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NCP Nursing Care Plans for Intestinal Obstruction

Lifenurses — Mon, 14 May 2012 11:26:59 +0000

NCP Nursing Care Plans for Intestinal Obstruction. Intestinal obstruction is the partial or complete blockage of the lumen of the small or large bowel. Intestinal obstruction occurs when a blockage obstructs the normal flow of contents through the intestinal tract. It’s commonly a medical emergency. Complete obstruction in any part of the bowel, if untreated, can cause death within hours from shock and vascular collapse. Intestinal obstruction is most likely after abdominal surgery or in people with congenital bowel deformities.

Causes for Intestinal Obstruction

The two major types of intestinal obstruction are mechanical and neurogenic or nonmechanical.

Intestinal obstruction results from mechanical or nonmechanical (neurogenic) blockage of the lumen.

Mechanical obstruction include adhesions and strangulated hernias (Mechanical obstruction usually associated with small-bowel obstruction) chronic, severe constipation or fecal impaction, carcinomas (usually associated with large-bowel obstruction) foreign bodies, such as fruit pits, gallstones, and worms; compression of the bowel wall from stenosis; intussusception; volvulus of the sigmoid or cecum, tumors and atresia.
Nonmechanical obstruction usually results from paralytic ileus, the most common of all intestinal obstructions. Paralytic ileus is a physiological form of intestinal obstruction that usually develops in the small bowel after abdominal surgery. Other nonmechanical causes of obstruction include electrolyte imbalances, toxicity, such as that associated with uremia or generalized infection; neurogenic abnormalities such as spinal cord lesions; and thrombosis or embolism of mesenteric vessels.

Complications for Intestinal Obstruction

Intestinal obstruction can lead to perforation, peritonitis, septicemia, secondary infection, metabolic alkalosis or acidosis, hypovolemia or septic shock and, if untreated, death.

Nursing Assessment Nursing Care Plans for Intestinal Obstruction

Investigation of the patient’s history often reveals predisposing factors, such as surgery (especially abdominal surgery), radiation therapy, and gallstones. The history may also disclose certain illnesses that can lead to obstruction, such as Crohn’s disease, diverticular disease, and ulcerative colitis. Family history may reveal colorectal cancer in one or more relatives. Hiccups are a common complaint in all types of bowel obstruction. Other specific assessment findings depend on the cause of obstruction mechanical or nonmechanical and its location in the bowel

Diagnostic tests for Intestinal Obstruction

Various tests help to establish the diagnosis and pinpoint complications. For example,

Abdominal X-rays.
Barium enema In large-bowel obstruction reveals a distended, air-filled colon or a closed loop of sigmoid with extreme distention
Serum sodium, chloride, and potassium levels may decrease because of vomiting.
White blood cell counts may be normal or slightly elevated if necrosis, peritonitis, or strangulation occurs. Serum amylase level may increase, possibly from irritation of the pancreas by a bowel loop.
Hemoglobin concentration and hematocrit may increase, indicating dehydration.
Sigmoidoscopy, colonoscopy, or a barium enema may be used to help determine the cause of obstruction.

Nursing diagnosis Nursing Care Plans for Intestinal Obstruction

Acute pain
Constipation
Deficient fluid volume
Imbalanced nutrition: Less than body requirements
Ineffective tissue perfusion: GI

Nursing Key outcomes Nursing Care Plans for Intestinal Obstruction

The patient will express feelings of comfort, Report pain is relieved/controlled, Verbalize methods that provide relief.
The patient’s bowel function will return to normal, Participate in bowel program as indicated.
The patient’s fluid volume will remain within normal parameters, Maintain fluid volume at a functional level as evidenced by individually adequate urinary output, stable vital signs, moist mucous membranes, good skin turgor.
The patient will maintain adequate caloric intake. Demonstrate behaviors, lifestyle changes to regain and/or maintain appropriate weight.
The patient will exhibit signs of adequate GI perfusion.

Nursing interventions Nursing Care Plans for Intestinal Obstruction

Pain Management Alleviation of pain or a reduction in pain to a level of comfort that is acceptable to the patient. Analgesic Administration Use of pharmacologic agents to reduce or eliminate pain. Environmental Comfort Management Manipulation of the patient’s surroundings for promotion of optimal comfort
Constipation/Impaction Management: Prevention and alleviation of constipation/impaction. Bowel Management: Establishment and maintenance of a regular pattern of bowel elimination
Fluid Management Promotion of fluid balance and prevention of complications resulting from abnormal or undesired fluid levels. Hypovolemia Management: Reduction in extracellular and/or intracellular fluid volume and prevention of complications in a patient who is fluid overloaded. Shock Management: Volume: Promotion of adequate tissue perfusion for a patient with severely compromised intravascular volume.
Nutrition Management Assisting with or providing a balanced dietary intake of foods and fluids. Weight Gain Assistance Facilitating gain of body weight.
Fluid/Electrolyte Management Promotion of fluid/electrolyte balance and prevention of complications resulting from abnormal or undesired fluid/serum electrolyte levels. Gastrointestinal Intubation: Insertion of a tube into the gastrointestinal tract

NCP Nursing Care Plan for Abdominal Trauma

Lifenurses — Sun, 13 May 2012 16:13:56 +0000

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NCP Nursing Care Plan for Abdominal Trauma. Blunt and penetrating abdominal injuries may damage major blood vessels and internal organs. Intra-abdominal trauma is usually not a single organ system injury; as more organs are injured, the risks of organ dysfunction and death climb. Such injuries are potentially fatal; the prognosis depends on the extent of injury and the organ damaged but is improved by prompt diagnosis and surgical repair.

Blunt injuries occur when there is no break in the skin; they often occur as multiple injuries. In blunt injuries, the spleen and liver are the most commonly injured organs. Injury occurs from compression, concussive forces that cause tears and hematomas to the solid organs such as the liver, and deceleration forces.

Penetrating injuries are those associated with foreign bodies set into motion. The foreign object penetrates the organ and dissipates energy into the organ and surrounding areas. The most commonly involved abdominal organs with penetrating trauma include the intestines, liver, and spleen.

Causes for Abdominal Trauma

Blunt (nonpenetrating) abdominal injuries usually result from motor vehicle accidents, fights, falls from heights, and sports accidents. Penetrating abdominal injuries usually result from stabbings and gunshots.

Complications for Abdominal Trauma

The abdominal cavity contains solid, gas filled, fluid filled, and encapsulated organs. These organs are at greater risk for injury than are other organs of the body because they have few bony structures to protect them. Immediate life threatening complications include hemorrhage and hypovolemic shock. Later complications include infection and dysfunction of major organs, such as the liver, spleen, pancreas, and kidneys.

