Nursing Care Plan for Abdominal Tumor
DEFINITIONS
Abdominal tumor is a solid mass with different thickness, which may wrap around large blood vessels and ureter. In the pathology of this disorder is easy to peel and can extend to retroperitonium, ureteral obstruction may occur or the inferior vena cava. Mass of fibrotic tissue that surround and define the structure in the wrapper but not invaded.
CAUSES
The immediate cause of the tumor is actually not known, but there are some results of the study showed that:
- Excess nutrients, especially fat.
- The end result of metabolic and bacterial.
- Constipation.
- Infections, trauma, hypersensitivity to the drug.
SIGNS AND SYMPTOMS
- Pain
- Anorexia, nausea, lethargy
- Weight loss
- Bleeding
- Enlargement of the existing organ tumors
DIAGNOSTIC TEST
- Digital rectal test
- X - ray
- Sigmoidoscope
- Fiber optic scope plexible
- Ultra sonography
Nursing Diagnosis and Interventions for Abdominal Tumor
1. Chronic Pain related to an emphasis on retroperitoneal organs,
Characterized by:
Subjective Data:
- Clients say pain in the abdominal area.
Objective Data:
- Grimacing facial expressions.
- Tenderness in the abdomen.
Outcomes :
- Clients do not complain of pain.
- Cheerful facial expressions.
- Vital signs within normal limits.
Interventions:
1. Assess and record the location and duration of pain.
R /: Knowing the client's perception and reaction to pain as an effective basis for further intervention.
2. Adjust the position of the fun.
R /: Reduce emphasis that can cause pain.
3. Observation of vital signs.
R /: Can be changed by pain and an indicator to assess the state of development of the disease.
4. Encourage clients to relax deep breath.
R /: It can help to relax the muscles so that the supply of O2 to the tissue smoothly so as to reduce pain.
5. Encourage clients perform massage around the painful area.
R /: Helps block pain stimuli that are not perceptible to the brain.
6. Management of analgesic drug administration according to the program so that the pain can be reduced / lost.
2 Risk for Imbalanced Nutrition: Less Than Body Requirements related to the intake of less
Characterized by:
Subjective Data:
- Clients complains of nausea.
- Clients say lack of appetite.
Objective Data:
- Intake less
- Vomiting
- Appears weak
Outcomes:
- Clients no nausea and vomiting.
- Adequate Intake.
- Clients are not weak.
Interventions:
1 Monitor food intake.
R /: Adequate intake affect the healing process.
2 Provision of adequate calories and balanced meals.
R /: Caloric intake helps the body in maintaining hemostasis.
3 Encourage clients to spend a portion of their food.
R /: adequate intake can assist in the process of wound healing and helps in improving the general state of the client.
4 Encourage clients to eat small meals but often.
R /: The food is more easily digested and can help intake is adequate.
5. Serve food in the form of interest and varies according to the client's nutritional needs.
R /: Increase appetite to fulfill the nutritional needs of the client.
3. Disturbed Sleep Pattern related to postoperative wound pain.
Goal: Sleep patterns resolved.
Outcomes:
- Clients sleep 7-8 hours.
- Clients seem cheerful.
1 Assess the client's pattern of sleep and rest.
R /: Knowing the disturbance of rest / sleep clients to determine further intervention.
2 Create a pleasant environment.
R /: A quiet environment can provide time for sleep.
3 Encourage clients to a lot of rest and enough sleep.
R /: Adequate sleep can give a fresh taste to the clients and accelerate the healing process.
4. Self-care deficit related to activity limitations.
Goal: The client indicates the requirement for self care.
Outcomes:
- Clients can be dressed, bathing, bowel movement, bladder itself.
- Clients seem fresh.
1 Assess the patient's ability in ADL.
R /: To determine the extent of assistance required to meet the client's ADL.
2 Assist clients in meeting the needs of bathing and dressing.
R /: Allows the requirement for a shower and get dressed so that the client can provide a fresh and comfortable sense.
3 Do activities ROM execise.
R /: To train all muscle movement and prevent muscle atrophy.
4 Encourage clients to practice sitting and walking.
R /: To train the muscle movement and the client does not feel bored to be in bed.
5. Encourage clients to perform self-care gradually.
R /: Self-care can gradually foster client independence in personal hygiene needs.
5. Anxiety related to ineffective coping
Goal: Anxiety is resolved
Outcomes:
- Cheerful facial expressions.
- Clients are not asked again about his illness.
- Clients have the hope of recovery.
Interventions:
1 Assess the level of anxiety.
R /: Facilitate the further action ..
2 Assist clients in meeting the needs of bathing and dressing.
R /: Thus, the client was relieved to express his feelings to the nurse.