Nursing Care Plan for Cushing's Syndrome

Nursing Care Plan for Cushing's Syndrome

Nursing Care Plan for Cushing's Syndrome   September 27, 2013

Definition of Cushing's syndrome

Cushing's syndrome is a condition caused by hyperadrenocorticism, is more often found in women, due to neoplasms in the adrenal cortex / anterior pituitary, or a result of long-term intake of glucocorticoids for therapeutic interest (Dorland).

Etiology of Cushing's syndrome

• Excessive activity of the adrenal cortex
• Corticosteroids / ACTH excess
• Adrenal cortex hyperplasia.

Symptoms of Cushing's syndrome

Most people with Cushing syndrome will have:

• Upper body obesity (above the waist) and thin arms and legs
• Round, red, full face (moon face)
• Slow growth rate in children

Skin changes that are often seen:

• Acne or skin infections
• Purple marks (1/2 inch or more wide) called striae on the skin of the abdomen, thighs, and breasts
• Thin skin with easy bruising

Muscle and bone changes include:

• Backache, which occurs with routine activities
• Bone pain or tenderness
• Collection of fat between the shoulders (buffalo hump)
• Rib and spine fractures (caused by thinning of the bones)
• Weak muscles

Women with Cushing syndrome often have:

• Excess hair growth on the face, neck, chest, abdomen, and thighs
• Menstrual cycle that becomes irregular or stops

Men may have:

• Decreased or no desire for sex
• Impotence

Other symptoms that may occur with this disease:

• Mental changes, such as depression, anxiety, or changes in behavior
• Fatigue
• Headache
• Increased thirst and urination

Management of Cushing's Syndrome

As more Cushing's Syndrome is caused by a pituitary tumor than adrenal tumor, the treatment is often directed at the pituitary gland.

1. Transsphenoidal hypophysectomy, surgical removal of the tumor.
2. Radiation pituitary gland, takes several months to control the symptoms.
3. Adrenalectomy, the treatment of choice for patients with primary adrenal hypertrophy.
4. Baffle adrenal enzyme preparations (ie, metyrapon, aminoglutethimide, mitotane, ketoconazole) to reduce hiperadrenalisme if due to ectopic ACTH secretion.

Nursing Care Plan for Cushing's Syndrome

Nursing Diagnosis for Cushing's Syndrome

1. Risk for injury and Risk for infection related to weakness and changes in protein metabolism and inflammatory response.
2. Self-care Deficit: weakness, feeling of tiredness, muscle atrophy and changes in sleep patterns.
3. Impaired skin integrity related to edema, impaired healing and the skin is thin and fragile.
4. Disturbed Body Image related to changes in physical appearance, sexual dysfunction and decreased activity levels.
5. Disturbed Thought Processes related to fluctuations in emotions, irritability and depression.

Tips to Lowering Blood Sugar in Diabetes

Tips to Lowering Blood Sugar in Diabetes

Hypertension   September 26, 2013

Lowering Blood Sugar in Diabetes Mellitus is very difficult to do, the key appropriate diet is often overlooked so that blood sugar levels continue to rise. In normal people, blood sugar levels can be reabsorbed by the cells to be processed into energy as a source of human motion. Whereas in diabetic patients, a simple sugar remains in the blood stream and cause blood sugar levels to rise. Therefore, for patients with diabetes need to add fibrous foods in the daily diet.

Reduce Excess Fat

Excess fat will affect the sensitivity of cells to insulin substances in the body, which then disrupt the function of insulin to absorb blood sugar. This will result in a rise in blood sugar levels drastically. Reduce excess fat to lower blood sugar is best, of course with regular exercise. Burn fat also aims to maintain a healthy weight and reduce the risk of cardiovascular disease. In this regard, please note.

Herbs for Diabetes Patients

Herbs are believed to reduce blood sugar levels naturally very much. The type of these plants include; bitter melon, turmeric, ceremai, bitter, mango leaves, gotu kola, ginseng, red betel leaf. That need to be considered in the use of herbs to lower blood sugar levels, is about the possibility of hypoglycemia. The use of herbal plants is certainly for a while, and not good if consumed continuously. To keep the best blood sugar levels naturally by adjusting the diet.