Nursing Assessment Nursing Care Plan for Abdominal Trauma

The patient’s history reveals an accidental or forcibly inflicted abdominal injury. Symptoms vary with the degree of injury and the organs damaged. History of the mechanism of injury by including a detailed report from the pre-hospital professionals, witnesses, or significant others. The patient with a blunt or penetrating abdominal injury typically is in obvious discomfort or pain.
Inspection pinpoints the type of abdominal injury and helps determine its severity. Depending on the severity of the injury, the patient may be pale, cyanotic, or dyspneic. Inspection of the patient with a blunt abdominal injury may also reveal bruises, abrasions, contusions and, possibly, distention, For a patient with a penetrating abdominal injury, inspection reveals the type of wound and associated blood loss. Internal bleeding caused by this type of trauma may be further determined by diagnostic tests. Gunshots usually produce both entrance and exit wounds, with variable blood loss, pain, and tenderness. The patient may also exhibit pallor, cyanosis, tachycardia, shortness of breath, and hypotension.
Palpation may reveal the extent of pain and tenderness and, in blunt abdominal injuries, abdominal splinting or rigidity. Rib fractures commonly accompany blunt abdominal injuries.
Auscultation may disclose tachycardia, decreased breath sounds, absent or decreased bowel sounds, or bowel sounds in the chest. Auscultate all four abdominal quadrants for 2 minutes per quadrant to determine the presence of bowel sounds. Although the absence of bowel sounds can indicate underlying bleeding, their absence does not always indicate injury

If the patient is hemorrhaging from a critical abdominal injury, he or she may be profoundly hypotensive with the symptoms of hypovolemic shock.

Diagnostic tests for Abdominal Trauma

Abdominal and Chest X-rays
Computed tomography (CT) scan
Focused abdominal sonogram fortrauma
Arterial blood gas analysis evaluates respiratory status
Excretory urography and cystourethrography show renal and urinary tract damage

Nursing diagnosis Nursing Care Plan for Abdominal Trauma

Common nursing diagnosis found in Nursing Care For Abdominal Trauma

Acute pain
Decreased cardiac output
Deficient fluid volume
Impaired gas exchange
Ineffective tissue perfusion: Renal, cardiopulmonary, gastrointestinal
Imbalanced nutrition: Less than body requirements
Impaired skin integrity
Anxiety
Risk for infection
Risk for post trauma syndrome

Nursing outcomes Nursing Care Plan for Abdominal Trauma

Nursing Key Outcome Nursing care Plan For Abdominal Trauma, Patient Will:

Express feelings of comfort and relief of pain.
Express that he feels less anxious.
Show signs of adequate cardiac output.
Fluid volume will remain within acceptable range.
Express understanding of special dietary needs.
Maintain adequate ventilation.
Regain skin integrity.
Develop effective coping mechanisms.
Show signs of adequate cardiopulmonary, renal, and gastrointestinal perfusion.
Exhibit no further signs or symptoms of infection.
Express his feelings and fears about the traumatic event.

Nursing interventions Nursing Care Plan for Abdominal Trauma

Provide emergency care, as needed, to support the patient’s vital functions, maintain airway and breathing.
Pain Management Alleviation of pain or a reduction in pain to a level of comfort that is acceptable to the patient
Analgesic Administration Use of pharmacologic agents to reduce or eliminate pain
Environmental Management Comfort Manipulation of the patient’s surroundings for promotion of optimal comfort
Hemodynamic Regulation Optimization of heart rate, preload, afterload, and contractility
Cardiac Care Limitation of complications resulting from an imbalance between myocardial oxygen supply and demand for a patient with symptoms of impaired cardiac function
Circulatory Care Mechanical Assist Devices Temporary support of the circulation through the use of mechanical devices or pumps
Fluid Management: Promotion of fluid balance and prevention of complications resulting from abnormal or undesired fluid levels
Hypovolemia Management: Reduction in extracellular and/or intracellular fluid volume and prevention of complications in a patient who is fluid overloaded
Shock Management Volume: Promotion of adequate tissue perfusion for a patient with severely compromised intravascular volume.
Respiratory Monitoring Collection and analysis of patient data to ensure airway patency and adequate gas exchange
Oxygen Therapy Administration of oxygen and monitoring of its effectiveness
Airway Management Facilitation of patency of air passages
Nutrition Management Assisting with or providing a balanced dietary intake of foods and fluids
Wound Care Prevention of wound complications and promotion of wound healing, Wound Site Care Cleansing, monitoring, and promotion of healing in a wound
Pressure Ulcer Care Facilitation of healing in pressure ulcers
Anxiety Reduction Minimizing apprehension, dread, foreboding, or uneasiness related to an unidentified source or anticipated danger, Calming Technique: Reducing anxiety in patient experiencing acute distress
Infection Protection Prevention and early detection of infection in a patient at risk
Infection Control Minimizing the acquisition and transmission of infectious agents
Infection Surveillance Purposeful and ongoing acquisition, interpretation, and synthesis of patient data for clinical decision making
Coping Enhancement: Assisting a patient to adapt to perceived stressors, changes, or threats that interfere with meeting life demands and role, Identify supportive persons for client

Honoring Nurses Around The World 12 May Is International Nurses Day

Lifenurses — Sat, 12 May 2012 12:10:30 +0000

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Honoring Nurses Around The World 12 May Is International Nurses Day. Each year, people around the world celebrate and honor the dedicated and devoted men and women who care for us when we need it most, nurses! International Nurses Day is celebrated around the world every May 12, the anniversary of Florence Nightingale’s birth. Florence Nightingale was one of the most influential women of her time. Born in Italy on May 12, 1820, she was the daughter of a wealthy landowner. She went on to become a nurse. During her nursing career, “The Lady with the Lamp” helped care for thousands of injured and sick soldiers during the Crimean War. In her later years, she went blind and became a “complete invalid.” Ironically, Nightingale required full-time nursing until she died in London in 1910 at the age of 90. May 12th is International Nurses Day (IND), an annual event observed on the anniversary of the birthday of the visionary nurse, Florence Nightingale.
Role of nurses vital in medical profession
Nurses serve as the backbone of the health care system. Because nurses play such a critical role in our lives, Nurses are health care professions who are part of a health care team. No longer the “handmaid” of the doctor, as mentioned by nursing professor Virginia Burggraf, nurses are an integral part of quality patient care.

