbody></table><div style="text-align: justify;">NCP <a href="http://nurse-thought.blogspot.com/">Nursing Care Plans</a> For Sudden Infant Death Syndrome SIDS. Sudden infant death syndrome (SIDS), also known as crib death, is the third leading cause of death among apparently healthy infants between ages 1 month to 1 year. In 2002, SIDS caused 2,295 infant deaths, accounting for 8.2% of total infant deaths that year. Most deaths occur between ages 1 and 4 months, with incidence declining rapidly between ages of 4 to 12 months.</div><div style="text-align: justify;">About 60% of victims are male infants who die in their sleep, without warning, sound, or struggle. The incidence is slightly higher in preterm infants, Inuit infants, disadvantaged black infants, infants born to mothers younger than age 20, and infants of multiple births.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Causes For Sudden Infant Death Syndrome SIDS</b></div><div class="fullpost"><div style="text-align: justify;">At one time, SIDS was attributed to abuse or accidental suffocation during sleep. On postmortem examination, some SIDS-diagnosed infants show changes indicating chronic hypoxia, hypoxemia, and large-airway obstruction, leading researchers to suspect more than one cause.</div><div style="text-align: justify;">Two leading hypotheses are the hypoxemia theory and the apnea theory. The hypoxemia theory suggests that SIDS occurs because of damage to the respiratory control center in the brain from chronic hypoxemia. The apnea theory holds that the SIDS victim experiences prolonged periods of sleep apnea and eventually dies during an episode. </div><div style="text-align: justify;">Another proposed cause involves Clostridium botulinum toxin, which has been linked to a few SIDS deaths. A disproved theory is an association between SIDS and diphtheria, tetanus, and pertussis vaccines. And, although bottle-feeding and advanced parental age don't cause the syndrome, breast-fed infants are at decreased risk for SIDS</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Nursing Assessment Nursing Care Plans For Sudden Infant Death Syndrome SIDS</b></div><div style="text-align: justify;">The patient history supplied by the parents may reveal that they found the infant wedged in a crib corner or with blankets wrapped around his head. Despite such findings, autopsy results rule out suffocation as the cause of death. The history may also note frothy, blood-tinged sputum found around the infant's mouth or on the crib sheets. However, autopsy findings show a patent airway, ruling out aspiration of vomitus as the cause of death.</div><div style="text-align: justify;">Typically, the parents report that the infant didn't cry and showed no signs of disturbed sleep. Reports of the infant found in a peculiar position or tangled in his blankets suggest movement before death, possibly from terminal spasm. Occasionally, the history may reveal a respiratory tract infection.</div><div style="text-align: justify;">Documentation of events before discovery of the infant's death should be part of the history. Often, bruising, possible fractured ribs, and the appearance of blood in the infant's mouth, nose, or ears from internal bleeding may be confused with abuse. Although this possibility shouldn't be dismissed, never assume that abuse caused the infant's death without obtaining further information. Avoid assessment questions that may suggest parental responsibility for the death.</div><div style="text-align: justify;">Depending on how long the infant has been dead, inspection may reveal an infant with mottled complexion and extremely cyanotic lips and fingertips. You may also see pooled blood in the legs and feet. These markings may be mistaken for bruises. The infant's diaper may be wet and full of stools.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Diagnostic tests For Sudden Infant Death Syndrome SIDS</b></div><div style="text-align: justify;">Diagnosis of SIDS requires an autopsy to rule out other causes of death. Characteristic histologic findings on autopsy include small or normal adrenal glands and petechiae over the visceral surfaces of the pleura, within the thymus (which is enlarged), and in the epicardium. Autopsy also reveals well-preserved lymphoid structures; signs of chronic hypoxemia such as increased pulmonary artery smooth muscle; edematous, congestive lungs fully expanded; liquid (not clotted) blood in the heart; and stomach curd inside the trachea</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Nursing Diagnosis Nursing Care Plans For Sudden Infant Death Syndrome SIDS</b></div><div style="text-align: justify;"></div><ul><li>Dysfunctional grieving</li>
<li>Fear</li>
<li>Hopelessness</li>
<li>Interrupted family processes</li>
<li>Spiritual distress</li>
</ul><div style="text-align: justify;"><b>Nursing Outcomes Nursing Care Plans For Sudden Infant Death Syndrome SIDS</b></div><div style="text-align: justify;"></div><ul><li>Family members will seek appropriate support persons for assistance.</li>
<li>Family members will use available support systems to assist in coping with fear.</li>
<li>Family members will identify feelings of hopelessness regarding the current situation.</li>
<li>Family members will share feelings about the event.</li>
<li>Family members will verbalize measures to prevent SIDS.</li>
<li>Family members will use effective coping strategies to ease spiritual discomfort.</li>
</ul><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Nursing Interventions NCP Nursing Care Plans For Sudden Infant Death Syndrome SIDS</b></div><div style="text-align: justify;"></div><ul><li>Grief Work Facilitation: Assistance with the resolution of a significant loss</li>
<li>Grief Work Facilitation: Perinatal Death: Assistance with the resolution of a perinatal loss</li>
<li>Coping Enhancement: Assisting a patient to adapt to perceived stressors, changes, or threats that interfere with meeting life demands and roles</li>
<li><a href="http://nurse-thought.blogspot.com/2009/03/nursing-care-plans-for-anxiety.html">Anxiety</a> Reduction: Minimizing apprehension, dread, foreboding, or uneasiness related to an unidentified source or anticipated danger</li>
<li>Security Enhancement: Intensifying a patient’s sense of physical and psychological safety</li>
<li>Hope Instillation: Facilitation of the development of a positive outlook in a given situation</li>
<li>Emotional Support: Provision of reassurance, acceptance, and encouragement during times of stress</li>
<li>Family Process Maintenance: Minimization of family process disruption effects</li>
<li>Family Integrity Promotion: Facilitating family participation in the emotional and physical care of the patient</li>
<li>Normalization Promotion: Assisting parents and other family members of children with chronic diseases or disabilities in providing normal life experiences for their children and families</li>
<li>Spiritual Support: Assisting the patient to feel balance and connection with a greater power</li>
<li>Grief Work Facilitation: Assistance with the resolution of a significant loss</li>
</ul><br />
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</div></div>Pri'ehttp://www.blogger.com/profile/12027499295412539384noreply@blogger.com0tag:blogger.com,1999:blog-6394596897241047527.post-54563682435415739912011-03-17T06:42:00.002+07:002011-03-17T06:42:54.576+07:00NCP Nursing Care Plans For Meningococcal Infections<div style="text-align: justify;">NCP <a href="http://nurse-thought.blogspot.com/">Nursing Care Plans</a> For Meningococcal Infections. Two major meningococcal infections, meningitis and meningococcemia, are caused by the gram-negative bacteria Neisseria meningitidis, which also causes primary <a href="http://nurse-thought.blogspot.com/2009/02/nursing-care-plans-for-pneumonia.html">pneumonia</a>, purulent conjunctivitis, endocarditis, sinusitis, and genital infection. Meningococcemia occurs as simple bacteremia, fulminating meningococcemia and, rarely, chronic meningococcemia. It commonly accompanies meningitis. Meningococcal infections may occur sporadically or in epidemics; particularly virulent infections may be fatal within a matter of hours.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Causes For Meningococcal Infections</b></div><div class="fullpost"><div style="text-align: justify;">Neisseria meningitidis has seven serogroups (A, B, C, D, X, Y, and Z</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Complications For Meningococcal Infections</b></div><br />
<ul><li style="text-align: justify;">Respiratory failure that requires mechanical ventilation. If severe </li>
<li style="text-align: justify;">Disseminated intravascular coagulation (DIC) develops, </li>
<li style="text-align: justify;">Hemorrhage GI tract, and urinary tract, as well as tissue ischemia.</li>
<li style="text-align: justify;">Septic arthritis, pericarditis, or endophthalmitis. </li>
<li style="text-align: justify;">Aspiration of the organism can cause meningococcal pneumonia.</li>
<li style="text-align: justify;">Meningococcal infections may progress very rapidly, causing neurologic deterioration and even death.</li>
</ul><br />
<div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Nursing Assessment Nursing Care Plans For Meningococcal Infections</b></div><div style="text-align: justify;">Features of meningococcal bacteremia include sudden spiking fever, headache, sore throat, cough, chills, myalgia , arthralgia, tachycardia, tachypnea, mild hypotension, and a petechial, nodular, or maculopapular rash. Headache and stiff neck can also occur as the infection extends to the meninges.</div><div style="text-align: justify;">Characteristics of the rare chronic meningococcemia include intermittent fever, rash, joint pain, and an enlarged spleen.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Diagnostic tests For Meningococcal Infections</b></div><div style="text-align: justify;">• Blood culture, </div><div style="text-align: justify;">• Cerebrospinal Fluid CSF culture</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Nursing diagnosis Nursing Care Plans For Meningococcal Infections</b></div><br />
<ul><li style="text-align: justify;">Acute <a href="http://nurse-thought.blogspot.com/2009/06/pain-nursing-care-plan.html">pain</a></li>
<li style="text-align: justify;">Hyperthermia</li>
<li style="text-align: justify;">Decreased cardiac output</li>
<li style="text-align: justify;"><a href="http://nurse-thought.blogspot.com/2010/09/nursing-diagnosis-impaired-skin.html">Impaired skin integrity</a></li>
<li style="text-align: justify;">Ineffective breathing pattern</li>
<li style="text-align: justify;">Ineffective tissue perfusion: Cardiopulmonary</li>
</ul><br />
<div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Nursing outcomes Nursing Care Plans For Meningococcal Infections</b></div><br />
<ul><li style="text-align: justify;">The patient will express feelings of comfort and relief from pain.</li>
<li style="text-align: justify;">The patient will maintain adequate cardiac output.</li>
<li style="text-align: justify;">The patient will remain a febrile.</li>
<li style="text-align: justify;">The patient's skin will remain warm, dry, and intact.</li>
<li style="text-align: justify;">The patient will exhibit healed or improved lesions or wounds.</li>
<li style="text-align: justify;">The patient's ventilation will remain adequate.</li>
<li style="text-align: justify;">The patient will maintain collateral circulation.</li>
<li style="text-align: justify;">The patient will remain hemodynamically stable.</li>
</ul><br />
<div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Nursing interventions Nursing Care Plans For Meningococcal Infections</b></div><br />
<ul><li style="text-align: justify;">Pain Management: Alleviation of pain or a reduction in pain to a level of comfort that is acceptable to the patient</li>
<li style="text-align: justify;">Analgesic Administration: Use of pharmacologic agents to reduce or eliminate pain</li>
<li style="text-align: justify;">Temperature Regulation: Attaining and/or maintaining body temperature within a normal range</li>
<li style="text-align: justify;">Fever Treatment: Management of a patient with hyperpyrexia caused by non environmental factors</li>
<li style="text-align: justify;">Malignant Hyperthermia Precautions: Prevention or reduction of hyper metabolic response to pharmacological agents</li>
<li style="text-align: justify;">Hemodynamic Regulation: Optimization of heart rate, preload, after load, and contractility</li>
<li style="text-align: justify;">Cardiac Care: Limitation of complications resulting from an imbalance between myocardial oxygen supply and demand for a patient with symptoms of impaired cardiac function</li>
<li style="text-align: justify;">Skin Surveillance: Collection and analysis of patient data to maintain skin and mucous membrane integrity</li>
<li style="text-align: justify;">Pressure Management: Minimizing pressure to body parts</li>
<li style="text-align: justify;">Pressure Ulcer Prevention: Prevention of pressure ulcers for a patient at high risk for developing them</li>
<li style="text-align: justify;">Ventilation Assistance: Promotion of an optimal spontaneous breathing pattern that maximizes oxygen and carbon dioxide exchange in the lungs</li>
<li style="text-align: justify;">Airway Management: Facilitation of patency of air passages</li>
<li style="text-align: justify;">Respiratory Monitoring: Collection and analysis of patient data to ensure airway patency and adequate gas exchange</li>
<li style="text-align: justify;">Fluid/Electrolyte Management: Promotion of fluid/electrolyte balance and prevention of complications resulting from abnormal or undesired fluid/serum electrolyte levels</li>
<li style="text-align: justify;">Cerebral Perfusion Promotion: Promotion of adequate perfusion and limitation of complications for a patient experiencing or at risk for inadequate cerebral perfusion</li>
<li style="text-align: justify;">Cardiac Care: Limitation of complications resulting from an imbalance between myocardial oxygen supply and demand for a patient with symptoms of impaired cardiac function</li>
<li style="text-align: justify;">Gastrointestinal Intubation: Insertion of a tube into the gastrointestinal tract Circulatory Care: Arterial/Venous Insufficiency: Promotion of arterial/venous circulation</li>
</ul><br />
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</div></div>Pri'ehttp://www.blogger.com/profile/12027499295412539384noreply@blogger.com0tag:blogger.com,1999:blog-6394596897241047527.post-44552881632491573592011-03-17T06:42:00.001+07:002011-03-17T06:42:43.594+07:00NCP Nursing Care Plans for Meningitis<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="http://sitemaker.umich.edu/mc12/files/meningitis4.jpg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="256" src="http://sitemaker.umich.edu/mc12/files/meningitis4.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Image courtesy of sitemaker.umich.edu</td></tr>