How to cultivate food for people with diabetes

Processing of food consumed will affect how patients with diabetes keep blood sugar levels. For example, to cook the rice to be consumed by people with diabetes is to use a regular pan is heated on the stove, not the engine or electric rice cooker appliance. It aims to keep the unraveling of complex carbohydrates into simple carbohydrates, and trigger a rise in blood sugar levels.

Cooking vegetables for diabetics, should not be too long. It is intended that the content of complex carbohydrates and nutrients in vegetables are not damaged. Diabetes sufferers, should also reduce fried foods. As a substitute, you can stir frying, grilling or using a vacuum frying techniques with particular cookware.

7 Ways to Take Care of Elderly Affected Hypertension

7 Ways to Take Care of Elderly Affected Hypertension

Hypertension   September 26, 2013

Hypertension is a condition where a person experiences an increase in blood pressure above normal indicated by the systolic number (top) and the bottom number (diastolic) blood pressure on examination using a blood pressure measuring device either in the form of mercury cuff (sphygmomanometer) or other digital devices .

The normal value of a person's blood pressure with height, weight, activity level and general health normal is 120/80 mmHg. In daily activities, normal blood pressure is stable with a numeric value range. But in general, the numbers decreased blood pressure during sleep and increased time when activity or exercise.

Here are some important things to consider in caring for elderly people who have hypertension:

1. Elderly affected by hypertension, decreased organ function, including the sense of taste. Usually the elderly will likely feel less salt or food was bland, although according to the usual size, salinity was fitting. Because of this, you need to do is to add sugar or spices cooking on food, but it is recommended not to use because of the flavor flavoring has a high salt content. In addition, if you want to buy food such as snacks and fast food, consider the salt content listed on the packaging.

2. Reduce foods containing sodium to less than 100 mmol / day (less than 6 g of sodium chloride, or less than 2.4 g of sodium per day).

3. Help the elderly to reduce weight up to a healthy weight and eat a diet rich in fruits and vegetables.

4. Help the elderly to limit consumption of caffeine and alcohol.

5. Accompany the elderly to light exercise such as walking, tai-chi, gymnastics heart that can be done 3-5 times / week for 30-45 minutes. However, avoid the habit of standing in a long time and perform strenuous activities, such as going up - and down the stairs.

6. Remind elderly, to change positions slowly. For example, when Elderly want to stand up from a lying position, preferably in advance Elderly sitting for about 5 minutes. If it does not feel dizzy, then stand slowly.

7. Help the elderly to measure blood pressure to elderly health worker, clinic or other health facility.

Home Health Care for The Elderly

Home Health Care for The Elderly

Home Health Care for The Elderly   September 26, 2013

Metabolic diseases such as hypertension, diabetes mellitus, osteoporosis, and stroke often complained about by parents in the elderly stage.

Older people with age above 50 years old are very susceptible to diseases, which include: diabetes mellitus, hypertension, and Osteoporosis. Therefore, for early prevention, you should always remind parents to avoid foods that are hard, dense, and too salty, sour or sweet.

Diet for the Elderly

Then you also have to adjust their diet. Reducing the share of food in the elderly needs to be done, because the energy needs of the parents dropped so drastically. In order not to affect the stamina and health of the elderly, you can make gradual reduction in size of the meal. You should also begin to provide food that is rather soft, easily digested by the stomach.

Right Food for the Elderly

In addition to adjusting the diet, other things that are needed to maintain the health of the elderly is that calcium can be obtained from drinking milk. Calcium is a substance used to strengthen bones, prevent body bent and reduce osteoporosis. so drinking milk on a regular basis, is highly recommended for the elderly.

Other substances are also very important for the elderly is Omega 3. Substances that are very useful for the body, can be obtained from fish, vegetables, fruit and fish oil, with the aim to prevent the occurrence of symptoms of stroke in elderly parents.