NCP Nursing Care Plans for Burns Injury

Lifenurses — Fri, 11 May 2012 15:26:58 +0000

NCP Nursing Care Plans for Burns Injury. A major burn is a devastating injury, requiring painful treatment and a long period of rehabilitation. Burns have a catastrophic effect on people in terms of human life, suffering, disability, and financial loss. Burns can be fatal, permanently disfiguring, and incapacitating, both emotionally and physically. Infections are a major cause of morbidity and mortality in seriously burned patients. The skin injury from burns has six different mechanisms of injury: scalds, contact burns, fire, chemical, electrical, and radiation.

Causes for Burns Injury

Thermal burns, the most common type, result from preventable accidents occur because of fires from motor vehicle crashes, accidents in residences, and arson or electrical malfunctions. Chemical burns result from the contact, ingestion, inhalation, or injection of acids, alkali, or vesicants. Electrical burns commonly occur after contact with faulty electrical wiring or high-voltage power lines. Friction, or abrasion, burns happen when the skin is rubbed harshly against a coarse surface. Sunburn follows excessive exposure to sunlight and improper use of tanning lights.

Complications for Burns Injury

Leading causes of death in burn patients are respiratory complications and sepsis.

Other possible complications include:

Hypovolemic shock
Anemia
Malnutrition
Multisystem organ dysfunction.

Nursing Assessment Nursing Care Plans for Burns Injury

Patient history. Obtain a complete description of the burn injury, including the time, the situation, the burning agent, and the actions of witnesses. The time of injury is extremely important since any delay in treatment may result in a minor or moderate burn becoming a major injury. Elicit specific information about the location of the accident, since closed-space injuries are related to smoke inhalation. If abuse is suspected, obtain a more in-depth history from a variety of people who are involved with the child. The injury may be suspect if there is a delay in seeking health care, if there are burns that are not consistent with the story, or if there are bruises at different stages of healing. Note whether the description of the injury changes or differs among family or household members.

Basic assessment of airway, breathing, and circulation (ABCs) takes first priority. Once the ABCs are stabilized, perform a complete examination of the burn wound to determine burn severity. First, determine the depth of tissue damage. A partial-thickness burn damages the epidermis and part of the dermis; a full-thickness burn also affects the subcutaneous tissue. The more traditional method is to gauge burns by degree. Most burns include a combination of degrees and thicknesses

RULE OF NINES

The “rule of nines” is a practical technique used to estimate the extent of TBSA total body surface area involved in a burn. The technique divides the major anatomic areas of the body into percentages: in adults, 9% of the TBSA is the head and neck, 9% is each upper extremity, 18% is each anterior and posterior portions of the trunk, 18% is each lower extremity, and 1% is the perineum and genitalia. Clinicians use the patient’s palm area to represent approximately 1% of TBSA. Serial assessments of wound healing determine the patient’s response to treatment. Ongoing monitoring throughout the acute and rehabilitative phases is essential for the burn patient. Fluid balance, daily weights, vital signs, and intake and outpu

Nursing diagnosis Nursing Care Plans for Burns Injury

Impaired gas exchange
Ineffective airway clearance
Acute pain
Decreased cardiac output
Deficient fluid volume
Ineffective tissue perfusion: Peripheral
Hypothermia
Impaired skin integrity
Impaired physical mobility
Disturbed body image
Risk for infection

Nursing outcomes Nursing Care Plans for Burns Injury

Nursing Key outcomes Nursing Care Plans for Burns Injury, Patient will:

Ventilation will remain adequate.
Airway will remain patent
Achieve pain relief with analgesia or other measures.
Maintain adequate cardiac output.
Fluid volume will remain within the acceptable range.
Exhibit signs of adequate peripheral perfusion
Communicate understanding of special dietary needs.
Maintain normal body temperature.
Wounds and incisions will appear clean, pink, and free of purulent drainage.
Attain the highest degree of mobility possible within the confines of the injury.
Express positive feelings about self.
Express that he feels less anxious.
Demonstrate effective coping mechanisms.
Remain free from signs and symptoms of infection.
Express his feelings and fears about the traumatic event.

Nursing interventions Nursing Care Plans for Burns Injury

Provide immediate, aggressive burn treatment to increase the patient’s chance for survival.
Airway management; Anxiety reduction; Oxygen therapy; Airway suctioning; Airway insertion and stabilization; Cough enhancement; Mechanical ventilation; Positioning; Respiratory monitoring
Airway Management Facilitation of patency of air passages
Pain Management: Alleviation of pain or a reduction in pain to a level of comfort that is acceptable to the patient. Analgesic Administration Use of pharmacologic agents to reduce or eliminate pain. Environmental Management Manipulation of the patient’s surroundings for promotion of optimal comfort
Hemodynamic Regulation Optimization of heart rate, preload, afterload, and contractility. Circulatory Care Mechanical Assist Devices: Temporary support of the circulation through the use of mechanical devices or pumps
Fluid Management Promotion of fluid balance and prevention of complications resulting from abnormal or undesired fluid levels. Hypovolemia Management Reduction in extracellular and/or intracellular fluid volume. Shock Management: Volume: Promotion of adequate tissue perfusion for a patient with severely compromised intravascular volume.
Fluid/Electrolyte Management Promotion of fluid/electrolyte balance and prevention of complications resulting from abnormal or undesired fluid/serum electrolyte levels. Circulatory Care Arterial/Venous Insufficiency: Promotion of arterial/venous circulation
Hypothermia Treatment Rewarming and surveillance of a patient whose core body temperature is below 35C. Temperature Regulation: Attaining and/or maintaining body temperature within a normal range
Wound Care Prevention of wound complications and promotion of wound healing
Exercise Therapy Use of active or passive body movement to maintain or restore flexibility; use of specific activity or exercise protocols to enhance or restore controlled body movement
Body Image Enhancement improving a patient’s conscious and unconscious perceptions and attitudes toward his/her body. Self Esteem Enhancement Assisting a patient to increase his/her personal judgment of self worth.
Infection Protection Prevention and early detection of infection in a patient at risk. Infection Control Minimizing the acquisition and transmission of infectious agents. Surveillance: Purposeful and ongoing acquisition, interpretation, and synthesis of patient data for clinical decision making

NCP Nursing Care Plan for Irritable Bowel Syndrome

Lifenurses — Fri, 11 May 2012 15:05:15 +0000

NCP Nursing Care Plan for Irritable Bowel Syndrome. Irritable bowel syndrome (IBS), sometimes called spastic, spastic colitis, mucous colitis. Is a common condition marked by chronic or periodic diarrhea alternating with constipation. It’s accompanied by straining and abdominal cramps. Although people with IBS have a gastrointestinal (GI) tract that appears normal, colonic smooth muscle function is often abnormal. The autonomic nervous system, which innervates the large bowel, fails to provide the normal contractions interspaced with relaxations that propel stool smoothly forward. Excessive spasm and peristalsis lead to constipation or diarrhea, or both. Generally patients with IBS have either diarrhea or constipation predominant syndrome. Irritable bowel syndrome occurs mostly in females, with symptoms first emerging before age 40.

