Nursing Care Plan for Impaired Respiratory Function

Nursing process in patients with Impaired Respiratory Function using measures ranging from assessment, nursing diagnosis, intervention, implementation and evaluation, thus enabling nursing care provided to clients can be optimized.

Assessment

General Assessment of the Respiratory System

The assessment process should be highly individualized nursing (according to the client's problems and needs of the moment). In reviewing the client's respiratory status, the nurse can conduct an interview and a physical examination to maximize the data collected without having to add client respiratory distress. Because the body is dependent on the respiratory system contain important aspect in evaluating the health of the client. Respiratory system primarily serves to maintain the exchange of oxygen and carbon dioxide in the lungs and tissues as well as to regulate acid-base balance, any change in the system will be used effects other systems in the body. In respiratory disease, pulmonary status change occurs slowly, allowing the client to adapt to hypoxia. However, changes such as pneumothorax aspiration, hypoxia that occurs suddenly and the body does not have time to adapt, so as to cause death.


Health History

Health history begins with collecting data on biography, which includes name, age, gender, and the client's life situation. Demographic data are usually recorded on the assessment form which have hospitals or clinics. Note the biological age of the client and compare the performances. Does the client seem appropriate for age, disorders such as lung cancer and chronic lung disease, the client looks older than age. Respiratory history contains information about the client's current condition and previous respiratory problems. Interview clients and families and focus it on the main clinical manifestations of the complaint, the events that led to the current state, past medical history, family history, psychosocial history. Share your questions with a simple, using short sentences that are easy to understand. Where appropriate repeat questions to clarify any questions that have been understandable. Collect a complete history of respiratory conditions conformed to the client.


Main complaint

The main complaint was collected to establish priority nursing interventions, and to assess understanding of the client's current health condition. Common complaints include dipsnea respiratory diseases, cough, sputum formation, hemoptysis, wheezing and chest pain. Focus on manifestations and prioritize questions to get an analysis of symptoms.


Past Medical History

Past medical history provides information about the client and family. Assess the client's clinical conditions such as cough, dyspnea, sputum and wheezing formation, because this condition gives hints about a new problem. In addition to collecting data on childhood immunization, ask the client about the incidence of tuberculosis, influenza, asthma, pneumonia and upper respiratory infection frequency after lower respiratory tract infections, fakator examine factors that affect the baby at the time such as cystic fibrosis, premature birth, the problems associated with the disorder obstructive pulmonary disease, restrictive. Ask clients whether they have been admitted to the hospital, ask when it happened, and obtained medical treatment when it's time. Get information about injuries nose mouth, throat or chest before (such as blunt trauma, fractures of the ribs, thoracic trauma). And important information about free drugs ever consumed.


Psychosocial History

Get information about the psychosocial aspects of client which includes occupation, geographical location, exercise habits, nutrition. Identify all environmental agents that may affect the client, and the work environment and habits.
Ask about the conditions of life of the client, who lives one house number, review the environmental hazards in crowded conditions, and poor circulation. Gather how long smoking history, and how the number of cigarettes consumed , also ask about the use of alcohol, lung ciliary movement is slowed by alcohol so it will reduce the clearance of mucus from the lungs. Ask if client activity tolerance decreased or stabilized, ask the client to describe how to walk, light housework that can be tolerated by the client or vice versa. Maintain a nutritious diet for clients with chronic respiratory disease. Chronic diseases that result in decreased lung capacity lungs work harder. Addition workload requires high calorie and nutrition and if not met will cause weight loss. Clients become secondary to medication anorexia and fatigue. Assess nutrient inputs during the last 24 hours, ask the client to remember the pattern of nutrient inputs during the last week.


