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Hypertension Diet

The DASH Diet (Dietary Approaches to Stop Hypertension) was tested and established by the National Heart, Lung and Blood Institute NHLBI. It recommends limiting salt and sodium intake to control blood pressure; in addition, it also recognizes the roles of another 3 minerals in controlling blood pressure - calcium, magnesium and potassium. Similar to the Dietary Guidelines for American 2005, the DASH diet puts more emphasis on whole grains, fruits and vegetables as well as low-fat dairy and meat products. Studies showed that the DASH diet has been shown to lower both systolic and diastolic blood pressure. Furthermore, it worked very quickly - usually within 2 weeks!

The current sodium recommendation made by the Federal Government's National High Blood Pressure Education Program NHBPEP is 2400 mg (~1 tsp of salt). The DASH-sodium study showed an even better blood pressure results with an intake of 1500 mg daily.

The following DASH diet is based on 2000 kcal a day.

Summary of the High Blood Pressure Diet - DASH
Grains
Vegetables
Fruits
Lowfat or Fat-free Dairy
Meats, poultry & fish
Nuts, seeds & dry beans
Fats & oils
Sweets
7-8 servings
4-5 servings
4-5 servings
2-3 servings
2 or less servings
4-5 per week
2-3
5 per week

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Healthy Diet for Diabetes Mellitus

Healthy Diet for Diabetes Mellitus


Diabetes Mellitus is a condition where the body is unable to process glucose (a form of sugar).

The most prevalent form of Diabetes is Type II Diabetes which occurs mainly in adults. You are at risk from this form of diabetes if you have a generic predisposition to it (i.e. it’s in your family history), if you are overweight, and/or are aged over 40. In Type II Diabetes, the pancreas still creates insulin, but not enough, – or the insulin does not function correctly (insulin resistance). This form of Diabetes can be managed (to some degree) with the right diet and exercise, but also with diabetes pills and insulin.


The purpose of Diabetes Mellitus Diet

Adjust food with the body's ability to use it, so help you:
  • Lowering blood sugar close to normal
  • Reducing sugar in the urine becomes negative
  • Achieve normal weight
  • Able to perform daily work as usual.

Recommended Cooking Method:
  • Before you eat, the food must be weighed in the form of cooking. Such as: rice, potatoes, fish, meat and vegetables group B.
  • When the disease is controlled, you can eat from the family menu, as long as the amount of food mixed in accordance with the provisions.
  • How to cook can be done like other family members.
  • If you want to eat sweet to use saccharin as a sugar substitute.

Sample Meal Plan:

Breakfast

1/2 Grapefruit, 1 medium bowl oatmeal topped with extra low-fat milk. 1 Tsp honey and 1 Tsp flax seeds.

Snack

1 kiwi fruit

Lunch

40g (uncooked) Basmati rice – cook and server with 4oz cooked chicken strips. 1 small orange, chopped cucumber, and 2 Tsp pine nuts, with oil-free French dressing.

Mid afternoon snack

2 dark rye crisp breads spread with yeast extract.

Dinner

4 oz salmon fillet topped with 1 1/2 Tsp olive oil blended with 1 garlic clove, grilled and server with 6ox potato mashed with seasoning. Serve with peas and spinach.
1 medium glass of dry white or red wine, or fruit juice.
READ MORE - Healthy Diet for Diabetes Mellitus

Nursing Care Plan for Dengue Hemorrhagic Fever

NCP for Dengue Hemorrhagic Fever



Dengue Hemorrhagic Fever

Dengue hemorrhagic fever is a severe, potentially deadly infection spread by certain species of mosquitoes (Aedes aegypti).

Causes

Four different dengue viruses are known to cause dengue hemorrhagic fever. Dengue hemorrhagic fever occurs when a person catches a different type dengue virus after being infected by another one sometime before. Prior immunity to a different dengue virus type plays an important role in this severe disease.

Worldwide, more than 100 million cases of dengue fever occur every year. A small number of these develop into dengue hemorrhagic fever. Most infections in the United States are brought in from other countries. It is possible for a traveler who has returned to the United States to pass the infection to someone who has not traveled.

Risk factors for dengue hemorrhagic fever include having antibodies to dengue virus from prior infection and being younger than 12, female, or Caucasian.

Symptoms

Early symptoms of dengue hemorrhagic fever are similar to those of dengue fever, but after several days the patient becomes irritable, restless, and sweaty. These symptoms are followed by a shock -like state.

Bleeding may appear as tiny spots of blood on the skin (petechiae) and larger patches of blood under the skin (ecchymoses). Minor injuries may cause bleeding.

Shock may cause death. If the patient survives, recovery begins after a one-day crisis period.

Early symptoms include:
  • Decreased appetite
  • Fever
  • Headache
  • Joint aches
  • Malaise
  • Muscle aches
  • Vomiting

Acute phase symptoms include:
  • Restlessness followed by:
    • Ecchymosis
    • Generalized rash
    • Petechiae
    • Worsening of earlier symptoms
  • Shock-like state
    • Cold, clammy extremities
    • Sweatiness (diaphoretic)
Source : www.nlm.nih.gov


Nursing Care Plan for Dengue Hemorrhagic Fever

Nursing Assessment for Dengue Hemorrhagic Fever
  1. Identity
    Dengue Hemorrhagic Fever is a tropical disease that often causes the death of children, adolescents and adults (Effendi, 1995)
  2. Main Complaint
    Patients complain of fever, headache, weakness, heartburn, nausea and decreased appetite.
  3. History of Disease Now
    Medical history showed headache, muscle pain, aches throughout the body, pain when swallowing, weakness, fever, nausea, and decreased appetite.
  4. Previous Disease History
    No illness is specific.
  5. Family Health History
    History of Dengue Hemorrhagic Fever disease in other family members is crucial, because the disease Dengue Hemorrhagic Fever is a disease that can be transmitted through the bite of mosquito Aedes aegipty.
  6. Environmental Health History
    Normally less clean environment, lots of clean water puddles like tin cans, old tires, a dirty bathtub.
  7. Historical Growth
  8. Assessment Per System
    • Respiratory System
      Shortness of breath, bleeding through the nose, shallow breathing, epistaxis, symmetrical chest movements, resonant percussion, auscultation sounds ronchi.
    • Neural System
      In grade III patients with anxiety and a decline in awareness and in grade IV can occur Dengue shock syndrome.
    • Cardiovascular System
      In grde I Hemo concentrations can occur, positive tourniquet test, thrombocytopenia, grade III to circulatory failure, rapid pulse, weakness, hypotension, cyanosis around the mouth, nose and fingers, in grade IV no palpable pulse and blood pressure can not be measured .
    • Digestive System
      Dry mucous membranes, difficulty swallowing, pain when the press in the epigastric, enlarged spleen, enlarged liver, abdominal stretch, decreased appetite, nausea, vomiting, pain on swallowing, can hematemesis, melena.
    • Urinary System
      Urine production declines, sometimes less than 30 cc / hour, will reveal pain when urinating, the colour of urine is red.
    • Integumentary System
      An increasing body temperature, dry skin, the grade I have a positive tourniquet test, occurred pethike, in grade III bleeding can occur spontaneously in the skin.
Nursing Diagnosis and Nursing Interventions for Dengue Hemorrhagic Fever (DHF)
READ MORE - Nursing Care Plan for Dengue Hemorrhagic Fever

Nursing Diagnosis and Nursing Interventions for Dengue Hemorrhagic Fever

Nursing Diagnosis for Dengue Hemorrhagic Fever (DHF)
  1. The increase in body temperature related to the process of dengue virus infection.
  2. Deficit fluid volume related to the migration of intravascular fluid into extravascular.
  3. Impaired nutrition: less than body requirements related to the decreased appetite.

