Nursing Diagnosis for Glaucoma (Pre and Post Operative)

Nursing Diagnosis for Glaucoma (Pre and Post Operative)

Nursing Diagnosis for Glaucoma - Pre and Post Operative   September 26, 2015

Glaucoma is a group of eye diseases causing optic nerve damage. Glaucoma often affects both eyes, usually to varying degrees. One eye may develop glaucoma quicker than the other.Glaucoma is a condition which can affect sight, usually due to build up of pressure within the eye.

The exact causes of optic nerve damage from glaucoma is not fully understood, but involves mechanical compression and/or decreased blood flow of the optic nerve. Although high eye pressure sometimes leads to glaucoma, many people can also develop glaucoma with "normal" eye pressure.

There are four main types of glaucoma:

• Acute angle-closure glaucoma – which often has severe symptoms
• Chronic open-angle glaucoma – the most common type which often has few symptoms
• Developmental glaucoma – a rare condition affecting young babies
• Secondary glaucoma – caused by other conditions or eye treatments

Nursing Diagnosis for Glaucoma (Pre Operative)

1. Disturbed Sensory Perception (visual) related to the reception of sensory disturbances, impaired organ status.

2. Pain (acute / chronic) related to an increase in intra-ocular pressure (IOP)
characterized by nausea and vomiting.

3. Anxiety related to physiological factors, changes in health status, pain, possibility / reality vision loss.

4. Deficient Knowledge (learning needs) about the condition, prognosis, and treatment related to less exposed / do not know the source.



Nursing Diagnosis for Glaucoma (Post Operative)

1. Pain (acute / chronic) related to the surgical incision.

2. Risk for injury related to increased IOP, vitreous loss.

3. Risk for infection related to invasive procedures.

Urinary Incontinence in the Elderly : Stress, Urgency, Overflow, Functional

Urinary Incontinence in the Elderly : Stress, Urgency, Overflow, Functional

Urology Nursing   November 30, 2013

There are several clinical categories on the urinary incontinence. Let us consider one by one.


Stress urinary incontinence

Maybe you've come across people who when laughing or coughing followed by discharge of urine, either a little or a lot. Generally, the incident caused by the weakening of the muscles in the pelvic floor.

Although not the sole cause, but the frequency of occurrence of urinary incontinence due to a weakening of the pelvic muscles. This category incontinence usually occurs in the elderly who are aged in their 70s and often suffered by women.


Urgency urinary incontinence

Some of the neurological problems associated with urinary urgency incontinence, such as dementia, Parkinson's disease, stroke, or spinal cord injury. That occurs in this type of urinary incontinence is the patient complained of insufficient time to get to the toilet, but the urine was out first.

The process is very fast between the desire to urinate and the urine before patients are in the bathroom. This type usually occurs in old age people, over 70s.


Overflow urinary incontinence

Perhaps this type of incontinence rather rare. Uncontrolled urine that comes out in this type of incontinence is associated with the occurrence of prostate enlargement or multiple sclerosis, which can cause the patient to contract the bladder.

Factor drugs can also cause this overflow incontinence. How it happened? Patients who suffer from overflow incontinence is usually only a few passing urine without feeling the sensation when her bladder is full.


Functional urinary incontinence

For this type, mostly occurs due to severe dementia, environmental factors, and psychological factors. In patients who suffer from this type of incontinence is usually accompanied by the emergence of a variety of symptoms and urodynamic picture of the occurrence of more than one type of urinary incontinence.

Urinary Retention in Pregnancy

Urinary Retention in Pregnancy

Urology Nursing   November 30, 2013

Uterine incarceration is a fairly rare occurrence with an incidence of only about 1 : 3000 pregnancies. Caused by uterine retroversion him, trapped behind the sacral promontory and fixed for the remainder of the pregnancy. Between 12-20 weeks gestation, the patient will complain of lower abdominal pain, constipation, urinary incontinence, urinary retention, or even urinate constantly.