</tbody></table><div style="text-align: justify;">NCP Nursing Care Plans for Meningitis. In meningitis, the brain and the spinal cord meninges become inflamed. Such inflammation may involve all three meningeal membranes: the dura mater, arachnoid membrane, and pia mater. For most patients, meningitis follows the onset of respiratory symptoms: In about 50% of patients, it develops over 1 to 7 days; in about 20% of patients, over 1 to 3 weeks. In about 25% of patients, meningitis is unheralded by respiratory symptoms; it has a sudden onset, causing serious illness within 24 hours.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Causes for Meningitis</b></div><div class="fullpost"><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">Meningitis can be caused by bacteria, viruses, protozoa, or fungi. It most commonly results from bacterial infection, usually due to Neisseria meningitides, Haemophilus <a href="http://nurse-thought.blogspot.com/2011/03/ncp-nursing-care-plans-for-common-cold.html">influenzae</a>, Streptococcus pneumoniae, or Escherichia coli. Occasionally the causative organism can't be determined.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Complications for Meningitis</b></div><div style="text-align: justify;">Potential complications of meningitis include:</div><br />
<ul><li style="text-align: justify;">Visual impairment</li>
<li style="text-align: justify;">Optic neuritis</li>
<li style="text-align: justify;">Cranial nerve palsies</li>
<li style="text-align: justify;">Deafness</li>
<li style="text-align: justify;">Personality change</li>
<li style="text-align: justify;">Headache</li>
<li style="text-align: justify;">Paresis or paralysis</li>
<li style="text-align: justify;">Endocarditis</li>
<li style="text-align: justify;">Coma</li>
<li style="text-align: justify;">Vasculitis</li>
<li style="text-align: justify;">Cerebral infarction</li>
<li style="text-align: justify;">Children may develop sensory hearing loss, epilepsy, mental retardation, hydrocephalus, or subdural effusions.</li>
</ul><br />
<div style="text-align: justify;"><br />
</div><div style="text-align: justify;">Nursing assessment Nursing Care Plans for Meningitis</div><div style="text-align: justify;">The cardinal signs of meningitis are those of infection and increased intracranial pressure (ICP).</div><div style="text-align: justify;">The patient history may detail headache, stiff neck and back, malaise, photophobia, chills and, sometimes, vomiting, twitching, and seizures. </div><br />
<ul><li style="text-align: justify;">Patient history varies according to which form of meningitis the patient has: acute or subacute. For the subacute form, the patient or family may describe vague, mild symptoms such as irritability, loss of appetite, and headaches. With an acute infection, there may be reports of a headache that became progressively worse, with accompanying vomiting, disorientation, or delirium. The patient may also note an increased sensitivity to light (photophobia), chills, fever, and even seizure activity. Frequently the patient or family describes a recent upper respiratory or other type of infection. A patient with pneumococcal meningitis may have had a recent ear, sinus, or lung infection or endocarditis.</li>
<li style="text-align: justify;">Physical Assesment findings vary, depending on the severity of the meningitis. You may note opisthotonus, (a spasm in which the back and extremities arch backward so that the body rests on the head and heels), a sign of meningeal irritation. In meningococcal meningitis, you may see a petechial, purpuric, or ecchymotic rash on the lower part of the body. Neurologic examination may uncover other indications of meningeal irritation, including positive Brudzinski's and Kernig's signs and exaggerated and symmetrical deep tendon reflexes. It may also reveal altered LOC, ranging from confusion or delirium to deep stupor or coma. Vision testing may reveal diplopia and other visual problems. Ophthalmoscopic examination may show papilledema (another sign of increased ICP), but this is rare.</li>
</ul><br />
<div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Diagnostic tests for Meningitis</b></div><br />
<ul><li style="text-align: justify;">Lumbar puncture cerebrospinal fluid (CSF)</li>
<li style="text-align: justify;">Chest X-rays</li>
<li style="text-align: justify;">White blood cell count</li>
<li style="text-align: justify;">Computed tomography scanning.</li>
</ul><br />
<div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Nursing diagnoses Nursing Care Plans for Meningitis</b></div><div style="text-align: justify;">Common nursing diagnosis found in nursing Care Plans for meningitis</div><br />
<ul><li style="text-align: justify;"><a href="http://nurse-thought.blogspot.com/2009/06/pain-nursing-care-plan.html">Acute pain</a></li>
<li style="text-align: justify;"><a href="http://nurse-thought.blogspot.com/2009/03/nursing-care-plans-for-anxiety.html">Anxiety</a></li>
<li style="text-align: justify;">Hyperthermia</li>
<li style="text-align: justify;">Impaired gas exchange</li>
<li style="text-align: justify;">Risk for deficient fluid volume</li>
<li style="text-align: justify;">Risk for impaired skin integrity</li>
</ul><br />
<div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Nursing outcomes Nursing Care Plans for Meningitis</b></div><br />
<ul><li style="text-align: justify;">The patient will express feelings of comfort and relief of pain.</li>
<li style="text-align: justify;">The patient will identify strategies to reduce anxiety.</li>
<li style="text-align: justify;">The patient will exhibit temperature within normal range.</li>
<li style="text-align: justify;">The patient will maintain adequate ventilation and oxygenation.</li>
<li style="text-align: justify;">The patient will maintain fluid volume within normal range.</li>
<li style="text-align: justify;">The patient's skin integrity will remain intact.</li>
</ul><br />
<div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Nursing interventions Nursing Care Plans for Meningitis</b></div><br />
<ul><li style="text-align: justify;">Pain Management: Alleviation of pain or a reduction in pain to a level of comfort that is acceptable to the patient</li>
<li style="text-align: justify;">Analgesic Administration: Use of pharmacologic agents to reduce or eliminate pain</li>
<li style="text-align: justify;">Environmental Management: Comfort: Manipulation of the patient’s surroundings for promotion of optimal comfort</li>
<li style="text-align: justify;">Anxiety Reduction: Minimizing apprehension, dread, foreboding, or uneasiness related to an unidentified source or anticipated danger</li>
<li style="text-align: justify;">Calming Technique: Reducing anxiety in patient experiencing acute distress</li>
<li style="text-align: justify;">Temperature Regulation: Attaining and/or maintaining body temperature within a normal range</li>
<li style="text-align: justify;">Fever Treatment: Management of a patient with hyperpyrexia caused by non environmental factors</li>
<li style="text-align: justify;">Malignant Hyperthermia Precautions: Prevention or reduction of hyper metabolic response to pharmacological agents.</li>
<li style="text-align: justify;">Respiratory Monitoring: Collection and analysis of patient data to ensure airway patency and adequate gas exchange</li>
<li style="text-align: justify;">Oxygen Therapy: Administration of oxygen and monitoring of its effectiveness</li>
<li style="text-align: justify;">Airway Management: Facilitation of patency of air passages</li>
<li style="text-align: justify;">Fluid Monitoring: Collection and analysis of patient data to regulate fluid balance</li>
<li style="text-align: justify;">Hemodynamic Regulation: Optimization of heart rate, preload, afterload, and contractility</li>
<li style="text-align: justify;">Skin Surveillance: Collection and analysis of patient data to maintain skin and mucous membrane integrity</li>
<li style="text-align: justify;">Pressure Management: Minimizing pressure to body parts</li>
<li style="text-align: justify;">Pressure Ulcer Prevention: Prevention of pressure ulcers for a patient at high risk for developing them</li>
</ul><br />
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</div><div style="text-align: justify;"><br />
</div></div>Pri'ehttp://www.blogger.com/profile/12027499295412539384noreply@blogger.com0tag:blogger.com,1999:blog-6394596897241047527.post-40701597566718209272011-03-15T07:24:00.001+07:002011-03-15T07:24:44.149+07:00NCP Nursing Care Plans for Croup<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiAUp2HfvHElyVppiug29TUJ7rdLyPJdXCBGPa6aWthMWk8W3rMtihMfN2YW0mss_1NAeRPLlmg2StjKldxhmIZyptWQvzINo7iblZb3TeAcwnUa_cCvCgkgm4giAmbbbBXyFHaxp2nWeqb/s1600/Throat+anatomy.jpg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="160" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiAUp2HfvHElyVppiug29TUJ7rdLyPJdXCBGPa6aWthMWk8W3rMtihMfN2YW0mss_1NAeRPLlmg2StjKldxhmIZyptWQvzINo7iblZb3TeAcwnUa_cCvCgkgm4giAmbbbBXyFHaxp2nWeqb/s200/Throat+anatomy.jpg" width="200" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0cm;"><span style="font-family: 'Times New Roman', serif; font-size: 12pt; line-height: 115%;">Image courtesy of ncbi.nlm.nih.gov<o:p></o:p></span></div></td></tr>
</tbody></table><div style="text-align: justify;">NCP Nursing Care Plans for Croup. A severe inflammation and obstruction of the upper airway, croup can occur as acute laryngotracheobronchitis, laryngitis, and acute spasmodic laryngitis. It must always be distinguished from epiglottitis. Croup is a childhood disease affecting boys more commonly than girls typically between age 3 months and 3 years that usually occurs during the winter.</div><div style="text-align: justify;">Croup usually occurs in the winter as acute laryngotracheobronchitis, laryngitis, or acute spasmodic laryngitis. It must be distinguished from epiglottiditis. Usually mild and self-limiting, acute laryngotracheobronchitis appears mostly in children ages 3 months to 3 years. Acute spasmodic laryngitis affects children between ages 1 and 3, particularly those with allergies and a family history of croup. Overall, up to 15% of patients have a family history of croup. Recovery is usually complete.</div><div class="fullpost"><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Causes for Croup</b></div><div style="text-align: justify;">Parainfluenza viruses, adenoviruses, respiratory syncytial virus, influenza viruses, measles viruses, and bacteria (pertussis and diphtheria)</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Complications for Croup</b></div><div style="text-align: justify;">Airway obstruction, respiratory failure, and dehydration are complications of croup. Latent complications are ear infection and pneumonia.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Nursing Assessment Nursing Care Plans for Croup</b></div><div style="text-align: justify;">Recent upper respiratory tract infection preceding croup.</div><div style="text-align: justify;">• inspection, you may observe the use of accessory muscles with nasal flaring during breathing. You typically hear the child's sharp, barklike cough and hoarse or muffled vocal sounds. As croup progresses, the patient may display further upper airway obstruction with severely compromised ventilation. (See How croup affects the upper airways.)</div><div style="text-align: justify;">• Auscultation may disclose inspiratory stridor and diminished breath sounds. These signs and symptoms may last for only a few hours, or they may persist for 1 to 2 days.</div><div style="text-align: justify;">• In laryngotracheobronchitis, the patient may complain of fever and breathing problems that occur more often at night. Typically, the child becomes frightened because he can't breathe out (because inflammation causes edema in the bronchi and bronchioles).</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Nursing diagnosis Nursing Care Plans for Croup</b></div><br />
<ul><li style="text-align: justify;"><a href="http://nurse-thought.blogspot.com/2009/03/nursing-care-plans-for-anxiety.html">Anxiety</a></li>
<li style="text-align: justify;">Deficient knowledge (home care)</li>
<li style="text-align: justify;">Disabled family coping</li>
<li style="text-align: justify;">Fear</li>
<li style="text-align: justify;">Hyperthermia</li>
<li style="text-align: justify;"><a href="http://nurse-thought.blogspot.com/2010/07/nursing-diagnosis-impaired-gas-exchange.html">Impaired gas exchange</a></li>
<li style="text-align: justify;"><a href="http://nurse-thought.blogspot.com/2010/07/nursing-diagnosis-ineffective-airway.html">Ineffective airway clearance</a></li>
</ul><br />
<div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Nursing outcomes Nursing Care Plans for Croup</b></div><br />
<ul><li style="text-align: justify;">Patient and family will verbalize strategies to reduce anxiety.</li>
<li style="text-align: justify;">Patient and family will demonstrate an understanding of what has been taught.</li>
<li style="text-align: justify;">Patient and family will Verbalize understanding of condition/disease process and treatment</li>
<li style="text-align: justify;">Patient and family will use available support systems to assist with coping.</li>
<li style="text-align: justify;">Family Coping: Family actions to manage stressors that tax family resources</li>
<li style="text-align: justify;">Patient and family will verbalize fears and concerns.</li>
<li style="text-align: justify;">The patient's temperature will be within normal range.</li>
<li style="text-align: justify;">The patient will maintain adequate ventilation and oxygenation.</li>
<li style="text-align: justify;">The patient will maintain a patent airway.</li>
</ul><br />
<div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Nursing Interventions Nursing Care Plans for Croup</b></div><br />
<ul><li style="text-align: justify;">Anxiety Control: Personal actions to eliminate or reduce feelings of apprehension and tension from an unidentifiable source</li>
<li style="text-align: justify;">Coping: Actions to manage stressors that tax an individual’s resources</li>
<li style="text-align: justify;">Teaching: Individual Planning, implementation, and evaluation of a teaching program designed to address a patient’s particular needs</li>
<li style="text-align: justify;">Learning Facilitation: Promoting the ability to process and comprehend information</li>
