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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.