Nursing Interventions for Dengue Hemorrhagic Fever
  1. The increase in body temperature related to the process of dengue virus infection.

    Goal:
    The body temperature returned to normal

    Expected Results:
    • Vital signs within normal limits, especially temperature (36 C - 37 C)
    • Mucous membranes moist.

    Nursing Intervention:
    • Observation of vital signs every 1 hour
      Rationale: Determining the continued intervention when changes
    • Give a warm water compress
      Rational: Compress will provide induction heat expenditure.
    • Encourage clients to drink lots of 1500 - 2000 ml
      Rationale: Changing the body fluid that comes out because of heat and spur spending urine.
    • Suggest to wear thin clothes and absorb sweat.
      Rational: To provide a sense of comfort and increase the evaporation heat
    • Observation on the intake and out put
      Rational: Detection of body fluid volume deficiency.
    • Collaboration for the provision of antipyretic
      Rational: Antipyretics useful for heat reduction.
  2. Deficit fluid volume related to the migration of intravascular fluid into extravascular

    Goal:
    Nothing happens hypovolemic shock

    Expected results:
    Blood pressure: 120/80 mmHg, Pulse: 80-100x/mnt, Strong pulse

    Nursing Intervention:
    • Observation of vital signs every hour or more. Rationale: Knowing the condition of intra-vascular fluid.
    • Observation of capillary refill
      Rational: Indications of adequate peripheral circulation.
    • Observation on the intake and output, record the number, color / concentration of urine.
      Rational: Decrease in urine output / urine is concentrated with an increased density of suspected dehydration.
    • Encourage to drink plenty of 1500-2000 mL
      Rational: To meet the needs of body fluids
    • Collaboration giving intravenous fluids or plasma or blood.
      Rationale: Increasing the amount of body fluids to prevent hypovolemic shock.
  3. Impaired nutrition: less than body requirements related to the decreased appetite

    Goal:
    Nutrition fulfilled

    Results expected:
    • Increased appetite
    • Meal spent

    Nursing Intervention:
    • Assess complaints of nausea, vomiting or decreased appetite
      Rationale: Determining the next intervention.
    • Give foods that are easy to swallow and easy to digest
      Rationale: Reduce fatigue and prevent gastrointestinal bleeding.
    • Give small portions of food, but often.
      Rational: Avoiding nausea and vomiting
    • Avoid foods that stimulate: spicy, sour.
      Rationale: Prevent the occurrence of distension of the stomach which can stimulate vomiting.
    • Give the client's favorite foods
      Rationale: Allows for more revenue
    • Collaboration parenteral fluid administration
      Rational: Parenteral nutrition is needed if the peroral intake was less.
READ MORE - Nursing Diagnosis and Nursing Interventions for Dengue Hemorrhagic Fever

Nursing Diagnosis and Nursing Interventions for Preeclampsia

Nursing Diagnosis and Nursing Interventions for Preeclampsia

Nursing Diagnosis for Preeclampsia
  1. High risk of seizures in pregnant women associated with decreased organ function (vasospasm and increased blood pressure).
  2. High risk of fetal distress related to changes in the placenta
  3. Impaired sense of comfort (pain) related to uterine contractions.

Nursing Interventions for Preeclampsia
  1. High risk of seizures in pregnant women related to decreased organ function (vasospasm and increased blood pressure).

    Goal :
    After the treatments, no seizures occurred in pregnant women

    Results expected :
    • Awareness: composmentis, GCS: 15 (E4 - V5 - M6)
    • Vital signs:
      • Blood Pressure: 100-120 / 70-80 mmHg
      • Temperature: 36-37 C
      • Nadi: 60-80 x / mnt
      • RR: 16-20 x / mnt

    Intervention :
    • Monitor blood pressure every 4 hours
      Rational: The pressure over 110 mmHg diastole and systole 160 or more an indication of PIH.
    • Record the patient's level of consciousness
      Rational: The decline of consciousness as an indication of decreased cerebral blood flow.
    • Assess signs of eclampsia (hyper active, the patellar reflexes, decreased pulse and respiration, epigastric pain and oliguria)
      Rational: The symptoms are a manifestation of changes in the brain, kidney, heart and lung that precedes seizure status.
    • Monitor for signs and symptoms of labor or uterine contractions.
      Rationale: Seizures will increase the sensitivity of the uterus which will allow the delivery.
    • Collaboration with the medical team in the provision of anti-hypertension
      Rationale: Anti-hypertension to lower blood pressure.
  2. High risk of fetal distress related to changes in the placenta

    Goal :
    After the treatments did not occur fetal distress

    Expected results:
    Fetal heart rate (+): 12-12-12

    Intervention :
    • Monitor fetal heart rate as indicated
      Rationale: Increased fetal heart rate as an indication of hipoxia, premature and solusio placenta.
    • Review on fetal growth
      Rational: Decrease in placental function may be caused by hypertension, causing IUGR.
    • Explain the signs of solutio placenta (abdominal pain, bleeding, uterine tension, decreased fetal activity)
      Rational: Pregnant women may know the signs and symptoms of solutio placenta. Pregnant women can learn from hipoxia in the fetus.
    • Collaboration with the medical ultrasound and NST.
      Rational: ultrasound and NST to a known state / welfare of the fetus.


  3. Impaired sense of comfort (pain) related to uterine contractions

    Goal :
    Pain is reduced / no pain

    Results expected:
    • Pregnant women understand the causes of pain
    • Pregnant women are able to adapt to the pain

    Intervention :
    • Assess the patient's pain intensity level
      Rational: The threshold of pain everyone is different, thus will be able to determine appropriate action treatment with the patient's response to pain.
    • Explain the causes of pain
      Rational: Pregnant women can understand the causes of pain
    • Teach the pregnant woman with the breath in anticipation of pain arise when HIS
      Rational: With a deep breath to relax the muscles, there was vasodilatation of blood vessels, optimal lung expansion, so that the oxygen demand on the tisue are met.
    • Help the pregnant woman by rubbing / massage on the painful part.
      Rational: To distract the patient.
READ MORE - Nursing Diagnosis and Nursing Interventions for Preeclampsia

Nursing Care Plan for Preeclampsia

NCP for Preeclampsia

Nursing Care Plan for Preeclampsia


Preeclampsia

Preeclampsia is a disorder of widespread vascular endothelial malfunction and vasospasm that occurs after 20 weeks' gestation and can present as late as 4-6 weeks postpartum. It is clinically defined by hypertension and proteinuria, with or without pathologic edema.

