Custom Search

Nursing Care Plan for Urinary Incontinence

Urinary Incontinence is urine output unnoticed in sufficient quantity and frequency, resulting in health problems and or social. Variation of urinary incontinence include out just a few drops of urine, to a really great deal, and sometimes also accompanied by incontinence Alvi (with expenditure feces).

The etiology or cause of urinary incontinence is due to weakness of the pelvic floor muscles. This is related to the anatomy and function of the urinary organs. The weakness of the pelvic floor muscles can be due to several causes including pregnancy is repetitive, error in straining. This can lead to such a person can not hold urine (beser). Urine incontinence can also occur due to excessive urine production due to various reasons. For example, metabolic disorders, such as diabetes mellitus, which should continue to be monitored. Another cause is excessive fluid intake can be alleviated by reducing fluid intake as caffeine is a diuretic.

Once we are aware of the meaning and causes of urinary incontinence, which is the review of Urinary Incontinence Medical Concepts, then to the next is our review of the terms of nursing, the Nursing Care Plan for Urinary Incontinence. As usual when we do nursing first step is to do a nursing assessment. And this is the assessment of care of patients with urinary incontinence.


Nursing Assessment for Urinary Incontinence

Assessment of urinary incontinence are we asking a patient about urinary incontinence when it began to appear and the things associated with symptoms of urinary incontinence:
  1. How many times incontinence occurs?
  2. Is there any redness, blisters, swelling in the perineal area?
  3. Is the client obese?
  4. Is the time between urine dripping urination, if there are how many?
  5. Is incontinence occurs at times that can be expected as during coughing, sneezing, laughing and lifting heavy objects?
  6. Is the client aware of or feel the urge to urinate before incontinence occurs?
  7. How long the client has difficulty in urinating / incontinence
  8. urine?
  9. Does the client feel bladder feels full?
  10. Is the client experiencing pain during urination?
  11. Is this problem getting worse?
  12. How do clients overcome incontinence?

Next is the assessment by conducting a physical examination physical examination inspection, palpation and percussion.

Inspection
  1. Redness, irritation / blisters and swelling in the perineal area.
  2. A lump or tumor in the spinal cord.
  3. The presence of obesity or lack of exercise.

Palpation
  1. Bladder distension or tenderness.
  2. Palpable lump spinal cord tumor area.

Percussion
  1. Voice sounded dim in the bladder area.


Nursing Diagnosis for Urinary Incontinence

Nursing Diagnosis Urine Incontinence In Patients were as follows:
  1. Anxiety
  2. Disturbed Body Image
  3. Deficient Knowledge
  4. Activity intolerance
  5. Low Self-Esteem
  6. Impaired Skin Integrity

Action Plan / Interventions:
  1. Maintain cleanliness of the skin, the skin is dry, changing bed linen or clothing when wet.
  2. Encourage clients to bladder training exercises.
  3. Encourage fluid intake of 2-2.5 liters / day if there are no contraindications.
  4. Checks taken drugs. May be related to incontinence.
  5. Check the client's psychological.
  6. Encourage clients to perineal exercises or Kegel's exercises to help strengthen muscular control (if indicated). This exercise can be lying down, sitting or standing and Kegel's the way it is with: Contract the perineal muscles to stop the discharge of urine, the contraction was maintained for 5-10 seconds and then loosen or detach, repeat up to 10 times, 3-4 times / day.

Dyslipidemia, Kwashiorkor and Marasmus

Dyslipidemia

Dyslipidemia is a health disorder due to abnormalities in blood fat. In dyslipidemia, levels of bad fats, namely: LDL (Low Density Lipoprotein) cholesterol and triglyceride levels increased. In contrast the levels of good fats that HDL cholesterol has decreased.

HDL cholesterol is called good fats because this type of role runoff transports cholesterol in the walls of blood vessels, and brought back to the heart. In other words, HDL cholesterol prevent atherosclerosis so that no coronary heart disease.

Dyslipidemia may occur due to factors of high fat intake, and the presence of heredity / family history, alcohol, estrogen hormones, and drugs.

In women, the age when menopause would increase the risk of dyslipidemia higher.

Total fat intake associated with obesity (excess weight).

Control of primary dyslipidemia using nonpharmacologic measures, namely: dietary modification, physical exercise, and weight management.

All three should be done simultaneously to obtain optimal results.


Kwashiorkor

Kwashiorkor is a disorder that is caused by protein deficiency.

Kwashiorkor is a protein deficiency is accompanied by deficiency of other nutrients commonly found in infants weaned future, and preschoolers.

In addition to the negative influence of socio-economic factors that contribute to cultural events in general malnutrition, negative nitrogen balance can be caused by chronic diarrhea, malabsorption of protein, loss of protein through the urine (nephrotic syndrome), chronic infections, burns, heart disease.

Kwashiorkor-type appearance, like a fat kid (suger baby), when the diet contains enough energy in addition to a lack of protein, although other parts of the body, especially in the butt visible atrophy. Looks very thin and or edema in both legs back until the whole body
Changes in mental status: whiny, cranky, sometimes apathetic.
Thin reddish hair like corn silk color and easily removed, the disease is advanced kwashiorkor can look dull head of hair.
Rounded and swollen face.
Child's eyes glazed.
Enlarged liver, enlarged liver can easily be palpated and feel rubbery on palpation slippery surfaces and sharp edges.
Skin disorders such as pink spots are widespread and turned into a dark brown and flaky.