<li style="text-align: justify;">Learning Readiness Enhancement: Improving the ability and willingness to receive information</li>
<li style="text-align: justify;">Family Therapy: Assisting family members to move their family toward a more productive way of living</li>
<li style="text-align: justify;">Family Support: Promotion of family values, interests, and goals</li>
<li style="text-align: justify;">Family Involvement Promotion: Facilitating family participation in the emotional and physical care of the patient</li>
<li style="text-align: justify;">Assisting a patient to adapt to perceived stressors, changes, or threats that interfere with meeting life demands and roles</li>
<li style="text-align: justify;">Temperature Regulation: Attaining and/or maintaining body temperature within a normal range</li>
<li style="text-align: justify;">Fever Treatment: Management of a patient with hyperpyrexia caused by nonenvironmental factors</li>
<li style="text-align: justify;">Malignant Hyperthermia Precautions: Prevention or reduction of hypermetabolic response to pharmacological agents used during surgery</li>
<li style="text-align: justify;">Respiratory Monitoring: Collection and analysis of patient data to ensure airway patency and adequate gas exchange</li>
<li style="text-align: justify;">Oxygen Therapy: Administration of oxygen and monitoring of its effectiveness</li>
<li style="text-align: justify;">Airway Management: Facilitation of patency of air passages</li>
<li style="text-align: justify;">Cough Enhancement: Promotion of deep inhalation by the patient with subsequent generation of high intrathoracic pressures and compression of underlying lung parenchyma for the forceful expulsion of air</li>
</ul><br />
<div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Patient teaching discharge and home health guidance for patient with Croup</b></div><br />
<ul><li style="text-align: justify;">If the patient is hospitalized, advise the parents that he may be placed in a cool-mist tent to provide high humidity.</li>
<li style="text-align: justify;">Explain that the hospitalized child may require hydration with I.V. fluids if he can't be hydrated orally.</li>
<li style="text-align: justify;">Warn parents that ear infections and pneumonia may complicate croup.</li>
<li style="text-align: justify;">Urge the parents to seek immediate medical attention if the patient has an earache, productive cough, high fever, or increased shortness of breath.</li>
</ul><br />
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</div></div>Pri'ehttp://www.blogger.com/profile/12027499295412539384noreply@blogger.com0tag:blogger.com,1999:blog-6394596897241047527.post-39510981183458595392011-03-15T07:22:00.000+07:002011-03-15T07:22:22.990+07:00NCP Nursing Care Plans For Amebiasis<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="http://www.netterimages.com/images/vpv/000/000/030/30547-0550x0475.jpg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="200" src="http://www.netterimages.com/images/vpv/000/000/030/30547-0550x0475.jpg" width="172" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Image courtesy of netterimages.com</td></tr>
</tbody></table><div style="text-align: justify;">NCP <a href="http://www.lifenurses.com/category/nursing/nursing-care-plans/">Nursing Care Plans</a> For Amebiasis. Also called amoebic dysentery, Amebiasis can take the form of either an acute or a chronic protozoal infection. Extraintestinal Amebiasis can induce hepatic abscess and infection of the lungs, pleural cavity, pericardium, peritoneum and, rarely, the brain. Amebiasis occurs worldwide; about 90% of infections are asymptomatic and the rest produce symptoms ranging from amoebic dysentery to abscesses of the liver and other organs. It's the third most common cause of death from paralytic disease, after schistosomiasis and malaria. It's most common in the tropics, subtropics, and other areas with poor sanitation and health practices.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Causes For Amebiasis</b></div><div class="fullpost"><div style="text-align: justify;">Amebiasis is caused by Entamoeba histolytica. This protozoan has two stages: during the cystic stage, it can survive outside the body; during the trophozoite stage, it can't</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Complications For Amebiasis</b></div><div style="text-align: justify;">Amebiasis can cause chronic, recurrent episodes of diarrhea and abdominal pain, ameboma, megacolon, intussusception, extraintestinal abscesses, and intestinal stricture, hemorrhage, or perforation. Rarely, it causes a brain abscess, which is usually fatal</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b><a href="http://www.lifenurses.com/nursing-assessment/">Nursing Assessment</a> Nursing Care Plans For Amebiasis</b></div><div style="text-align: justify;">The patient may have a history of recent travel to an area with poor sanitation, sexual practices involving oral-anal contact, eating or drinking suspect food or water, or institutionalization.</div><div style="text-align: justify;">The patient's signs and symptoms vary with the severity of the infestation, from no symptoms or mild diarrhea to fulminating dysentery.</div><div style="text-align: justify;">If the patient has acute amebiasis, he may complain of chills and abdominal cramping; profuse, bloody diarrhea with tenesmus; and diffuse abdominal tenderness (caused by extensive rectosigmoid ulcers). He also develops a sudden high fever, with a temperature of 104° to 105° F (40° to 40.5° C).</div><div style="text-align: justify;">A patient with chronic amebiasis may report intermittent diarrhea that lasts for 1 to 4 weeks and recurs several times a year. Such diarrhea produces 4 to 8 (or, in severe diarrhea, up to 18) foul-smelling mucous- and blood-tinged stools daily. The patient may also report vague abdominal cramps and, possibly, weight loss. Any fever he has is mild.</div><div style="text-align: justify;">Inspection may reveal perianal ulceration and systemic signs of dehydration or anemia. Palpation may reveal diffuse abdominal tenderness and hepatomegaly. Auscultation of the abdomen may disclose hyperactive bowel sounds, particularly in the lower quadrants, when the patient has acute diarrhea.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b><a href="http://www.lifenurses.com/category/nursing/nursing-diagnosis/">Nursing diagnosis</a> Nursing Care Plans For Amebiasis</b></div><div style="text-align: justify;">Common nursing diagnosis found in Nursing Care Plans For Amebiasis:</div><div style="text-align: justify;">• Acute pain</div><div style="text-align: justify;">• Deficient fluid volume</div><div style="text-align: justify;">• Diarrhea</div><div style="text-align: justify;">• Fatigue</div><div style="text-align: justify;">• Hyperthermia</div><div style="text-align: justify;">• Imbalanced nutrition: Less than body requirements</div><div style="text-align: justify;">• Impaired skin integrity </div><div style="text-align: justify;">• Risk for infection</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Nursing outcomes <a href="http://nurse-thought.blogspot.com/">Nursing Care Plans</a> For Amebiasis</b></div><div style="text-align: justify;">Nursing outcomes patient will:</div><div style="text-align: justify;">• The patient will express feelings of comfort and relief from pain.</div><div style="text-align: justify;">• The patient's electrolyte levels will stay within normal range.</div><div style="text-align: justify;">• The patient's elimination pattern will return to normal.</div><div style="text-align: justify;">• The patient will report an increased energy level.</div><div style="text-align: justify;">• The patient will remain afebrile.</div><div style="text-align: justify;">• The patient will experience no further weight loss.</div><div style="text-align: justify;">• The patient will avoid skin breakdown or infection.</div><div style="text-align: justify;">• The patient will experience no further signs or symptoms of infection.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Nursing Interventions Nursing Care Plans For Amebiasis</b></div><div style="text-align: justify;"></div><ul><li style="text-align: justify;">Pain Management: Alleviation of pain or a reduction in pain to a level of comfort that is acceptable to the patient</li>
<li style="text-align: justify;">Analgesic Administration: Use of pharmacologic agents to reduce or eliminate pain</li>
<li style="text-align: justify;">Environmental Management: Comfort: Manipulation of the patient’s surroundings for promotion of optimal comfort</li>
<li style="text-align: justify;">Fluid Management: Promotion of fluid balance and prevention of complications resulting from abnormal or undesired fluid levels</li>
<li style="text-align: justify;">Hypovolemia Management: Reduction in extracellular and/or intracellular fluid volume and prevention of complications in a patient who is fluid overloaded</li>
<li style="text-align: justify;">Shock Management: Volume: Promotion of adequate tissue perfusion for a patient with severely compromised intravascular volume.</li>
<li style="text-align: justify;">Diarrhea Management: Management and alleviation of diarrhea</li>
<li style="text-align: justify;">Fluid Monitoring: Collection and analysis of patient data to regulate fluid balance</li>
<li style="text-align: justify;">Perineal Care: Maintenance of perineal skin integrity and relief of perineal discomfort</li>
<li style="text-align: justify;">Energy Management: Regulating energy use to treat or prevent fatigue and optimize function</li>
<li style="text-align: justify;">Exercise Promotion: Facilitation of regular physical exercise to maintain or advance to a higher level of fitness and health</li>
<li style="text-align: justify;">Temperature Regulation: Attaining and/or maintaining body temperature within a normal range.</li>
<li style="text-align: justify;">Fever Treatment: Management of a patient with hyperpyrexia caused by nonenvironmental factors.</li>
<li style="text-align: justify;">Nutrition Management: Assisting with or providing a balanced dietary intake of foods and fluids</li>
<li style="text-align: justify;">Weight Gain Assistance: Facilitating gain of body weight</li>
<li style="text-align: justify;">Eating Disorders Management: Prevention and treatment of severe diet restrictions and over exercising or binging and purging of foods and fluids</li>
<li style="text-align: justify;">Pressure Ulcer Care: Facilitation of healing in pressure ulcers</li>
<li style="text-align: justify;">Infection Protection: Prevention and early detection of infection in a patient at risk</li>
<li style="text-align: justify;">Infection Control: Minimizing the acquisition and transmission of infectious agents</li>
<li style="text-align: justify;">Surveillance: Purposeful and ongoing acquisition, interpretation, and synthesis of patient data for clinical decision making</li>
</ul><div style="text-align: justify;"><b><a href="http://www.lifenurses.com/category/patient-teaching/">Patient Teaching discharge and Home Health Guidance</a> for Patient with Amebiasis</b></div><div style="text-align: justify;"></div><ul><li>Teach the patient about amebicide therapy, including precautions he should take and adverse effects of the medication</li>
<li>Encourage the patient to return for follow-up appointments at scheduled intervals.</li>
<li>Teach the patient and his family how to handle infectious material and about the need for careful hand washing.</li>
<li>Advise travelers to endemic areas and campers to boil untreated or contaminated water to prevent the disease.</li>
</ul><br />
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</div></div>Pri'ehttp://www.blogger.com/profile/12027499295412539384noreply@blogger.com0tag:blogger.com,1999:blog-6394596897241047527.post-1315069343673617392011-03-14T09:58:00.000+07:002011-03-14T09:58:19.116+07:00NCP Nursing Care Plans for Common Cold<div style="text-align: justify;">NCP Nursing Care Plans for Common Cold. The common cold is an acute, usually afebrile, viral infection that causes inflammation of the upper respiratory tract. It's the most common infectious disease and is more prevalent in children, adolescent boys, and females. In temperate climates, it occurs more often in the colder months; in the tropics, during the rainy season.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Causes for Common Cold</b></div><div style="text-align: justify;"><br />
</div><div class="fullpost"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1b09U-k-s3PbFvNwckG79fqsi5J2375VegNzcAHxZWeEwK5AjzmXPIXNoDZ-OTgm8NYj0v6I5JvaJSzAJp5V_ScrqlU0BvbsbTTJ8w0M4d8-ccSRPOdHkphmkxFOpT3sz0yzYO0nCM0M/s320/common_cold.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1b09U-k-s3PbFvNwckG79fqsi5J2375VegNzcAHxZWeEwK5AjzmXPIXNoDZ-OTgm8NYj0v6I5JvaJSzAJp5V_ScrqlU0BvbsbTTJ8w0M4d8-ccSRPOdHkphmkxFOpT3sz0yzYO0nCM0M/s200/common_cold.jpg" width="200" /></a></div><div style="text-align: justify;">About 90% of colds stem from a viral infection of the upper respiratory tract passages and consequent mucous membrane inflammation. The most common causative agent is the rhinovirus; however, some colds result from Mycoplasma. Other offenders include coronaviruses, myxoviruses, adenoviruses, coxsackieviruses, and echoviruses.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Complications for Common Cold</b></div><div style="text-align: justify;">Secondary bacterial infection may occur, causing sinusitis, otitis media, pharyngitis, or lower respiratory tract infection</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Nursing Assessment <a href="http://www.lifenurses.com/category/nursing/nursing-care-plans/">Nursing Care Plans</a> for Common Cold</b></div><div style="text-align: justify;">Assess patient’s exposure to others with the common cold. Patient usually complains of nasal congestion, headache, and burning, watery eyes. He may also report chills, myalgia, arthralgia, malaise, lethargy, and a hacking, nonproductive, or nocturnal cough. Most patients are afebrile, although fever may occur, especially in children.Clinical features develop more fully as the cold progresses. By the second day (in addition to initial symptoms), the patient may report a copious nasal discharge that often irritates the nose, adding to his discomfort. About 3 days after onset, major symptoms diminish, but congestion often persists for a week. Reinfection (with productive cough) is common, but complications are rare.</div><div style="text-align: justify;">• Inspection may reveal a reddened nose and eyes and nasal discharge. The nasal and pharyngeal mucous membranes may exhibit increased erythema, and the patient's voice may have a nasal quality. The skin around the nose may be excoriated because of frequent nose blowing.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b><a href="http://www.lifenurses.com/category/nursing/nursing-diagnosis/">Nursing diagnosis</a> Nursing Care Plans for Common Cold</b></div><div style="text-align: justify;">Common nursing diagnosis found in Nursing Care Plans for Common Cold</div><br />