Preeclampsia is part of a spectrum of hypertensive disorders that complicate pregnancy. These include chronic hypertension, preeclampsia superimposed on chronic hypertension, gestational hypertension, preeclampsia, and eclampsia. Although each of these disorders can appear in isolation, they are thought of as progressive manifestations of a single process and are believed to share a common etiology.
emedicine.medscape.com


Causes

The exact cause of preeclampsia is not known. Possible causes include:
  • Autoimmune disorders
  • Blood vessel problems
  • Diet
  • Genes
Preeclampsia occurs in a small percentage of pregnancies. Risk factors include:
  • First pregnancy
  • Multiple pregnancy (twins or more)
  • Obesity
  • Older than age 35
  • Past history of diabetes, high blood pressure, or kidney disease.

Symptoms

Often, women who are diagnosed with preeclampsia do not feel sick.

Symptoms of preeclampsia can include:
  • Swelling of the hands and face/eyes (edema)
  • Weight gain
    • More than 2 pounds per week
    • Sudden weight gain over 1 - 2 days
Note: Some swelling of the feet and ankles is considered normal with pregnancy.

Symptoms of more severe preeclampsia:
  • Headaches that are dull or throbbing and will not go away
  • Abdominal pain, mostly felt on the right side, underneath the ribs. Pain may also be felt in the right shoulder, and can be confused with heartburn, gallbladder pain, a stomach virus, or the baby kicking
  • Agitation
  • Decreased urine output, not urinating very often
  • Nausea and vomiting (worrisome sign)
  • Vision changes -- temporary loss of vision, sensations of flashing lights, auras, light sensitivity, spots, and blurry vision.
www.nlm.nih.gov


Nursing Care Plan for Preeclampsia

Nursing Assessment
  1. Subjective Data :
    • Age is usually common in primigravida, less than 20 years or more than 35 years.
    • Health history is now: increased blood pressure, edema, headache, epigastric pain, nausea, vomiting, blurred vision.
    • Previous health history: kidney disease, anemia, vascular essential, chronic hypertension, diabetes mellitus.
    • History of pregnancy: a history of multiple pregnancy, hydatidiform mole, hidramnion and the history of pregnancy with preeclampsia or eclampsia before.
    • Pattern of nutrition: the type of food consumed staple food good or distraction.
    • Psychosocial: Unstable Emotions can lead to anxiety, and therefore need moral readiness to face the risks.
  2. Objective Data :
    • Inspection: edema did not disappear within 24 hours.
    • Palpate: to know the uterine fundus height, location of the fetus, the location of edema.
    • Auscultation: listening to fetal heart rate to determine the existence of fetal distress.
    • Percussion: to know the patellar reflex.
    • Other Assessments :
      • Vital Signs: Measuring in a reclined position or sleeping, measured 2 times with an interval of 6 hours.
      • Laboratory: urine protein, with a catheter or midstream (usually increased to 0.3 g / lt or +1 to +2 on the qualitative scale), decreased hematocrit levels, increased serum creatinine, uric acid is usually> 7 mg/100 ml.
      • Weight: weight increase over 1 kg / week.
      • Level of consciousness: a reduction in GCS as a sign of abnormalities in the brain.
      • Ultrasound: to know the state of the fetus.
Nursing Diagnosis and Nursing Interventions for Preeclampsia
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Nursing Diagnosis and Nursing Interventions for Malaria

Nursing Diagnosis and Nursing Interventions for Malaria
  1. Changes in nutrition less than body requirements related to inadequate food intake, anorexia, nausea / vomiting

    Nursing Intervention :
    • Assess history of nutrition, including foods that are preferred. Observation and record the client's food input.
      Rational: watching caloric intake or lack of quality of food consumption.
    • Give extra food to eat little and small.
      Rational: gastric dilatation may occur when feeding too fast after a period of anorexia.
    • Maintain a schedule of regular body weight.
      Rational: Monitors the effectiveness of weight loss or nutrition intervention.
    • Discuss the preferred client and input in a pure diet.
      Rational: It can increase input, increase the sense of participation / control.
    • Observation and record the events of nausea / vomiting, and other related symptoms.
      Rational: to show the effect of GI symptoms of anemia (hypoxia) on organ.
    • Collaboration with a dietitian.
      Rational: Need help in planning a diet that meets nutritional needs.
  2. High risk of infection related to a decrease in body systems (main defense is inadequate), invasive procedures.

    Nursing Intervention:
    • Monitor body temperature increases.
      Rational: Fever caused by the effects of endotoxin on the hypothalamus and hypothermia are important signs that reflect the development status of shock / decrease in tissue perfusion.
    • Observe the chills and diaforosis.
      Rational: Shivering often precedes the height of the temperature on a common infection.
    • Monitor the sign deviation condition / failure to improve during therapy.
      Rational: It can show Inaccurate antibiotic therapy or growth of organisms.
    • Provide anti-infective medication as directed.
      Rational: It can kill / give temporary immunity to common infections.
    • Get spisemen blood.
      Rational: The identification of the causes of malaria infections.


  3. Hyperthermia is related to increased metabolism of circulating germ dehydration direct effect on the hypothalamus.

    Nursing Intervention:
    • Monitor patient's temperature (degree and pattern), note the chills.
      Rational: Hipertermi showed an acute infectious disease process. The pattern of fever indicates a diagnosis.
    • Monitor the temperature of the environment.
      Rational: The temperature of the room / the number of sheets should be changed to maintain the temperature close to normal.
    • Give a warm compress bath, avoid using alcohol.
      Rational: It can help reduce a fever, use of ice / alcohol may cause cold. In addition, alcohol can dry the skin.
    • Give antipyretics.
      Rational: Used to reduce fever with its central action on the hypothalamus.
    • Give a cooling blanket.
      Rational: Used to reduce fever with hyperthermia.
READ MORE - Nursing Diagnosis and Nursing Interventions for Malaria

Nursing Care Plan for Malaria

NCP for Malaria


Malaria

Malaria is an infectious disease caused by a parasite, Plasmodium, which infects red blood cells. Malaria is characterized by cycles of chills, fever, pain, and sweating. Historical records suggest malaria has infected humans since the beginning of mankind. The name "mal aria" (meaning "bad air" in Italian) was first used in English in 1740 by H. Walpole when describing the disease. The term was shortened to "malaria" in the 20th century. C. Laveran in 1880 was the first to identify the parasites in human blood. In 1889, R. Ross discovered that mosquitoes transmitted malaria. Of the four common species that cause malaria, the most serious type is Plasmodium falciparum malaria. It can be life-threatening. However, another relatively new species, Plasmodium knowlesi, is also a dangerous species that is typically found only in long-tailed and pigtail macaque monkeys. Like P. falciparum, P. knowlesi may be deadly to anyone infected. The other three common species of malaria (P. vivax, P. malariae, and P. ovale) are generally less serious and are usually not life-threatening. It is possible to be infected with more than one species of Plasmodium at the same time.