Right Sport for the Elderly

In addition to providing nutritious food intake for the elderly and maintaining the proper diet, you also have to set a routine exercise for the elderly. Indeed sporting activities undertaken not as heavy as you are still young. However, for the elderly walking is the simplest activity and relatively safe. Walking activity can train the heart muscle strength, leg and maintain smooth breathing for the elderly.

Conclusion:

• Metabolic diseases such as diabetes mellitus, hypertension, stroke and osteoporosis often complained of by the elderly,
• To keep Health Care, can be done with lifestyle and healthy eating, as well as light exercise on a regular basis.

The Scope of Nursing Research

The Scope of Nursing Research

The Scope of Nursing Research   September 25, 2013

The scope of nursing research problem is divided into six (6) scope of the research problem, namely:

A. Basic Nursing and Nursing Management

1. Development of concepts and theories of nursing
   Focuses on the study of theory that has been there to convince the public, that the science of nursing is different with other health professions, as well as the spesific knowledge in the nursing field, consisting of:
   
   1. Adaptation theory. (Calista Roy)
   2. Self-care deficits. (Orem)
   3. Environmental health. (Florence Nightingale)
   4. The concept of nursing practice models. (Betty Neuman)
2. Issue of basic human needs
   Study of the causes and efforts to meet basic needs, include:
   
   1. Oxygenation problems
   2. Nutritional problems
   3. Fluid and electrolyte problems
   4. Elimination problem
3. Nursing Education
   
   1. Curriculum development and implementation
   2. Students and faculty
   3. Learning methods
   4. Evaluation system
4. Nursing Management
   
   1. The role and performance of nurses
   2. Nursing management system
   3. The role and performance of nursing committee
5. The role and function of professional organizations
   
   1. Organizational roles within nursing practice system (Registration, license, legalization).
   2. Role of standard-setting organizations within nursing practice.
   3. Organization's role in the development of the higher education system of nursing.

B. Pediatric Nursing
Scope of pediatric nursing research, based on a philosophy of nursing children (Biopsychosocial) children due to hospitalization and nursing roles in children and families, including:

1. Impact of hospitalization.
2. Developmental problems of children.
3. Child immunization issues.
4. Nursing care problems of children with disorders body system.

C. Maternity Nursing
The scope of this study focused on women of childbearing age couples, prenatal, natal and post natal and reproductive disorders, include:

1. Problems of pregnant women
2. Maternal intrapartum problems (I - IV) and nursing care of low birth weight babies, assessment - evaluation)
3. Postpartum maternal problems (vulvar hygiene, breast care, postnatal exercises, how to breastfeed)
4. Maternal problems with reproductive disorders (early detection of reproductive disorders, anxiety Ca cervix)

D. Medical-surgical Nursing and Emergency
In the scope of medical-surgical nursing, research focusing on askep clients with impaired adult body systems approach to the nursing process.

1. Scope of Medical Surgical Nursing Science
   
   • Immune system
     
     1. Effect of regular exercise to increase endurance.
     2. The effect of vitamin A on the production of leukocytes.
     3. Relationship anxiety with immune function.
   • Respiration and oxygenation system
     1. Differences in the effectiveness of the use of masks and hoses oxygenation (catheter)
     2. The most effective nursing interventions for the treatment of clients with hoarding thick secretions in the airways.
   • Cardiovascular system
     1. Effect of physical exercise on health improvement coronary heart patients.
     2. O2 delivery methods are most effective to improve / maintain PaCO2.
     3. Terapy influence relaxation to decrease pain angina pectoris clients.
   • Neural system
     
     1. Effectiveness of the method in dealing with acute pain distraction postoperative patients.
     2. Effectiveness with warm water immersion in overcoming the pain of dislocation.
     3. The most effective method for detecting early impairment of consciousness.
   • Urinary system
     
     1. Educational relationship with dietary adherence clients with kidney stones.
     2. Influence the frequency of sexual intercourse on the incidence of BPH.
     3. BPH influence on the formation of urinary tract stones.
   • Gastrointestinal tract
     
     1. Dietary adherence relationship to the incidence of peptic ulcers in clients with gastritis.
     2. The most effective method in reducing pain in NGT installation.
     3. Effect of frequency / number of smoking on the incidence of gastritis.
   • Endocrine system
     
