Risk for Impaired Tissue Integrity related to Graves' Disease

Nursing Diagnosis for Graves' Disease : related to changes in the mechanism of protection of the eyes; damage eyelid closure / exophthalmos.

Goal: Being able to identify measures to provide protection to the eyes and prevention of complications.

Nursing Interventions:

Independent:

1. Observation periorbital edema, eyelid closure disorders, narrow field of vision, excessive tears. Note the presence of photophobia, taste any thing beyond the eyes and eye pain.
R /: general manifestations of excessive adrenergic stimulation associated with thyrotoxicosis who require support to the resolution of crisis intervention can eliminate symptomatology.

2. Evaluation of the sharpness of the eyes, report the presence of blurred vision or double vision (diplopia).
R /: Infiltrative ophthalmopathy (Graves' disease) is the result of an increase in the retro-orbital tissue, which creates exophthalmos and lymphocyte infiltration of the extraocular muscles that cause fatigue. The emergence of visual impairment can worsen or improve the independence of therapy and clinical course of the disease.

3. Instruct the patient to use sunglasses when the patient woke up and cover with a blindfold during sleep as needed.
R /: Protecting corneal damage if the patient can not close their eyes to perfect as edema or fibrosis pads as fat.

4. The head of the bed elevated and limit the use of salt if indicated.
R /: Lowering tissue edema when there are complications such as CHF which can aggravate exophthalmos.

5. Instruct the patient that the extraocular eye muscles if possible.
R /: Improving circulation and maintain eye movements.

6. Give the patient the opportunity to discuss their feelings about the picture changes, body size or shape to improve self-image.
R /: Eyeball rather prominent cause someone unattractive, it can be reduced by using makeup, wearing glasses.

Collaboration:
1. Give the medicine according to the indication.
R /: Awarded to reduce inflammation that develops rapidly.

2. Antithyroid drugs
Can reduce signs / symptoms or prevent the situation getting worse.

3. Diuretics
Can reduce edema in the soft state.

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Fatigue related to Graves' Disease

Nursing Care Plan for Graves' Disease


Nursing Diagnosis : Fatigue related to hypermetabolic with increased energy needs; sensitive stimulation of nerves in connection with disorders of body chemistry.

Supporting Data: reveal very lack of energy to maintain the usual routine, decreased performance, lability / emotional stimuli sensitive, nervous, tense, agitated behavior, damage the ability to concentrate.

Goal: verbally disclose about an increase in energy levels, showed improvement in the ability to participate in the activity.

Nursing Intervention:

Independent:

1. Monitor vital signs and record pulse both at rest and during activity.
R /: pulse widely increased and even at rest, tachycardia (above 160 times / min) may be found.

2. Note the development of tachypnea, dyspnea, pallor and cyanosis.
R /: Needs and oxygen consumption will be increased on a hypermetabolic state, which is potentially hypoxia while doing the activity.

3. Provide / create a quiet environment, cold room, lower sensory stimulation, the colors are cool and relaxing music (calm).
R /: Lowering stimulation is likely to cause agitation, hyperactivity and insomnia.

4. Advise the patient to reduce the activity and increase bed rest as much as possible whenever possible.
R /: Helps combat the effects of increased metabolism.

5. Give the act of making the patient comfortable, such as: touch / massage, powder cool.
R /: Can lose energy in the nerves which further enhances relaxation.

6. Provide alternate activities fun and quiet, like reading, listening to the radio and watching television.
R /: Allows for the use of energy in a constructive way and probably will also reduce anxiety.

7. Avoid talking about a topic that is annoying or threatening the patient, discuss how to respond to these feelings.
R /: Increased sensitivity of the central nervous system can cause the patient easily aroused, agitation and excessive emotion.

8. Discuss with the people in a state of fatigue and emotional unstable.
R /: Understand that the physical behavior improve coping with the current state of encouragement and advice of people nearby to respond positively and provide support to the patient.

Collaboration:
9. Give the drug as indicated.
R /: To cope with the situation (nervous), hyperactivity and insomnia.

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Anxiety and Self-Esteem Disturbances related to Nasal Cavity Cancer

Nursing Care Plan for Nasal Cavity Cancer

Nursing Diagnosis for Nasal Cavity Cancer : Anxiety related to a crisis situation (malignancy), the threat of change in health status-social-economic, function-role changes, changes in social interaction, the threat of death, separation from family.

Nursing Interventions :

1. Orient the client and the people closest to routine procedures and activities are expected.
2. Exploration client anxiety and provide feedback.
3. Emphasize that anxiety is a common problem experienced by many people in the client's current situation.
4. Allow clients accompanied by a family (significant others) during the phase of anxiety and maintain tranquility of the surroundings.
5. Collaboration of sedative drugs.
6. Monitor and record verbal and non-verbal responses that show the client's anxiety.

Rational :

1. Precise information about the situation faced by the clients can reduce anxiety / foreign flavor to the surrounding environment and help the clients to anticipate and accept the situation.
2. Identify trigger factors / ballast anxiety problems and offering solutions that can be done by the client.
3. Indicate that anxiety is normal and not only experienced by the client only in the hope the client can understand and accept his condition.
4. Mobilize support system, prevent feelings of isolation and reduce anxiety.
5. Reduce anxiety, ease of rest.
6. Assessing the development of the client's problem.

