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Minggu, 19 Februari 2012

Nursing Care Plan for Obesity

Obesity is a global problem that plagued the world today. Lifestyle changes including the propensity to consume foods high in fat is a factor contributing to obesity.

The majority of obesity is due to overeating. It is considered the primary obesity. And others, caused by disease or hormonal disorders or genetic disorders that are in the secondary obesity.

Efforts to streamline the body have been conducted, including the dietary, lifestyle changes, medication and surgery to reduce fat or remove some of the intestines.

Food intake should always be sufficient to meet the needs of the body's metabolism and is also not excessive, causing obesity. Also, because the foods contain different proportions of protein, carbohydrate, and fat are different, then a reasonable balance must be maintained among all of these foods so that all segments of the body's metabolic system can be supplied with the materials needed.

Definition of Obesity

Obesity is defined as the excess accumulation of body fat, at least 25% of the average weight for age, sex, and height.

Obesity is also a pathological condition with the presence of an excessive accumulation of fat than is necessary for bodily functions. Nutritional problems due to excess calories usually accompanied by excess fat and protein, fiber and micro-nutrient excess. Nutrients that would be a risk factor for the occurrence of various types of degenerative diseases such as diabetes, hypertension, coronary heart disease, rheumatism and various types of malignant disease (cancer) and other health problems that would require a very large medical expenses.

Clinical Manifestations of Obesity

Obesity can occur in all age groups, but usually occurs in children and adolescents in the period ahead of teens, especially girls, in addition to body weight increased rapidly, as well as more rapid growth and development (apparently if you check the age of the bones), so that ultimately adolescents rapidly grow and mature it will have a relatively low height compared to children her own age.

Body shape, appearance and expression in patients with obesity:

a. Thighs look great, especially on the proximal, relatively small hands with fingers shaped tapered.

b. Emotional expression disorder, nose and mouth appears to be relatively small with a double chin shaped.

c. Chest and enlarged breasts, breast forms similar to the breast that had been grown in male children such circumstances lead to an unpleasant feeling.

d. Abdomen, and hung bulge, similar to the form of pendulum clocks, there are sometimes white or purple strie.

e. Upper arms enlarged, the enlargement of the upper arm is usually found in the biceps and triceps.

In people, common symptoms of emotional distress which may be the cause or circumstances of obesity.

Nursing Care Plan for Obesity

Nursing Care Plan for Obesity

Nursing Assessment for Obesity

Physical Examination

1. Activity / Rest
symptoms:
- Weakness, drowsiness trended
- Inability / lack of desire to be active or exercise regularly
- Dyspnea with work
signs:
- Increased heart rate / breathing with activity

2. circulation
symptoms:
- History of cultural factors / lifestyle affects food choices
- Weight loss can / can not be accepted as a problem
- Eating may relieve feelings of pleasure, such as loneliness, frustration, boredom
- Prisoners of the closest people to lose weight

3. Food / fluid
symptoms:
- Digesting food with excess / normal
- Experiment with different types of diet with little results
- History repeated and decreased weight gain
signs:
- Weight loss is not right with height
- Endormofik body type (soft / about)
- Failed to determine the input of food to reduce demand (eg, changes in lifestyle from active to not exercise, aging)

4. Pain / Comfort
Symptoms: Pain / discomfort in the joints that support weight loss or spine

5. Breathing
Symptoms: Dyspnea
Signs: cyanosis, respiratory distress

6. Sexuality
Symptoms: menstrual disorders, amenorrhea

7. Education / learning
symptoms:
- Problems can be either lifetime or in connection with life events
- Family history of obesity
- Health problems that accompany diabetes, including hypertension, gallbladder disease and cardiovascular disease, hypothyroidism


Nursing Diagnosis  for Obesity

Nursing Interventions for  Obesity
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Minggu, 12 Februari 2012

Nursing Interventions for Impaired Physical Mobility related to Stroke

Nursing Diagnosis and Interventions for Impaired Physical Mobility

In general, vascular disorders of the brain or stroke is a disorder of cerebral circulation. Is a focal neurologic disorder that can occur secondary to a pathological process in the cerebral blood vessels, such as thrombosis, embolus, rupture the vessel wall or vascular disease basis, such as atherosclerosis, arteritis, trauma, aneurysm and developmental abnormalities.

Stroke can also be interpreted as a functional disorder of the brain that are:
  • and focal or global
  • acute
  • last between 24 hours or more
  • caused disturbances of brain blood flow
  • not caused by tumor / infection
Classification based on pathology:

1. Hemorrhage stroke: a stroke that occurs because blood vessels in the brain ruptures causing ischemic and hypoxia in the downstream. Causes of hemorrhage stroke include: hypertension, aneurysm rupture, arterivenosa malformations,

2. Non-hemorrhage stroke: stroke caused by embolus and thrombus.


Nursing Diagnosis for Stroke: Impaired Physical Mobility related to neuromuscular weakness, the inability of cognitive perception

Evidenced by:

Inability to move, on the physical environment: weakness, coordination, limited range of motion, decreased muscle strength.