<ul><li style="text-align: justify;">Acute pain</li>
<li style="text-align: justify;">Fatigue</li>
<li style="text-align: justify;">Hyperthermia</li>
<li style="text-align: justify;">Ineffective airway clearance</li>
<li style="text-align: justify;">Ineffective breathing pattern</li>
<li style="text-align: justify;">Risk for infection</li>
</ul><br />
<div style="text-align: justify;"><b>Nursing outcomes Nursing Care Plans for Common Cold</b></div><br />
<ul><li style="text-align: justify;">The patient will be free from pain.</li>
<li style="text-align: justify;">The patient will report increased energy.</li>
<li style="text-align: justify;">The patient will remain afebrile.</li>
<li style="text-align: justify;">The patient will expectorate sputum effectively.</li>
<li style="text-align: justify;">The patient will express feelings of comfort in maintaining air exchange.</li>
<li style="text-align: justify;">The patient will experience no further signs or symptoms of infection.</li>
</ul><br />
<div style="text-align: justify;"><b>Nursing Interventions Nursing Care Plans for Common Cold</b></div><br />
<ul><li style="text-align: justify;">Pain Management</li>
<li style="text-align: justify;">Administer analgesics, as indicated</li>
<li style="text-align: justify;">Energy Management: Regulating energy use to treat or prevent fatigue and optimize function</li>
<li style="text-align: justify;">Exercise Promotion: Facilitation of regular physical exercise to maintain or advance to a higher level of fitness and health</li>
<li style="text-align: justify;">Nutrition Management: Assisting with or providing a balanced dietary intake of foods and fluids</li>
<li style="text-align: justify;">Temperature Regulation: Attaining and/or maintaining body temperature within a normal range.</li>
<li style="text-align: justify;">Fever Treatment: Management of a patient with hyperpyrexia caused by nonenvironmental factors.</li>
<li style="text-align: justify;">Malignant Hyperthermia Precautions: Prevention or reduction of hypermetabolic response to pharmacological agents used during surgery</li>
<li style="text-align: justify;">Maintain airway patency.</li>
<li style="text-align: justify;">Expectorate/clear secretions readily.</li>
<li style="text-align: justify;">Demonstrate absence/reduction of congestion with breath sounds clear, respirations noiseless, improved oxygen exchange</li>
<li style="text-align: justify;">Infection Protection: Prevention and early detection of infection in a patient at risk</li>
<li style="text-align: justify;">Infection Control: Minimizing the acquisition and transmission of infectious agents</li>
<li style="text-align: justify;">Surveillance: Purposeful and ongoing acquisition, interpretation, and synthesis of patient data for clinical decision making</li>
</ul><br />
<div style="text-align: justify;"><br />
</div></div>Pri'ehttp://www.blogger.com/profile/12027499295412539384noreply@blogger.com0tag:blogger.com,1999:blog-6394596897241047527.post-90085495709770646032010-12-24T09:43:00.000+07:002010-12-24T09:43:21.636+07:00Happy Holidays everyone!Happy Holidays everyone!<br />
<br />
<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgfm5tnmehFyU71e_WhDKEsLqIk9JoZMkDXWYRTzNDxqADmBxHxyRZweIZLN-deFwpKitxlHbVWuMrqrBLUSFsVCi3zlYvEG2_2zw5sWHSSHFiwBlzuNwwkB5LGodTVLLR9DWVEPtoYqwAE/s1600/Happy+Holidays.gif" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgfm5tnmehFyU71e_WhDKEsLqIk9JoZMkDXWYRTzNDxqADmBxHxyRZweIZLN-deFwpKitxlHbVWuMrqrBLUSFsVCi3zlYvEG2_2zw5sWHSSHFiwBlzuNwwkB5LGodTVLLR9DWVEPtoYqwAE/s400/Happy+Holidays.gif" width="400" /></a></div><br />
<br />
<div style="text-align: justify;">Happy Holidays and Best wishes for a happy and prosperous New Year. </div><div style="text-align: justify;">Wishing you a very happy holidays from <b><a href="http://nurse-thought.blogspot.com/">Nurse Thought</a></b></div>Pri'ehttp://www.blogger.com/profile/12027499295412539384noreply@blogger.com0tag:blogger.com,1999:blog-6394596897241047527.post-4731659778998784082010-09-07T22:53:00.001+07:002010-09-07T22:58:52.163+07:00Nursing Diagnosis Impaired Skin integrity<a href="http://www.lifenurses.com/category/nursing-diagnosis/">Nursing Diagnosis</a> Impaired Skin integrity<br />
Altered epidermis and/or dermis: Invasion of body structures, destruction of skin layers (dermis), and disruption of skin surface (epidermis).<br />
<br />
Related Factors: <br />
External:<br />
Hyperthermia, hypothermia, chemical substance, mechanical factors (e.g. friction, shearing forces, pressure, restraint), physical immobilization, humidity, extremes in age, moisture, radiation, medications <br />
Internal:<br />
Altered metabolic state, altered nutritional state (e.g. obesity, emaciation), altered circulation, altered sensation, altered pigmentation, skeletal prominence, developmental factors, immunological deficit, alterations in skin turgor (change in elasticity), altered fluid status.<br />
<br />
Suggested Nursing Outcomes<br />
<div class="fullpost"><ul><li>Tissue Integrity: Skin and Mucous Membranes</li>
<li>Wound Healing: Primary Intention</li>
<li>Wound Healing: Secondary Intention</li>
</ul>Client Outcomes<br />
<ul><li>Regains integrity of skin surface</li>
<li>Reports any altered sensation or pain at site of skin impairment</li>
<li>Demonstrates understanding of plan to heal skin and prevent reinjury</li>
<li>Describes measures to protect and heal the skin and to care for any skin lesion</li>
</ul>Suggested Nursing Interventions<br />
<ul><li>Incision Site Care</li>
<li>Pressure Ulcer Care</li>
<li>Skin Care: Topical Treatments</li>
<li>Skin Surveillance Wound Care</li>
</ul><br />
<br />
Nursing Interventions and Rationales<br />
<br />
<table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border: none; margin-left: 5.4pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-yfti-tbllook: 1184;"><tbody>
<tr style="mso-yfti-firstrow: yes; mso-yfti-irow: 0;"> <td style="border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 225.65pt;" valign="top" width="301"><div align="center" class="MsoNormal" style="margin-right: 15.0pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span lang="EN-GB" style="color: black;">Nursing Interventions<o:p></o:p></span></b></div></td> <td style="border-left: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-themecolor: text1; mso-border-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 220.9pt;" valign="top" width="295"><div align="center" class="MsoNormal" style="margin-right: 15.0pt; mso-margin-bottom-alt: auto; mso-margin-top-alt: auto; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span lang="EN-GB">Rationales<span style="color: black;"><o:p></o:p></span></span></b></div></td> </tr>
<tr style="mso-yfti-irow: 1; mso-yfti-lastrow: yes;"> <td style="border-top: none; border: solid black 1.0pt; mso-border-alt: solid black .5pt; mso-border-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 225.65pt;" valign="top" width="301"><div class="MsoListParagraphCxSpFirst" style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.8pt; margin-right: 15.0pt; margin-top: 0cm; mso-add-space: auto; mso-list: l1 level1 lfo2; text-align: justify; text-indent: -14.2pt;"><span lang="EN-GB" style="color: black; font-family: Symbol; font-size: 10pt; line-height: 115%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="EN-GB" style="color: black;">Assess site of skin impairment and determine etiology (e.g., acute or chronic wound, burn, dermatological lesion, pressure ulcer, skin tear)<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.8pt; margin-right: 15.0pt; margin-top: 0cm; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.8pt; margin-right: 15.0pt; margin-top: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -14.2pt;"><span lang="EN-GB" style="color: black; font-family: Symbol; font-size: 10pt; line-height: 115%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="EN-GB" style="color: black;">Monitor site of skin impairment at least once a day for color changes, redness, swelling, warmth, pain, or other signs of infection.<o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.8pt; margin-right: 15.0pt; margin-top: 0cm; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.8pt; margin-right: 15.0pt; margin-top: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo1; text-align: justify; text-indent: -14.2pt;"><span lang="EN-GB" style="color: black; font-family: Symbol; font-size: 10pt; line-height: 115%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="EN-GB" style="color: black;">Individualize plan according to client's skin condition, needs, and preferences. <em><span style="font-style: normal;">Avoid harsh cleansing agents, hot water, extreme friction or force, or cleansing too frequently .</span></em> <o:p></o:p></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.8pt; margin-right: 15.0pt; margin-top: 0cm; mso-add-space: auto; text-align: justify;"><br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.8pt; margin-right: 15.0pt; margin-top: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -14.2pt;"><span lang="EN-GB" style="color: black; font-family: Symbol; font-size: 10pt; line-height: 115%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="EN-GB" style="color: black;">For clients with limited mobility, use a risk-assessment tool to systematically assess immobility-related risk factors.<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></div><div class="MsoNormal" style="line-height: 115%; margin-right: 15.0pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-right: 15.0pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-right: 15.0pt;"><span lang="EN-GB" style="color: black; font-family: Symbol; font-size: 10pt; line-height: 115%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="EN-GB" style="color: black;">Do not position client on site of skin impairment. If consistent with overall client management goals, turn and position client at least every 2 hours</span></div><div class="MsoNormal" style="line-height: 115%; margin-right: 15.0pt;"><br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.8pt; margin-right: 15.0pt; margin-top: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -14.2pt;"><span lang="EN-GB" style="color: black; font-family: Symbol; font-size: 10pt; line-height: 115%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="EN-GB" style="color: black;">Evaluate for use of specialty mattresses, beds<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span><br />
<span lang="EN-GB" style="color: black;"><br />
</span></div><div class="MsoListParagraphCxSpMiddle"><br />
</div><div class="MsoListParagraphCxSpMiddle"><span class="Apple-style-span" style="line-height: 18px;"><span lang="EN-GB" style="color: black; font-family: Symbol; font-size: 10pt; line-height: 115%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="EN-GB" style="color: black; font-family: Verdana, sans-serif; font-size: 9pt; line-height: 115%;"> </span><span lang="EN-GB" style="color: black;">Select a topical treatment that will maintain a moist wound-healing environment and that is balanced with the need to absorb exudates</span></span><br />
<span class="Apple-style-span" style="line-height: 18px;"><span lang="EN-GB" style="color: black;"><br />
</span></span></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.8pt; margin-right: 15.0pt; margin-top: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -14.2pt;"><span lang="EN-GB" style="color: black; font-family: Symbol; font-size: 10pt; line-height: 115%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="EN-GB" style="color: black;">Avoid massaging around the site of skin impairment and over bony prominences.<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span><br />
<span lang="EN-GB" style="color: black;"><br />
</span></div><div class="MsoListParagraphCxSpLast" style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 8.8pt; margin-right: 15.0pt; margin-top: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -14.2pt;"><span lang="EN-GB" style="color: black; font-family: Symbol; font-size: 10pt; line-height: 115%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="EN-GB" style="color: black;">Assess client's nutritional status<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></div></td> <td style="border-bottom: solid black 1.0pt; border-left: none; border-right: solid black 1.0pt; border-top: none; mso-border-alt: solid black .5pt; mso-border-bottom-themecolor: text1; mso-border-left-alt: solid black .5pt; mso-border-left-themecolor: text1; mso-border-right-themecolor: text1; mso-border-themecolor: text1; mso-border-top-alt: solid black .5pt; mso-border-top-themecolor: text1; padding: 0cm 5.4pt 0cm 5.4pt; width: 220.9pt;" valign="top" width="295"><div class="MsoNormal" style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 9.95pt; margin-right: 15.0pt; margin-top: 0cm; mso-list: l0 level1 lfo1; text-indent: -14.2pt;"><em><span lang="EN-GB" style="color: black; font-family: Symbol; font-size: 10pt; font-style: normal; line-height: 115%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></em><em><span lang="EN-GB" style="color: black;">Prior assessment of wound etiology is critical for proper identification of nursing interventions.</span></em><em><span lang="EN-GB" style="color: black; font-style: normal;"><o:p></o:p></span></em></div><div class="MsoNormal" style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 9.95pt; margin-right: 15.0pt; margin-top: 0cm;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 9.95pt; margin-right: 15.0pt; margin-top: 0cm;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 9.95pt; margin-right: 15.0pt; margin-top: 0cm; mso-list: l0 level1 lfo1; text-indent: -14.2pt;"><span lang="EN-GB" style="color: black; font-family: Symbol; font-size: 10pt; line-height: 115%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><em><span lang="EN-GB" style="color: black;">Systematic inspection can identify impending problems early.</span></em><span lang="EN-GB" style="color: black;"> <o:p></o:p></span></div><div class="MsoNormal" style="line-height: 115%; margin-right: 15.0pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-right: 15.0pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-right: 15.0pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-right: 15.0pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-right: 15.0pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-right: 15.0pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-right: 15.0pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 9.95pt; margin-right: 15.0pt; margin-top: 0cm; mso-list: l0 level1 lfo1; text-indent: -14.2pt;"><span lang="EN-GB" style="color: black; font-family: Symbol; font-size: 10pt; line-height: 115%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><em><span lang="EN-GB" style="color: black;">A validated risk-assessment tool such as the Norton or Braden scale should be used to identify clients at risk for immobility-related skin breakdown.</span></em><span lang="EN-GB" style="color: black;"> <b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span><br />