     1. Client compliance with diabetes mellitus, the diet
     2. The most effective method in dealing with hypoglycemia
     3. Client adherence diabetes mellitus, the blood sugar control
2. Scope of Emergency Nursing
   
   • Respiratory gravity
     
     1. Early detection of severe breathing method on the client
     2. The role of nurses in addressing severe breathing
     3. Technical development chest physio therapy
   • Cardiovascular gravity
     
     1. The role of the nurse within the gravity handlers cardio-vaskuer (use of DC sock)
   • Psychiatric emergency
     
     1. Effective methods of binding (restrain) client rampage 
     2. The role of the nurse within the handling of client rage, depression and suicide attempts.

E. Psychiatric Nursing Science

1. Scope of application of the nursing process
   
   • Influence on the development of therapeutic modalities klein depression.
   • Development of therapeutic communication techniques
   • Development of therapeutic modalities
2. Therapeutic group activities
   
   • Effective methods of activity therapy for depression client
3. Therapeutic environment / environmental manipulation
   
   • Effectiveness of preventive home visits to clients relapse of mental disorder
   • Recurrence relation with the client receiving the surrounding environment.

F. Nursing Community, Family and Gerontic

1. Scope of Community
   
   • Ommunity participation in efforts to improve public health.
   • Maternal perception of the implementation of ante-natal
   • TB patient compliance in the implementation of therapy (DOTS)
2. Scope of family
   
   • Terapiutik communication effectiveness in a family approach
   • Family roles to the treatment of pulmonary Tb
   • Perceptions of family heads towards family planning program
3. Scope Gerontic
   
   • Method approach is effective in elderly
   • The role of nurses within nutritional needs of the elderly
   • Effect of occupational therapy on stress reduction elderly.

Purpose and Implications of Nursing Research

Purpose and Implications of Nursing Research

Purpose and Implications of Nursing Research   September 25, 2013

Nursing research is a systematic study, assessing problems or phenomena paktik nursing and nursing care through kreatiif study, initiating and evaluating change, take action to generate new knowledge that is useful for nursing.

Research activities in a systematic and regular moves, ranging from;

1. discovery issues;
2. collect data based on appropriate research design;
3. data analysis and;
4. formulate the conclusion of the study.

Control is a key element of the scientific approach. Involves inserting control conditions in order to study the situation the problem can be minimized and the validity and reliability (precision) can be achieved. Empirical is the process by which an event rooted in objective and collected directly or indirectly through sensing and is used for the formulation of the problem. Empirical investigation result of research objectivity because the idea / ideas tested in real situations. Generalization is a hallmark slah scientific method, meaning the study did not use the scientific method to a specific event, but should be able to use the research results to a broad scope. Generalization fosters science, provide explanations and predictions for pristiwa that will happen.

Purpose of research is to define, develop and test the truth, especially the science of knowledge. It also aims to find discordant thoughts in solving the problem. This is consistent with the objectives of research is to find answers to questions on an issue faced through basic and applied research activities.

The results of a study in the form of findings will provide the implications for parties:

1. Science (enhance existing knowledge);
2. Repair services or programs;
3. Follow-up studies in comprehension.

That is why research must be clear, open, honest and can be repeated or developed by others. Even more than that, the results of the study should be widely disesiminasikan either through print media and large group discussions such as seminars or panel discussions.

Nursing research conducted to address nursing issues and solving specific problems. This was done to develop a complete knowledge for nursing. Studying the field of nursing research integrity and knowledge of human behavior and influence one another is an attempt to learn the health issues related to human behavior and how that behavior relationships to health and illness.

The purpose of nursing research to improve the practice of the nursing profession in particular for improving the quality of nursing care.

Nursing Care of The Elderly with Immobility and Functional Mobility

Nursing Care of The Elderly with Immobility and Functional Mobility

Nursing Care Plan   September 24, 2013

Various changes occur in the musculoskeletal system, including bone loss (osteoporosis), enlarged joints, tendon stiffness, limited motion, thinning of the intervertebral disc, and muscle weakness, occurs in the aging process.