Fernandes et al (2012) noted in 10 years at a hospital in Boston occurred eight cases of uterine incarceration. The risk is spontaneous abortion. In some severe cases, the uterus may interfere with the attitude of the bladder and rectum, so as causing rupture of the bladder and rectum gangrene.

Incarceration of the uterus can lead to misdiagnosis as ectopic pregnancy, the uterus is experiencing retroflexi part, presumed gestational sac cul - de -sac while the inferior part of the uterine endometrium unexpectedly empty. Ultrasound will show that the length of the cervix appears anterosuperior position. Fundus will be in the posterior, located next to the pelvic cavity.

In a journal written on J Ultrasound Med 2012; 31:645-50, Fernandes et al revealed that the repositioning of the uterus during pregnancy should be done between 14-20 weeks old. The patient was placed with the dorsal lithotomy position, then paired urinary catheter, and hand pressed bimanually the uterus. One finger went into the rectum, and then increase the pressure on the uterus. If difficult to do with regional anesthesia, this procedure can be performed laparoscopically or even laparotomy. Having returned to the position anteflexi uterus, uterine pessarium fitted for a week in order not to go back into retroversion.

Gastritis - Definition, Classification, Pathophysiology and Prevention

Gastritis - Definition, Classification, Pathophysiology and Prevention

Gastritis   November 19, 2013

Definition of Gastritis

Gastritis is an inflammation localized or diffuse, in the gastric mucosa that develops when the mucosal protective mechanisms are filled with bacteria or irritants. (J. Reves, 1999).


Classification of Gastritis

Gastritis by type divided into 2 (two), namely :

1. Acute gastritis
Gastritis (inflammation of the gastric mucosa) is most often caused by carelessness diet, such as eating too much, too fast, eating food too much seasoning or infected food. Other causes include alcohol, aspirin, bile fefluks and radiation therapy. Gastritis can also be the first sign of acute systemic infection. Form a more severe acute gastritis caused by strong acid or alkali, which can lead to gangrene or perforation of the mucosa.

2. Chronic gastritis
Prolonged inflammation caused by both benign and malignant gastric ulcers, by the bacteria H. Pylori. Chronic gastritis may be classified as Type A or Type B. Type A occurs in gastric fundus or corpus. Type B (H. Pylori) the antrum and pylorus. May be related to the bacteria H. Pylori. Dietary factors such as hot drinks, seasonings, use of drugs, alcohol, smoking or reflux of intestinal contents into the stomach.


Pathophysiology of Gastritis

Foodstuffs, drinks, drugs and chemicals that go into the stomach causing irritation or erosion of the gastric mucosa to lose barrier (protective). Furthermore an increase in diffusion of hydrogen ions. Diffusion in mucosal disruption and increased gastric acid secretion is increased / lot. Stomach acid and digestive enzymes. Then invades the gastric mucosa and inflammatory reaction occurs. This is called gastritis. Response of the gastric mucosa against irritants are mostly with mucosal regeneration, therefore such disturbances often disappears by itself.

With the constant irritation, tissue become inflamed and can bleed.
The introduction of substances such as strong acids and bases are corrosive resulting in inflammation and necrosis of the stomach wall (gastritis corrosive). Necrosis can result in perforation of the stomach wall to the next due to bleeding and peritonitis.
Chronic gastritis can lead to a state of atrophy of the gastric glands and the state of mucosal thickening patches are gray or greenish gray (gastitis atrophic). The loss of the gastric mucosa will ultimately result in reduced gastric secretion and the onset of pernicious anemia. Atrophic gastritis may be a precursor to gastric carcinoma. Chronic Gastritis may also occur in conjunction with peptic ulcer or may occur after the action gastroyeyunostomía.


Prevention of Gastritis

Although infection of H. pylori can not always be prevented, here are some suggestions to reduce the risk of gastritis:

1. Eating correctly. Avoid foods that can irritate especially spicy foods, acidic, fried or fatty. Which is just as important as the selection of the right foods for health is how to eat it. Eat a sufficient amount, on time and done with ease.

2. Avoid alcohol. The use of alcohol can irritate and erode the mucous lining of the stomach and can cause inflammation and bleeding.