Symptoms and Signs

The symptoms characteristic of malaria include flulike illness with fever, chills, muscle aches, and headache. Some patients develop nausea, vomiting, cough, and diarrhea. Cycles of chills, fever, and sweating that repeat every one, two, or three days are typical. There can sometimes be vomiting, diarrhea, coughing, and yellowing (jaundice) of the skin and whites of the eyes due to destruction of red blood cells and liver cells.

People with severe P. falciparum malaria can develop bleeding problems, shock, liver or kidney failure, central nervous system problems, coma, and can die from the infection or its complications. Cerebral malaria (coma, or altered mental status or seizures) can occur with severe P. falciparum infection. It is lethal if not treated quickly; even with treatment, about 15%-20% die.
medicinenet.com





Nursing Care Plan for Malaria


Nursing Assessment for Malaria
  1. Activity / rest
    Symptoms: Fatigue, weakness, general malaise
    Signs: Tachycardia, muscle weakness and decreased strength.
  2. Circulation
    Signs: Blood pressure normal or slightly decreased. Peripheral pulse strong and rapid (phase of fever) warm skin, diuresis (diaphoresis) due to vasodilation. Pale and moist (vasoconstriction), hypovolemia, decreased blood flow.
  3. Elimination
    Symptoms: Diarrhea or constipation, decreased urine output
    Signs: abdominal distension
  4. Food and fluid
    Symptoms: Anorexia, nausea and vomiting
    Signs: Weight loss, reduced subcutaneous fat, and decrease in muscle mass. Decrease in urine output, urine concentration.
  5. Neuro Sensory
    Symptoms: Headache, dizziness and fainting.
    Signs: Nervousness, fear, mental chaos, disorientas delirium or coma.
  6. Breathing Signs: Tackipnea with a reduced depth of breathing. Symptoms: short breath at rest and activity
  7. Counseling / learning
    Symptoms: chronic health problems, such as liver, kidney, alcohol poisoning, history of splenectomy, had just had surgery / invasive procedures, traumatic injury.



Nursing Diagnosis for Malaria

Nursing diagnosis in patients with malaria on the basis of signs and symptoms that arise can be described as below (Doengoes, Moorhouse and Geissler, 1999) :
  1. Changes in nutrition less than body requirements related to inadequate food intake, anorexia, nausea / vomiting
  2. High risk of infection related to decreased immune system; invasive procedure
  3. Hyperthermia related to increased metabolism, dehydration, direct effects on the hypothalamic circulation of germs.
  4. Changes in tissue perfusion related to decreased cellular components in the need for delivery of oxygen and nutrients in the body.
  5. Lack of knowledge, about illness, prognosis and treatment needs related to lack of exposure, the interpretation of information ,cognitive limitations.
Nursing Diagnosis and Nursing Interventions for Malaria

Nursing Care Plan for Malaria
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Nursing Care Plan for Cataract

NCP for Cataract

Nursing Care Plan for Cataract


Cataracts

A cataract is a clouding of the eye's natural lens, which lies behind the iris and the pupil. The lens works much like a camera lens, focusing light onto the retina at the back of the eye. The lens also adjusts the eye's focus, letting us see things clearly both up close and far away.

The lens is mostly made of water and protein. The protein is arranged in a precise way that keeps the lens clear and lets light pass through it.

But as we age, some of the protein may clump together and start to cloud a small area of the lens. This is a cataract, and over time, it may grow larger and cloud more of the lens, making it harder to see.

Researchers are gaining additional insights about what causes these specific types of proteins (crystallins) to cluster in abnormal ways to cause lens cloudiness and cataracts. One recent finding suggests that fragmented versions of these proteins bind with normal proteins, disrupting normal function.

Cataracts are classified as one of three types :
  • A subcapsular cataract begins at the back of the lens. People with diabetes, high farsightedness or retinitis pigmentosa, or those taking high doses of steroids, may develop a subcapsular cataract.
  • A nuclear cataract is most commonly seen as it forms. This cataract forms in the nucleus, the center of the lens, and is due to natural aging changes.
  • A cortical cataract, which forms in the lens cortex, gradually extends its spokes from the outside of the lens to the center. Many diabetics develop cortical cataracts.
allaboutvision.com


Causes

The lens is made mostly of water and protein. Specific proteins within the lens are responsible for maintaining its clarity. Over many years, the structures of these lens proteins are altered, ultimately leading to a gradual clouding of the lens. Rarely, cataracts can present at birth or in early childhood as a result of hereditary enzyme defects, and severe trauma to the eye, eye surgery, or intraocular inflammation can also cause cataracts to occur earlier in life. Other factors that may lead to development of cataracts at an earlier age include excessive ultraviolet-light exposure, diabetes, smoking, or the use of certain medications, such as oral, topical, or inhaled steroids. Other medications that are more weakly associated with cataracts include the long-term use of statins and phenothiazines.
emedicinehealth.com


Signs and symptoms

As a cataract becomes more opaque, clear vision is compromised. A loss of visual acuity is noted. Contrast sensitivity is also lost, so that contours, shadows and color vision are less vivid. Veiling glare can be a problem as light is scattered by the cataract into the eye. The affected eye will have an absent red reflex. A contrast sensitivity test should be performed and if a loss in contrast sensitivity is demonstrated an eye specialist consultation is recommended.

In the developed world, particularly in high-risk groups such as diabetics, it may be advisable to seek medical opinion if a 'halo' is observed around street lights at night, especially if this phenomenon appears to be confined to one eye only.

The symptoms of cataracts are very similar to the symptoms of ocular citrosis.
wikipedia


Nursing Care Plan for Cataract

Nursing Assessment
  1. Activity / Rest: The change from the usual activities / hobbies in connection with visual impairment.
  2. Neurosensory: Impaired vision blurred / not clear, bright light causes glare with a gradual loss of peripheral vision, difficulty focusing work with closely or feel the dark room. Vision cloudy / blurry, looking halo / rainbow around the beam, changes eyeglasses, medication does not improve vision, photophobia (acute glaucoma).

    Signs: Looks brownish or milky white in the pupil (cataract), the pupil narrows and red / hard eye and a cloudy cornea (glaucoma emergency, increased tears)
  3. Pain / Leisure: Discomfort light / watery eyes. Sudden pain / heavy persist or pressure on or around the eyes, headaches.

Nursing Diagnosis and Nursing Interventions
  1. High risk of injury related to loss of vitreous, intraocular hemorrhage, increased IOP

    Marked by :
    • Any signs of cataract decreased visual acuity
    • Blurred vision, etc.

    Goal :
    Expressing understanding of the factors involved in the possibility of injury.

    Expected Results :
    • Indicates changes in behavior, lifestyle to reduce risk factors and to protect themselves from injury.
    • Changing the environment as an indication to increase security.

