Tuesday, January 6, 2015

Knowledge Deficit related to Ectopic Pregnancy


Nursing Care Plan for Ectopic Pregnancy

Nursing Diagnosis : Knowledge Deficit

Ectopic pregnancy is a pregnancy that occurs outside the uterine cavity.

Ectopic pregnancy is usually caused by the obstacles on the way the egg, from the ovary (ovarian) to the womb (uterus).
In rare cases, ectopic pregnancy is caused by the transfer of the egg from the ovary side one, go to the opposite side of the Fallopian tubes.

Clinical signs and symptoms are visible also depends on the location of the growth and development of the embryo. Symptoms that most frequent complaint is that there is pain in the abdominal area.

Knowledge Deficit

Definition:
The absence or lack of cognitive information with respect to the specific topic.

Defining characteristics: verbalization of their problems, inaccuracies follow instructions, the behavior is not appropriate.

Related factors: cognitive limitations, interpretation of misinformation, lack of desire to search for information, do not know the sources of information.

NOC:
  • Knowledge: disease process
  • Knowledge: health behavior
Goal: After nursing care within 2x24 hours the client can understand their health status.

Expected outcomes:
  • Patients and families expressed understanding of the disease, condition, prognosis and treatment programs.
  • Patients and families are able to implement the procedures described correctly.
  • Patients and families are able to explain again what is described nurses / other health.

NIC:

Teaching: Disease Process
  • Give an assessment of the patient's level of knowledge about specific disease processes.
  • Provide information to patients about the condition, in a proper way.
  • Describe the pathophysiology of the disease and how it relates to anatomy and physiology, in a proper way.
  • Describe the signs and symptoms usually appear in the disease, in a proper way.
  • Describe the process of the disease, in a proper way.
  • Avoid hopeless.
  • Provide for the family of information about the progress of a patient in a proper way.
  • Discuss lifestyle changes that may be needed to prevent complications in the future and or process of controlling the disease.
  • Discuss the choice of therapy or treatment.
  • Encourage the patient to explore or get a second opinion in a way that is appropriate or indicated.
  • Exploration of possible sources or support, in an appropriate manner.
  • Refer the patient to the group or agency in the local community, in an appropriate manner.
  • Instruct patients about the signs and symptoms to report to the health care provider, in an appropriate manner.

Tuesday, April 15, 2014

Nursing Diagnosis for Hypothyroidism

Hypothyroidism is a condition in which the gland tirod less active and produces too little thyroid hormone. Hypothyroidism is a very heavy-called myxoedema.

If inadequate thyroid hormone production will compensate the thyroid gland to increase secretion in response to stimulation hormone TSH.
The decrease in the secretion of hormones, thyroid hormones will lower basal metabolic rate which will be used effects all body systems. Metabolic processes are influenced by:
  • Decreased production of stomach acid.
  • Decreased intestinal motility.
  • Decreased heart rate.
  • Impaired neurological function.
  • The decrease in heat production.
Decreased thyroid hormone will also interfere with the metabolism of fat which would be an increase in cholesterol and triglyceride levels so that potential clients experiencing atherosclerosis. Accumulation of hydrophilic proteoglycans in interstitial voids as the pleural cavity, cardiac and abdominal as a sign of myxoedema. Formation of erythrocytes that are not optimal sebgai impact of declining thyroid hormone allows the client to have anemia.

Symptoms of Hypothyroidism
  • Decreased appetite.
  • Constipation.
  • Growth of bones and teeth are slow.
  • Hoarseness.
  • Speaking slowly.
  • Eyelid down.
  • Facial swelling.
  • Thin hair, dry and rough.
  • Skin dry, rough, scaly and thickened.
  • Slow pulse.
  • Slow body movements.
  • Weak.
  • Dizziness.
  • Tired.
  • Pale.
  • Pain in the joints or muscles.
  • Not resistant to cold.
  • Depression.
  • Decreased sense of taste and smell function.
  • Eyebrow loss.
  • Sweat is reduced.

Early symptoms of hypothyroidism are nonspecific, but extreme fatigue sufferers difficult to implement the day-to-day work in full, or participate in a common activity undertaken. Reports of hair loss, brittle nails and dry skin that is often found, and complaints of numbness and paresthesias in the fingers may occur. Sometimes the sound becomes rough, and the patient may complain of hoarseness. Menstrual disorders such as menorrhagia or amenorrhea will occur in addition to loss of libido. Hypothyroidism affects women five times more frequently than men and is most common in the age of 30-60 years.