Causes for Irritable Bowel Syndrome

Although the precise etiology is unclear, irritable bowel syndrome involves a change in bowel motility, reflecting an abnormality in the neuromuscular control of intestinal smooth muscle.

Contributing or aggravating factors include anxiety and stress. Irritable bowel syndrome may also result from dietary factors, such as fiber, fruits, coffee, alcohol, and foods that are cold, highly seasoned, or laxative in nature. Other possible triggers include hormones, laxative abuse, and allergy to certain foods or drugs.

Complications for Irritable Bowel Syndrome

Irritable bowel syndrome is associated with a higher-than-normal incidence of diverticulitis and colon cancer. Although complications are usually few, the disorder may lead to chronic inflammatory bowel disease.

Nursing Assessment NCP Nursing Care Plan for Irritable Bowel Syndrome

Patient reports a history of chronic constipation, diarrhea, or both. investigate possible contributing psychological factors such as a recent stressful life change that may have triggered or aggravated symptoms.
Inspection, the patient may seem anxious and fatigued, but otherwise normal. Auscultation may reveal normal bowel sounds. Palpation typically discloses a relaxed abdomen. Occasionally, percussion reveals tympany over a gas-filled bowel.
Auscultation of the abdomen, normal bowel sounds may be heard, although they may be quiet during constipation. Tympanic sounds may be heard over loops of filled bowel. Although palpation often discloses a relaxed abdomen, it may reveal diffuse tenderness, which becomes worse if the sigmoid colon is palpable. The patient may have pain on rectal examination but does not usually experience rectal bleeding.

Diagnostic tests for Irritable Bowel Syndrome

No definitive test exists to confirm irritable bowel syndrome, the diagnosis typically involves studies to rule out other, more serious disorders, such as diverticulitis or colon cancer. The most frequently performed tests include barium enema, stool examination and Flexible sigmoidoscopy or colonoscopy

Nursing diagnosis NCP Nursing Care Plan for Irritable Bowel Syndrome

Acute pain
Constipation
Deficient knowledge (diagnosis and treatment)
Diarrhea
Disturbed body image
Ineffective coping

Nursing Key outcomes Nursing Care Plan for Irritable Bowel Syndrome

Nursing outcomes Nursing Care Plan for Irritable Bowel Syndrome, patient will;

Express feelings of comfort.
Patient’s stool will be soft and will pass easily.
Express an understanding of the disease process and treatment regimen.
Bowel function will return to normal.
Express positive feelings about herself.
Demonstrate adaptive coping behaviors.

Nursing interventions NCP Nursing Care Plan for Irritable Bowel Syndrome

Usually Patient isn’t hospitalized; nursing interventions focus on patient teaching and home health care guidance.

Teach to the patient about disease and treatment plan, prescribed drugs, reviewing their desired effects and possible adverse reactions. Diagnostic tests. Review all pretest guidelines. Explain that diagnostic tests can’t specifically diagnose irritable bowel syndrome but do rule out other disorders.
Help the patient to implement lifestyle changes that reduce stress
Remind the patient about regular exercise, Discourage smoking, Explain the need for regular physical examinations

NCP Nursing Care Plan For Nonviral Hepatitis

Lifenurses — Fri, 11 May 2012 14:43:05 +0000

NCP Nursing Care Plans For Nonviral Hepatitis. Hepatitis can be caused by bacteria, by hepatotoxic agents (drugs, alcohol, industrial chemicals), or most commonly, by a virus. In Non viral hepatitis Classified as toxic or drug-induced (idiosyncratic) hepatitis, nonviral hepatitis is an inflammation of the liver. Most patients recover from this illness, although a few develop fulminating hepatitis or cirrhosis

Causes For Nonviral Hepatitis

Alcohol overuse
Direct hepatotoxicity hepatocellular damage and necrosis usually caused by toxins
Cholestatic reactions
Metabolic and autoimmune disorders
Infectious agents

Complications For Nonviral Hepatitis

Complications may include cirrhosis, hepatitis, and liver failure.

Nursing Assessment Nursing Care Plan For Nonviral Hepatitis

Patient history of alcohol use or recent infection. His medication history may include one implicated in causing the disorder, as stated above.

Clinical features of toxic and drug-induced hepatitis vary with the severity of the liver damage and the causative agent. In most patients, symptoms resemble those of viral hepatitis: anorexia, nausea, vomiting, jaundice, dark urine, hepatomegaly, possibly abdominal pain, clay-colored stools, and pruritus with the cholestatic form of hepatitis.

Diagnostic tests For Nonviral Hepatitis

Diagnostic findings include elevations in serum aspartate aminotransferase, alanine aminotransferase, both total and direct bilirubin (with cholestasis), and alkaline phosphatase levels; white blood cell (WBC) count; and eosinophil count (possible in the drug-induced type).

Liver function tests
Liver scan: May be indicated for differential diagnosis, to identify underlying chronic liver disease, or for evaluating organ function.
Liver biopsy: Considered if diagnosis is uncertain or if clinical course is atypical or unduly prolonged.
Urinalysis: Checks the urine for bilirubin for the nonjaundiced client with suspected viral hepatitis.

Nursing diagnosis Nursing Care Plan For Nonviral Hepatitis

Acute pain
Activity intolerance
Anxiety
Deficient knowledge (diagnosis and treatment)
Fear
Imbalanced nutrition: Less than body requirements
Risk for infection
Risk for injury

Nursing Key outcomes NCP Nursing Care Plan For Nonviral Hepatitis

Pain Level Control: Severity of reported or demonstrated pain, Personal actions to control pain, Report pain is relieved/controlled. Demonstrate use of relaxation skills and diversional activities as indicated for individual situation
The patient will perform activities of daily living within the confines of the disease process, Extent of active management of energy to initate and sustain activity.
The patient will identify strategies to reduce anxiety, Personal actions to eliminate or reduce feelings of apprehension and tension from an unidentifiable source.
The patient and family will express an understanding of the disease process and treatment regimen Ability to acquire, organize, and use information. Verbalize understanding of condition/disease process and treatment.
The patient will discuss fears and concerns, Acknowledge and discuss fears, recognizing healthy versus unhealthy fears.
The patient will achieve adequate caloric and nutritional intake, Display normalization of laboratory values and be free of signs of malnutrition.
The patient will remain free from signs and symptoms of infection, patient will Identify interventions to prevent/reduce risk of infection.
The patient will avoid complications, Demonstrate behaviors, lifestyle changes to reduce risk factors and protect self from injury.