    Nursing Intervention :
    • Discuss what happens on the condition of post-surgery, pain, limitation of activity, performance, bandage the eye.
    • Give the patient the position back, head high, or tilted to the side that is not ill, according to patient preference.
    • Limit activities such as moving heads suddenly, scratched eyes, bent over.
    • Ambulation with assistance: give special bathroom when recovering from anesthesia.
    • Encourage deep breathing, coughing to maintain a healthy lung.
    • Encourage use stress management techniques.
    • Maintain eye protection as indicated.
    • Ask the client to distinguish between discomfort and a sudden sharp pain, Investigate anxiety, disorientation, impaired bandage.
    • Provide appropriate indication of antiemetic drugs, Asetolamid, analgesics.


  2. Impaired sensory perception: the perceptual vision, related to impaired sensory reception / status of sensory organs, a therapeutic environment is limited.

    Marked by :
    • Reduced visual acuity
    • Changes in response to the stimuli normally.

    Goal :
    Improved visual acuity within the limits of individual situations, recognize sensory disturbance and compensated against changes.

    Expected Results :
    • Know the sensory disturbances and compensated against changes.
    • Identify / fix potential hazards in the environment.

    Nursing Intervention :
    • Determine visual acuity, note whether one or two eyes involved.
    • Orient clients to the environment
    • Observation signs of disorientation.
    • Approach from the side that was operated on, talk to touch.
    • Note about dim or blurred vision and eye irritation, which can occur when using eye drops.
    • Remind clients use of cataract glasses whose purpose enlarge approximately 25 percent, loss of peripheral vision and blind spot may exist.
    • Put the items required / position call bell within reach.

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4 Cataract Nursing Diagnosis and Interventions

READ MORE - Nursing Care Plan for Cataract

Nursing Care Plan for Hepatoma

NCP for Hepatoma


Hepatoma

A hepatoma is a cancer that starts in the liver. It is the most common type of cancer originating in the liver.


Symptoms

The first signs of the disease may include :
  • Abdominal pain
  • Weight loss
  • Large mass that can be felt in the upper right section of the abdomen

People who have had cirrhosis for a long time may also experience :
  • Sudden feeling of illness
  • Fever
  • Sudden abdominal pain and shock (very low blood pressure) caused by a rupture or bleeding of the tumor

Causes and Risk Factors

Risk factors for hepatoma include :
  • Long-standing cases of cirrhosis (severe scarring of the liver)
  • Chronic infection with hepatitis B
  • Chronic infection with hepatitis C
  • Certain food fungi

Diagnosis

At first, symptoms may not offer clues that the disease is present. When the person has had cirrhosis for a long time and a tumor can be felt in the abdomen, the doctor will suspect hepatoma.

Other ways to detect the disease include :
  • Ultrasound
  • Computed tomography (CT) scans
  • Magnetic resonance imaging (MRI)scans
  • Liver biopsy. For this, a small sample of tissue is taken for examination under a microscope.

Treatment

The survival rate for people with hepatoma is poor. This is because the tumor is usually discovered at a later stage.

Treatment options include :
  • Surgery, if the tumor is small
  • Chemotherapy. This can slow the growth of the tumor but not cure the cancer.
Source : www.cedars-sinai.edu



Nursing Care Plan for Hepatoma


Nursing Assessment

On physical examination can be obtained :
  • Ascites
  • Jaundice
  • Hypoalbuminemia
  • Splenomegaly, spider nevi, palmar eritoma, edema.

In general, nursing assessment in patients with hepatoma, including :
  • Metabolic disorders
  • Bleeding
  • Ascites
  • Edema
  • Hipoproteinemia
  • Jaundice / icterus
  • Endocrine Complications
  • Activities were disrupted by treatment.

Nursing Diagnosis for Hepatoma

Based on the above assessment, the nursing diagnoses that often arises is :
  1. Malnutrition: Weight loss related to anorexia, nausea, impaired absorption, metabolism of vitamins.
  2. Ineffectiveness of breathing related to the existence of ascites and emphasis diapragma.
  3. Pain related to abdominal wall tension
  4. Lack of fluids and electrolytes related to excessive ascites, bleeding, and edema
  5. The risk of infection related to a deficiency of white blood cells
  6. The risk of skin integrity problems related to pruritus, edema, and ascites
  7. Sexual dysfunction related to hormonal dysfunction and decreased libido
  8. Anxiety related to hospitalization
  9. Lack of knowledge about the disease process and its causes
  10. Social isolation related to the risk of spreading infection.
READ MORE - Nursing Care Plan for Hepatoma

Nursing Care Plan for Glaucoma

NCP for Glaucoma

Nursing Care Plan for Glaucoma

Glaucoma


Glaucoma is a disease of the major nerve of vision, called the optic nerve. The optic nerve receives light-generated nerve impulses from the retina and transmits these to the brain, where we recognize those electrical signals as vision. Glaucoma is characterized by a particular pattern of progressive damage to the optic nerve that generally begins with a subtle loss of side vision (peripheral vision). If glaucoma is not diagnosed and treated, it can progress to loss of central vision and blindness.

Glaucoma is usually, but not always, associated with elevated pressure in the eye (intraocular pressure). Generally, it is this elevated eye pressure that leads to damage of the eye (optic) nerve. In some cases, glaucoma may occur in the presence of normal eye pressure. This form of glaucoma is believed to be caused by poor regulation of blood flow to the optic nerve.


Symptoms and Signs

Patients with open-angle glaucoma and chronic angle-closure glaucoma in general have no symptoms early in the course of the disease. Visual field loss (side vision loss) is not a symptom until late in the course of the disease. Rarely patients with fluctuating levels of intra-ocular pressure may have haziness of vision and see haloes around lights, especially in the morning.

On the other hand, the symptoms of acute angle-closure are often extremely dramatic with the rapid onset of severe eye pain, headache, nausea and vomiting, and visual blurring. Occasionally, the nausea and vomiting exceed the ocular symptoms to the extent that an ocular cause is not contemplated.

The eyes of patients with open-angle glaucoma or chronic angle-closure glaucoma may appear normal in the mirror or to family or friends. Some patients get slightly red eyes from the chronic use of eyedrops. The ophthalmologist, on examining the patient, may find elevated intraocular pressure, optic-nerve abnormalities, or visual field loss in addition to other less common signs.

The eyes of patients with acute angle-closure glaucoma will appear red, and the pupil of the eye may be large and nonreactive to light. The cornea may appear cloudy to the naked eye. The ophthalmologist will typically find decreased visual acuity, corneal swelling, highly elevated intraocular pressure, and a closed drainage angle.
Source : www.medicinenet.com


Nursing Care Plan for Glaucoma

Nursing Assessment for Glaucoma
  1. History or presence of risk factors :
    • Positive family history (believed to be associated with primary open angle glaucoma).
    • Tumors of the eye
    • Hemorrhage intraocular
    • Inflammatory intraocular uveiti)
    • Eye contusion from trauma.
  2. Physical examination based on those in the general assessment of the eye may indicate:
    For primary open angle
    Reported a loss of peripheral vision slow (see tunnel)
    For primary angle closure :
    • Incidence of sudden severe pain in the eye is often accompanied by headache, nausea and vomiting.
    • Complaints halo light, blurred vision, and decreased light perception.
    • The pupils are being fixed with redness due to inflammation of the sclera and cornea looks cloudy.
  3. Diagnostic Examination
    • Tonometri used to measure intra-ocular pressure. Glaucoma is suspected when IOP greater than 22 mmHg.
    • Gonioskopi possible to see directly the anterior chamber angle glaucoma to distinguish between closed and open-angle glaucoma.
    • Optalmoskopi allow inspectors to see directly optic disc and internal eye structure.
  4. Assess the patient's understanding about the condition and emotional response to the condition and plan of action.