Physical Assessment

Physical assessment is done after collecting medical history, use techniques of inspection, palpation, percussion, auscultation. The success of the examination requires nurses to master the posterior thoracic landmarks, lateral, anterior. Use these landmarks to locate under the thoracic organs, especially the lobe of the lung, heart and major blood vessels. Compare one side to the other. Palpation, percussion, auscultation performed backward from the front or from the side of the chest to the other side of the thorax, so that the results obtained are continuous with the other parts to make a comparison. Conditions and skin color observed during the inspection (pale, blue, red). Assess the client's level of awareness and orient the client during the client checks to determine the adequacy of gas exchange.



Nursing Diagnosis

1. Impaired gas exchange related to decreased lung expansion, the presence of pulmonary secretions, inadequate oxygen intake.

2. Ineffective Airway Clearance related to impaired cough, incision pain, decreased level of consciousness.

3. Ineffective Breathing Pattern related to immobilization, depression of ventilation, use of narcotics, neuromuscular damage, airway obstruction.

4. Decreased cardiac output related to irregular heart rhythms, rapid heartbeat.

5. Risk for infection related to static lung secretions.

6. Activity Intolerance which relate to: weakness, inadequate nutrition, fatigue.



Planning

Clients who suffered damage oxygenation, requiring nursing care plan is intended to meet the needs of the actual oxygenation and any potential client. Nurses identify specific end result of care provided. The plan includes one or more client-centered targets the following:

1. Maintain airway patency.
2. Maintain and sustain and improve lung expansion.
3. Capable of removing the pulmonary excretion.
4. Achieve an increase in activity tolerance.
5. Maintained or increased tissue oxygenation.
6. Cardiopulmonary function improved and maintained.

Implementation

Nursing interventions to improve oxygenation and maintain the domain covered by the nursing administration and monitoring therapeutic interventions and programs. This includes independent nursing actions such as behavioral health promotion and prevention, setting position, coughing techniques, and collaborative interventions such as oxygen therapy, lung inflation techniques, hydration, chest physiotherapy, and medicine.

Read More..

Impaired Physical Mobility - Nursing Care Plan

Nursing Diagnosis for Impaired Physical Mobility

Musculoskeletal System:

1. Risk for Injury (fall when ambulation)
related to:

• limited endurance.
• a decrease in muscle strength.
• stiffness and joint pain.
• orthostatic hypotension.

2. Impaired Physical Mobility (individuals have limitations on the ability to physically move independently)
related to:

• decreased range of motion.
• bed rest.
• a decrease in muscle strength.
• pain or discomfort.

characteristics:

• Not able to move in bed and the environment, not able to move or ambulation.
• Limitations on the movement of the joints.
• Decreased muscle strength and control of the movement of which is restricted.

Cardiovascular System

1. Activity Intolerance
related to:

• long-term bedrest,
• general weakness,
• imbalance between demand and supply of oxygen.

2. Ineffective Tissue perfusion
related to:

• disorders of blood flow through the vein.
• edema.

Respiratory System

1. Ineffective breathing pattern
related to:

• decrease in lung expansion.
• chest muscle atrophy.
• administration of depressant agents (analgesics, sedatives).

2. Impaired gas exchange
related to:

• Ineffective breathing pattern.
• decline in lung development.
• buildup of lung secretions.

3. Ineffective airway clearance
related to:

• stasis of pulmonary secretions.
• imprecision body position.

Metabolic and Nutritional Systems

1. Imbalanced Nutrition Less Than Body Requirements
related to:

• intake is inadequate.
• catabolism of muscle mass.

2. Imbalanced Nutrition More than Body Requirements
related to:

• imbalance between intake with energy expenditure.

Urinary System

1. Risk for infection: urinary
related to:

• stasis of urine,
• obstruction of urine flow.

 Elimination System

1. Constipation
related to:

• decrease in physical activity,
• lack of privacy is maintained,
• inadequate diet.

Integumentary System

1. Impaired skin integrity
relate to:

• Limitations mobilization.
• Skin surface pressure.
• Frictional forces on the surface of the skin ..

Planning

Musculoskeletal system :

• Muskuloskeltal maintain normal function.
• Normal ROM in all joints.
• Normal strength and muscle mass.
• Actively participate in the activities.