In the elderly, the collagen structure is less able to absorb the energy. Joint cartilage degeneration and areas that support the body longer to heal. This resulted in the occurrence of osteoarthritis. So also in muscle mass and strength is also reduced.

Definition

Mobility is the movement that gave freedom and independence for someone. Although this type of activity changed throughout human life, mobility is central to participate in and enjoy life. Maintaining optimal moblitas very important for the mental and physical health of all elderly.

Mobility is not an absolute and static in determining the ability to walk; optimal but mobility is something individualistic, relative, and depends on the dynamic interaction between environmental factors and social, afetif and physical function. For one, optimal mobility may be running about 8 kilometers per day; for others, mobility may involve limited movement with the help.

Immobility is broadly defined as the level of activity that is less than optimal mobility. Barriers to physical mobility nursing diagnosis, potential disuse syndrome, and activity intolerance providing a more limited definition of immobility and immobility included in a broader definition.

Immobility, activity intolerance and disuse syndrome often occurs in the elderly. Studies on the incidence of nursing diagnoses used for the elderly who are in care institutions revealed that barriers to physical mobility is the first or the second diagnosis most often appear. The prevalence of this problem extends beyond the institutions to involve the entire elderly.


Impaired Physical Mobility

Definition

A state of the limited ability of independent physical movement experienced by a person.

Defining characteristics :

• Inability to move with purpose in the environment, including bed mobility, move, and ambulation.
• Reluctance to perform the movement.
• Limitation of range of motion.
• Decrease the power, control, or muscle mass.
• Experienced restrictions on movement, including protocols and medical mechanical.
• Impaired coordination.

Related factors :

• Activity intolerance.
• Decreased strength and endurance.
• Pain and discomfort.
• Perceptual or cognitive disorders.
• Neuromuscular disorders.
• Depression.
• Severe anxiety.

Potential Disuse Syndrome

Definition

A state of someone who is at risk to suffer damage as a result of the body's systems of musculoskeletal inactivity recommended by the physician or unavoidable.

Risk factors :

• Paralysis
• Mechanical immobilization
• Immobilization recommended by the doctor
• severe pain
• Changes in level of consciousness

Activity Intolerance

Definition

A state of energy insufficiency in physiological or psychological on a person to survive or complete activities of daily living is needed or desired.

Defining characteristics :

• Verbal report of fatigue or weakness.
• Heart rate or blood pressure is not normal to the activity.
• Discomfort or dyspnea after the move.
• Electrocardiographic changes indicating the presence of dysrhythmias or ischemia.

Related factors :
Bed rest and immobility
General weakness
Sedentary lifestyle
Imbalance between oxygen supply and requirement


Internal Factors

Various internal factors resulted in the immobilization of the body or body parts. Detailed discussion of internal factors which contribute to immobility can be found in the related chapters in this text.

Internal factors that cause or contribute to the immobilization

• Musculoskeletal function decline
• Muscles (atrophy, dystrophy, or injury)
• Bones (fractures infection, tumor, osteoporosis, or osteomalacia)
• Joints (arthritis and tumors)
• Combination structure (and cancer drugs)

Changes in neurological function

• Infection (eg, ensevalitis)
• Tumor
• Trauma
• Drugs
• Vascular disease (eg, stroke)
• Demyelinating disease (eg, multiple sclerosis)
• Degenerative diseases (eg, Parkinson's disease)
• Exposure to toxic products (eg, carbon monoxide)
• Metabolic disorders (eg, hypoglycemia)
• Nutrition disorders

Pain

• Multiple and varied causes such as chronic illness and trauma

Perceptual deficits

• Excess or shortage of input sensory perception

Reduced ability cognitive
Koqnitif process disturbances, such as severe dementia

Fall

• Physical effects: injury or fracture
• Psychological effects: syndrome after fall

Changes in social relations

• Actual factors (eg, loss of a spouse, moving away from family, or friends)
• Perceptual factors (eg, change of mindset as depression)

Psychological aspects

• Helplessness in learning.
• Depression

External Factors

Many external factors that alter the mobility of the elderly. These include therapeutic program, the characteristics of residence and staff, nursing care delivery systems, barriers, and institutional policies.