Nursing Diagnosis and Nursing Interventions for Glaucoma

Pain related to spasm, intra-ocular pressure, glaucoma acute.

Which is characterized by :
  • patients express pain in the eye,
  • protect the side of the pain patients,
  • frowned and whimpered.

Goal :
reduction of discomfort, said pain is gone / reduced, relaxed facial expression, no moaning.

Intervention :
  • Monitor blood pressure, pulse, and respiration every 4 hours.
    Monitor the degree of eye pain every 30 minutes during the acute phase.
    Monitor input and output every 8 hours while receiving intravenous osmotic agent.
    Monitor visual acuity at any time before hatching ophthalmic agents.
  • Give appropriate instructions optalmic agent for glaucoma. Inform your doctor if :
    • hypotension
    • urinary output of less than 240 ml / hour
    • No loss of pain in the eye within 30 minutes of drug therapy
    • Decrease in constant visual acuity.
  • Prepare patients for surgery
  • Maintain bed rest in semi-Fowler position. Prevent increase in IOP :
    • Instruct to avoid coughing, sneezing, straining, or placing the head below the pelvic
  • Provide quiet environment and avoid light.
  • Give anlgetic prescription and evaluation of its effectiveness.
READ MORE - Nursing Care Plan for Glaucoma

Nursing Interventions for Drug Addiction : Narcotics, Psychotropic and Other Addictive Substance

Nursing Interventions for Drug Addiction : 
Narcotics, Psychotropic and Other Addictive Substance
  1. Overdose Conditions

    Goal :
    Patients do not experience life threatening

    Nursing Intervention :
    • Observation of vital signs, consciousness in 15 minutes in the first 3 hours, 30 minutes to 3 hours the second, each 1 hour in the next 24 hours
    • Work with the doctor for medication
    • Observation of fluid balance
    • Maintain patient safety
    • Accompany patient
    • Fixation if necessary

  2. Intoxication Condition

    Goal :
    Intoxication in patients can be overcome, anxiety is reduced / lost

    Nursing Intervention :
    • Establish trusting relationship
    • Assessing the level of anxiety
    • Speak in simple language, short and easy to understand
    • Listen to the patient talk
    • Frequent use of therapeutic communication
    • Avoid the attitude that creates a feeling of suspicion, stick to the promise, to give real answers, do not whisper in front of the patient, be firm, friendly.

  3. Withdrawal Condition

    Nursing Intervention :
    • Observation of the signs of seizures
    • Give a warm compress on the abdomen when the spasms
    • Providing care to patients delusions, hallucinations: primarily to reduce the feeling that caused this problem: fear, suspicion, anxiety, excessive joy, justify a wrong perception
    • Working together with the doctor in providing pain medication.


  4. Detoxication Condition

    Nursing Intervention :
    • Practice concentration: group held a morning discussion
    • Provide counseling to moral and spiritual changes that deviate, change the patient to become responsible human beings, mentally healthy, feeling grateful, and optimistic
    • Preparing patients to return to the community, by working with social workers, psychologists.
READ MORE - Nursing Interventions for Drug Addiction : Narcotics, Psychotropic and Other Addictive Substance

Nursing Diagnosis for Drug Addiction : Narcotics, Psychotropic and Other Addictive Substance

Nursing Diagnosis for Drug Addiction : 
Narcotics, Psychotropic and Other Addictive Substance

  1. The threat of life
    • Fluid balance disturbances: nausea, vomiting related to termination of opioid substances.
    • Risks to rampage related to sedative hypnotic intoxication.
    • High risk of self harm related to intoxication
      related to alcohol intoxication, sedatives, hypnotics.
    • Panic related to alcohol withdrawal.

  2. Intoxication
    • Anxiety related to cannabis intoxication
    • Damage verbal communication related to sedative hypnotic intoxication, alcohol, opioids.

  3. Withdrawal
    • Change thought process : delusional related to withdrawal of alcohol, sedatives, hypnotics
    • Pain related to withdrawal of opioda, MDMA: Extasy
    • Changes in nutrition less than the needs related to opioid withdrawal.

  4. Post Detoxification
    • Impaired concentration of attention related to the impact of the use of addictive substances
    • Impaired self-concept: low self-esteem related to not able to recognize the positive qualities of self.
    • Escape risk related to dependence on addictive substances.
READ MORE - Nursing Diagnosis for Drug Addiction : Narcotics, Psychotropic and Other Addictive Substance

Sample Nursing Assessment on Patients with Abuse and Addiction Narcotics, Psychotropic and Other Addictive Substances

Sample Nursing Assessment on Patients with Abuse and Addiction Narcotics, Psychotropic and Other Addictive Substances
  1. Assess the situation and condition of the use of Narcotics, Psychotropic and Other Addictive Substances
    • When Narcotics, Psychotropic and Other Addictive Substances used.
    • When Narcotics, Psychotropic and Other Addictive Substances become more frequently used / started to become a problem.
    • When Narcotics, Psychotropic and Other Addictive Substances reduced / stopped, even if only temporary.


  2. Assess the risks associated with substance use
    • Sharing injecting equipment
    • Conduct an uncomfortable sex
    • Driving while intoxicated
    • History overdose
    • History of attacks (seizures) during withdrawal


  3. Assess the pattern of usage
    • Time usage in a day (at the time of preparing meals night)
    • Use of the week
    • This type of situation (relax in front of the TV)
    • The location (the desire to use Narcotics, Psychotropic Substances and Other Addictive after walking through a townhouse)
    • The presence or meet with certain people (ex-boyfriend, friends use)
    • The existence of certain thoughts ("I've not stand anymore, I have to make")
    • The existence of certain emotions (anxious or bored)
    • The existence of trigger factors (if tired, shaky, hungry, can not sleep or prolonged stress)


  4. Review the terms of good / bad about substance use and about the conditions
    when not in use.
READ MORE - Sample Nursing Assessment on Patients with Abuse and Addiction Narcotics, Psychotropic and Other Addictive Substances

Nursing Assessment of Drug Addiction: Narcotics, Psychotropic and Other Addictive Substance

Nursing Assessment of Drug Addiction: Narcotics, Psychotropic and Other Addictive Substance

Nursing Assessment of Drug Addiction: Narcotics, Psychotropic and Other Addictive Substance
  1. Physical

    Overall, the effect of each drug class on physiological functions have much in common. The data may be found in clients who use the drug include: pain, sleep pattern disturbance, decreased appetite, constipation, diarrhea, sexual behaviors violate norms, do not take care of themselves, the potential complications.