3. Do not smoke. Smoking affect the protective stomach lining, making the stomach more susceptible to gastritis and ulcers. Smoking also increases stomach acid, thereby delaying the healing of the stomach and is a major cause of gastric cancer. However, to be able to quit smoking is not easy, especially for heavy smokers. Consult with your doctor about methods that can help to stop smoking.

4. Do exercise regularly. Aerobic exercise can increase heart rate and breathing, also can stimulate bowel muscle activity that helps remove food waste from the intestines more quickly.

5. Control stress. Stress increases the risk of heart attack and stroke, lowers the immune system and can lead to skin problems. Stress also increases the production of stomach acid and slow down the speed of digestion. Because stress for some people can not be avoided, then the key is to control it effectively by way of a nutritious diet, adequate rest, regular exercise and adequate relaxation.

6. Replace pain medication. If possible, avoid the use of NSAIDs, this class of drugs will cause inflammation and will make existing inflammation worse. Replace with pain relievers containing acetaminophen.

7. Follow the doctor's recommendations.

Nursing Care Plan for Gastritis

Urinary Tract Infection : Definition, Classification, Etiology, Signs and Symptoms

Urinary Tract Infection : Definition, Classification, Etiology, Signs and Symptoms

Urinary Tract Infections   November 18, 2013

Definition

Urinary Tract Infection (UTI) is a state of the invasion of microorganisms in the urinary tract. (Agus Tessy, 2001)

Urinary Tract Infection (UTI) is a bacterial infection of the state of the urinary tract. (Enggram, Barbara, 1998)


Classification

Classification of urinary tract infections as follows:

1. Bladder (cystitis)
2. Urethra (urethritis)
3. Prostate (prostatitis)
4. Kidneys (pyelonephritis)

Urinary Tract Infection (UTI) in the elderly, can be divided into :

1 . Uncomplicated (simple)
Simple UTI that occurs in patients with urinary tract is not good, normal anatomic and functional. This UTI in elderly patients, especially regarding women and the infection just about superficial bladder mucosa.

2 . Complicated
Often cause a lot of problems because they are often difficult to eradicate germs, germs are often resistant to multiple kinds of antibiotics, frequent bacteremia, sepsis and shock. The UTI occurs when the circumstances are as follows :

• Abnormal urinary tract abnormalities, such as stone, reflex vesico urethral obstruction, bladder atony, paraplegia, permanent bladder catheter and prostatitis.
• Abnormalities of renal physiology : renal failure acute and chronic renal failure.
• Immune disorders
• Infections caused by virulent organisms such as prosteus spp, which produce urease.

Etiology

1. The types of microorganisms that cause UTI, among others:

• Pseudomonas, Proteus, Klebsiella: the cause of complicated UTI.
• Escherichia Coli : 90% cause of uncomplicated UTI (simple).
• Enterobacter, epidemidis staphylococci, enterococci, and-others.

2. The prevalence of UTI in the elderly, among others:

• Residual urine in the bladder is increased due to the bladder emptying less effective.
• Decreased mobility.
• Nutrition is often poor.
• Decreased immune system, either cellular or humoral.
• Barriers to the flow of urine.
• Loss of bactericidal effect of prostate secretions.

Signs and Symptoms

1. Signs and symptoms of lower UTI are:

• Frequent pain and a burning sensation when urinating.
• Spasame the bladder and suprapubic area.
• Hematuria.
• Back pain can occur.

2. Signs and symptoms of upper UTI are:

• Fever.
• Chills.
• Pelvic pain and waist.
• Pain when urinating.
• Malaise.
• Dizziness.
• Nausea and vomiting.

Urinary Retention related to Benign Prostatic Hyperplasia (BPH)

Nursing Care Plan for Urinary Tract Infection

Nanda for Urinary Tract Infection

Altered Urinary Elimination - NCP Urinary Tract Infections

Altered Urinary Elimination - NCP Urinary Tract Infections

Urinary Tract Infections   November 18, 2013

Nursing Care Plan for Urinary Tract Infections

A urinary tract infection (UTI) is an infection that affects part of the urinary tract.
Symptoms from a lower urinary tract include painful urination and either frequent urination or urge to urinate (or both), while those of pyelonephritis include fever and flank pain in addition to the symptoms of a lower UTI.