1.) Therapeutic program
Medical treatment program has a strong influence on the quality and quantity of patient movement. Examples of programs include restrictions on mechanical factors and pharmacological, bed rest, and restrein.
2.) Occupant characteristics Institutions
Mobility levels and patterns of behavior of a group of peers may affect client mobility patterns and behavior.
3.) characteristics of staff
Three characteristics of the nursing staff is affecting the mobility patterns of knowledge, commitment, and the amount.
4.) Nursing care delivery systems
Type of nursing care delivery system in use at the institution can affect the mobility status of its inhabitants.
5.) Barriers
Physical and architectural barriers can interfere with mobility. Physical barriers include the lack of available tools for mobility, knowledge in the use of mobility aids inadequate for foot rest.
6.) Institutional policies
Another important environmental factor for Lasia are the policies and procedures of the institution.

Theories of Aging Process (Biology, Sociology and Psychology)

Theories of Aging Process (Biology, Sociology and Psychology)

Geriatric Nursing   September 24, 2013

Theories of Aging Process : Biology

1. Theory "Genetic Clock"

This theory states that occur as a result of the aging process at the genetic program inside nuclei. This clock will spin in a certain period of time and if the clock has run out of rotation then, would impede the process of mitosis. This is demonstrated by the results of the study Haiflick, (1980) cited Darmojo and Martono (1999) on the theory that stated the relationship between the ability of cells to divide in culture with somatic mutation of species age (error catastrophe theory) Another important thing to consider in analyzing factors actor is the cause of the aging process of the environmental factors that cause the occurrence of somatic mutations. It is now known that radiation and chemicals can shorten the life. According to this theory that progressive mutations in somatic cell DNA, will cause a decline in the ability of these cells functionally.

2. Theory "Error"

One hypothesis is that associated with somatic cell mutations are hypothesized "Error castastrophe" (Darmojo and Martono, 1999). According to the theory of aging caused by accumulated an assortment of errors throughout the human life. As a result of these errors will result in errors of metabolism that can cause cell damage and cell function slowly.

3. The theory of "autoimmune"

Aging process may occur due to changes in post-translational protein which can result in reduced ability of the body's immune system to recognize - self recognition. If the somatic mutation causes abnormalities in the cell surface, then this will result in the body's immune system considers cells undergoing changes as foreign cells and destroy Goldstein (1989) quoted by Aziz (1994). This is evidenced by the rising prevalence of auto-antibodies in the elderly (Brocklehurst, 1987 quoted from Darmojo and Martono, 1999). On the other hand the body's own immune system defenses decreased in the aging process, the antigen being attacked to decrease, resulting in pathological cells increases with age menigkatnya (Suhana, 1994 dikutif of Nuryati, 1994)

4. Theory "Free Radical"

Aging can occur due to the interaction of the components of free radicals in the human body. Free radicals can be: superoxide (O2), Hydroxyl radicals (OH) and hydrogen peroxide (H2O2). Free radicals are very damaging because it is highly reactive, so it can react with DNA, proteins, and unsaturated fatty acids. According Oen (1993) dikutif of Darmojo and Martono (1999) states that the older the age of the more free radicals are formed, so that poses destruction continues, the more damage cell organelles cells eventually die.

5. Wear & Tear Theory

Excess effort and stress cause the damaged body cells.

6. Collagen Theory 

Increase the amount of collagen in the tissue causing tissue damage and slowing the speed of repair tissue cells.


Theories of Aging Process : Sociology

1. Activity theory
Aging will cause a decrease in the number of activities directly.

2. Continuity theory
Continued existence of a personality that led to the existence of a pattern of behavior that increase stress.

3. Disengagement Theory
Lose touch with the outside world such as community relations, relationships with other individuals.

4. Age stratification theory
Because the people who fall in old age will accelerate the aging process.


Theories of Aging Process : Psychology

1. Maslow's theory of human needs
People who can reach 5% actualization according to research and not everyone can achieve that requirement perfectly.