<em><span lang="EN-GB" style="color: black;"><br />
</span></em></div><div class="MsoNormal" style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 9.95pt; margin-right: 15.0pt; margin-top: 0cm; mso-list: l0 level1 lfo1; text-indent: -14.2pt;"><span lang="EN-GB" style="color: black; font-family: Symbol; font-size: 10pt; line-height: 115%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><span lang="EN-GB" style="color: black;">Transfer client with care to protect against the adverse effects of external mechanical forces such as pressure, friction, and shear.<b style="mso-bidi-font-weight: normal;"><o:p></o:p></b></span></div><div class="MsoNormal" style="line-height: 115%; margin-right: 15.0pt;"><br />
<br />
</div><div class="MsoListParagraph" style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 9.95pt; margin-right: 15.0pt; margin-top: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -14.2pt;"><span lang="EN-GB" style="color: black; font-family: Symbol; font-size: 10pt; line-height: 115%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><em><span lang="EN-GB" style="color: black; font-style: normal;">To reduce shear and friction, and use lift devices, pillows, foam wedges, and pressure-reducing devices in the bed.</span></em><i style="mso-bidi-font-style: normal;"><span lang="EN-GB" style="color: black;"><o:p></o:p></span></i></div><div class="MsoNormal" style="line-height: 115%; margin-right: 15.0pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-right: 15.0pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-right: 15.0pt;"><br />
</div><div class="MsoNormal" style="line-height: 115%; margin-right: 15.0pt;"><br />
<br />
</div><div class="MsoListParagraphCxSpFirst" style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 9.95pt; margin-right: 15.0pt; margin-top: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -14.2pt;"><em><span lang="EN-GB" style="color: black; font-family: Symbol; font-size: 10pt; font-style: normal; line-height: 115%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span></em><em><span lang="EN-GB" style="color: black; font-style: normal;">Massage may lead to deep-tissue trauma</span></em><em><span lang="EN-GB" style="color: black; font-family: Verdana, sans-serif; font-size: 9pt; line-height: 115%;"> </span></em><em><b style="mso-bidi-font-weight: normal;"><span lang="EN-GB" style="color: black;"><o:p></o:p></span></b></em></div><div class="MsoListParagraphCxSpMiddle" style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 9.95pt; margin-right: 15.0pt; margin-top: 0cm; mso-add-space: auto;"><br />
<br />
</div><div class="MsoListParagraphCxSpLast" style="line-height: 115%; margin-bottom: .0001pt; margin-bottom: 0cm; margin-left: 9.95pt; margin-right: 15.0pt; margin-top: 0cm; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -14.2pt;"><span lang="EN-GB" style="color: black; font-family: Symbol; font-size: 10pt; line-height: 115%;">·<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></span><em><span lang="EN-GB" style="color: black; font-style: normal;">Inadequate nutritional intake places individuals at risk for skin breakdown and compromises healing</span></em><b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><span lang="EN-GB" style="color: black;"><o:p></o:p></span></i></b></div></td> </tr>
</tbody></table><br />
<br />
Home Care Interventions <a href="http://www.lifenurses.com/category/patient-teaching/">Client and Family Teaching </a><br />
<br />
<ul><li>Teach skin and wound assessment and ways to monitor for signs and symptoms of infection, complications, and healing</li>
<li>Teach client to use a topical treatment that is matched to the client, wound, and setting.</li>
<li>If consistent with overall client management goals, teach how to turn and reposition at least every 2 hours</li>
<li>Teach client to use pillows, foam wedges, and pressure-reducing devices to prevent pressure injury</li>
</ul><br />
<br />
<br />
</div>Pri'ehttp://www.blogger.com/profile/12027499295412539384noreply@blogger.com0tag:blogger.com,1999:blog-6394596897241047527.post-7245454939648656302010-07-06T11:00:00.000+07:002010-07-06T11:00:56.519+07:00Nursing Diagnosis Impaired Gas exchange<div style="text-align: justify;"><a href="http://www.lifenurses.com/category/nursing-diagnosis/">Nursing Diagnosis</a> Impaired Gas exchange Excess or deficit in oxygenation and/or carbon dioxide elimination at the alveolar-capillary membrane.</div><div style="text-align: justify;">Visual disturbances, decreased carbon dioxide, dyspnea, abnormal arterial blood gases, hypoxia, irritability, somnolence, restlessness, hypercapnia, tachycardia, cyanosis, abnormal skin color, hypoxemia, hypercarbia, headache on awakening, abnormal rate rhythm depth of breathing, diaphoresis, abnormal arterial pH, abnormal nasal flaring</div><br />
<b>Nursing Outcomes </b><br />
<div class="fullpost"><br />
<ul><li>Respiratory Status: Gas Exchange</li>
<li>Respiratory Status: Ventilation</li>
<li>Tissue Perfusion: Pulmonary</li>
<li>Vital Signs Status</li>
<li>Electrolyte and Acid-Base Balance</li>
</ul><br />
<b>Client Outcomes</b><br />
<br />
<ul><li>Demonstrates improved ventilation and adequate oxygenation as evidenced by blood gases within client's normal parameters</li>
<li>Maintains clear lung fields and remains free of signs of respiratory distress</li>
<li>Verbalizes understanding of oxygen and other therapeutic interventions</li>
</ul><br />
<br />
<b>Nursing Interventions </b><br />
<br />
<ul><li>Airway Management</li>
<li>Oxygen Therapy</li>
<li>Respiratory Monitoring</li>
<li>Acid-Base Management</li>
<li>Monitor respiratory Auscultate breath sounds, rate, depth, and effort, including use of accessory muscles, nasal flaring, and abnormal breathing patterns, oxygen saturation using pulse oximeter. Note blood gas results as available continuously</li>
<li>Monitor client's behavior and mental status for onset of restlessness, agitation, confusion, and extreme lethargy.</li>
<li>Observe for cyanosis sign</li>
<li>coach the client to slow respiratory rate, Demonstrate and encourage the client to use pursed-lip breathing</li>
<li>Position client with head of bed elevated, in a semi-Fowler's position, If client has unilateral lung disease, alternate semi-Fowler's position with lateral position. If client has a bilateral <a href="http://www.lifenurses.com/acute-respiratory-distress-syndrome-ards/">lung disease</a>, position in either a semi-Fowler's or side-lying position</li>
<li>Administer oxygen</li>
<li>If <a href="http://nurse-thought.blogspot.com/2009/06/nursing-care-plan-for-patient-with-copd.html">chronic pulmonary disease</a> is interfering with quality of life, refer client for pulmonary rehabilitation.</li>
<li>Encourage client to stop smoking</li>
</ul><br />
<br />
</div>Pri'ehttp://www.blogger.com/profile/12027499295412539384noreply@blogger.com0tag:blogger.com,1999:blog-6394596897241047527.post-33354068028861105652010-07-01T10:56:00.000+07:002010-07-01T10:57:14.940+07:00Nursing Diagnosis Ineffective Airway clearance<div style="text-align: justify;"><a href="http://www.lifenurses.com/category/nursing-diagnosis/">Nursing Diagnosis</a> Ineffective Airway clearance Inability to clear secretions or obstructions from the respiratory tract to maintain a clear airway</div><div style="text-align: justify;">Dyspnea, diminished breath sounds, orthopnea, adventitious breath sounds crackles, wheezes, cough, ineffective or absent sputum production, cyanosis, difficulty vocalizing, wide-eyed, changes in respiratory rate and rhythm, restlessness</div><br />
Related Factors: <br />
<div style="text-align: justify;">Environmental, Smoking, smoke inhalation, second-hand smoke, Obstructed Airway, Airway spasm, retained secretions, excessive mucus, presence of artificial airway, foreign body in airway, secretions in bronchi, exudates in alveoli, Physiological, Neuromuscular dysfunction, hyperplasia of bronchial walls; chronic obstructive pulmonary disease; infection; asthma; allergic airways</div><br />
<div class="fullpost">Nursing Outcomes<br />
• Respiratory Status: Ventilation <br />
• Respiratory Status: Airway Patency <br />
• Respiratory Status: Gas Exchange <br />
• Aspiration Control <br />
<br />
• Demonstrates effective coughing and clear breath sounds; is free of cyanosis and dyspnea <br />
• Maintains a patent airway at all times <br />
• Relates methods to enhance secretion removal <br />
• Relates the significance of changes in sputum to include color, character, amount, and odor <br />
• Identifies and avoids specific factors that inhibit effective airway clearance <br />
<br />
<b>Nursing Interventions</b><br />
• Airway Management <br />
• Airway Suctioning <br />
• Cough Enhancement <br />
<br />
<br />
<ul><li>Monitor respiratory, including patterns, rate, depth, and effort, Breath sounds.</li>
<li>Position client to optimize respiration (e.g., head of bed elevated 45 degrees and repositioned at least every 2 hours)</li>
<li>If the client has unilateral lung disease, alternate a semi-Fowler's position with a lateral position</li>
<li>Teach client to deep breath and perform controlled coughing.</li>
<li>Assist with clearing secretions from pharynx by offering tissues and gentle suction of the oral pharynx if necessary.</li>
<li>Observe sputum, noting color, odor, and volume</li>
<li>Encourage activity and ambulation as tolerated. If unable to ambulate client, turn client from side to side every 2 hours</li>
<li>Encourage increased fluid.</li>
<li>Administer oxygen as ordered.</li>
<li>Administer medications such as bronchodilators or inhaled steroids as ordered.</li>
<li>Provide Chest physical therapy: postural drainage, percussion, and vibration as ordered.</li>
<li>Refer for physical therapy or respiratory therapy for further treatment.</li>
<li>Monitor blood gas values and pulse oxygen saturation levels.</li>
<li>If the client has <a href="http://nurse-thought.blogspot.com/2009/06/nursing-care-plan-for-patient-with-copd.html">COPD</a>, consider helping the client use the huff cough technique</li>
</ul><br />
<br />
</div>Pri'ehttp://www.blogger.com/profile/12027499295412539384noreply@blogger.com0tag:blogger.com,1999:blog-6394596897241047527.post-42995198948799643542010-06-27T00:26:00.000+07:002010-06-27T00:26:58.270+07:00Nursing Diagnosis Risk for Infection<a href="http://www.lifenurses.com/category/nursing-diagnosis/">Nursing Diagnosis</a> Risk for Infection: At increased risk for being invaded by pathogenic organisms<br />
<br />
<b>Risk Factors</b><br />
<br />
<ul><li>Invasive procedures</li>
<li>Insufficient knowledge regarding avoidance of exposure to pathogens</li>
<li>Trauma, Tissue destruction and increased environmental exposure, Rupture of amniotic membranes</li>
<li>Pharmaceutical agents (e.g. Immunosuppressant)</li>
<li>Malnutrition</li>
<li>Increased environmental exposure to pathogens</li>
<li>Inadequate acquired immunity</li>
<li>Inadequate secondary defences (e.g. <a href="http://www.lifenurses.com/anemia/">decreased haemoglobin</a>)</li>
<li>Chronic disease</li>
</ul><br />
<br />
<div class="fullpost"><b>Nursing Outcomes</b><br />
<br />
<ul><li>Immune Status</li>
<li>Knowledge: Infection Control</li>
<li>Risk Control</li>
<li>Risk Detection</li>
</ul><br />
<b>Client Outcomes</b><br />
<br />
<ul><li>Remains free from symptoms of infection</li>
<li>States symptoms of infection of which to be aware</li>
<li>Demonstrates appropriate care of infection.</li>
<li>Maintains white blood cell count and differential within normal limits</li>
<li>Demonstrates appropriate hygienic measures such as hand washing, oral care, and perinea care</li>
</ul><br />
<br />
<b>Nursing Interventions</b><br />
Infection Control <br />
Infection Protection <br />
<br />
<ul><li>Observe and report signs of <span class="Apple-style-span" style="font-family: 'Times New Roman', serif; font-size: 16px;">Infection</span>.</li>
<li>Assess temperature, Use an electronic or mercury thermometer to assess temperature.</li>
<li>Note and report laboratory values (e.g., white blood cell count and differential, serum protein, serum albumin, and cultures).</li>
<li>Assess skin for colour, moisture, texture, and turgor (elasticity).</li>
<li>Carefully wash and pat dry skin, including skinfold area. Use hydration and moisturization on all at-risk surfaces.</li>
<li>Encourage a balanced diet, emphasizing proteins to feed the immune system.</li>
<li>Prevent nosocomial <a href="http://www.lifenurses.com/nursing-care-plans-for-pneumonia/">pneumonia</a>.</li>
<li>Encourage fluid intake and adequate rest to bolster the immune system.</li>
<li>Before and after giving care to client use Proper hand washing techniques.</li>
<li>Use goggles, gloves, and gowns when appropriate Follow Standard Precautions and wear gloves during any contact with blood, mucous membranes, nonintact skin, or any body substance.</li>
<li>Transmission Based Precautions for</li>
</ul><br />
• Airborne<br />
• Droplet<br />
• Contact transmitted<br />
<br />
<ul><li>Sterile technique on catheterize.</li>
<li>Use careful technique when changing and emptying urinary catheter bags; avoid cross contamination.</li>
<li>Use careful sterile technique wherever there is a loss of skin integrity.</li>
<li>Ensure client's appropriate hygienic care with hand washing; bathing; and hair, nail, and perinea care.</li>
<li>Antibiotics.</li>
</ul><br />
<br />