Nursing Diagnosis for Nasal Cavity Cancer : Self-Esteem Disturbances related to deformity of the body due to malignancy, effects of radiotherapy / chemotherapy.

Nursing Interventions :

1. Discuss with the client and family influence diagnosis and treatment of the client's personal life and work activities.
2. Explain the side effects of surgery, radiation and chemotherapy are to be anticipated by the client.
3. Discuss on problem-solving efforts in the client's changing role of the family and community associated with the disease.
4. Thank difficulty client adaptation to the problems faced by the client and inform the possible need for psychological counseling
5. Evaluation of the support system that can help the client (family, relatives, social organization, spiritual leaders)
6. Evaluation of the symptoms of hopelessness, helplessness, denial of treatment and feelings of worthlessness that show impaired self-esteem the client.

Rational :

1. Assist the client and the family understand the problems he faced as a first step problem-solving process.
2. Anticipated therapeutic effect further facilitate the process of adaptation to the client's problems that may arise.
3. Changes in health status that brings change socio-economic status-role-function is a problem that often occurs on the client malignancy.
4. Inform alternative professional counseling that may be taken in solving client problems.
5. Identify sources of support that may be used in alleviating the problem the client.
6. Assessing the development of the client's problem.

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Nursing Care Plan for Nasal Cavity Cancer

Nasal Cavity Cancer : 5 Nursing Diagnosis

Nasal Cavity Cancer is cancer that attacks the nasal cavity.

Malignant tumors of the nasal cavity and paranasal sinuses are inseparable because both affect each other.


Causes

The cause of the nasal cavity cancer is not known for certain, but there are some great possibilities, including:

• Heavy smokers, fistula oroantral, atrophic rhinitis, alkolhol addicts.
• Chronic infection of the nose and sinuses paranosal.
• Contact with wood dust on furniture workers (factor of chronic irritation from dust and wood).
• Contact with industrial materials, such as nickel, chrome, isopropanolol.
• Thorium dioxide is used as a contrast fluid on X-ray examination.
• Chronic maxillary sinusitis.

Pathophysiology

Foreign matter (smoke, nicotine, wood dust, nickel, chrome, etc.) into the nasal cavity occurs continuously and for a long time, causing mass formation, changes in the structure and the nasal mucosa, causing obstruction of the nasal cavity to the nasal septum (cavity deformity, nasal septum, trauma cavity / nasal septum, the septum hematoma and septal perforation) or new growth such as nasal polyps, papilloma, inversion and tumor beligna / malignant). In addition, a variety of other reasons cause nasal airway obstruction (adenoid hypertrophy, foreign bodies, atresia, koana, intra-nasal scar tissue, and collapse). This is the mass of the nasal cavity causing edema of the nasal mucosa due to the flow of lymph and venous disorders as well as shaping the polypoid on the nasal cavity. The tumor invades into the upward until cranial fossa and lateral to the orbit.


Signs and Symptoms of Nasal Cavity Cancer

Signs and symptoms of Nasal Cavity Cancer, depending on where the tumor origin and direction as well as the wide-spread.
1. Maxillary sinus tumor and spread to medial.
Signs and symptoms:

• Nasal congestion.
• Persistent unilateral rhinorrhea and smelling.
• Epistaxis.

2. Ethmoid sinus tumors and lamina cribriformis.
Signs and symptoms:

• Nasal congestion.
• Anomsia.
• Runny.
• Pain frontal area.

3. The basic antrum tumor and extends downward.
Signs and symptoms:

• Wobbly tooth.
• Occlusive disorders.
• Pain in molars.
• Swelling and lacerations area palate.

4. Tumor extends to the area of the orbit and the nasolacrimal duct.
Signs and symptoms:

• Diplopia.
• Proptosis.
• Blockage of the tear ducts.
• Eye looks swollen.
• Musa and orbital palpable.
• Eyes stand out.

5. Tumor extends to anterior.
Signs and symptoms:

• Enlargement cheek one side (asymmetric).

6. Advanced stage of the superior alveolar nerve.
Signs and symptoms:

• Numbness in the upper jaw teeth and gums.

7. The tumor spread and invade into the nasopharynx.
Signs and symptoms:

• Conductive deafness due to eustachian tube disorders.

8. Another expansion may affect the nerves.
Signs and symptoms:

• Nerve deafness.
• Not being able to open the mouth.
• Facial paresis.
• Hemiplegia.
• Hyperesthesia.
• Severe headache.
• Changes in eye position.

Nursing Diagnosis for Nasal Cavity Cancer:

1. Anxiety related to a crisis situation (malignancy), the threat of change in health status-social-economic, function-role changes, changes in social interaction, the threat of death, separation from family.
2. Disturbance of self-esteem related to deformity of the body due to malignancy, effects of radiotherapy / chemotherapy.
3. Pain (Acute / Chronic) related to compression / nerve tissue destruction and inflammation.
4. Imbalanced Nutrition: less than body requirements related to the increase in metabolic status due to malignancy, effects of radiotherapy / chemotherapy and emotional distress.
5. Risk for infection related to the inadequate secondary defenses and immunosuppressive effects of radiotherapy / chemotherapy.

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