    Goal: The client is able to live a regular basis.
  2. Emotional

    Feelings of anxiety (fear of unknown), insecure, paranoid and helpless. Potential mental disorder and behavior. With the addition of emotional symptoms are present in each of Narcotics, Psychotropic and Other Addictive Substance.

    Goal: The client can control and to control his emotions
  3. Social

    The social environment usually familiar with the user agent client is a friend, other family members, users of substances at school or campus environment.
  4. Intellectual

    The mind that always wants to use addictive substances, feeling free to stop, school or college activity decreased until it stops, the work stopped.

    Goal: The client is able to concentrate and increase the power of thought to something positive.
  5. Spiritual

    Religious activity is less or absent, the values of kindness abandoned because of behavioral changes such as: stealing, lying.

    Goal: The client is able to increase the activities of religion and worship, the implementation of the values of kindness.
  6. Family

    Fear of client behavior, shame on the people, scattering and draining the family economy by the client, communication and ineffective parenting, moral support to the client is not fulfilled

    Goal: The family could care for clients until they are able to anticipate the occurrence of relapse (relapse).

Nursing Diagnosis for Drug Addiction : Narcotics, Psychotropic and Other Addictive Substance

Sample Nursing Assessment on Patients with Abuse and Addiction Narcotics, Psychotropic and Other Addictive Substances
READ MORE - Nursing Assessment of Drug Addiction: Narcotics, Psychotropic and Other Addictive Substance

Nursing Diagnosis and Nursing Interventions for Pneumonia

Nursing Diagnosis for Pneumonia
  1. Ineffective airway clearance related to inflammation, accumulation of secretions.
  2. Impaired gas exchange related to changes in alveolar capillary membrane.
  3. The reduced volume of liquid related to inadequate oral intake, fever, tachypnoea.
  4. Activity intolerance related to decreased blood oxygen levels.
  5. Changes in the comfort related to fever, dyspnea, chest pain.
  6. The increase in body temperature related to the infection process.
  7. Anxiety related to the impact of hospitalization.


Nursing Interventions for Pneumonia
  1. Ineffective airway clearance related to inflammation, accumulation of secretions

    Goal :
    Effective way of breath, lung ventilation is adequate and there is no buildup of secretions.

    Interventions :
    • Monitor respiratory status every 2 hours, review the increase in respiratory status and abnormal breath sounds.
    • Perform percussion, vibration and postural drainage every 4-6 hours.
    • Give appropriate oxygen therapy program.
    • Help cough up secretions / suction mucus.
    • Give the comfortable position that allows the patient to breathe.
    • Create a comfortable environment so that patients can sleep calmly.
    • Monitor blood gas analysis to assess respiratory status.
    • Give drink enough.
    • Provide sputum for culture / sensitivity test.
    • Manage provision of appropriate antibiotics and other drugs program.

  2. Impaired gas exchange related to changes in alveolar capillary membrane.

    Goal :
    Patients showed improvement ventilation, optimal gas exchange and tissue oxygenation is adequate.

    Interventions :
    • Observation of the level of consciousness, respiratory status, cyanosis signs every 2 hours.
    • Give Fowler position semi-Fowler.
    • Give oxygen by program.
    • Monitor blood gas analysis.
    • Create an environment of calm and comfort patients.
    • Prevent the occurrence of fatigue in patients.

  3. The reduced volume of liquid related to inadequate oral intake, fever, tachypnoea.

    Goal :
    Patients will maintain a normal body fluids.

    Interventions :
    • Record fluid intake and output.
    • Monitor fluid balance: mucous membranes, skin turgor, rapid pulse, decreased consciousness, vital signs.
    • Maintain the accuracy of the drip infusion based on the program.
    • Perform oral hygiene.

  4. Activity intolerance related to decreased blood oxygen levels.

    Goal :
    Patients can do activities based on conditions.

    Interventions :
    • Assess the patient's physical tolerance.
    • Assist patients in activities of daily activities.
    • Provide age-appropriate games that patients with activities that do not spend a lot of energy, match the activity with the condition.
    • Give oxygenation by program.
    • Give the energy needs.

  5. Changes in the comfort related to fever, dyspnea, chest pain.

    Goal :
    Patients will show tightness and pain is reduced, to cough effectively and normal temperature.

    Interventions :
    • Check the temperature every 4 hours.
    • Manage provision of antipyretic, anlgesik, antibiotics based on the program.
    • Help the patient in a comfortable position for him.
    • Help reduce chest, use a pillow when coughing.
    • Keep the patient to rest / sleep.
READ MORE - Nursing Diagnosis and Nursing Interventions for Pneumonia

Nursing Care Plan for Pneumonia

Nursing Care Plan for Pneumonia


Pneumonia

Pneumonia is an infection of one or both lungs which is usually caused by bacteria, viruses, or fungi. Prior to the discovery of antibiotics, one-third of all people who developed pneumonia subsequently died from the infection. Currently, over 3 million people develop pneumonia each year in the United States. Over a half a million of these people are admitted to a hospital for treatment. Although most of these people recover, approximately 5% will die from pneumonia. Pneumonia is the sixth leading cause of death in the United States.


Symptoms and Signs

Most people who develop pneumonia initially have symptoms of a cold (upper respiratory infection, for example, sneezing, sore throat, cough), which are then followed by a high fever (sometimes as high as 104 F), shaking chills, and a cough with sputum production. The sputum is usually discolored and sometimes bloody. Depending on the location of the infection, certain symptoms are more likely to develop. When the infection settles in the air passages, cough and sputum tend to predominate the symptoms. In some, the spongy tissue of the lungs that contain the air sacs is more involved. In this case, oxygenation can be impaired, along with stiffening of the lung, which results in shortness of breath. At times, the individual's skin color may change and become dusky or purplish (a condition known as "cyanosis") due to their blood being poorly oxygenated.

The only pain fibers in the lung are on the surface of the lung, in the area known as the pleura. Chest pain may develop if the outer aspects of the lung close to the pleura are involved. This pain is usually sharp and worsens when taking a deep breath and is known as pleuritic pain or pleurisy. In other cases of pneumonia, depending on the causative organism, there can be a slow onset of symptoms. A worsening cough, headaches, and muscle aches may be the only symptoms.