</div>Pri'ehttp://www.blogger.com/profile/12027499295412539384noreply@blogger.com0tag:blogger.com,1999:blog-6394596897241047527.post-48164713752257608592009-08-29T23:01:00.000+07:002009-08-29T23:02:19.639+07:00Nursing Care Plans Attention Deficit Hyperactivity Disorder (ADHD)<div style="text-align: justify;">Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common <a href="http://free-ebooks-to-downloads.blogspot.com/2009/08/children-and-behavioural-problems.html">childhood disorders </a>and can continue through adolescence and adulthood. Attention-deficit hyperactivity disorder (ADHD) is characterized by a persistent pattern of inattention or hyperactivity impulsivity that is more frequent and severe than is typically observed in individuals at a comparable level of development (APA, 2000). The patient with attention deficit hyperactivity disorder has difficulty focusing his attention, engaging in quiet passive activities, or both. Some patients have an attention deficit without hyperactivity; they're less likely to be diagnosed and receive treatment. Although attention deficit hyperactivity disorder is present at birth, diagnosis before age 4 or 5 is difficult unless the child exhibits severe symptoms. Some patients, however, aren't diagnosed until they reach adulthood. Males are three times more likely to be affected than females. The presence of other <a href="http://free-ebooks-to-downloads.blogspot.com/2009/08/child-and-adolescent-mental-health.html">psychiatric disorders</a> also needs to be determined, this disorder occurs in roughly 3% to 5% of school-age children.</div><br />
<b>Causes for Attention Deficit Hyperactivity Disorder (ADHD)</b><br />
<div style="text-align: justify;">Attention deficit hyperactivity disorder is thought to be a physiologic brain disorder with a familial tendency. Some studies indicate that it may result from altered neurotransmitter levels in the brain. Scientists are not sure what causes ADHD, although many studies suggest that genes play a large role. Like many other illnesses, ADHD probably results from a combination of factors. In addition to genetics, researchers are looking at possible environmental factors, and are studying how brain injuries, nutrition, and the social environment might contribute to ADHD</div><br />
<b>Complications for Attention Deficit Hyperactivity Disorder (ADHD)</b><br />
<div class="fullpost"><div style="text-align: justify;">Emotional and social complications can result from the child's impulsive behavior, inattentiveness, and disorganization in school. Hyperactivity can also lead to poor nutrition.</div><br />
<b>Assessment Nursing Care Plans Attention Deficit Hyperactivity Disorder (ADHD)</b><br />
<div style="text-align: justify;">The patient is usually characterized as a fidgeted and a daydreamer. He may also be described as inattentive and lazy. The parents may state that their child is intelligent but that his school or work performance is sporadic. They may also report that he has a tendency to jump quickly from one partly completed project, thought, or task to another. If the child is younger, the parents may note that he has difficulty waiting in line, remaining in his seat, waiting his turn, or concentrating on one activity long enough to complete it. An older child or an adult may be described as impulsive and easily distracted by irrelevant thoughts, sights, or sounds. He may also be characterized as emotionally labile, inattentive, or prone to daydreaming. His disorganization becomes apparent when, for example, he has difficulty meeting deadlines and keeping track of school or work tools and materials.</div><ul><li>Difficulties in performing age-appropriate tasks</li>
<li>Highly distractible</li>
<li>Extremely limited attention span</li>
<li>Shifts from one uncompleted activity to another</li>
<li>Impulsivity, or deficit in inhibitory control, is common</li>
<li>Difficulty forming satisfactory interpersonal relationships</li>
<li>Disruptive and intrusive behaviors inhibit acceptable social interaction</li>
<li>Difficulty complying with social norms</li>
<li>Some children with ADHD are very aggressive or oppositional. Others exhibit more regressive and immature behaviors.</li>
<li>Low frustration tolerance and outbursts of temper are common.</li>
<li>Boundless energy, exhibiting excessive levels of activity, restlessness, and fidgeting</li>
<li>Often described as “perpetual motion machines,” continuously running, jumping, wiggling, or squirming </li>
<li>They experience a greater than average number of accidents, from minor mishaps to more serious incidents that may lead to physical injury or the destruction of property.</li>
</ul><br />
<b>Predisposing Factors for Attention Deficit Hyperactivity Disorder (ADHD)</b><br />
<div style="text-align: justify;">The patient with attention deficit hyperactivity disorder has difficulty focusing his attention, engaging in quiet passive activities, or both. Some patients have an attention deficit without hyperactivity; they're less likely to be <a href="http://free-ebooks-to-downloads.blogspot.com/2009/08/diagnostic-and-statistical-manual-of.html">diagnosed</a> and receive treatment. Although attention deficit hyperactivity disorder is present at birth, diagnosis before age 4 or 5 is difficult unless the child exhibits severe symptoms. Some patients, however, aren't diagnosed until they reach adulthood. Attention deficit hyperactivity disorder is thought to be a physiologic brain disorder with a familial tendency. Some studies indicate that it may result from altered neurotransmitter levels in the brain. Scientists are not sure what causes ADHD, although many studies suggest that genes play a large role. Like many other illnesses, ADHD probably results from a combination of factors. In addition to genetics, researchers are looking at possible environmental factors, and are studying how brain injuries, nutrition, and the social environment might contribute to ADHD</div><div style="text-align: justify;"></div><br />
<br />
<b>Predisposing Factors for Attention Deficit Hyperactivity Disorder (ADHD)</b><br />
<b>Physiological</b><br />
<div style="text-align: justify;"><i><b>Genetics</b></i>. A number of studies have indicated that hereditary factors may be implicated in the predisposition to ADHD. Siblings of hyperactive children are more likely than normal children to have the disorder.</div><div style="text-align: justify;"><i><b>Biochemica</b></i>l. Abnormal levels of the neurotransmitters dopamine, norepinephrine, and possibly serotonin have been suggested as a causative factor.</div><div style="text-align: justify;"><i><b>Prenatal, Perinatal, and Postnatal Factors</b></i>. Maternal smoking during pregnancy has been linked to ADHD . Premature birth, fetal distress, precipitated or prolonged labor, and perinatal asphyxia have also been implicated. Postnatal factors include cerebral palsy, epilepsy, and other central nervous system abnormalities resulting from trauma, infections, or other neurological disorders.</div><div style="text-align: justify;"></div><b>Psychosocial</b><br />
<i><b>Environmental Influences</b></i>: Disorganized or chaotic environments or a disruption in family equilibrium may predispose some individuals to ADHD. A high degree of psychosocial stress, maternal mental disorder, paternal criminality, low socioeconomic status, and foster care have been implicated.<br />
Nursing diagnosis Nursing Care Plans Attention Deficit Hyperactivity Disorder (ADHD)<br />
<br />
Common <a href="http://free-ebooks-to-downloads.blogspot.com/2009/08/diagnostic-and-statistical-manual-of.html">Nursing Diagnosis</a> and Interventions found on Nursing Care Plans Attention Deficit Hyperactivity Disorder (ADHD)<br />
<ul><li>Risk for self directed or other directed violence</li>
<li>Defensive coping</li>
<li>Impaired social interaction</li>
<li>Ineffective coping</li>
<li>Low self esteem</li>
<li>Noncompliance</li>
<li>Anxiety (moderate to severe)</li>
<li>Compromised family coping</li>
<li>Imbalanced nutrition: Less than body requirements</li>
<li>Ineffective family therapeutic regimen management </li>
<li>Interrupted family processes</li>
<li>Risk for impaired parenting</li>
</ul><br />
Key outcomes nursing diagnosis Nursing Care Plans Attention Deficit Hyperactivity Disorder (ADHD)<br />
<ul><li>The patient and his family will report concern about difficulties in social interactions.</li>
<li>The patient and his family will communicate understanding of special dietary needs.</li>
<li>The patient will demonstrate effective social interaction skills.</li>
<li>The patient and his family will comply with the prescribed treatment regimen.</li>
<li style="text-align: justify;">The patient's family will discuss the impact of the patient's illness and feelings about it with a health care professional.</li>
<li>The parents will utilize support groups and other community resources.</li>
<li>The patient will acknowledge and respond to efforts by others to establish communication.</li>
</ul><br />
<b>Nursing interventions for ADHD</b><br />
<ul><li style="text-align: justify;">Set realistic expectations and limits because the patient with attention deficit hyperactivity disorder is easily frustrated </li>
<li>Always remain calm and consistent with the child.</li>
<li>Keep all your instructions to the child short and simple.</li>
<li>Provide praise and rewards whenever possible.</li>
<li>Provide the patient with diversional activities suited to his short attention span.</li>
<li style="text-align: justify;">Help the parents and other family members develop planning and organizing systems to help them cope more effectively with the child's short attention span.</li>
</ul><br />
Nursing diagnosis Risk for self directed or other-directed violence<br />
<ul><li>Observe client’s behavior frequently.</li>
<li>Observe for suicidal behaviors: Verbal statements, such as “ statement going to kill myself”</li>
<li>Determine suicidal intent and available means. Ask how where and when you plan to kill yourself</li>
<li>Obtain contract from client not to harm self and agreeing to seek out staff when ideation occurs.</li>
<li>Help client to recognize when anger occurs and to accept those feelings</li>
<li>Act as a role model for appropriate expression of angry feelings.</li>
<li>Give positive reinforcement.</li>
</ul><br />
Nursing diagnosis Defensive coping<br />
<ul><li style="text-align: justify;">Encourage client to recognize and verbalize feelings of inadequacy and need for acceptance from others and to recognize how these feelings provoke defensive behaviors</li>
<li>Provide immediate, fact, nonthreatening feedback for unacceptable behaviors</li>
<li>Help client identify situations that provoke defensiveness </li>
<li>Practice with role play for appropriate responses</li>
<li>Give positive feedback for acceptable behaviors</li>
<li>Evaluate and discuss with client the effectiveness of the new behaviors and any modifications for improvement</li>
</ul><br />
Nursing diagnosis Impaired social interaction<br />
<ul><li>Develop trust relationship</li>
<li>Give to the client’s constructive criticism and positive reinforcement for client’s efforts</li>
<li>Give Positive feedback to client</li>
<li>Provide group situations for client</li>
</ul><br />
Nursing diagnosis Ineffective coping<br />
<ul><li>Provide safe environment for continuous large muscle movement, If client is hyperactive</li>
<li>Provide large motoric activities</li>
<li>Do not debate, argue, rationalize, or bargain with the client.</li>
<li>Explore with client and discus alternative ways of handling frustration that would be most suited for client</li>
</ul><br />
Nursing diagnosis Low self esteem<br />
<br />
Nursing diagnosis Anxiety<br />
<ul><li>Establish a trusting relationship</li>
<li>Maintain an atmosphere of calmness</li>
<li>Offer support during times of elevated anxiety, Use of touch is comforting for some clients</li>
<li>When anxiety diminishes, help client to recognize specific events that preceded onset of anxiety.</li>
<li>Provide help to client to recognize signs of escalating anxiety</li>
<li>On escalating anxiety provide tranquilizing medication, as ordered</li>
</ul><br />
Nursing diagnosis Compromised family coping<br />
<br />
Nursing diagnosis Imbalanced nutrition: Less than body requirements<br />
<br />
Nursing diagnosis Ineffective family therapeutic regimen management <br />
<br />
Nursing diagnosis Interrupted family processes<br />
<br />
Nursing diagnosis Risk for impaired parenting<br />
<br />
<br />
Patient teaching Nursing Care Plans Attention Deficit Hyperactivity Disorder (ADHD)<br />
<ul><li>Make certain that the parents fully understand the child's prescribed medication regimen. </li>
<li>Teach the patient and family about any adverse reactions that may occur, emphasizing those that may require immediate medical attention.</li>
<li>Encourage the parents to provide the child with nutritious snacks such as fruit to supplement his dietary intake.</li>
<li>Refer the parents to appropriate support groups.</li>
</ul><br />
<br />
</div>Pri'ehttp://www.blogger.com/profile/12027499295412539384noreply@blogger.com0tag:blogger.com,1999:blog-6394596897241047527.post-59035531860218773232009-08-12T22:53:00.000+07:002009-08-12T22:55:33.253+07:00Nursing Care Plan for Abortion<div class="separator" style="clear: both; text-align: center;"></div><div style="text-align: justify;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjkg7zVYtCEW94WNhL0BfBnOqHJIVQE4pcl1m43pPvAaAeLEPIJxB_rgidY1QCqx9Xq8NR89_BOO2kKaM74ypDXIBUDPQRXk9A5k68fc_k2Pg-xSOxgD5NtL9bhIpFLahfHKH8S06qam397/s1600-h/Nursing+Care+Plan+for+Abortion.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="267" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjkg7zVYtCEW94WNhL0BfBnOqHJIVQE4pcl1m43pPvAaAeLEPIJxB_rgidY1QCqx9Xq8NR89_BOO2kKaM74ypDXIBUDPQRXk9A5k68fc_k2Pg-xSOxgD5NtL9bhIpFLahfHKH8S06qam397/s320/Nursing+Care+Plan+for+Abortion.jpg" width="209" /></a>In <b>nursing care plan for abortion</b> definitions for Abortion is: Spontaneous abortion, miscarriage, or induced abortions, the products of conception are expelled from the uterus before fetal viability and gestation of less than 20 weeks is achieved. </div><div style="text-align: left;"></div>Causes for Abortion<br />
It’s May result from fetal, placental, or maternal factors:<br />
<ul><li>Fetal factors usually include defective embryologic development resulting from abnormal chromosome division (the most common cause of fetal death), faulty implantation of fertilized ovum, and failure of the endometrium to accept the fertilized ovum, usually cause such abortions between 9 and 12 weeks of gestation</li>
<li>Placental factors usually include premature separation of the normally implanted placenta, abnormal placental implantation, and abnormal platelet function. Usually cause abortion around the 14th week of gestation.</li>
<li>Maternal factors usually include maternal infection, severe malnutrition, and abnormalities of the reproductive organs. usually cause abortion between 11 and 19 weeks of gestation</li>