Nursing interventions NCP Nursing Care Plan For Nonviral Hepatitis

Pain Management: Alleviation of pain or a reduction in pain to a level of comfort that is acceptable to the patient. Analgesic Administration: Use of pharmacologic agents to reduce or eliminate pain. Environmental Management: Comfort: Manipulation of the patient’s surroundings for promotion of optimal comfort
Activity Therapy: Prescription of and assistance with specific physical, cognitive, social, and spiritual activities to increase the range, frequency, or duration of an individual’s (or group’s) activity. Energy Management: Regulating energy use to treat or prevent fatigue and optimize function. Exercise Promotion: Facilitation of regular physical exercise to maintain or advance to a higher level of fitness and health
Anxiety Reduction: Minimizing apprehension, dread, foreboding, or uneasiness related to an unidentified source or anticipated danger. Calming Technique: Reducing anxiety in patient experiencing acute distress
Teaching Individual about disease, diagnosis and treatment. Learning Facilitation: Promoting the ability to process and comprehend information. Learning Readiness Enhancement: Improving the ability and willingness to receive information.
Anxiety Reduction: Minimizing apprehension, dread, foreboding, or uneasiness related to an unidentified source or anticipated danger. Security Enhancement: Intensifying a patient’s sense of physical and psychological safety. Coping Enhancement: Assisting a patient to adapt to perceived stressors, changes, or threats that interfere with meeting life demands and roles
Nutrition Management: Assisting with or providing a balanced dietary intake of foods and fluids. Weight Gain Assistance: Facilitating gain of body weight
Infection Protection: Prevention and early detection of infection in a patient at risk. Infection Control: Minimizing the acquisition and transmission of infectious agents. Surveillance: Purposeful and ongoing acquisition, interpretation, and synthesis of patient data for clinical decision making
Surveillance: Safety: Purposeful and ongoing collection and analysis of information about the patient and the environment for use in promoting and maintaining patient safety. Analysis of potential risk factors, determination of health risks, and prioritization of risk reduction strategies for an individual or group. Environmental Management Manipulation of the patient’s surroundings for therapeutic benefit

NCP Nursing Care Plan For Colorectal Cancer

Lifenurses — Thu, 10 May 2012 00:17:11 +0000

NCP Nursing Care Plan for Colorectal Cancer, Colorectal cancer accounts for about 15% of all malignancies and for about 11% of cancer mortality in both men and women living in the United States. It is the third most common cause of death from cancer among men and women, combined. Malignant tumors of the colon or rectum are almost always adenocarcinomas. About half of these are sessile lesions of the rectosigmoid area; the rest are polypoid lesions.

Colorectal cancer tends to progress slowly and remains localized for a long time. Consequently, it’s potentially curable in 75% of patients. With early diagnosis, the 5-year survival rate is 50%. It is potentially curable in 75% of patients if an early diagnosis allows resection before nodal involvement

Causes For Colorectal Cancer

The cause of colorectal cancer is largely unknown; however there is much evidence to suggest that incidence increases with age. Risk factors include a family history of colorectal cancer and a personal history of past colorectal cancer, ulcerative colitis, Crohn’s disease, or adenomatous colon polyps. Other factors that magnify the risk of developing colorectal cancer include obesity, diabetes mellitus, alcohol usage, night shift work, and physical inactivity. It has been strongly suggested that diets high in fat and refined carbohydrates play a role in the development of colorectal cancer.

Complications For Colorectal Cancer

As the tumor grows and encroaches on the abdominal organs, abdominal distention and intestinal obstruction occur. Anemia may develop if rectal bleeding isn’t treated

Nursing Assessment Nursing Care Plan For Colorectal Cancer

Signs and symptoms depend on the tumor’s location. If it develops on the colon’s right side, the patient probably won’t have signs and symptoms in the early stages because the stool is still in liquid form in that part of the colon. He may have a history of black, tarry stools, however, and report anemia, abdominal aching, pressure, and dull cramps. As the disease progresses, he may complain of weakness, diarrhea, obstipation, anorexia, weight loss, and vomiting.

Patient History. Seek information about the patient’s usual dietary intake, family history, and the presence of the other major risk factors for colorectal cancer. A change in bowel pattern (diarrhea or constipation) and the presence of blood in the stool are early symptoms and might cause the patient to seek medical attention. Patients may report that the urge to have a bowel movement does not go away with defecation. Cramping, weakness, and fatigue are also reported. As the tumor progresses, symptoms develop that are related to the location of the tumor within the colon. When the tumor is in the right colon, the patient may complain of vague cramping or aching abdominal pain and report symptoms of anorexia, nausea, vomiting, weight loss, and tarrycolored stools. A partial or complete bowel obstruction is often the first manifestation of a tumor in the transverse colon. Tumors in the left colon can cause a feeling of fullness or cramping, constipation or altered bowel habits, acute abdominal pain, bowel obstruction, and bright red bloody stools. In addition, rectal tumors can cause stools to be decreased in caliber, or “pencil-like.” Depending on the tumor size, rectal fullness and a dull, aching perineal or sacral pain may be reported; however, pain is often a late symptom.

Physical Examination. Inspect, auscultate, and palpate the abdomen. Note the presence of any distension, ascites, visible masses, or enlarged veins (a late sign due to portal hypertension and metastatic liver involvement). Bowel sounds may be high-pitched, decreased, or absent in the presence of a bowel obstruction. An abdominal mass may be palpated when tumors of the ascending, transverse, and descending colon have become large. Note the size, location, shape, and tenderness related to any identified mass. Percuss the abdomen to determine the presence of liver enlargement and pain. A rectal tumor can be easily palpated as the physician performs a digital rectal exam.

Diagnostic tests For Colorectal Cancer

Several tests support a diagnosis of colorectal cancer. Digital rectal examination can detect almost 15% of colorectal cancers. Specifically, it can detect suspicious rectal and perianal lesions. Fecal occult blood test can detect blood in stools, a warning sign of rectal cancer.