Intervention:

• Create a workout schedule ROM: active, passive and isotonic.
• Encourage active participation remedy selfcare activities.
• Bodyaligment good position.
• Ambulation aids clients if they can or standing on the side of the bed.

Cardiovascular system

• Minimal cardiovascular disorders, characterized by: a standard backflow; adequate vein (no edema, pain, inflammation, venous distention, skin perubahn)

Intervention:

• Monitor vital signs.
• Teach clients how and when should Valsalva maneuver.
• Wear tights if possible.
• Elevate the legs about 20 minutes every day.
• Assess skin in depressed areas.
• View and add also the musculoskeletal system interventions.

Respiratory system

• Maintain normal respiratory function, characterized by clean breath sounds during auscultation, normal chest expansion, no chest pain, fever, chest muscle movement embolism and atelectasis.

Intervention:

• Assess breath sounds and chest expansion every 8 hours.
• Teach clients effective deep breathing and coughing.
• Change the position every 2 hours, and ambulation if possible and place it on a chair.
• Diagfragma abdominal breathing exercises.

Elimination System

• Normal elimination pattern marked no less urine output 1500 ml, urine specific gravity from 1 to 1.025 acidic urine. There is no sign of retention / urinary infection.
• Shaped and soft stool, bowel movement over 2-3 days.

Intervention:

• Monitor the color, density, total acidity of urine, feces color and characteristics, frequency of defecation.
• Diet: increase in protein, calories, fiber.
• Vitamin and mineral supplements.
• Parenteral and enteral supplements.
• Early ambulation and ROM exercises.

Read More..

Nursing Care Plan for Impaired Oxygenation

Impaired Oxygenation


Assessment

1. Patient Data

• Name:
• Address:
• Age:
• Gender:
• Level of education:

2. Medical history

• Main complaints: cough, chest pain, increased sputum production, hemoptysis, shortness of breath.
• Family history: a family disease, hereditary diseases and allergies.
• Social history: smoking, work, recreation, environmental conditions, factors allergen.
• The state of the environment: a rundown, marshes, big cities, habits: smoking, activity.

Physical Examination

• Cough: is there any pain when coughing, sputum, shortness of coughing.
• Type cough: is productive, non-productive, continuous.
• When did the cough arises: morning or during activity.
• Sputum: color, odor, consistency: thick / liquid, the amount of blood and frothy.
• Dyspnoea (difficulty breathing): when it arises, the tolerance level of the client's activities.
• Hemoptysis: anytime, anything originators.
• Chest pain: when there is pain, whether the rhythm of breathing.
• Wheezing: sound arising from the air passing through a small channel.
• Skin color: peripheral or central cyanosis.
• Facial edema: usually due to an infection and swelling of the sinuses.
• Chest shape: bird chest, since when did it start.
• Musculoskeletal disorders: is there any use of accessory muscles, weakness, muscle pain.
• Clubbing of nail: Abnormalities of the nails.
• Bad breath: spending waste products of metabolism, kind of smelly breath, acetone, urea and alcohol.
• Breathing pattern: (Neunatus: 30 - 60x/menit; Baby: 44x / min; Children: 20 - 25x / min; adult: 15 - 20x / min), tachypnea, hyperventilation, Kussmaul, cheyne stokes, biot.
• Tactile fremitus: to increase the consolidation and decreased in pneumothorax and pleural effusion.