</ul><div style="text-align: justify;">Other maternal factors include endocrine problems, such as thyroid gland dysfunction or lowered estriol secretion, trauma, including any type of surgery that necessitates manipulation of the pelvic organs, blood group incompatibility and Rh isoimmunization, and recreational drug use and environmental toxins.</div><div style="text-align: justify;">Therapeutic abortion is performed to preserve the mother's mental or physical health in cases of unplanned pregnancy, or medical conditions, such as cardiac dysfunction or fetal abnormality.</div><div class="fullpost"><br />
Complications that may happen in <b>Nursing Care Plan for Abortion</b><br />
<ul><li>Infections in case of the products of conception aren't completely expelled</li>
<li>Hemorrhage</li>
<li>Anemia</li>
<li>Coagulation defects such as disseminated intravascular coagulation</li>
</ul><br />
Assessment Nursing Care Plan for Abortion<br />
<ul><li>Pink discharge for several days or a scant brown discharge for several weeks</li>
<li>Cramps and increased vaginal bleeding</li>
<li>If any contents remain, cramps and bleeding continue.</li>
</ul>Assess the patient’s emotional status, as well as that of the baby’s father and other family members. Often this hospital admission is the first one for the patient, and it may cause anxiety and fear<br />
<br />
Diagnostic tests Nursing Care Plan for Abortion<br />
<ul><li>HCG in the blood or urine confirms</li>
<li>Decreased HCG level</li>
<li>Laboratory test results reflect a decreased hemoglobin level</li>
<li>Ultrasound examination; absence of fetal heart sounds</li>
</ul><br />
<a href="http://nurse-thought.blogspot.com/2009/01/list-of-nanda-nursing-diagnosis.html">Nursing diagnosis</a><br />
Primary Nursing Diagnosis found in <b>Nursing Care Plan for Abortion</b><br />
Anticipatory grieving related to an unexpected pregnancy outcome<br />
Common nursing diagnosis found in <b>Nursing Care Plan for Abortion</b><br />
<ul><li><a href="http://nurse-thought.blogspot.com/2009/03/nursing-care-plans-for-anxiety.html">Anxiety</a></li>
<li>Disabled family coping</li>
<li>Dysfunctional grieving</li>
<li>Hopelessness</li>
<li>Powerlessness</li>
<li>Risk for infection</li>
</ul>Nursing outcomes, Interventions, and Patient teaching Nursing Care Plan for Abortion</div>Pri'ehttp://www.blogger.com/profile/12027499295412539384noreply@blogger.com0tag:blogger.com,1999:blog-6394596897241047527.post-64720585796733039862009-07-19T22:19:00.000+07:002009-07-19T22:20:16.915+07:00Nursing Outcome, Nursing Interventions, and Patient Teaching For Inguinal Hernia<div style="text-align: justify;">Common Nursing diagnoses found on Nursing care plan for Inguinal Hernia</div><br />
<ul><li style="text-align: justify;"><a href="http://nurse-thought.blogspot.com/2009/03/nursing-care-plans-for-activity.html">Activity intolerance</a><br />
</li>
<li style="text-align: justify;">Acute <a href="http://nurse-thought.blogspot.com/2009/06/pain-nursing-care-plan.html">pain</a><br />
</li>
<li style="text-align: justify;">Ineffective tissue perfusion: Gastro Intestinal<br />
</li>
<li style="text-align: justify;">Risk for infection<br />
</li>
<li style="text-align: justify;">Risk for injury<br />
</li>
</ul><br />
<div style="text-align: justify;"></div><div style="text-align: justify;">Nursing outcomes <span class="Apple-style-span" style="font-weight: bold;"><a href="http://nurse-thought.blogspot.com/2009/06/hernia-is-protrusion-or-projection-of.html">nursing care plans for Inguinal Hernia</a> </span></div><br />
<ul><li style="text-align: justify;">The patient will perform activities of daily living within the confines of the disease process.<br />
</li>
<li style="text-align: justify;">The patient will express feelings of comfort.<br />
</li>
<li style="text-align: justify;">The patient's bowel function will return to normal.<br />
</li>
<li style="text-align: justify;">The patient will remain free from signs or symptoms of infection.<br />
</li>
<li style="text-align: justify;">The patient will avoid complications.<br />
</li>
</ul><br />
<div style="text-align: justify;"></div><div style="text-align: justify;">Nursing interventions <span class="Apple-style-span" style="font-weight: bold;">nursing care plans for Inguinal Hernia</span></div><div class="fullpost"><br />
<ul><li style="text-align: justify;">Apply a truss only after a hernia has been reduced. For best results, apply it in the morning before the patient gets out of bed.<br />
</li>
<li style="text-align: justify;">Assess the skin daily and apply powder for protection because the truss may be irritating.<br />
</li>
<li style="text-align: justify;">Watch for and immediately report signs of incarceration and strangulation.<br />
</li>
<li style="text-align: justify;">Closely monitor vital signs and provide routine preoperative preparation. If necessary, When surgery is scheduled<br />
</li>
<li style="text-align: justify;">Administer I.V. fluids and analgesics for pain as ordered.<br />
</li>
<li style="text-align: justify;">Control fever with acetaminophen or tepid sponge baths as ordered.<br />
</li>
<li style="text-align: justify;">Place the patient in Trendelenburg's position to reduce pressure on the hernia site.<br />
</li>
</ul><br />
<div style="text-align: justify;">After surgery, </div><br />
<ul><li style="text-align: justify;">Provide routine postoperative care.<br />
</li>
<li style="text-align: justify;">Don't allow the patient to cough, but do encourage deep breathing and frequent turning.<br />
</li>
<li style="text-align: justify;">Apply ice bags to the scrotum to reduce swelling and relieve pain; elevating the scrotum on rolled towels also reduces swelling.<br />
</li>
<li style="text-align: justify;">Administer analgesics as necessary.<br />
</li>
<li style="text-align: justify;">In males, a jock strap or suspensory bandage may be used to provide support.<br />
</li>
</ul><br />
<div style="text-align: justify;"></div><div style="text-align: justify;">Patient teaching home health guide</div><br />
<ul><li style="text-align: justify;">Explain what an inguinal hernia is and how it's usually treated.<br />
</li>
<li style="text-align: justify;">Explain that elective surgery is the treatment of choice and is safer than waiting until hernia complications develop, necessitating emergency surgery.<br />
</li>
<li style="text-align: justify;">Warn the patient that a strangulated hernia can require extensive bowel resection, involving a protracted hospital stay and, possibly, a colostomy.<br />
</li>
<li style="text-align: justify;">Tell the patient that immediate surgery is needed if complications occur.<br />
</li>
<li style="text-align: justify;">If the patient uses a truss, instruct him to bathe daily and apply liberal amounts of cornstarch or baby powder to prevent skin irritation.<br />
</li>
<li style="text-align: justify;">Warn against applying the truss over clothing, which reduces its effectiveness and may cause slippage. Point out that wearing a truss doesn't cure a hernia and may be uncomfortable.<br />
</li>
<li style="text-align: justify;">Tell the postoperative patient that he'll probably be able to return to work or school and resume all normal activities within 2 to 4 weeks.<br />
</li>
<li style="text-align: justify;">Explain that he or she can resume normal activities 2 to 4 weeks after surgery.<br />
</li>
<li style="text-align: justify;">Remind him to obtain his physician's permission before returning to work or completely resuming his normal activities.<br />
</li>
<li style="text-align: justify;">Before discharge, Instruct him to watch for signs of infection (oozing, tenderness, warmth, redness) at the incision site. Tell him to keep the incision clean and covered until the sutures are removed.<br />
</li>
<li style="text-align: justify;">Inform the postoperative patient that the risk of recurrence depends on the success of the surgery, his general health, and his lifestyle.<br />
</li>
<li style="text-align: justify;">Teach the patient signs and symptoms of infection: poor wound healing, wound drainage, continued incision pain, incision swelling and redness, cough, fever, and mucus production.<br />
</li>
<li style="text-align: justify;">Explain the importance of completion of all antibiotics. Explain the mechanism of action, side effects, and dosage recommendations of all analgesics.<br />
</li>
<li style="text-align: justify;">Caution the patient against lifting and straining.<br />
</li>
</ul><br />
<div style="text-align: justify;"></div><div style="text-align: justify;"></div><div style="text-align: justify;"></div><div style="text-align: justify;"></div></div><div style="text-align: justify;"></div>Pri'ehttp://www.blogger.com/profile/12027499295412539384noreply@blogger.com0tag:blogger.com,1999:blog-6394596897241047527.post-14223681392327886592009-06-09T18:26:00.000+07:002009-06-09T18:26:28.189+07:00Nursing Care Plans For Angina Pectoris<div style="text-align: justify;"><div class="separator" style="clear: both; text-align: justify;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhTTHXUESGsBlLShRX9lqRiBIAU7ZiPU4mT2MK11epSZNcrVwfSQFQgn7pssNNWFP2bRGEFTRmBnY85DT8zEHWsi2pXah5Uso5fTSEQKDF6WWG6HqEwtZ_UQVWowH8M07S5k4WfCsrxY29c/s1600-h/Nursing+Care+Plans+For+Angina+Pectoris.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhTTHXUESGsBlLShRX9lqRiBIAU7ZiPU4mT2MK11epSZNcrVwfSQFQgn7pssNNWFP2bRGEFTRmBnY85DT8zEHWsi2pXah5Uso5fTSEQKDF6WWG6HqEwtZ_UQVWowH8M07S5k4WfCsrxY29c/s200/Nursing+Care+Plans+For+Angina+Pectoris.jpg" /></a>Angina pectoris is a symptom of ischemic heart disease that is characterized by paroxysmal and usually recurring substernal or precordial chest pain or discomfort. It’s caused by an imbalance between myocardial oxygen supply and demand and decreased myocardial perfusion. Either can be caused by a primary decrease in coronary blood flow or by a disproportionate increase in myocardial oxygen requirements. Blood flow through the coronary arteries is partially or completely obstructed because of coronary artery spasm, fixed stenosing plaques, disrupted plaques, thrombosis, platelet aggregation, and embolization.</div></div><br />
<span style="font-weight: bold;">Causes of Angina pectoris</span><br />
<div class="fullpost"><div style="text-align: justify;">Most angina pectoris caused by atherosclerosis, which is the most common cause of coronary artery disease (CAD). However, it may occur in patients with normal coronary arteries.</div><br />
Classification and Sign and symptoms of Angina Pectoris<br />
<div style="text-align: justify;"><span style="font-weight: bold;"><span style="font-style: italic;">Chronic Stable Angina</span></span>: The most common anginal syndrome, described as a discomfort, pressure, or squeezing sensation and burning, sticking, or sharp with few minutes duration Chronic Stable Angina location often in the substernal area, precardium, or epigastrium with radiation to the left arm, jaw, or neck</div><br />
<div style="text-align: justify;"><span style="font-weight: bold;"><span style="font-style: italic;">Unstable Angina Pectoris</span></span>, is a combination of syndromes which have been referred to by various names, such as preinfarction angina, impending myocardial infarction, progressive or crescendo angina, coronary insufficiency, new onset angina, etc.Usually in patients with Unstable Angina Pectoris presents in one or more of three patterns:</div><ol><li style="text-align: justify;"><span class="Apple-style-span" style="font-weight: bold;">Angina pectoris </span>of recent onset (less than 1 month) that is provoked by minimal exertion.<br />
</li>
<li style="text-align: justify;">Chronic stable angina showing a crescendo pattern, with chest pain occurring more frequently, with greater severity and duration, with less provocation, and requiring larger doses of nitroglycerine to abort attacks.<br />
</li>
<li>Prolonged chest pain at rest, clinically indistinguishable from acute MI at the time of presentation.<br />
</li>
</ol>Diagnostic test for <span class="Apple-style-span" style="font-weight: bold;">Angina pectoris</span><br />
<ul><li>Electrocardiogram<br />
</li>
<li>Chest x-ray may found cardiomegaly<br />
</li>
<li>Coronary angiography’s<br />
</li>
<li>Coronary Arteriography<br />
</li>
<li>Exercise Stress Testing<br />
</li>
</ul><br />
Primary <span class="Apple-style-span" style="font-weight: bold;">Nursing Diagnosis for Angina pectoris</span><br />
<div style="text-align: justify;">Altered tissue perfusion (myocardial) related to narrowing of the coronary arteries and associated with arteriosclerosis, spasm, or thrombosis</div>Common Nursing Diagnosis found on <span class="Apple-style-span" style="font-weight: bold;">nursing care plans for angina</span> pectoris, <span class="Apple-style-span" style="font-weight: bold;"><span class="Apple-style-span" style="color: #45818e;">click here</span></span>.<br />
<br />
Nursing outcome, nursing interventions and patient teaching <span class="Apple-style-span" style="font-weight: bold;">nursing care plans for angina pectoris</span>, <span class="Apple-style-span" style="font-weight: bold;"><span class="Apple-style-span" style="color: #45818e;">here</span></span><br />
<br />
</div>Pri'ehttp://www.blogger.com/profile/12027499295412539384noreply@blogger.com0tag:blogger.com,1999:blog-6394596897241047527.post-2595840022485417252009-05-31T00:28:00.001+07:002009-06-11T21:06:02.419+07:00Head to toe nursing assessment videos<div style="text-align: justify;">If you want to improve your <span style="font-weight: bold;">nursing assessment skills</span>, whether in <span style="font-weight: bold;"><span style="color: #660000;">Geriatric nursing assessment</span></span>, or <span style="font-weight: bold;"><span style="color: #660000;">pediatric nursing assessment</span></span>. What you need is to see directly when the <span style="font-weight: bold;">nursing assessment</span> is done to the patient. If you can not see its done why don’t you see the <span style="font-weight: bold;">nursing assessment</span> videos. Below is a complete head to toe <span style="font-weight: bold;">nursing assessment</span> videos.</div><div style="text-align: justify;">Enjoy it’s, hopefully its will improve your <span style="font-weight: bold;">nursing assessment skills</span></div><br />
<br />
<div class="fullpost"><br />
<br />