Digital examination.
Hemoccult test (guaiac).
Proctoscopy or sigmoidoscopy.
Colonoscopy permits visual inspection (and photographs) of the colon up to the ileocecal valve and gives access for polypectomies and biopsies of suspected lesions.
Computed tomography scan.
Barium X-ray. Barium examination should follow endoscopy or excretory urography because the barium sulfate interferes with these tests.
Carcinoembryonic antigen, although not specific or sensitive enough for an early diagnosis, is helpful in monitoring patients before and after treatment to detect metastasis or recurrence.

Nursing diagnosis Nursing Care Plan For Colorectal Cancer

Acute pain
Anxiety
Constipation
Deficient fluid volume
Diarrhea
Fear
Imbalanced nutrition: Less than body requirements
Risk for infection

Nursing Key outcomes Nursing Care plan for Colorectal Cancer

The patient will express that he feels less pain.
The patient will express feeling less anxious.
The patient will have soft, formed stools that are easy to pass.
The patient’s fluid volume will be maintained within normal range.
The patient will resume a regular elimination pattern.
The patient will verbalize fears and concerns relating to his diagnosis and condition.
The patient won’t experience further weight loss.
The patient won’t exhibit signs or symptoms of infection.

Nursing interventions Nursing Care Plan for Colorectal Cancer

Pain Management, Analgesic Administration, Environmental Comfort Management, Alleviation of pain or a reduction in pain to a level of comfort that is acceptable to the patient, Use of pharmacologic agents to reduce or eliminate pain, Manipulation of the patient’s surroundings for promotion of optimal comfort
Anxiety Reduction: Minimizing apprehension, dread, foreboding, or uneasiness related to an unidentified source or anticipated danger. Calming Technique: Reducing anxiety in patient experiencing acute distress.
Constipation/Impaction Management: Prevention and alleviation of constipation/impaction. Bowel Management: Establishment and maintenance of a regular pattern of bowel elimination.
Fluid Management: Promotion of fluid balance and prevention of complications resulting from abnormal or undesired fluid levels. Hypovolemia Management: Reduction in extracellular and/or intracellular fluid volume and prevention of complications in a patient who is fluid overloaded. Shock Management: Volume: Promotion of adequate tissue perfusion for a patient with severely compromised intravascular volume.
Diarrhea Management: Management and alleviation of diarrhea. Fluid Monitoring: Collection and analysis of patient data to regulate fluid balance. Perineal Care: Maintenance of perineal skin integrity and relief of perineal discomfort
Anxiety Reduction: Minimizing apprehension, dread, foreboding, or uneasiness related to an unidentified source or anticipated danger. Security Enhancement: Intensifying a patient’s sense of physical and psychological safety Coping Enhancement: Assisting a patient to adapt to perceived stressors, changes, or threats that interfere with meeting life demands and roles
Nutrition Management: Assisting with or providing a balanced dietary intake of foods and fluids. Weight Gain Assistance: Facilitating gain of body weight
Infection Protection: Prevention and early detection of infection in a patient at risk Infection Control: Minimizing the acquisition and transmission of infectious agents. Surveillance: Purposeful and ongoing acquisition, interpretation, and synthesis of patient data for clinical decision making

NCP Nursing Care Plan for Liver abscess

Lifenurses — Tue, 08 May 2012 03:22:49 +0000

NCP Nursing Care Plan for Liver abscess. Liver abscess is a relatively uncommon but life-threatening disorder that occurs when bacteria or protozoa destroy hepatic tissue. The damage produces a cavity, which fills with infectious organisms, liquefied hepatic cells, and leukocytes. Necrotic tissue then walls off the cavity from the rest of the liver.

A liver abscess occurs when bacteria or protozoa destroy hepatic tissue, producing a cavity, which fills with infectious organisms, liquefied liver cells, and leukocytes. Necrotic tissue then walls off the cavity from the rest of the liver. Liver abscess carries a mortality of 10% to 20%, despite treatment. Liver abscess affects both sexes and all age-groups, although it’s slightly more prevalent in hospitalized children (because of a high rate of immunosuppression) and in females (most commonly those between ages 40 and 60).

Causes for Liver abscess

Underlying causes of liver abscess include benign or malignant biliary obstruction along with cholangitis, extrahepatic abdominal sepsis, and trauma or surgery

Certain illnesses or conditions may also lead to abscess development; these include cholecystitis, colon cancer, diverticulitis, peritonitis, regional enteritis, infective endocarditis, pelvic inflammatory disease, pneumonia, trauma, and septicemia.

Nursing Assessment Nursing Care Plan for Liver abscess

Signs and symptoms of liver abscess depend on the degree of involvement. Some patients are acutely ill; in others, the abscess is recognized only at autopsy, after death from another illness.

With a pyogenic abscess, the onset of symptoms is usually sudden; with an amebic abscess, it’s more insidious. Common signs and symptoms include abdominal pain, weight loss, fever, chills, diaphoresis, nausea, vomiting, and anemia. Symptoms of right pleural effusion, such as dyspnea and pleural pain, develop if the abscess extends through the diaphragm. Liver damage may cause jaundice.

The patient may report right abdominal and shoulder pain, chills, fever, diaphoresis, nausea, vomiting, and weight loss. If the abscess extends through the diaphragm, he may complain of dyspnea and chest pain (symptoms of pleural effusion); if he has developed anemia, he may report fatigue. Inspection may disclose jaundice, a sign of liver damage. On palpation, the liver may feel enlarged, indicating hepatic disease.

Diagnostic Tests For Liver Abscess

Ultrasonography and
Computed tomography scan
Blood cultures and percutaneous liver aspiration, Liver biopsy
Urinalysis
Stool

Nursing diagnosis Nursing Care Plan for Liver abscess

Impaired Liver Function
Acute pain
Deficient knowledge (diagnosis and treatment)
Imbalanced nutrition: Less than body requirements
Risk for impaired skin integrity
Risk for infection

Nursing Key outcomes Nursing Care Plan for Liver abscess

Be free of signs of liver failure as evidenced by liver function studies within normal limits (WNL) and absence of jaundice, hepatic enlargement, or altered mental status
The patient will express feelings of comfort.
The patient and family will express an understanding of the disease process and treatment regimen.
The patient will achieve adequate caloric and nutritional intake.
The patient’s skin integrity will remain intact.
The patient will remain free from signs and symptoms of infection.