Nursing Diagnosis : Altered Urinary Elimination related to mechanical obstruction of the bladder or other urinary tract structures.

Outcomes:
Improved elimination pattern , not the signs urinary disorders : urgency , oliguric , dysuria

Intervention:

1. Monitor input and output and urine characteristics.
Rational: provides information about kidney function and presence of complications.

2. Encourage increased fluid intake.
Rationale: increased hydration washes the bacteria.

3. Assess complaints of the urinary bladder.
Rational: urinary retention may occur causing tissue distension (bladder / kidney).

4. Observation of changes in the level of consciousness.
Rational: accumulation of uremic and electrolyte imbalances can be toxic to the central nervous system.

5. Monitor laboratory tests; electrolytes, BUN, creatinine.
Rational: monitoring of renal dysfunction.

6. Take action to maintain acidic urine: input increase berry juice and give medications to increase uric acid.
Rational: uric acid deter the growth of bacteria. Increased input preformance juice can affect the treatment of urinary tract infections.

Pleural Effusion Definition, Etiology, Signs and Symptoms

Pleural Effusion Definition, Etiology, Signs and Symptoms

Pleural Effusion   November 11, 2013

Pleural Effusion Definition

Pleural effusion is buildup of fluid in the pleural space, a primary disease process are rare but usually occurs secondary to other diseases. Effusion may be a clear liquid, which may be a transudate, exudate, or may be blood or pus (Baughman C Diane, 2000)

Pleural effusion is a collection of fluid in the pleural space which lies between the visceral and parietal surfaces, primary disease process is rare but is usually a secondary disease to other diseases. Normally, the pleural space contains a small amount of fluid (5 to 15 ml) serves as a lubricant that allows the pleural surface to move without friction. (Smeltzer C Suzanne, 2002).

Pleural effusion is a term used for the accumulation of fluid in the pleural cavity. (Price C Sylvia, 1995)


Pleural Effusion Etiology

Barriers resorption of fluid from the pleural cavity, because of the dam as in cardiac decompensation, renal disease, mediastinal tumor, Meig syndrome (ovarian tumor) and superior vena cava syndrome.

Formation of excess fluid, due to inflammation (tuberculosis, pneumonia, viral), bronchiectasis, sub-Phrenic amoebic abscess penetrating into the pleural cavity, because the tumor where the incoming fluid and bleeding due to trauma.

Excess fluid can accumulate in the pleural cavity neoplastic disease process, thromboembolic, cardiovascular, and infection. This is caused by at least one of the four basic mechanisms:

• Increase in capillary pressure or subpleural lymphatics.
• Decrease in colloid osmotic pressure of blood.
• Increase in negative intrapleural pressure.
• Inflammatory or neoplastic pleura.

Pleural Effusion Signs and Symptoms

• The existence of liquid deposits resulting in pain due to friction, after fluid lost quite a lot of pain. When a lot of fluid, the patient will be short of breath.
• The existence of the cause of disease symptoms such as fever, chills, and chest pain pleurisy (pneumonia), high heat (cocci), sub-febrile (tuberculosis), a lot of sweat, cough, lots of ripples.
• Tracheal deviation away from sore spots may occur if there is a significant accumulation of pleural fluid.
• Physical examination in the state of lying and sitting would be different, because the liquid will move. The sick will be less engaged in breathing, fremitus weakened (touch and vocals), the region was found percussion dullness, sits in a state of liquid surface forming a curved line (line "Ellis Damoiseu") .
• Was found ; triangle Garland, the percussion area at the top of the line dim timpani "Ellis Domiseu". Triangle "Grocco - Rochfusz", ie volatile region as fluid pushed mediastinum to the other side, this area was found on auscultation with a weakened vesicular rales.
• At the beginning and end of the disease, pleural audible crackles.

Nursing Care Plan for Pleural Effusion