<object height="344" width="425"><param name="movie" value="http://www.youtube.com/v/GvU3-ZN_VjE&hl=en&fs=1"></param><param name="allowFullScreen" value="true"></param><param name="allowscriptaccess" value="always"></param><embed src="http://www.youtube.com/v/GvU3-ZN_VjE&hl=en&fs=1" type="application/x-shockwave-flash" allowscriptaccess="always" allowfullscreen="true" width="425" height="344"></embed></object></div>Pri'ehttp://www.blogger.com/profile/12027499295412539384noreply@blogger.com0tag:blogger.com,1999:blog-6394596897241047527.post-38535997791104459832009-05-26T19:36:00.000+07:002009-05-26T19:36:39.763+07:00Nursing Care Plan for Nephrotic Syndrome<div style="text-align: justify;"><span style="font-weight: bold;">Nephrotic syndrome</span> isn't a disease but is characterized by marked proteinuria, hypoalbuminemia, hyperlipidemia, lipiduria, increased coagulation, and edema. It results from a glomerular defect that affects the vessels' permeability and indicates renal damage. Some forms of nephrotic syndrome may eventually progress to end-stage renal failure.</div><div style="text-align: justify;">All of these diseases increase glomerular protein permeability, which leads to increased urinary excretion of protein, especially albumin, and subsequent hypoalbuminemia.</div><br />
Causes for <span style="font-weight: bold;">Nephrotic syndrome</span><br />
<span class="Apple-style-span" style="font-weight: bold;">nephrotic syndrome</span> result from primary (idiopathic) glomerulonephritis:<br />
<br />
<ul><li>Lipid nephrosis (nil lesions): usually occurs in children<br />
</li>
<li>Membranous glomerulonephritis<br />
</li>
<li>Focal glomerulosclerosis<br />
</li>
<li>Membranoproliferative glomerulonephritis<br />
</li>
</ul><br />
Other causes of <span class="Apple-style-span" style="font-weight: bold;">nephrotic syndrome</span> include<br />
<br />
<ul><li>Metabolic diseases: diabetes mellitus<br />
</li>
<li>Collagen-vascular disorders: systemic lupus erythematosus,periarteritis nodosa.<br />
</li>
<li>Circulatory diseases: heart failure, sickle cell anemia, and renal vein thrombosis.<br />
</li>
<li>Nephrotoxins: mercury, gold, and bismuth.<br />
</li>
<li>Infections: tuberculosis, enteritis; allergic reactions; pregnancy; hereditary nephritis<br />
</li>
<li>Neoplastic: multiple myeloma<br />
</li>
</ul><br />
<br />
Treatment For <span class="Apple-style-span" style="font-weight: bold;">Nephrotic Syndrome</span><br />
<div style="text-align: justify;">Effective treatment of <span class="Apple-style-span" style="font-weight: bold;">nephrotic syndrome</span> requires correction of the underlying cause if possible. Supportive treatment, avoid All nephrotoxins .</div><br />
<span class="Apple-style-span" style="font-weight: bold;">Nephrotic Syndrome Nursing diagnoses </span><br />
<br />
<ul><li>Disturbed body image<br />
</li>
<li>Excess fluid volume<br />
</li>
<li>Imbalanced nutrition: Less than body requirements<br />
</li>
<li>Ineffective tissue perfusion: Renal<br />
</li>
<li>Risk for infection<br />
</li>
<li>Risk for injury<br />
</li>
</ul><br />
<br />
Nursing outcomes <a href="http://nurse-thought.blogspot.com/">Nursing Care Plan</a> for Nephrotic Syndrome<br />
The patient will:<br />
<br />
<ul><li>Express positive feelings about him.<br />
</li>
<li>Maintain fluid balance.<br />
</li>
<li>Show no signs of malnutrition.<br />
</li>
<li>Maintain adequate urine output.<br />
</li>
<li>Free from signs or symptoms of infection.<br />
</li>
<li>Avoid or minimize complications.<br />
</li>
</ul><br />
<br />
Nursing interventions <span class="Apple-style-span" style="-webkit-border-horizontal-spacing: 2px; -webkit-border-vertical-spacing: 2px; font-size: 13px; white-space: pre;"><span class="Apple-style-span" style="font-weight: bold;"><span class="Apple-style-span" style="font-family: Times, 'Times New Roman', serif;">Nursing Care Plan for Nephrotic Syndrome</span></span></span><br />
<br />
<ul><li>Assessment and Document the location and character of the patient's edema.<br />
</li>
<li style="text-align: justify;">Measure blood pressure with the patient lying down and standing. Immediately report a decrease in systolic or diastolic pressure exceeding 20 mm Hg.<br />
</li>
<li style="text-align: justify;">If the patients receive a renal biopsy, watch for bleeding and signs of shock.<br />
</li>
<li style="text-align: justify;">Monitor intake and output and weigh the patient each morning after he voids and before he eats. Make sure he's wearing the same amount of clothing each time you weigh him.<br />
</li>
<li style="text-align: justify;">Ask the dietitian to plan a low-sodium diet with moderate amounts of protein.<br />
</li>
<li style="text-align: justify;">Frequently check urine for protein.<br />
</li>
<li style="text-align: justify;">Monitor plasma albumin and transferrin concentrations to evaluate overall nutritional status.<br />
</li>
<li style="text-align: justify;">Provide meticulous skin care to combat the edema that usually occurs with nephrotic syndrome.<br />
</li>
<li style="text-align: justify;">Use a reduced-pressure mattress or padding to help prevent pressure ulcers.<br />
</li>
<li style="text-align: justify;">To prevent the occurrence of thrombophlebitis, encourage activity and exercise, and provide antiembolism stockings as ordered.<br />
</li>
<li style="text-align: justify;">Give the patient and family reassurance and support, especially during the acute phase, when edema is severe and the patient's body image changes<br />
</li>
</ul><br />
<div style="text-align: justify;">Patient teaching and home health care guide for <span class="Apple-style-span" style="-webkit-border-horizontal-spacing: 2px; -webkit-border-vertical-spacing: 2px; font-family: Arial; font-size: 13px; white-space: pre;">Nephrotic Syndrome</span></div><br />
<ul><li style="text-align: justify;">If the patients receive immunosuppressants, teach him and family members to report even mild signs of infection.<br />
</li>
<li style="text-align: justify;">If the patients receive long-term corticosteroid therapy, teach him and family members to report muscle weakness and mental changes.<br />
</li>
<li style="text-align: justify;">To prevent GI complications, suggest to the patient that he take steroids with an antacid or with cimetidine or ranitidine. Explain that the adverse effects of steroids subside when therapy stops, but warn the patient not to discontinue the drug abruptly or without a physician's consent.<br />
</li>
<li style="text-align: justify;">Stress the importance of adhering to the special diet.<br />
</li>
<li style="text-align: justify;">If the physician prescribes antiembolism stockings for home use, show the patient how to safely apply and remove them.<br />
</li>
</ul>Pri'ehttp://www.blogger.com/profile/12027499295412539384noreply@blogger.com0tag:blogger.com,1999:blog-6394596897241047527.post-59996482295472491072009-05-24T22:17:00.001+07:002009-12-22T08:59:56.493+07:00Myocardial Infarction (MI); Nursing Outcomes, Nursing Interventions, Patient Teaching And Home Health CareNursing outcomes for <span style="font-weight: bold;">Myocardial Infarction (MI)</span>, Patients will<br />
<ul><li style="text-align: justify;">Perform activities of daily living without excessive fatigue or exhaustion.<br />
</li>
<li style="text-align: justify;">Express feelings of comfort and decreased pain.<br />
</li>
<li style="text-align: justify;">Verbalize strategies to reduce anxiety and stress.<br />
</li>
<li style="text-align: justify;">Maintain adequate cardiac output.<br />
</li>
<li style="text-align: justify;">Develop no complications of fluid volume excess.<br />
</li>
<li style="text-align: justify;">Verbalize the importance of balancing activities, as tolerated, with adequate rest periods.<br />
</li>
<li style="text-align: justify;">Achieve ideal weight.<br />
</li>
<li style="text-align: justify;">Develop adequate coping skills.<br />
</li>
<li style="text-align: justify;">The patient will recognize his acute condition and accept the lifestyle changes he needs to make.<br />
</li>
<li style="text-align: justify;">Express feelings about changes in sexual patterns.<br />
</li>
<li style="text-align: justify;">Maintain hemodynamic stability and develop no arrhythmias.<br />
</li>
</ul><br />
Nursing interventions for <a href="http://nurse-thought.blogspot.com/2009/05/myocardial-infarction-mi-nursing-care.html">Myocardial Infarction (MI)</a> ;<br />
<br />
<ul><li style="text-align: justify;"><a href="http://nurse-thought.blogspot.com/">Nursing Care</a> for patients who have suffered a Myocardial Infarction (MI), Most most of them receive treatment in the coronary care unit (CCU), where they're under constant observation for complications.<br />
</li>
<li style="text-align: justify;">On admission to the CCU, monitor and record the patient's ECG readings, blood pressure, temperature, and heart and breath sounds.<br />
</li>
<li style="text-align: justify;">Assess pain and give an analgesic as ordered.<br />
</li>
<li style="text-align: justify;">Record the severity of pain, location, type, and duration of pain.<br />
</li>
<li style="text-align: justify;">Check the patient's blood pressure before and after giving nitroglycerin, especially the first dose.<br />
</li>
<li style="text-align: justify;">Frequently monitor ECG rhythm strips to detect rate changes and arrhythmias. if any new arrhythmias are documented, if chest pain occurs, or at least every shift change or according to facility protocol.<br />
</li>
<li style="text-align: justify;">Obtain ECG readings and blood pressure and pulmonary artery catheter measurements, if applicable, to determine changes. During episodes of chest pain<br />
</li>
<li style="text-align: justify;">Watch for crackles, cough, tachypnea, and edema, which may indicate impending left-sided heart failure.<br />
</li>
<li style="text-align: justify;">Monitor daily weight, intake and output, respiratory rate, serum enzyme levels, ECG readings, and blood pressure.<br />
</li>
<li style="text-align: justify;">Organize patient care and activities to maximize periods of uninterrupted rest.<br />
</li>
<li style="text-align: justify;">Provide a clear liquid diet dietary until nausea subsides. A low-cholesterol, low-sodium diet, without caffeine-containing beverages, may be ordered.<br />
</li>
<li style="text-align: justify;">Provide a stool softener to prevent straining during defecation, which causes vagal stimulation and may slow heart rate.<br />
</li>
<li style="text-align: justify;">Allow the patient to use a bedside commode, and provide as much privacy as possible.<br />
</li>
<li style="text-align: justify;">Assist with ROM exercises.<br />
</li>
<li style="text-align: justify;">If the patient is immobilized by a severe <span style="font-weight: bold;">Myocardial Infarction (MI)</span>, turn him often.<br />
</li>
<li style="text-align: justify;">Give Antiembolism stockings to prevent venostasis and thrombophlebitis.<br />
</li>
<li style="text-align: justify;">Provide emotional support, and help reduce stress and <a href="http://nurse-thought.blogspot.com/2009/03/nursing-care-plans-for-anxiety.html">anxiety</a> .<br />
</li>
<li style="text-align: justify;">If the patient has undergone PTCA, sheath care is necessary. Keep the sheath line open with a heparin drip. Observe the patient for generalized and site bleeding. Keep the leg with the sheath insertion site immobile. Maintain strict bed rest. Check peripheral pulses in the affected leg frequently. Provide an analgesic for back pain if needed.<br />
</li>
<li style="text-align: justify;">After thrombolytic therapy, administer continuous heparin as ordered. Monitor the partial thromboplastin time every 6 hours, and monitor the patient for evidence of bleeding.<br />
</li>
</ul><br />
<br />
Patient Teaching and Home Healthcare Guide for Patients with <span style="font-weight: bold;">Myocardial Infarction (MI)</span><br />
<div style="text-align: justify;">Explain procedures and answer questions for both the patient and family. Explain the CCU environment and routine. Remember that you may need to repeat explanations after the emergency situation has resolved.<br />
</div><br />
<ul><li style="text-align: justify;">To promote compliance with the prescribed medication regimen and other treatment measures, thoroughly explain dosages and therapy. Inform the patient of the drug's adverse reactions, and advise him to watch for and report signs and symptoms of toxicity (for example, anorexia, nausea, vomiting, mental depression, vertigo, blurred vision, and yellow vision, if the patient is receiving a cardiac glycoside).<br />
</li>
<li style="text-align: justify;">Explain the need to treat recurrent chest pain or <span style="font-weight: bold;">Myocardial Infarction (MI)</span> discomfort with sublingual nitroglycerin every 5 minutes for three doses. If the pain persists for 20 minutes, teach the patient to seek medical attention. If the patient has severe pain or becomes short of breath with chest pain, teach the patient to take nitroglycerin and seek medical attention right away<br />
</li>
<li style="text-align: justify;">Review dietary restrictions with the patient. If he must follow a low-sodium, low-fat, or low-cholesterol diet, provide a list of foods to avoid. Ask the dietitian to speak to the patient and family.<br />
</li>
<li style="text-align: justify;">Explore mechanisms to implement diet control, an exercise program, and smoking cessation if appropriate.<br />
</li>
<li style="text-align: justify;">Encourage the patient to participate in a cardiac rehabilitation exercise program. The physician and the exercise physiologist should determine the level of exercise and then discuss it with the patient and secure his agreement to a stepped-care program.<br />
</li>
<li style="text-align: justify;">Counsel the patient to resume sexual activity progressively. He may need to take nitroglycerin before sexual intercourse to prevent chest pain from the increased activity.<br />
</li>
<li style="text-align: justify;">Advise the patient about appropriate responses to new or recurrent symptoms.<br />
</li>
<li style="text-align: justify;">Advise the patient to report typical or atypical chest pain. Post <span style="font-weight: bold;">Myocardial Infarction (MI)</span> syndrome may develop, producing chest pain that must be differentiated from a recurrent MI, pulmonary infarction, and <a href="http://nurse-thought.blogspot.com/2009/04/nursing-care-plans-for-congestive-heart.html">heart failure</a> .<br />
</li>
<li style="text-align: justify;">Stress the need to stop smoking. If necessary, refer the patient to a support group.<br />
</li>
<li style="text-align: justify;">Be sure the patient understands all the medications, including the dosage, route, action, and adverse effects.<br />
</li>
<li style="text-align: justify;">Instruct the patient to keep the nitroglycerin bottle sealed and away from heat.<br />
</li>
<li style="text-align: justify;">The medication may lose patients potency.<br />
</li>
</ul>Pri'ehttp://www.blogger.com/profile/12027499295412539384noreply@blogger.com0