Severe hypothyroidism resulting in body temperature and pulse rate subnormal. Patients typically begin to experience weight gain occurred even without an increase in food intake, although patients with severe hypothyroidism can be seen cachexia. The skin becomes thick due to accumulation of mucopolysaccharides in the subcutaneous tissue. Hair thinning and loss, and expressionless face looks like a mask. Patients often complain of feeling cold even in warm environments.

At first, the patient may be irritable and complained of feeling weak, but with the continuation of these conditions, the emotional response to the above will be reduced. Mental processes become dull and seem apathetic patients. Talk becomes slow, enlarged tongue, and the size of the hands and feet increases. Patients often complain of constipation and deafness can occur.

In hypothyroidism continued, will lead to dementia and cognitive changes accompanied a distinctive personality. Inadequate respiration and apnea during sleep may occur in severe hypothyroidism. Pleural effusion, pericardial effusion and respiratory muscle weakness may occur.

Severe hypothyroidism will be accompanied with a significant increase in serum cholesterol levels, atherosclerosis, coronary heart disease and poor left ventricular function. Further hipotiroidime patients will experience hypothermia and abnormal sensitivity to preparaf sedatives, opioids and anesthetics, and therefore all of these drugs is only given on certain conditions.

Patients with hypothyroidism who have not been identified and is undergoing surgery, will face a higher risk for experiencing intraoperative hypotension, postoperative congestive heart failure and mental status changes.


Other clinical features:
  • Inaction, slowing the intellect, and the awkward slow motion.
  • The decrease in heart rate, cardiac enlargement (myxoedema heart) and decreased cardiac output.
  • Swelling and edema of the skin, especially under the eyes and around the ankle.
  • The decrease in metabolic rate, decrease caloric needs, decreased appetite and nutrient absorption from the gastrointestinal tract.
  • Constipation.
  • Changes in reproductive function.
  • Dry, scaly skin and hair of the head and body are thin and fragile.


Nursing Diagnosis for Hypothyroidism

  1. Ineffective breathing pattern related to depression of ventilation.
  2. Constipation related to a decrease in gastrointestinal.
  3. Altered Body Temperature.
  4. Activity intolerance related to fatigue and decreased cognitive processes.
  5. Altered thought processes related to metabolic disorders and cardiovascular and respiratory status changes.
  6. Deficient knowledge about treatment programs for lifelong thyroid replacement therapy.

Anxiety related to Cataract Surgery Pre-operative

Nursing Diagnosis and Interventions for Cataract

A cataract is a clouding of the lens in the eye that affects vision. It is the most common cause of blindness and is conventionally treated with surgery. Most cataracts are related to aging. Cataracts are very common in older people.

Those with cataracts commonly experience difficulty in appreciating colors and changes in contrast, driving, reading, recognizing faces, and coping with glare from bright lights.

4 Types of cataract
  1. Congenital cataract. Some babies are born with cataracts or develop them in childhood, often in both eyes. These cataracts may be so small that they do not affect vision. If they do, the lenses may need to be removed.
  2. Traumatic cataract. Cataracts can develop after an eye injury, sometimes years later.
  3. Secondary cataract. Cataracts can form after surgery for other eye problems, such as glaucoma. Cataracts also can develop in people who have other health problems, such as diabetes. Cataracts are sometimes linked to steroid use.
  4. Radiation cataract. Cataracts can develop after exposure to some types of radiation.

Signs and symptoms of Cataract
  • Clouded, blurred or dim vision
  • Seeing "halos" around lights
  • Fading or yellowing of colors
  • Increasing difficulty with vision at night
  • Frequent changes in eyeglass or contact lens prescription
  • Sensitivity to light and glare
  • Double vision in a single eye

Nursing Diagnosis and Interventions for Cataract

Anxiety related to Deficient Knowledge and information cataract surgery pre-operative

Goal: Anxiety decreased after nursing action.

Outcomes:
The patient calm and relaxed.
Can reveal the cause of anxiety.
Being able to control the anxiety.
Can explain about the surgery.


Interventions:

1. Assess the patient's level of anxiety, measuring vital signs.
2. Provide the necessary patient information prior to surgery.
3. Provide relaxation techniques and mental suport involving religious elements.
4. Give the patient the opportunity to express his feelings before the surgery.
5. Encourage management to use relaxation techniques, visualization, and breathing deeply.


Rational:

1. Possible increase in blood pressure and pulse rate accompanied by shallow and irregular breathing showed anxiety manifestations in patients.
2. Adequate information and good delivery will change the perception and mindset of the patient.
3. Patient is able to control the emotions and anxiety levels, by trying some regular breathing techniques,
4. Calm soul that affect the level of emotion and anxiety.
4. Increase relaxation and coping may lower IOP (intra-ocular pressure).