Physical Examination (Head to Toe)

a. Inspection

• Chest examination starts from the posterior thorax, the client in a sitting position.
• Chest observed by comparing one side to the other.
• Actions carried out from the top (apex) to the bottom.
• Inspection of the posterior thorax and condition the skin color, scars, lesions, masses, such as spinal disorders: kyphosis, scoliosis and lordosis.
• Record the number, rhythm, respiratory depth, and symmetry of chest movement.
• Observations respiratory type, such as: nasal breathing or diaphragmatic breathing, and use of accessory muscles of breathing.
• Abnormalities in chest shape: Barrel Chest; Funnel Chest (Pectus excavatum); Pigeon Chest (Pectus carinatum); kyphoscoliosis; Kiposis; Scoliosis.
• Observations symmetry of chest movement. Movement disorders or inadequate chest expansion indicate lung or pleural disease.
• Observation of abnormal retractions intercostal spaces during inspiration, which can indicate airway obstruction.

b. Palpation

• Thoracic palpation to determine abnormalities in the review of inspections such as: mass, lesion, swelling.
• Assess also the softness of the skin, especially if the client complains of pain.
• Vocal premitus: chest wall vibrations generated when speaking.

c. Percussion

• Normal Percussive sound: Resonant (Sonor) à resonate, low tone. Generated in normal lung tissue.; À dullness generated above the heart or lungs; Tympany àmusikal, resulting in over air-filled stomach.
• Abnormal Percussive sound: Hiperresonan à resonated lower than the resonant and raised in the abnormal lung filled with air. Flatness à very dullness and therefore a higher tone. Percussion can be heard on the thigh, where the area is completely unbiased network.

d. Auscultation

• Normal breath sounds: Bronchial; Bronchovesikular; Vesicular.
• Additional breath sounds: wheezing; Ronchi; Pleural friction rub; Crackles.

Nursing Diagnosis

1. Ineffective Airway Clearance related to :

• Airway obstruction due to thick secretions or foreign bodies.
• Abdominal pain or chest pain that reduces the movement of the chest.
• Drugs that suppress the cough reflex and respiratory center.
• Inadequate hydration, the formation of thick secretions that.
• Immobilization.
• Chronic lung disease that makes it easy buildup of secretions.

characterized by : abnormal breath sounds, productive or non-productive cough, cyanosis, shortness of breath, changes in breathing patterns.


2. Ineffective Breathing Pattern related to

• Inadequate lung development due to: immobilization, obesity and pain.
• Neuromuscular disorders such as tetraplegia, head trauma, anesthesia drugs.
• Airway obstruction due to acute infection, allergy that causes bronchial spasm or edema.

characterized by: dyspnoea, increased respiratory frequency, shallow breathing, chest retraction, enlargement of the fingers (clubbing fingger), breathing through the mouth, cyanosis, orthopneu, vomiting, lung expansion is not elastic.


3. Impaired gas exchange related to:

• Reduced blood volume due to hemorrhage, dehydration.
• Keidakseimbangan excess electrolytes such as blood potassium.

characterized by: cardiac arrhythmias, unstable td, tachycardia or bradycardia, cyanosis, weak, jugular venous distention, reduced urine, edema various respiratory problems (orthopneu, dyspnoea, shortness of breath, cough).



Nursing Interventions

1. Maintaining the airway open.

• Installation of an artificial airway.
• Deep breathing and coughing exercises effective.
• Good position: Fowler or semi-Fowler.
• Suctioning.
• Bronchodilators drug delivery.

2. Mobilization of pulmonary secretions

• Hydration.
• Humidification.
• Postural drainage.

3. Retain and maintain lung development.

• Breathing exercises.
• Installation of mechanical ventilation.
• Installation of chest tube drainage or chest.

4. Reducing / correcting hypoxia and hypoxia due to the compensation body.

• Giving O2 via nasal cannula, catheter, simple mask, endotracheal tube.

5. Increasing gas transportation and cardiak output.

• CPR

Evaluation

Done by collecting repeated data after implementation and the data is compared to the destination.

Read More..

Effective Cough Techniques

Effective Cough Definition

Effective cough is a cough with correct method, where clients can save energy so tired and can not easily remove phlegm fullest. Effective cough techniques are actions taken to clear secretions from the respiratory tract. The goal of an effective cough is to improve lung expansion, mobilization of secretions and prevent the side effects of retention of secretions such as pneumonia, atelectasis and fever. Cough effectively make a positive contribution towards expenditure sputum volume. With effective cough patients become aware of how to put out sputum. Healthy people do not spend sputum; sometimes if there is, the amount is very small so it can not be measured. The amount released is not only determined by the disease that was suffered, but also by the stage of the disease.