Marasmus

Marasmus is a form of protein-calorie malnutrition is mainly due to the severe calorie deficiency and chronic mainly occurred during the first year of life and care of subcutaneous fat and muscle.

Is a nutritional disorder due to deficiency of carbohydrates. Symptoms such as parents face (wrinkled), no visible fat and muscle under the skin (visible bones under the skin), brittle hair and redness, skin disorders, digestive disorders (frequent diarrhea), enlargement of the liver and so on. Children often seem fussy and cried a lot though after eating, because they still feel hungry.

Here are the symptoms of marasmus are:
Children looked very thin due to the loss of most of the fat and muscles, and bones wrapped in skin.
Face as parents.
Xylophone ribs and concave stomach.
Thigh muscle relaxes (baggy pant).
Whiny and cranky, after a meal still felt hungry children.

Nursing Care Plan for Conginetal Talipes Equinus Varus

Conginetal Talipes Equinus Varus (CTEV) is a congenital defect that is a combination of abnormalities consisting of:
Front legs (fore foot) adduction and supination through the midtarsal joints.
Heel varus, through the subtalar joint and selalui joint equinus foot (ankle).
Medial deviation to the entire foot, seen from the knee joint.


Etiology of Conginetal Talipes Equinus Varus

The exact cause is unknown.
There are several theories:
  • Genetic factors are sometimes obtained familiar (wyne davis).
  • Mechanical factors (denis brown).
  • Cessation of fetal growth (borm).
  • Dysplasia of the muscles, causing imbalance (imbalance) muscle (Garceau).
  • Primary abnormality os talus: Kaput and neck strap tapers towards deviase to medial and plantar of the corpus rope (adam, sotile, Irani and Sherman).
  • MC Kay added the calcaneus to the medial rotation of the subtalar.

Assessment

a. Data Collection
Identity: name, age, address, occupation, date of admission to the hospital, medical diagnostics.
b. Main complaints
Is most disturbing complaints of discomfort in activities that disrupt or current.
c. Disease History Now
Can not run perfectly because there are abnormalities on the front foot (forefoot).
d. Past history of disease
With CTEV disease is a disease inborn.
e. Family history of disease
Regarding the picture of a family health history of the descendants of the parents.
f. Psychosocial History
Who is caring for the patient, how relationships with family, friends.
g. Pregnancy History
Includes prenatal, natal and post natal.
h. Immunization History
Includes immunization: BCG, DPT, Hepatitis and Polio.
i. Developmental History
In CTEV clients typically experience a delay in walking.


Patterns of Health Functions
1. Patterns and perceptions of governance healthy life.
Lifestyle people or clients who suffer CTEV in maintaining personal hygiene, care and management of a healthy life a little bit disturbed because of a physical condition.
2. Nutrition and metabolic patterns
There is no disruption in this pattern.
3. The pattern of elimination
Bowel and bladder patterns in clients with CTEV not impaired.
4. Rest and sleep patterns
Clients with CTEV on this pattern is not impaired.
5. The pattern of activity and exercise
Clients typically have limitations because of physical activity on the front foot (forefoot).
6. Patterns of perception and self-concept
How perceptions of surgery to be performed and usually patients withdrew due to illness embarrassment.
7. The pattern of sensory and cognitive
Regarding the knowledge of patients and families against illness.
8. Patterns of sexual reproduction
Is there pain during a disturbance / not related to social reproduction.
9. The pattern of relationships and roles
Usually clients with CTEV withdrew because of an illness suffered.
10. The pattern of response to stress
Families need to provide support and encouragement of life for clients.
11. The pattern of values ​​and beliefs
Family and patients are always optimistic and pray that the disease can be cured.

Impaired Gas Exchange related to Asthma

Nursing Care Plan for Asthma

Impaired Gas Exchange : Excess or deficit in oxygenation and/or carbon dioxide elimination at the alveolar-capillary membrane

Defining Characteristics:
  • Visual disturbances;
  • decreased carbon dioxide;
  • dyspnea;
  • abnormal arterial blood gases;
  • hypoxia;
  • irritability;
  • somnolence;
  • restlessness;
  • hypercapnia;
  • tachycardia;
  • cyanosis (in neonates only);
  • abnormal skin color (pale, dusky);
  • hypoxemia;
  • hypercarbia;
  • headache on awakening;
  • abnormal rate, rhythm, depth of breathing;
  • diaphoresis;
  • abnormal arterial pH;
  • nasal flaring

Asthma is a chronic, or life long, disease that can be serious—even life threatening. There is no cure for asthma. The good news is that it can be managed so you can live a normal, healthy life.

Asthma is a lung disease that makes it harder to move air in and out of your lungs. There are three things that you should know about asthma:
  1. Asthma is chronic. In other words, you live with it every day.
  2. It can be serious – even life threatening.
  3. There is no cure for asthma, but it can be managed so you live a normal, healthy life.


Nursing Diagnosis for Asthma

Impaired Gas Exchange related to CO2 retention, increased secretion, increased respiration, and a disease process.

1) Goal
  • The client will maintain adequate gas exchange and oxygenation.

2) Expected Outcomes
  • Frequency of breathing 16-20 times / min
  • Pulse frequency 60-120 times / min
  • Normal skin color, no dipnea and blood gas analysis within normal limits

3) Interventions
  • Monitoring of respiratory status every 4 hours, blood gas analysis, income and output.
  • Place client in semi-Fowler position.
  • Give intravenous therapy as directed.
  • Give oxygen through a nasal cannula 4 l / min, then adapt the results of PaO 2.
  • Give the medication that has been prescribed and observe if there are signs of toxicity.