Nursing interventions Nursing Care Plan for Liver abscess

Pain Management: Alleviation of pain or a reduction in pain to a level of comfort that is acceptable to the patient. Analgesic Administration: Use of pharmacologic agents to reduce or eliminate pain. Environmental Management: Comfort: Manipulation of the patient’s surroundings for promotion of optimal comfort
Teaching: Individual Planning, implementation, and evaluation of a teaching about Liver abscess. Learning Facilitation: Promoting the ability to process and comprehend information. Learning Readiness Enhancement: Improving the ability and willingness to receive information.
Nutrition Management: Assisting with or providing a balanced dietary intake of foods and fluids. Weight Gain Assistance: Facilitating gain of body weight
Skin Surveillance: Collection and analysis of patient data to maintain skin and mucous membrane integrity. Pressure Management: Minimizing pressure to body parts. Pressure Ulcer Prevention: Prevention of pressure ulcers for a patient at high risk for developing them
Infection Protection, Infection Control, Surveillance: Prevention and early detection of infection in a patient at risk. Minimizing the acquisition and transmission of infectious agents. Purposeful and ongoing acquisition, interpretation, and synthesis of patient data for clinical decision making

NCP Nursing Care Plan for Hydrocephalus

Lifenurses — Fri, 04 May 2012 01:21:16 +0000

NCP Nursing Care Plan for Hydrocephalus. Hydrocephalus is an excessive accumulation of cerebrospinal fluid (CSF) in the ventricular spaces of the brain. Result from obstruction in CSF flow (noncommunicating hydrocephalus) or from faulty absorption of CSF (communicating hydrocephalus). It’s most common in neonates but can also occur in adults as a result of injury or disease. In infants, hydrocephalus enlarges the head; in both infants and adults, resulting compression can damage brain tissue. With early detection and surgical intervention, the prognosis improves but remains guarded. Even after surgery, such complications as developmental delay, impaired motor function, and vision loss can persist. Without surgery, the prognosis is poor: Mortality may result from increased intracranial pressure (ICP) in people of all ages; infants may also die prematurely of infection and malnutrition.

Characteristics of hydrocephalus in infants, changes characteristic of hydrocephalus include marked enlargement of the head; distended scalp veins; thin, shiny, and fragile-looking scalp skin; and underdeveloped neck muscles.

Causes for Hydrocephalus

Hydrocephalus may result from an obstruction in CSF flow (noncommunicating hydrocephalus) or from faulty absorption of CSF (communicating hydrocephalus). In noncommunicating hydrocephalus, the obstruction occurs most frequently between the third and fourth ventricles and at the aqueduct of Sylvius. It can also occur at the outlets of the fourth ventricle (foramina of Luschka and Magendie) or, rarely, at the foramen of Monro. This obstruction may result from faulty fetal development (myelomeningocele, congenital arachnoid cysts), infection (syphilis, granulomatous diseases, meningitis), tumor, cerebral aneurysm, or a blood clot. In communicating hydrocephalus, faulty reabsorption of CSF may result from surgery to repair a myelomeningocele, adhesions between meninges at the base of the brain, or meningeal hemorrhage.

Complications for Hydrocephalus

Potential complications of hydrocephalus include:

Mental retardation,
Impaired motor function, and vision loss.
Death may result from increased intracranial pressure (ICP) in people of all ages
In infants may also die of infection and malnutrition.

Nursing Assessment Nursing Care Plan for Hydrocephalus

The patient’s history may reveal the cause of hydrocephalus, infection (syphilis, granulomatous diseases, meningitis), tumor, cerebral aneurysm, In severe hydrocephalus, the infant’s parents may report irritability, anorexia, episodes of projectile vomiting, and a high-pitched, shrill cry. Inspection may reveal depression of the roof of the eye orbit, displacement of the eyes downward, and prominent sclera (sunset sign).

Physical examination: a focus area of the head

Inspection In an infant may reveal an enlarged head that is clearly disproportionate to the infant’s growth, an unmistakable sign of hydrocephalus. Neurologic examination may demonstrate abnormal muscle tone of the legs.

In adults and older children with a fused cranium, the patient history may uncover signs of increased ICP, including frontal headaches, nausea, and vomiting that may be projectile. If the patient or parents report that these symptoms cause wakening or occur on awakening, hydrocephalus should be suspected. The patient may also report diplopia and restlessness. Neurologic examination may detect a decreased level of consciousness, ataxia, and impaired intellect. Neurologic impairment may also cause incontinence.

Diagnostic tests for Hydrocephalus

Skull X-ray.
Angiography,
Computed tomography scanning, and magnetic resonance imaging

Nursing diagnosis Nursing Care Plan for Hydrocephalus

Common nursing diagnosis found in Nursing Care Plan for Hydrocephalus

Acute pain
Anxiety
Delayed growth and development
Imbalanced nutrition: Less than body requirements
Impaired gas exchange
Ineffective tissue perfusion: Cerebral.
Interrupted family processes.
Infant Behavior, risk for disorganized.
Risk for infection

Nursing Key outcomes Nursing Care Plan for Hydrocephalus

The patient will exhibit no signs of pain or agitation.
Family members will identify measures to reduce anxiety.
The patient will achieve age-appropriate growth, behaviors, and skills to the fullest extent possible.
The patient will show no signs of malnutrition.
The patient will maintain adequate ventilation and oxygenation.
The patient will maintain and improve current level of consciousness (LOC).
Family members will verbalize the effect of the patient’s condition on their daily life.
The patient will remain free from signs of seizure activity.
The patient will remain free from signs and symptoms of infection.

Nursing Interventions Nursing Care Plan for Hydrocephalus

Pain Management, Analgesic Administration, Environmental Management: Alleviation of pain or a reduction in pain to a level of comfort that is acceptable to the patient: Use of pharmacologic agents to reduce or eliminate pain: Comfort: Manipulation of the patient’s surroundings for promotion of optimal comfort
Anxiety Reduction: Minimizing apprehension, dread, foreboding, or uneasiness related to an unidentified source or anticipated danger, Calming Technique: Reducing anxiety in patient experiencing acute distress
Developmental Enhancement, Nutritional Monitoring, Developmental Care: Child/Adolescent Facilitating or teaching parents/caregivers to facilitate the optimal gross motor, fine motor, language, cognitive, social, and emotional growth of preschool and school-age children/of individuals during the transition from childhood to adulthood; Collection and analysis of patient data to prevent or minimize malnourishment; Structuring the environment and providing care in response to the behavioral cues and states of the preterm infant
Nutrition Management: Assisting with or providing a balanced dietary intake of foods and fluids; Weight Gain Assistance: Facilitating gain of body weight
Respiratory Monitoring, Oxygen Therapy, Airway Management; Collection and analysis of patient data to ensure airway patency and adequate gas exchange; Administration of oxygen and monitoring of Facilitation of patency of air passages
Cerebral Perfusion Promotion of adequate perfusion and limitation of complications for a patient experiencing or at risk for inadequate cerebral perfusion
Family Process Maintenance, Family Integrity Promotion, Normalization Promotion: Minimization of family process disruption effects, Facilitating family participation in the emotional and physical care of the patient, Assisting parents and other family members of children with chronic diseases or disabilities in providing normal life experiences for their children and families
Developmental Care: Structuring the environment and providing care in response to the behavioral cues and states of the preterm infant. Environmental Management: Manipulation of the patient’s surroundings for therapeutic benefit
Infection Protection, Infection Control, Surveillance: Prevention and early detection of infection in a patient at risk, Minimizing the acquisition and transmission of infectious agents, Purposeful and ongoing acquisition, interpretation, and synthesis of patient data for clinical decision making