The trick is prior to coughing, clients are encouraged to drink warm water with a rationalization to dilute phlegm. After it is advisable for the inspiration. This is done for two times. Then after the third inspiration, encourage clients to cough up firmly.


Effective Cough destination

1. Exercising respiratory muscles in order to perform functions properly.
2. Removing existing seputum sputum or respiratory canals.
3. Coaching clients so accustomed to breathing with a good way.

Benefits of Effective Cough

1. To remove secretions that obstruct the airway.
2. To lighten the complaint during a shortness of breath in heart patients.

Indication of Effective Cough
COPD (chronic obstructive pulmonary disease), emphysema, fibrosis, asthma, chest infection, bedrest or postoperative patients.


How Effective Cough

1. Encourage clients to drink warm water (for easy in spending secretion).
2. Breathe in 4-5 times.
3. On the next pull of the breath hold for 1-2 seconds.
4. Lift shoulders and chest loosened and batukan firmly.
5. Do it four times every cough effective, custom-tailored frequency.
6. Note the condition of the patient.

Read More..

Hemorrhagic Stroke - 2 Nursing Diagnosis and Interventions

Nursing Care Plan for Hemorrhagic Stroke

Stroke is a neurological disease that is common and must be dealt with quickly and appropriately. Stroke is a brain dysfunction arising due to sudden occurrence of circulatory disorders of the brain and can happen to anyone and at anytime.

Stroke is the most common disease-causing defects such as limb paralysis, impaired speech, memory and thought processes forms other disability as a result of brain dysfunction.

Around the world, the incidence of stroke average of about 180 per 100,000 per year (0.2%) with a prevalence rate of 500-600 per 100,000 (0.5%).

In fact, many patients who came to the hospital in a state of decreased consciousness (coma). Such circumstances require special handling and care are: general, special, rehabilitation and discharge planning clients.

Knowing the circumstances mentioned above, the role of the nurse in collaboration with other health care team is needed both acute period, or thereafter. That can be implemented include overall health care, ranging promotive, preventive, curative to rehabilitation.


Hemorrhagic Stroke

Definition

Acute neurological dysfunction caused aleh as circulatory disorders of the brain, where it suddenly (several seconds) or quickly (a few hours) symptoms and signs corresponding to the focal area of disturbed tampered. (Djunaedi W, 1992).

According to Hudak and Gallo in the critical care book launch hemorrhagic CVA sudden onset and lasts 24 hours as a result of cerebrovascular desease.



Nursing Diagnosis for Hemorrhagic Stroke

1. Risk for Ineffective airway clearance related to the decline cough reflex.

Goal: not an interruption in airway clearance

Outcomes:
regular respiration, no stridor, Ronchi, whezing, RR: 16-20 x / min, no cough reflex.

Interventions:

1. Observe the speed, depth and breath sounds.
R /: respiratory rate indicates the body's attempt to meet the needs of O2.

2. Perform suction with extra caution when audible stridor.
R /: decreased cough reflex, causing bottlenecks spending secretions.

3. Maintain a half-sitting position, not pressed to one side.
R /: Ventilation easier when the position of the head in a neutral position, causing the emphasis to one point increase in ICT.

4. Perform chest physiotherapy.
R /: claping and vibrating cilia stimulates bronchial secretions to issue

5. Explain to the family about the change position every 2 hours.


2. Imbalanced Nutrition Less Than Body Requirements related to muscle weakness swallow.

Goal: Nutritional needs of clients are met.

Outcomes: either turgor, the intake can be entered in accordance
needs, there is the ability to swallow, the sonde is removed, increased weight 1kg.

Intervention:
1. Observations texture, skin turgor.
R /: to know the client's nutritional status.