4) Rational
  • To identify the indications towards progress or deviations from the client.
  • Upright position allowing better lung expansion.
  • To enable rapid rehydration and can assess the situation for vascular administration of emergency drugs.
  • Giving oxygen to reduce the burden of respiratory muscles.
  • Treatment to restore bronchial conditions as the previous conditions.
  • For ease breathing and prevent atelectasis.

Nursing Assessment for Dengue Hemorrhagic Fever

Dengue Haemorrhagic Fever (DHF) is a disease caused by the dengue virus which is transmitted through the bite of Aedes aegypti and Aedes albopictus which causes disturbances in capillary blood vessels and the blood clotting system, resulting in bleeding.

Dengue hemorrhagic fever (DHF) is a specific syndrome that tends to affect children under 10 years of age. It causes abdominal pain, hemorrhage (bleeding), and circulatory collapse (shock).

Symptoms such as headache, fever, exhaustion, severe joint and muscle pain, swollen glands (lymphadenopathy), and rash. The presence (the "dengue triad") of fever, rash, and headache (and other pains) is particularly characteristic of dengue fever.
Nursing Assessment for Dengue Hemorrhagic Fever.

Assessment

a. Subjective data
  • Weak.
  • Heat or fever.
  • Headache.
  • Anorexia, nausea, thirst, painful swallowing.
  • Heartburn.
  • Pain in the muscles and joints.
  • Stiffness throughout the body.
  • Constipation.

b. Objective data
  • High body temperature, shivering, redness of the face looks.
  • Dry oral mucosa, bleeding gums, tongue dirty.
  • Red spots appear on the skin (petechiae), torniquet test (+), epistaxis, ecchymosis,
  • Hyperemia of the throat.
  • Epigastric tenderness.
  • On palpation palpable enlarged liver and spleen.
  • On shock (degree IV) rapid and weak pulse, hypotension, cold extremities, restlessness, peripheral cyanosis, shallow breathing.

Laboratory tests in DHF will be found:
  • Ig G positive dengue.
  • Thrombocytopenia.
  • Hemoglobin increase> 20%.
  • Hemoconcentration (hematocrit increased).
  • Blood chemistry workup showed hypoproteinemia, hyponatremia, hypochloremic.

On day 2 and 3 occur leukopenia, neutropenia, aneosinofilia, increased lymphocytes, monocytes, and basophils
  • SGOT / SGPT may be increased.
  • Urea and blood pH may be elevated.
  • Bleeding time elongated.
  • Metabolic acidosis.
  • On urine examination found mild albuminuria.

Catheterization Technique and Management of Urinary Retention

Urinary retention is a urological emergency most common and can occur anytime and anywhere.

Means that a doctor or nurse wherever he served, or will likely ever encounter this disorder. Therefore, the question must be able to detect the disorder and can then start handling it correctly.

When urinary retention not handled properly, will result in complications that aggravate morbidity of patients concerned. Basically do not need special equipment or skills to detect and handle patients with urinary retention, anything that causes the disorder.

Problems that are often encountered :
  • Urinary retention was not detected because it is unthinkable abnormality, the patient did not complain or say that can still pee on a regular basis (paradoxical incontinence).
  • Retention add to the suffering or causing harmful complications, even be permanent and this can happen because the doctor or nurse to handle the disorder without regard to the specified requirements, inexperienced or does not have the required equipment.

In this paper, will be described in the fundamental causes of urinary retention, how to detect and correct way of handling and will be presented as well as some tips to keep in mind.

Urinary retention is a condition where the sufferer can not remove the accumulated urine in the bladder so that the maximum capacity of the bladder is exceeded.

Micturition process:

Bladder has a dual function
1. Accommodate urine as a "reservoir". In this phase, the bladder muscle (detrusor) in a state of relaxation while in a state of tense sphincter (closing). When urine volume reaches physiological capacity (in adults ranges between 250-400 ml), there will be a stimulus to micturition, but the process can still be suspended because of micturition retained by the concerned. When urine volume reaches maximum capacity (in adults ranges between 500-600 ml), increasing stimulation for micturition, causing discomfort and micturition process can still be put on hold while the urethral sphincter tense eksternum consciously (striped muscles).

2. Emptying the contents, called micturition process. This event requires cooperation harmoniously coordinated between detrusor contraction and sphincter relaxation so that the urine that had gushed out until the pot is empty.
In the second phase of the above, the drainage of the bladder to prevent urine back into the ureters (to prevent reflux).
Micturition process will run smoothly when the detrusor and sphincter in good condition, normal function (coordinated in harmony) and there are no obstacles in the urethra.

Cause of urinary retention.
  • Detrusor weakness.
  • injury / disorder in the spinal cord, nerve fiber damage (diabetes mellitus), detrusor experience stretching / dilation is excessive for a long time.
  • Impaired coordination of detrusor-sphincter (dis-synergies)
  • injury / spinal cord disorders in the cauda equina.
  • Constraints on the way out the urine:
    • urethral stricture
    • abnormal prostate gland (BPH, Ca)
    • urethral stones
    • urethral damage (trauma)
    • blood clot in the lumen of the bladder (clot retention) etc..