The patient goals / evaluation criteria;
  • No contractures, foot drop.
  • There is an increasing function of the ability of feeling, or compensation of the body
  • Appears behavioral skills / engineering activities
  • The maintenance of skin integrity

Nursing Interventions: Impaired Physical Mobility - Nursing Care Plan for Stroke

Independent
  • Change position every two hours (prone, supine, oblique)
  • Start training active / passive range of motion in all extremities
  • Support your limb in a functional position, use a foot board at the time during the period of paralysis. Keep head in neutral.
  • Evaluate the use of assistive devices regulatory position
  • Help improve sitting balance
  • Help manipulated to influence the skin color of edema or normalize circulation

Collaborative
  • Consul assigned to physiotherapy
  • Assist in electrical stimulation gave the
  • Use a special bed as indicated
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Kamis, 02 Februari 2012

Ineffective Airway Clearance related to Sinusitis

Nursing Diagnosis Ineffective Airway Clearance related to Sinusitis

Sinusitis or sinus infection can cause a great deal of pain. It is the result of an inflammation of the sinus or nasal passages or both. When someone has a sinus infection there are several symptoms that will help him or her to recognize that that is what he or she are suffering from. Sinusitis is often accompanied by a feeling of tenderness or pressure around the nose, eyes, cheeks or forehead. Sometimes it is accompanied by headache pain.

Sinusitis can come on suddenly and then leave after the correct treatment, lasting a few weeks, or it can be a chronic problem that lasts more than eight weeks at a time with at least four occurrences yearly. Surprisingly most cases of sinusitis are chronic in nature.

Sinusitis treatment through medical or home methods can be done to make you feel better. The goals of these treatments are the improvement of drainage of mucus, reduce swelling in the sinuses, relieve pain and pressure, clear up any infection, prevent the formation of scar tissue, and avoid permanent damage to the tissues lining the nose and sinuses.

Ineffective Airway Clearance Definition:

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

Maintaining a patent airway is vital to life. Coughing is the main mechanism for clearing the airway. However, the cough may be ineffective in both normal and disease states secondary to factors such as pain from surgical incisions/ trauma, respiratory muscle fatigue, or neuromuscular weakness.
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Nursing Care Plan for Sinusitis

Ineffective Airway Clearance related to obstruction / secret is thickened.

Purpose: Purpose: return airway is effective, within 10-15 minutes.

Expected outcomes are:

a) The client no longer uses the nostril breathing

b) The absence of additional breath sounds

c) Ronchi (-)

d) Respiration = 16-20 times / minute

e) The absence of chest wall retraction in 10-15 minutes.




 No  Nursing Interventions Rational
1.  Collaboration: Give neutralizer Nebulizier can dilute the secret and act as bronchodilators to widen the airway.
2. Chest X-ray and do clapping or vibration
Knowing the location of secret
3.
Teach effective cough (in patients who did not experience a decrease in consciousness and is able to cough effectively).
Removing the secret of the airway especially in patients who did not experience a decrease disturbance of consciousness and can perform an effective cough.
4. Observation of vital signs To find out the healthy development of clients.
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Nursing Diagnosis for Sinusitis

Nursing Diagnosis Nursing Care Plan for Sinusitis

Sinusitis

Sinusitis is the inflammation or infection of the paranasal sinuses (cavities) that are adjacent to the nasal cavity in your face. If the infection or inflammation lasts for not more than 8 weeks, then it is considered as an acute sinusitis. If the condition lasts for more than 3 months, then you are suffering from chronic sinusitis.

The most common cause of acute sinusitis is common cold. But chronic sinusitis can be due to many other reasons. The inflammation or infection of the sinusitis is caused due to infection of viruses, fungus or bacteria. It can also be due to some allergic reactions in your body or nasal cavity. Pollens, dust particles, and other such suspended particles in the air can be responsible for the allergic reaction in the sinuses. In rare cases the cause of the problem could be autoimmune response. In this particular trait the immune system of your body attacks the good part of your body.

Sinusitis Symptoms may include:
  • Pain and pressure in the facial area which gets worse when leaning forward.
  • Congested nasal passages with green or yellow mucus secretion that drains down at the back of your nose and into your throat.
  • Severe headache
On the other hand, less common symptoms of a sinus infection may include:
  • Fatigue
  • Bad breath
  • Reduced sense of smell and taste
  • Fever

Nursing Diagnosis for Sinusitis - Nursing Care Plan for Sinusitis


1. Acute Pain / Chronic Pain: head, throat, sinus related to inflammation of the nose.

2. Anxiety related to lack of client knowledge about diseases and medical procedures (sinus irrigation / operation).

3. Ineffective Airway Clearance related to obstruction / secret is thickened.
4. Disturbed Sleep Pattern related to clogged nose, nasal inflammation secondary pain.
5. Imbalanced Nutrition: Less than Body Requirements related to decreased appetite secondary to sinus inflammation.
6. Self-concept disturbance related to bad breath and a runny nose.
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