2. Perform oral hygiene.
R /: oral hygiene stimulate appetite.

3. Observation intake out put.
R /: to know the client's nutritional balance.

4. Observation position and the success of the sonde
R / menghundari risk for infection / irritation

5. Collaboration:
- Provision of diet / sonde on schedule
R / help meet the nutritional needs of the client because the client swallow reflex decrease.

Read More..

Ineffective Individual Coping and Self-Care Deficit related to Hypopituitarism

Nursing Diagnosis and Interventions for Hypopituitarism

Signs and symptoms :

Anterior pituitary insufficiency (Panhypopituitarism) in general, will affect all of hormone that is normally secreted by the anterior pituitary gland. Therefore, the clinical manifestations of the combined effect of metabolic Panhypopituitarism is due to reduced secretion of each hormone hypophysis.

Clinical syndrome caused by Panhypopituitarism in children and adults differently. In children, somatic growth disturbances due to release growth hormone deficiency . Midget ( dwarfism ) is a consequence of the deficiency. When the child reaches puberty, it is a sign of secondary sksual and external genetalia tools fail to grow . Additionally often found slow intellectual development. The skin is usually pale in the absence of MSH.

In adults known as Simmonds disease characterized by general weakness, intolerance to cold, poor appetite, weight loss and hypotension, women who have the disease will be the cessation of Hait cycles or amenorrhea, later followed by breast trophy and external genetalia. While the men will show progresiof reduction in body hair and reed, beard, and reduced muscle growth, impotence and loss of libido. Also the skin will look pale due to the lack of MSH.

1. Ineffective Individual Coping related to the chronicity of the disease condition.

Goal: After nursing action was done to increase the level of individual coping.

Outcomes:

• Express feelings related to emotional state.
• Identify personal coping patterns and the consequences resulting behavior.
• Identifying personal strengths and to receive support through the nursing relationship.
• Make decisions and proceed with the appropriate action / change the provocative situation in the personal environment.

Intervention:
1. Assess the status of the existing individual coping.
R /: Improving the process of social interaction because the client has increased communicative.

2. Provide support if the individual speaking.
R /: Increasing confidence to others.

3. Helps individuals to suss out problems (problem solving).
R /: With less tension, fear will decrease and not isolate themselves from the environment.

4. Instruct individuals to perform technical relations, in the process of learning the techniques of stress management.
R /: The precision handling and healing process.

5. Collaboration with experts in the process of counseling psychology.
R / Client understand about the disease.


2. Self-Care Deficit related to reduced muscle strength.

Goal: After nursing actions clients can be active in self-care activities.

Outcomes:

• Identify the ability of self-care activities.
• Optimal hygiene after aid in the treatment given.
• Participate in physical / verbal activities, personal care / fulfillment of basic needs.

Intervention:
1. Assess factor of causation declining self-care deficit.
R / Inhibit causal factors can improve self-care.

2. Increase optimal participation.
R / optimal to maximize the participation of self-care.

3. Evaluation of the ability to participate in any activity of the treatment.
R / Can foster client confidence.

4. Give encouragement to express the feelings of lack of self-care.
R / can give the client a chance to perform self-care.

Read More..

Nursing Care Plan for Hypopituitarism

Definition of Hypopituitarism


Hypofunction of the pituitary gland (hypopituitarism) can occur due to diseases of the gland or the hypothalamus. (Robbins Cotran Kumar)

Hypopituitarism refers to the state of the anterior pituitary secretion of several hormones, which is very low. (ElizabethC Erorwin)

Hypopituitarism is hypersecretion of one or more anterior pituitary hormones. (Barbara C. Long)


Hypopituitarism is a condition that arises as a result of pituitary hypofunction. Definition of anterior pituitary hormones may occur from 3 pathways:

1. Abnormalities in the gland that can damage the secretory cells.
2. Abnormalities within or adjacent to the pituitary stalk which can lead to termination of the spread of the factors that originate from the hypothalamus.
3. Abnormalities in the hypothalamus which may impair the release of the regulator on the front hypofyse.