NCP Nursing Care Plan For Hepatitis B

Lifenurses — Tue, 01 May 2012 01:20:51 +0000

Image Courtesy Of chop.edu

Hepatitis B is irritation and swelling (inflammation) of the liver due to infection with the hepatitis B virus (HBV).Other types of viral hepatitis include:

Hepatitis A
Hepatitis C
Hepatitis D

Causes, Incidence, And Risk Factors for Hepatitis B

Hepatitis B infection can be spread through having contact with the blood, semen, vaginal fluids, and other body fluids of someone who already has a hepatitis B infection.Infection can be spread through:

Blood transfusions (not common in the United States)
Direct contact with blood in health care settings
Sexual contact with an infected person
Tattoo or acupuncture with unclean needles or instruments
Shared needles during drug use
Shared personal items (such as toothbrushes, razors, and nail clippers) with an infected person.

The hepatitis B virus can be passed to an infant during childbirth if the mother is infected.

Risk factors for hepatitis B infection include:

Being born, or having parents who were born in regions with high infection rates (including Asia, Africa, and the Caribbean)
Being infected with HIV
Being on hemodialysis
Having multiple sex partners
Men having sex with men

Most of the damage from the hepatitis B virus occurs because of the way the body responds to the infection. When the body’s immune system detects the infection, it sends out special cells to fight it off. However, these disease-fighting cells can lead to liver inflammation.

Complications for Hepatitis Bhere is a much higher rate of hepatocellular carcinoma in people who have chronic hepatitis B than in the general population.

Other complications may include:

Chronic persistent hepatitis
Cirrhosis
Fulminant hepatitis, which can lead to liver failure and possibly death

Nursing Assessment NCP Nursing Care Plan for Hepatitis B

Patient history. Question the patient about potential sources of transmission and risks: a history of blood dyscrasias, multiple blood or blood product transfusions, alcohol or drug abuse (sharing of needles), exposure to hepatotoxic chemicals or medications, and travel to third world countries or areas where the sanitation is poor. Since HAV transmission occurs in association with daycare centers, among male homosexuals, and among household contacts of persons with acute cases, inquire into these areas. Also ask about recent meals, because hepatitis A occasionally occurs from contaminated food or improper sewage treatment. Determine the patient’s occupation; teratogen exposure may cause a nonviral hepatitis.

Diagnostic tests for Viral hepatitis

Antibody to HBsAg (Anti-HBs) — a positive result means you have either had hepatitis B in the past, or have received a hepatitis B vaccine
Antibody to hepatitis B core antigen (Anti-HBc) — a positive result means you had a recent infection or an infection in the past
Hepatitis B surface antigen (HBsAg) — a positive result means you have an active infection
Hepatitis E surface antigen (HBeAg) — a positive result means you have a hepatitis B infection and are more likely to spread the infection to others through sexual contact or sharing needles

Nursing diagnosis NCP Nursing Care Plan for Hepatitis B

• Activity intolerance

• Anxiety

• Deficient knowledge (diagnosis and treatment)

• Fear

• Imbalanced nutrition: Less than body requirements

• Risk for infection

• Risk for injury

Nursing Key outcomes NCP Nursing Care Plan for Hepatitis B

The patient will perform activities of daily living within the confines of the disease process, Extent of active management of energy to initiate and sustain activity.
The patient will identify strategies to reduce anxiety, Personal actions to eliminate or reduce feelings of apprehension and tension from an unidentifiable source.
The patient and family will express an understanding of the disease process and treatment regimen Ability to acquire, organize, and use information. Verbalize understanding of condition/disease process and treatment.
The patient will discuss fears and concerns, Acknowledge and discuss fears, recognizing healthy versus unhealthy fears.
The patient will achieve adequate caloric and nutritional intake, Display normalization of laboratory values and be free of signs of malnutrition.
The patient will remain free from signs and symptoms of infection, patient will Identify interventions to prevent/reduce risk of infection.
The patient will avoid complications, Demonstrate behaviors, lifestyle changes to reduce risk factors and protect self from injury.

Nursing interventions NCP Nursing Care Plan for Hepatitis B

Activity Therapy: Prescription of and assistance with specific physical, cognitive, social, and spiritual activities to increase the range, frequency, or duration of an individual’s (or group’s) activity. Energy Management: Regulating energy use to treat or prevent fatigue and optimize function. Exercise Promotion: Facilitation of regular physical exercise to maintain or advance to a higher level of fitness and health
Anxiety Reduction: Minimizing apprehension, dread, foreboding, or uneasiness related to an unidentified source or anticipated danger. Calming Technique: Reducing anxiety in patient experiencing acute distress
Teaching Individual about disease, diagnosis and treatment. Learning Facilitation: Promoting the ability to process and comprehend information. Learning Readiness Enhancement: Improving the ability and willingness to receive information.
Anxiety Reduction: Minimizing apprehension, dread, foreboding, or uneasiness related to an unidentified source or anticipated danger. Security Enhancement: Intensifying a patient’s sense of physical and psychological safety. Coping Enhancement: Assisting a patient to adapt to perceived stressors, changes, or threats that interfere with meeting life demands and roles
Nutrition Management: Assisting with or providing a balanced dietary intake of foods and fluids. Weight Gain Assistance: Facilitating gain of body weight
Infection Protection: Prevention and early detection of infection in a patient at risk. Infection Control: Minimizing the acquisition and transmission of infectious agents. Surveillance: Purposeful and ongoing acquisition, interpretation, and synthesis of patient data for clinical decision making
Surveillance: Safety: Purposeful and ongoing collection and analysis of information about the patient and the environment for use in promoting and maintaining patient safety. Analysis of potential risk factors, determination of health risks, and prioritization of risk reduction strategies for an individual or group. Environmental Management Manipulation of the patient’s surroundings for therapeutic benefit