Result of urinary retention
  • Bladder expands beyond the maximum capacity so that the pressure inside of the walls lumennya and voltage will increase.
  • If this situation is allowed to continue, increased pressure within the lumen will obstruct the flow of urine from the kidney and ureter, causing hydroureter and hydronephrosis and renal failure occurs slowly.
  • When the pressure within the bladder increases and exceeds the resistance in the urethra, the urine will radiate over and over again (in small amounts) by the patient uncontrollably, while the bladder remains full of urine. This situation is called: paradoxical incontinence or "overflow incontinence"
  • Voltage of the bladder wall continued to rise until the limit of tolerance is reached and after this limit is passed, the bladder muscle will be dilated so that the capacity of the bladder exceeds the maximum capacity, with the force of contraction of the bladder muscles will shrink.
  • Urinary retention is a predilection for the occurrence of urinary tract infection (UTI) and when this happens, it can lead to serious conditions such as acute pyelonephritis, urosepsis, particularly in elderly patients.


Management of Urinary Retention

When the diagnosis of urinary retention is enforced correctly, management determined based on issues related to the cause of retention of urine.

Catheterization

Conditions
  • Performed by the principles of aseptic
  • Use catheter Nelaton / type that is not too big, kind of Foley
  • Sought no pains to avoid spasm of the sphincter.
  • Cultivated with a closed system when the catheter remains.
  • Given prophylactic antibiotics before insertion of a catheter (usually not needed antibiotics at all). Catheters were maintained as short as possible, just along still needed.
Catheterization technique
  • Foley Catheter sterile, for adult size 16-18 F.
  • Disinfection with desinfektans effective, does not irritate the skin of the genitalia (no alcohol)
  • Topical anesthesia in patients who are sensitive to 2-4% xylocaine jelly. Jelly is at once acts as a lubricant. (On stone or urethral stricture, resistance will be felt when entering the jelly)
  • Spread with jelly sterile catheter inserted into the urethra. In the female patient is usually no problem. In the male patients, a catheter is inserted gently until urine flows (always note the number and color / aspect urine), then the balloon was developed by 5-10 ml. .
  • When it was decided to settle, the catheter is connected to a sterile reservoir bag and maintained as a closed system.
  • Catheter in fixation with plaster on the skin proximal thigh or inguinal region and labored to lead kelateral penis, this is to prevent necrosis due to pressure on the ventral part of the urethra in the area penoskrotal.

Function Theory in Behavior Change

This theory is based on the assumption that individual behavior change depending on the needs. This means that a stimulus that can cause changes in a person's behavior when the stimulus is understandable in the context of the person's needs. According to Katz (1960) was based behavior-backs by the needs of the individual concerned. Katz assume that:
  • Behavior has an instrumental function, meaning that it can function and provide services to the needs. A person can act (behave) positive to the object for the fulfillment of their needs. Conversely, if the object can not meet their needs then it will behave negatively. For example, people want to make a toilet, the toilet if really has become needs.

  • Behavior serves as a defense mecanism or as a defense in the face of the environment. That is, the behavior, the actions, to protect human threats coming from outside. For example, people can avoid dengue fever, as the disease is a threat to himself.

  • Behavior serves as a receiver object, and the giver of meaning. In the role of the action, a constantly adjust to the environment. With the day-to-day actions are someone has done decisions with respect to the object or stimulus encountered. Decisions that result in such actions (done spontaneously and in a short time. Example, if a person feels headache, then quickly, without thinking long, he will act to overcome the pain by buying drugs in a stall and then drink it , or other measures.

  • Behavior as a function of one's self expressive values ​​in responding to a situation. Expressive value is derived from the concept of one's self and a reflection of the heartstrings. Therefore, the behavior can be a screen where all people can be self-expression. For example, people who are angry, happy, upset, and so can be seen from the behavior or actions.

This theory believes that the function of the behavior of the function has to face the world outside the individual, and constantly adapt to their environment according to their needs. Therefore, in the conduct of human life seemed to change constantly and relative terms.

Family Therapy for Schizophrenia

Schizophrenia is a group of psychotic reactions that affect various areas of individual functions, including thinking and communicating, receiving and interpreting reality, feel and show emotions and behave in a manner that is socially unacceptable (Durand and Barlow, 2007)

Family Therapy for Schizophrenia

Family psychotherapy is an important aspect in the treatment of Schizophrenia. In general, the goal of psychotherapy is to build a collaborative relationship between the patient, family, and doctor or psychologist. Through psychotherapy, the patient is helped to socialize with their environment. Family and friends are the ones that are also very instrumental in helping patients to socialize. In the case of acute schizophrenia, patients should receive special treatment from the hospital. If necessary, he should stay in the hospital for some time so that the doctors can do with regular control and ensure the safety of patients.

But in fact, the most important is the support of the patient's family, because if this support is not obtained, the patient is not likely to experience hallucinations returned. According to Dadang, a number of people with schizophrenia also often recur even after completion of therapy for six months. Therefore, in order to hallucinations did not reappear, then the patient should continue to communicate with reality. However, the family also should not exaggerate in treating patients with schizophrenia.

According to dr. LS Chandra, SpKJ, schizophrenic patients requires attention and empathy, but the family needs to avoid being Expressed Emotion (EE) or an overreaction as overly critical attitude, indulgent, and too controlling who can actually complicate healing.

All family members should play a role in the effort to support for people with schizophrenia. Efforts to form a self help group among families who have family members with schizophrenia is a positive step (Arif, 2006).

Discussant group serves as a group therapy for the treatment of schizophrenia. According to the authors, the provision of group therapy in patients with schizophrenia are less precise. The main reason is the usual group therapy used in the rehabilitation process of drug addicts (the healing process). The basic concept is group therapy mediation problems in groups, group dynamics, or outbound (with individuals who are having the same problem).