Etiology

Hypopituitarism may occur due to a malfunction of the pituitary gland or hypothalamus. Cause concerns:

• Infection or inflammation by: fungal, pyogenic bacteria.
• Autoimmune diseases (autoimmune lymphoid pituitary)
• Tumors, for example of a type of hormone-producing cells that can interfere with the formation of one or another hormone arbitrarily.
• Feedback from the target organ experiencing malfunctions. For example, there will be a decrease in the secretion of TSH from the pituitary gland when the thyroid is diseased secrete excessive levels of HT.
• Hypoxic necrotic (death due to lack of O2) pituitary or oxygenation can damage some or all of the hormone-producing cells. One of them sheecan syndrome, which occurs after maternal hemorrhage.

Clinical Manifestations

• Headache and visual disturbances or signs of increased intracranial pressure.
• Overview of the production of growth hormone excess include acromegaly (large hands and feet as well as the tongue and jaw), profuse sweating, hypertension and arthralgia (joint pain).
• Hyperprolactinemia : amenorrhea or oligomenorrhea, galactorrhea (30 %), infertility in women, impotence in men.
• Chusing syndrome : central obesity, hirsutism, striae, hypertension, diabetes mellitus, osteoporosis.
• Growth hormone deficiency : (growt hormone = GH) growth disorders in children.
• Gonadotropin deficiency : impotence, decreased libido, body hair loss in men, amenorrhea in women.
• TSH deficiency : fatigue, constipation, dry skin laboratory picture of hyperthyroidism.
• Corticotropin Deficiency : malaise, anorexia, fatigue is real, pale, the symptoms are very severe for ordinary mild systemic disease, laboratory overview of the decline in adrenal function.
• Vasopressin deficiency : polyuria, polydipsia, dehydration, unable to concentrate urine.

Physical Examination
1. Physical examination

• Inspection : Observe the shape and size of the body, measuring weight and height, observe the shape and size of the breast, axillary and pubic hair growth in male clients, observe also the growth of facial hair (beard and mustache).
• Palpation : Palpation of the skin, the woman usually becomes dry and rough.Depending on the cause hipopituitary, other data should also be assessed as a concomitant of data as if the cause is a tumor it is necessary to check the function of the cerebrum and cranial nerve function and the presence of headaches.

2. Assess the physical changes also impact on the ability of clients to meet their basic needs.
3. Supporting data of the diagnostic workup such as :

• X-ray of cranium to see the dilation and erosion of the sella turcica or .
• Examination of blood serum : LH and FSH GH, prolactin, alsdosteron, testosterone, cortisol, androgens, which include test stimulation of insulin tolerance test and thyroid releasing hormone stimulation.

Complication
1. Cardiovascular.

• Hypertension.
• Thrombophlebitis.
• Thromboembolism.
• Acceleration uterosklerosis.

2. Immunology.

• Increased risk of infection and disguise any signs of infection.

3. Changes in the eye.

• Glaucoma.
• Corneal lesions.

4. Musculoskeletal.

• Muscle wasting.
• Poor wound healing.
• Osteoporis with vertebral compression fractures, long bone pathologic fractures, aseptic necrosis of the femoral head.

5. Metabolic. Changes in glucose metabolism of steroid withdrawal syndrome.
6. Changes in appearance.

• Such as moon face (moon face).
• Weight gain.
• Acne.

Nursing Diagnosis for Hypopituitarism

1. Disturbed Body Image related to changes in body structure and function of the body due to deficiency of gonadotropin and growth hormone deficiency.

2. Ineffective individual coping related to the chronicity of the disease condition.

3. Low Self-Esteem related to changes in body appearance.

4. Disturbed Sensory perception (visual) related to impaired transmission of impulses as a result of suppression of tumor on the optic nerve.

5. Anxiety related to threat or change in health status.

6. Self care deficit related to the decrease in muscle strength.

7. Risk for impaired skin integrity (drought) related to declining hormonal levels.

Read More..