2. Jung's theory
There are levels of living which has the task in the development of life.

3. Course of Human Life Theory
A person in relation to the environment is no maximum level.

4. Development Task Theory
Each stage of life has age-appropriate developmental tasks.

Imbalanced Nutrition related to Hyperemesis Gravidarum

Imbalanced Nutrition related to Hyperemesis Gravidarum

Obstetrical Nursing   September 22, 2013

Nursing Care Plan for Hyperemesis Gravidarum - Nursing Diagnosis : Imbalanced Nutrition: less than body requirements

Hyperemesis Gravidarum

Nausea and vomiting (emesis gravidarum) is a natural phenomenon and is often caught in the first trimester of pregnancy. Nausea usually occurs in the morning, but can arise at any time and at night. These symptoms occur approximately 6 weeks after the first day of the last menstrual period and lasts for approximately 10 weeks. Nausea and vomiting occur in 60-80% primi gravida and 40-60% multi gravida. One in every thousand pregnancies, these symptoms become more severe.

Nausea is largely attributable because of increased levels of estrogen and HCG (Human Chorionic Gonadrotropin) in serum. Physiological effect of the hormone increase is not clear, probably because the central nervous system or the gastric emptying of the stomach is reduced. In general, women can adapt to this situation, though symptoms of severe nausea and vomiting that can last up to 4 months. Daily work was interrupted, and the general condition became worse. This condition is called hyperemesis gravidarum. Complaints of symptoms and physiological changes determine the severity of the disease. (Prawirohardjo, 2002)

Hyperemesis gravidarum is defined as excessive vomiting or uncontrolled during pregnancy, which causes dehydration, electrolyte imbalance, or nutritional deficiencies, and weight loss. The incidence of this condition is approximately 3.5 per 1000 births. Although most cases of missing and disappeared over time, one out of every 1,000 pregnant women will undergo hospitalization. Hyperemesis gravidarum usually disappear on their own (self-limiting), but healing is slow and frequent relapses are common. The condition often occurs among primigravida women and tends to recur in subsequent pregnancies. (Lowdermilk, 2004).


Nursing Diagnosis for Hyperemesis Gravidarum : Imbalanced Nutrition: less than body requirements related to excessive frequency of nausea and vomiting.

Nursing Intervention for Hyperemesis Gravidarum

1. Limit oral intake until the vomiting stops.
R /: Maintain electrolyte fluid balance and prevent further vomiting.

2. Give anti-emetic drugs are prescribed at low doses.
R /: Preventing vomiting and maintain fluid and electrolyte balance.

3. Maintain fluid therapy is programmed.
R /: Correct the hypovolemia and electrolyte balance.

4. Record intake and output.
R /: Determining hydration fluids through vomiting and spending.

5. Anjurjan eat small meals but often.
R /: Can adequate intake of nutrients your body needs.

6. Instruct to avoid fatty foods.
R /: to stimulate nausea and vomiting.

7. Instruct the patient to eat a snack such as biscuit, bread and hot tea before getting out of bed during the day and before bed.
R /: Food distraction can reduce or avoid excessive excitatory nausea vomiting.

8. Record intake, if oral intake can not be given within a certain period.
R /: To maintain a balance of nutrients.

9. Inspection of an irritation or lesions in the mouth.
R /: To determine the integrity of the oral mucosa.

10. Assess oral hygiene and personal hygiene as well as the use of oral cleaning fluids as often as possible.
R /: To maintain the integrity of the oral mucosa.

11. Monitor hemoglobin and hematocrit.
R /: Identify the potential anemia and decreased oxygen-carrying capacity of the mother.

12. Test urine for acetone, albumin and glucose.
R /: Establish baseline data; performed routinely to detect potential high-risk situations such as the inadequate intake of carbohydrate, diabetic and hypertension due to pregnancy ketoasedosis.

13. Measure uterine enlargement.
R /: Malnutrition affects maternal fetal growth and aggravate komplemensel decrease in fetal brain, resulting in deterioration of fetal development and the possibilities further.