How could the schizophrenics could do things over?
Discussant group presents some of the following on group therapy:
  1. Provide education about schizophrenia, including symptoms and signs of recurrence.
  2. Provide information about and monitor the effects of treatment with antipsychotics.
  3. Avoid blaming each other in the family.
  4. Improve communication and problem solving skills in the family.
  5. Encourage patients and families to develop their social contacts, especially related to the support network.
  6. Raising hopes that everything is improved, and the patient may not have to go back to the hospital.

Points 3, 4, and 5 is actually part of the process of family therapy. So maybe there is still confusion in the group of discussants on the basic concept of group therapy and family therapy.

Symptoms of Heart Disease and Heart Attack

Heart disease is still the No. 1 killer in the world. Why did it happen? The causes are many people with heart disease who ignore the symptoms of heart disease. This is understandable since not many people know what kind of traits and symptoms of a heart attack. But of course such a thing should not be allowed.

A. Symptoms of Heart Disease

Here are the symptoms of heart disease that is often overlooked, as reported by detikhelath:

1. Frequent fatigue

If you often feel tired, though not strenuous, immediately consult your personal physician. This could be an indication of heart problems. Fatigue is also often felt when I wake up.

2. Frequent sweating

Generally a person sweats after exercise or in hot weather. But if you sweat easily, despite not doing anything, it is likely a problem with your heart.

3. Excessive nausea

Symptoms of heart disease begins with swelling in the abdomen. This causes the patient to lose appetite and feel nauseous excess.

4. Feeling Anxiety and Tense

Many believe, heart attacks culminated in trauma. As a result, those who have had heart attacks more often experience stress, fear, or anxiety about death. It is associated with psychological anxiety and stress which causes more frequent attacks.

5. Pain in the body

The pain became stronger sign of heart disease. In men, the pain felt in the left arm, while women experience pain in both arms. The pain comes and goes is also felt in the shoulders, elbows back, and neck. Pain at some point part of the body is caused due to clogged arteries.

6. Chest Pain

This is a common symptom of a heart problem. Women are more likely to feel pain in the chest due to blockage of the arteries that causes the flow of blood throughout the body is not smooth. This condition can also cause numbness and weakness in the body.

7. Headache
Those who have heart problems, will experience headaches when exposed to light. This effect on heart rate, whether it's beating slower or faster.

Especially in women who experience frequent migraine or visual disturbances, at least two times a month, need to be vigilant. This could be a symptom of cardiac disease progression. According to a study published by the American Academy of Neurology. According to researchers, this occurs because the blood circulation irregularities that cause severe headaches.

8. Irregular heartbeat

If you experience irregular heartbeat, this should be wary because it can be fatal. Generally irregular heartbeat due to thickening of the heart muscle in the valve. This leads to the narrowing of the valve, causing a leak.

9. Shortness of breath

Shortness of breath caused by thickening of the blood vessels that block the blood supply to the entire body. This also results in an irregular heartbeat, liver abnormalities or infections, thickening of the heart muscle, as well as abnormalities in heart valves.

10. Swelling of the legs and abdomen

Swelling occurs when fluid accumulates in the body. Generally occurs at the ankle and abdomen. This symptom is a sign that the heart is experiencing disabilities and abnormalities of the heart valves.


B. Symptoms of Heart Attack

Heart attack symptoms to watch out for.

In men, symptoms of heart can be seen from serious sexual dysfunction and hair loss. Cholesterol and excess fat in the body is linked as a trigger factor of heart disease. For that, you need to know and be aware of heart attack symptoms appear suddenly:

1. Sudden pain in the chest behind the breastbone or as chest tightness.

2. Chest pain can be repeated a few minutes (20 minutes or more).

3. The pain can be a pressure in the chest, and neck as if to choke causes a cold sweat.

4. Suddenly collapsed, unconscious but may return. This happens because there are heart rhythm disturbances.

Symptoms and Risk Factors of Heart Disease in Women


Actually, women are more at risk of dying from heart disease than men. But in fact cases of heart attacks more common among men. Recognize the signs and symptoms before it's too late.

The heart is a vital organ that is important for their health is maintained. They, (women in particular) who suffered or suffer from heart disease, usually caused by lack of oxygen supply to the heart, so the heart does not function properly.

Bad habits that often we do not realize, especially diet, is very influential on heart health disorders. This is not a single cause. Heart problems also triggered by lack of physical activity such as exercise and prolonged stress.

Moreover, in female smokers, heart health problems more likely. This is due to the instability of the hormone estrogen in the body due to exposure to nicotine. In fact, estrogen is Horom antidote to heart disease.

The most common disease is a heart attack. In the report Prevention, every year has found the data that woman died of a heart attack. That is, women are more at risk of heart attack than men.


Symptoms of Heart Disease in Women

As the silent killer, basically this disease also issue signals that can unwittingly help you to detect it early. The rest, recognize these symptoms as stated Dr John F Knight in his book entitled "Family Medical care"

1. Shortness of Breath
Nearly 58 percent of women experience an inability to regulate their breathing. This can be caused due to excessive tiredness issued emotion, walk up the stairs, or after strenuous activity.

2. Lightweight pain
In this condition, the pain is not limited to that part of the heart. This pain can occur in other parts, such as the sternum, upper back, shoulders, neck, and the unexpected part: jaw.