Children and babies who develop pneumonia often do not have any specific signs of a chest infection but develop a fever, appear quite ill, and can become lethargic. Elderly people may also have few symptoms with pneumonia.
www.medicinenet.com



Nursing Care Plan for Pneumonia



Nursing Assessment for Pneumonia
  1. Health History :
    • A history of previous respiratory tract infection / cough, runny nose, takhipnea, fever.
    • Anorexia, difficulty swallowing, vomiting.
    • History of disease associated with immunity, such as; morbili, pertussis, malnutrition, immunosuppression.
    • Other family members who suffered respiratory illness.
    • Productive cough, breathing nostrils, rapid and shallow breathing, restlessness, cyanosis.
  2. Physical Examination :
    • Fever, takhipnea, cyanosis, nostrils.
    • Auscultation of lung: wet ronchi, stridor.
    • Laboratory: leukocytosis, AGD abnormal, the LED increases.
    • Chest X-rays: abnormal (scattered patches of consolidation in both lungs).
  3. Psychosocial Factors :
    • Age, growth.
    • Tolerance / ability to understand the action.
    • Coping.
    • The experience of parting with the family / parents.
    • The experience of previous respiratory tract infections.
  4. Family Knowledge, Psychosocial :
    • The level family knowledge about the disease bronchopneumonia.
    • Experience in dealing with the family of respiratory disease.
    • Readiness / willingness of families to learn to care for her child.
    • Family Coping
    • The level of anxiety.
Nursing Diagnosis and Nursing Interventions for Pneumonia

NANDA Pneumonia

READ MORE - Nursing Care Plan for Pneumonia

Nursing Diagnosis and Nursing Intervention for Parkinson's Disease

Nursing Diagnosis and Nursing Intervention for Parkinson's Disease
  1. Impaired physical mobility related to muscle stiffness and tremors are marked with :
    Subjective data: client said it was difficult to do activities
    Objective Data: tremors while on the move

    Goal : To increase mobility

    Nursing Intervention
    • Help clients every day of exercise such as walking, cycling, swimming, or gardening.
    • Encourage clients to stretch and exercise as directed postural therapist.
    • Client bathe with warm water and do the ordering to help muscle relaxation.
    • Instruct the client to rest regularly to avoid weakness and frustration.
    • Teach for postural exercise and walking techniques to reduce the stiffness when walking and the possibility of learning continued.
    • Instruct the client to walk with an open leg position.
    • Create client raised his hand with consciousness, lift the feet when walking, use the shoes for walking, and walking with step length.
    • Tell the client to walk to the music to help improve the sensory.

  2. Impaired compliance with nutrition: less than body requirements related to the difficulty: moving food, chewing, and swallowing, marked with
    Subjective data: client said it was difficult to eat, weight loss
    Objective Data: thin, weighing less than 20% ideal body weight, pale conjunctiva, and mucous membranes pale.

    Goal : To optimize the nutritional status

    Nursing Intervention
    • Teach client to think while swallow-shut lips and teeth together, lifting the tongue with food on it, then move the tongue back and swallowing, lifting his head backward.
    • Instruct client to chewing and swallowing, using a second wall of the mouth.
    • Tell the client to consciously control the accumulation of saliva and swallowing by holding the head periodically.
    • Give a sense of security on the client, with a stable eating and using the equipment.
    • Suggest eat in small portions and add food interlude (snack).
    • Monitor weight.

  3. Verbal communication disorders related to decreased ability to speak and is characterized by facial muscle stiffness
    Subjective data: client / family say the difficulty in speaking
    Objective Data: elusive words, stony-faced.

    Goal : To maximize the ability to communicate.

    Nursing Intervention
    • Keep the complications of treatment.
    • Refer to speech therapy.
    • Teach client and facial exercises using breathing methods to improve the words, volume, and intonation.
      • breath in before speaking to increase the volume and number of words in sentences each breathe.
      • Train speak in short sentences, reading aloud in front of the glass or into a voice recorder (tape recorder) to monitor progress.
READ MORE - Nursing Diagnosis and Nursing Intervention for Parkinson's Disease

Nursing Care Plan for Parkinson's Disease

Nursing Care Plan for Parkinson's Disease


Nursing Care Plan for Parkinson's Disease


Parkinson's Disease

Parkinson's disease is one of a larger group of neurological conditions called motor system disorders. Historians have found evidence of the disease as far back as 5000 B.C. It was first described as "the shaking palsy" in 1817 by British doctor James Parkinson. Because of Parkinson's early work in identifying symptoms, the disease came to bear his name.

In the normal brain, some nerve cells produce the chemical dopamine, which transmits signals within the brain to produce smooth movement of muscles. In Parkinson's patients, 80 percent or more of these dopamine-producing cells are damaged, dead, or otherwise degenerated. This causes the nerve cells to fire wildly, leaving patients unable to control their movements. Symptoms usually show up in one or more of four ways :
  • tremor, or trembling in hands, arms, legs, jaw, and face
  • rigidity, or stiffness of limbs and trunk
  • bradykinesia, or slowness of movement
  • postural instability or impaired balance and coordination.
Though full-blown Parkinson's can be crippling or disabling, experts say early symptoms of the disease may be so subtle and gradual that patients sometimes ignore them or attribute them to the effects of aging. At first, patients may feel overly tired, "down in the dumps," or a little shaky. Their speech may become soft and they may become irritable for no reason. Movements may be stiff, unsteady, or unusually slow.


Symptoms

Tremors- the most noticeable early symptom. It often begins very localised, such as in a finger of one hand. Over time it spreads throughout the whole arm. Tremors often occur when the limb is at rest or when held in a stiff, unsupported position. Tremors also may occur in the lips, feet or tongue.

Bradykinesia- slowness of motion. The individual's movements become increasingly slow and over time muscles may randomly "freeze".

Akinesia- muscle rigidity. Often begins in the legs and neck. These muscles become very stiff. When it affects the muscles of the face the individual adopts a mask like stare.

Digestion problems- the ability to process food slows down, resulting in low energy and constipation.

Depression- Parkinson's causes chemical changes in the brain that may result in depression. This can be an early warning sign, but as depression becomes more common in older adults, it is not often associated with the disease.

Low Blood Pressure- can result in light headedness and fainting.

Temperature sensitivity- perception of temperature can be affected, and may result in hot flashes and excessive sweating.

Leg discomfort- some patients report burning sensations and cramp in the legs.

Balance- There is a progressive loss of coordination and sense of balance, putting the individual at risk of falls.
Source : www.parkinsons.org


Nursing Care Plan for Parkinson's Disease

Nursing Assessment for Parkinson's Disease
  1. Assess cranial nerves, cerebral function (coordination) and motor function.
  2. Observation of gait and while doing the activity.
  3. Review the history of symptoms and their effects on body functions.
  4. Assess the clarity and speed of speech.
  5. Review the signs of depression.

Nursing Diagnosis for Parkinson's Disease
  1. Impaired physical mobility related to muscle stiffness and tremors are marked with :
    Subjective data: client said it was difficult to do activities
    Objective Data: tremors while on the move
  2. Impaired compliance with nutrition: less than body requirements related to the difficulty: moving food, chewing, and swallowing, marked with
    Subjective data: client said it was difficult to eat, weight loss
    Objective Data: thin, weighing less than 20% ideal body weight, pale conjunctiva, and mucous membranes pale.
  3. Verbal communication disorders related to decreased ability to speak and is characterized by facial muscle stiffness
    Subjective data: client / family say the difficulty in speaking
    Objective Data: elusive words, stony-faced.
READ MORE - Nursing Care Plan for Parkinson's Disease

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