3. Fatigue often
Strenuous work or exercise factors become one of the emergence of fatigue. But when you light physical activity then easily tired, it should be wary. Approximately 70 percent of this is an early symptom of heart disease, due to lack of oxygen to the heart.

4. Dizziness and Nausea
This condition is often felt in about 39 percent of women who experience indigestion. If it is severe, you not only experience dizziness or pain in the head only, but you can not afford to faint from pain.

5. Sweating without Activity
Sweaty hands or body parts is often associated with heart problems. Come on. When you are not doing activities that drain sweat or sudden sweating, beware! This is one indication of heart disease is also characterized by a pale face.

6. Excessive Anxiety
Body will signal that you are in a state of anxiety. This could happen due to psychological factors, such as stress for example. This condition triggers a sudden heart attack.

7. Sleeplessness or Insomnia
This can lead to increased coronary heart disease in women. Conditions sleeplessness or insomnia is experienced by about 48 per cent of women, and will last for several months. Not only that, the quality of sleep is also not long enough to help you sleep soundly.


Risk Factors of Heart Disease

So, who is most at risk of developing these symptoms? The point is, the more risk factors you have, the greater your risk of getting a heart attack, such as:

• Stop Menstrual
• Smoking
• Family history of heart disease before the age of 60 years
• High blood pressure (hypertension)
• Diabetes
• Obesity
• High cholesterol

The heart is an organ whose function is vital for the body. Therefore it is important to maintain heart health. Begin by familiarizing your dear heart healthy lifestyle and recognize the early symptoms of heart disease.

Causes, Symptoms and Risk Factors for Alzheimer's Disease

Alzheimer's disease is the loss of intellectual and social abilities severe enough to affect daily activities. In Alzheimer's disease, brain tissue health has decreased, causing decline in memory and mental abilities.

Alzheimer's disease is not contagious, but rather a kind of syndrome with apoptosis of brain cells at the same time, so that the brain seems to shrink and shrink. Alzheimer's disease is also said to be synonymous with the parents.

Alzheimer's is not part of the normal aging process, but the risk increases with age. Five per cent of people aged between 65-74 years suffering from Alzheimer's disease, and nearly 50 percent of people over the age of 85 years have Alzheimer's disease.

Although this disease has no cure, treatment can improve quality of life for people with Alzheimer's. They were sentenced to Alzheimer need support and affection from friends and family to cope.


Causes of Alzheimer's Disease

None of the factors that appear to be the cause of Alzheimer's. Scientists believe that the disease is a combination of genetic, lifestyle and environmental factors. Alzheimer's damage and kill brain cells.

Two types of damage brain cells (neurons) that are common in people with Alzheimer 's:

1. Plaques

Clumps of a protein called beta-amyloid affects the communication between brain cells. Although there are no known cases of Alzheimer's that causes death, the facts show that the process of the abnormal protein beta-amyloid may be the cause.

2. Tangles / puzzler

Support structures in the brain cells depends on the normal function of a protein called tau. In people with Alzheimer's, threads of tau protein undergo changes that cause them to be of unsound mind. Many scientists believe that this is the destruction of neurons and can cause death for patients with Alzheimer's.


Symptoms of Alzheimer's Disease

Alzheimer's disease may begin with slight memory loss and confusion, but in the end will lead to mental impairment which is irreversible and destroys a person's ability to remember, think, learn, and imagine.

1. Memory loss

Everyone has lapses in memory. Is a normal thing when you forget where you put your car keys or forgetting names of people that you rarely see. But the memory problems associated with long Alzhaimer and bad. People with Alzhaimer possible:
  • Repeating something she had done
  • Often forget the words and promises he does
  • Often misplaced something, often put things in unusual places
  • Eventually forget the names of family members and objects used in daily life.
2. Difficulty in finding the right words

Difficult for people with Alzhaimer to find the right words to convey their thinking or when they were deep in conversation. Will ultimately affect their ability to read and write.

3. Problematic when thinking abstractly

People with Alzheimer's have trouble thinking about something, especially in the form of numbers.

4. Lost the ability to judge

Resolve everyday problems is a difficult and becomes more difficult until the end is something that is felt to be possible for those who have Alzheimer's. Alzheimer's has characteristics very difficult to do something that requires planning, decision making and judgment.

5. Disorientation

People with Alzheimer's often lose the ability to remember the time and date, and will find themselves lost in the actual environment familiar to them.

6. Difficult to perform ordinary tasks

Difficult to perform routine tasks that require sustained steps in the process of completion, for example cooking. In the end, the person with Alzheimer's may forget how to do even the most basic things.

7. Changes in personality

People with Alzheimer's show:
  • Mood swings
  • Lost the trust of others
  • Increasing stubbornness
  • Depression
  • Restless
  • Aggressive


Risk Factors of Alzheimer's Disease

1. Age factor

Alzheimer's Disease usually affects people over the age of 65 years, but it also affects people under the age of 40. At least 5 per cent of people aged between 65 and 74 have Alzheimer's. In people aged 85 and above increased to 50 percent.

2. Men / women

Women are more susceptible than men, this is because women generally live longer than men.

3. Descent

Alzheimer's risk appears slightly higher if first-degree relatives - parents and siblings - has Alzheimer's.

4. Mild cognitive impairment

People who have mild cognitive impairment have memory problems worse than what might diekspektasikan on age and not bad enough to classify as dementia. Many of those who are in this condition persists has Alzheimer's disease.

5. Lifestyle

The same factors that make you are at the same risk of heart disease also increase the likelihood you will be affected by Alzheimer's disease. Examples are:
  • pressure
  • high blood pressure
  • high cholesterol
  • less in controlling blood sugar
  • keep your body to stay fit is important to you, you should be able to train the mind properly. Several studies have shown that active in training the mind and mental along your life especially in the elderly will reduce the risk of Alzheimer's disease.
6. Level of education

The study found an association between low education and the risk of Alzheimer's. But the underlying reasons are not known precisely. Some scientists theorize, the more often you use the brain more synapses you make a lot of reserves which will be available in the old days. It would be difficult to find Alzheimer's brains in people who train on a regular basis, or those who have a higher education level.

Colon Cancer Nursing Diagnosis


Most colon cancers originate from small, noncancerous (benign) tumors called adenomatous polyps that form on the inner walls of the large intestine. Some of these polyps may grow into malignant colon cancers over time if they are not removed during colonoscopy. Colon cancer cells will invade and damage healthy tissue that is near the tumor causing many complications.

Colon cancer is not necessarily the same as rectal cancer, but they often occur together in what is called colorectal cancer. Rectal cancer originates in the rectum, which is the last several inches of the large intestine, closest to the anus.

Cancer symptoms are quite varied and depend on where the cancer is located, where it has spread, and how big the tumor is. It is common for people with colon cancer to experience no symptoms in the earliest stages of the disease. However, when the cancer grows, symptoms include:
  • Diarrhea or constipation
  • Changes in stool consistency
  • Narrow stools
  • Rectal bleeding or blood in the stool
  • Pain, cramps, or gas in the abdomen
  • Pain during bowel movements
  • Continual urges to defecate
  • Weakness or fatigue
  • Unexplained weight loss
  • Irritable bowel syndrome (IBS)
  • Iron deficiency (anemia)
9 Nursing Diagnosis for Colon Cancer

1. Constipation related to obstructive lesions.
2. Acute Pain related to tissue compression secondary to obstruction.
3. Fatigue related to anemia and anorexia.
4. Imbalanced Nutrition, Less Than Body Requirements related to nausea and anorexia.
5. Risk for fluid volume deficit related to vomiting and dehydration
6. Anxiety related to cancer diagnosis and surgery planning
7. Knowledge Deficit: the diagnosis, surgical procedures, and self-care.
8. Impaired Skin Integrity related to surgical incision (abdominoperineal), stoma formation, and faecal contamination of the skin periostomal.
9. Disturbed body image related to colostomy.

Nursing Interventions : Impaired Physical Mobility - Rheumatoid Arthritis

Nursing Diagnosis for Rheumatoid Arthritis: Impaired Physical Mobility

related to:

  • skeletal deformity
  • painful
  • discomfort
  • activity intolerance
  • decreased muscle strength.

Can be evidenced by:
  • Reluctance to try moving / inability to move in with their own physical environment.
  • Limiting the range of motion, coordination imbalances, decreased muscle strength / control and mass (advanced stage).

The expected outcomes / evaluation criteria, patients will:
  • Maintaining a function of position in the absence / restrictions contractures.
  • Maintain or improve strength and function of and / or compensation of the body.
  • Demonstrate techniques / behaviors enabling activities.

Nursing Interventions : Impaired Physical Mobility - Rheumatoid Arthritis

1. Keep the rest bed rest / activity schedule to sit if necessary to provide a continuous period and nighttime sleep uninterrupted.
Rationale: Systemic Rest is recommended during acute exacerbations, and all phases of the disease is important to prevent exhaustion maintain strength

2. Evaluation / continue monitoring the level of inflammation / pain in the joints.
Rationale: The level of activity / exercise depends on the development / resolution of inflammation peoses

3. Change positions frequently with sufficient amount of personnel. Demonstrate / aids removal techniques and the use of mobility assistance.
Rationale: Eliminates stress on the network and improves circulation. Memepermudah patient self-care and independence. Proper removal techniques to prevent tearing skin abrasion.

4. Assist with range of motion active / passive, and resistive exercise also demikiqan isometris if possible.
Rationale: Maintain / improve joint function, muscle strength and general stamina.

5. Position with pillows, sand bags.
Rationale: Increase stability (reducing the risk of injury) and required memerptahankan joint position and body alignment, reducing contractor

6. Encourage the patient to maintain an upright posture and sitting height, standing, and walking.
Rationale: To maximize joint function and maintain mobility.

7. Provide a safe environment, such as raising the chair, using the toilet railings, wheelchair use.
Rationale: Avoiding injury due to accidents / falls

8. Use a small pillow / thin below the neck.
Rationale: Preventing neck flexion.

9. Collaboration: consul with physiotherapy.
Rationale: Useful in formulating training programs / activities based on individual needs and identifying tools.

10. Collaboration: Provide foam mat / converter pressure.
Rationale: Reducing pressure on fragile networks to reduce the risk of immobility.

11. Collaboration: give medications as indicated (steroids).
System may be needed to suppress acute inflammation.

Source : http://nanda-nurse-diary.blogspot.com/2012/11/nursing-diagnosis-impaired-physical.html

Preeclampsia Nursing Diagnosis

Nanda Nursing Diagnosis for Preeclampsia
Preeclampsia/eclampsia is a complex hypertensive disorder of pregnancy affecting multiple systems. Preeclampsia is a condition that pregnant women can get. Preeclampsia and eclampsia are complications of pregnancy. In preeclampsia, the woman has dangerously high blood pressure, swelling, and protein in the urine.




7 Nursing Diagnosis for Preeclampsia

1. Acute pain
reated to post Caesarean section incision

2. Alteration in Bowel Elimination: Constipation
related to decreased intestinal peristalsis.

3. Risk for Infection
related to tissue trauma / skin damage

4. Risk for Fluid Volume Deficit
related to the bleeding

5. Altered family processes
related to the preparation of infant acceptance.

6. Sleep pattern disturbance
related to the tension during the birth process, pain.

7. Knowledge Deficit: perawtan about babies, family planning, nutrition
related to inadequate information. 

Source : http://nanda-nurse-diary.blogspot.com/2012/11/nanda-7-nursing-diagnosis-for.html

Nursing Diagnosis and Interventions for Patent Ductus Arteriosus (PDA)

Nursing Diagnosis for Patent Ductus Arteriosus (PDA)
  1. Decreased Cardiac Output related to malformations of the heart.
  2. Impaired Gas Exchange related to pulmonary congestion.
  3. Activity Intolerance related to imbalance between oxygen consumption by the body and oxygen supply to the cells.
  4. Delayed Growth and Development related to an inadequate supply of oxygen and nutrients to the tissues.
  5. Imbalanced Nutrition Less than Body related to fatigue at mealtime and increased caloric needs.
  6. Risk for Infection related to decreased health status.

Nursing Interventions for Patent Ductus Arteriosus (PDA)
1. Maintain adequate cardiac output:
  • Observation of the quality and strength of heart rate, peripheral pulses, skin color and warmth.
  • Enforce the degree of cyanosis (circumoral, mucous membranes, clubbing).
  • Monitor signs of CHF (restlessness, tachycardia, tachypnea, spasms, fatigue, periorbital edema, oliguria, and hepatomegaly).
  • Collaboration of drugs in accordance with the order, using toxicity hazard prevention techniques.
  • Provide treatment to reduce afterload.
  • Give diuretics as indicated.
2. Reduce the increase in pulmonary vascular resistance:
  • Monitor the quality and rhythm of breathing.
  • Adjust the position of the child with Fowler position.
  • Avoid children from an infected person.
  • Give adequate rest.
  • Provide optimal nutrition.
  • Give oxygen if indicated.
3. Maintaining adequate levels of activity:
  • Allow the child to rest frequently, and avoid disturbances during sleep.
  • Encourage to engage in play and light activity.
  • Help child to choose activities appropriate to the age, condition and abilities.
  • Avoid the ambient temperature is too hot or too cold.
  • Avoid the things that cause fear / anxiety in children.
4. Provide support for the Growth and Development :
  • Assess the level of development of the child.
  • Give the stimulation of growth and development, play activities, gaming, watching TV, puzzles, drawing, and others according to the condition and age of the child.
  • Involve the family in order to continue to provide stimulation during care.
5. Maintaining growth in weight and height appropriate:
  • Provide a balanced diet, high nutrients for adequate growth.
  • Monitor height and weight, documented in the form of graphs to determine the trend of growing children.
  • Measure weight every day with the same weight and the same time.
  • Record intake and output correctly.
  • Provide food with small portions but often to avoid fatigue during meals.
  • Children who receive diuretics are usually very thirsty, and therefore not restricted fluid.
6. Children will not show signs of infection:
  • Avoid contact with infected individuals.
  • Give adequate rest.
  • Provide optimal nutritional needs.

Source : http://fundamentalsnursing.com/

Perichondritis - Nursing Diagnosis and Interventions

Nursing Diagnosis and Interventions:

Nursing Diagnosis 1.

Acute Pain related to inflammation
Goal: pain can be reduced.
Expected outcomes:
  • Reported pain reduced / controlled.
  • Facial expression / posture relaxed.
Interventions and Rationale :
1. Assess the level of pain with a pain scale
R /: Giving info to assess the response to intervention.
2. Assess and record the patient’s response to intervention
R: Assist in providing interventions.
3. Collaboration give analgesic preparations
R /: Reduce pain.
4. Replacing the fuse when experiencing auditory canal edema
R /: To keep the canal open.

Nursing Diagnosis 2.

Anxiety related to lack of knowledge about the disease, the cause of infection and preventive actions.
Goal: reduce anxiety
Expected outcomes:
  • Clients do not show signs of restlessness
  • Clients look calm
Interventions and Rationale:
1. Listen carefully to what the client is saying about the disease and actions.
R /: Listening enables the detection and correction of the misconceptions and misinformation.
2. Provide an explanation of the causative organism; targeted treatment; schedule follow-up
R /: Knowledge of specific diagnoses and actions to improve compliance.
3. Give the client a chance to ask and discuss.
R /: Questions client signifies a problem that needs to be clarified.

Nursing Diagnosis 3.

Knowledge Deficit related to lack of exposure to information about the disease, treatment.
Goal: increased knowledge about the condition and treatment is concerned.
Expected outcomes :
Reported understanding of disease experienced.
Inquire about the treatment options that are clues readiness to learn.
Nursng Diagnosis and Interventions:
1. Assess the patient’s level of knowledge.
R /: Knowing the patient’s level of understanding and knowledge about the disease and indicators in intervention.
2. Provide information to patients about the course of their illness.
R /: Improve understanding of the client’s health condition.
3. Provide a description of the patient on any given act of nursing.
R /: Reduce levels of anxiety and help promote cooperation in support of a given therapy program.

Source : http://fundamentalsnursing.com