Activity Intolerance - Hypertension Nursing Interventions

Nursing Care Plan fro Hypertension

Nursing Diagnosis for Hypertension : Activity Intolerance related to general weakness, imbalance between supply and oxygen demand.

Purpose:

Having given nursing care are expected to perform activities that are tolerated.

Expected outcomes:
  • clients participate in activities desired / required.
  • reported an increase in tolerance activity can be measured.
  • showed a decrease in physiological signs of intolerance.

Nursing Intervention:

1. Assess the client's response to the activity, attention pulse rate more than 20 times per minute in the frequency of breaks; significant increase in BP during / after activity, dyspnea, chest pain; excessive fatigue and weakness; diaphoresis; dizziness or fainting.

2. Instruct patients about energy saving techniques, eg, using the bath seat, sitting as combing hair or brushing teeth, doing activities slowly.

3. Encourage activity / self-care gradually if tolerated. Provide assistance as needed.

Rational:

1. Mention parameter helps in assessing response to stress physiology and activity when there is an indicator of excess work-related activity levels.

2. Energy saving technique reduces energy reduction also helps balance between supply and oxygen demand.

3. Progress activity increased gradually to prevent sudden cardiac work, provide only limited assistance needs will encourage independence in their daily activities.

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The Impact of Menopause for Health


The Impact of Menopause for Health

One of the important problems in the elderly are older reproductive health. Reproductive problems in the elderly, especially in a woman is perceived as fertility period ends (menopause), despite the fact that a man will also face the same thing that has decreased reproductive function (andropause) although in this case it happened older than a woman .

In the discussion of reproductive health of older times more likely to focus on the problems of menopause in women.

Definition of Menopause

Menopause is a condition where a woman stops menstruating (menopause). Diagnosis of menopause is when a woman has not menstruated for at least 1 year.

Before menopause occurs, it first entered the climacterium. Climacterium is a period of 4-5 years before menopause where a woman begins to feel the changes that the symptoms are not the same to everyone.

Menopause is closely related to menarche (first menstruation in women). In the circumstances the earlier occurrence of menarche occurs, the slower the rise and vice versa menopause menarche occurs more slowly accelerated menopause arise.

Menopause is not the same in every person affected by several factors:
  • descent
  • general health
  • habits

The Impact of Menopause for Health

Short-term effects:
  • Hot flush the chest burning sensation that radiates to the face often occur at night
  • Psychological disorders: depression, irritability, irritability, lack of confidence, sexsual arousal disorder, change in behavior.
  • Eye disorders: dry and itchy eyes due to decreased tear production.
  • Urinary tract and genitals: simple infections, painful intercourse, bleeding after sexual intercourse due to atrophy of the genitals.

Long-term effects:
  • Osteoporosis is loss of bone density in women due to a lack of estrogen so that bones become brittle and easily broken.
  • Coronary heart disease: Decreased estrogen can lower levels of good cholesterol and increase bad cholesterol levels that increase the incidence of coronary heart disease in women.
  • Dementia (Alzheimer's type Dementia): estrogen deficiency affects the central nervous system / brain, causing difficulty concentrating, memory loss on short-term events.

How to deal with sexual problems at menopause
  • Maintaining health in general, both physically and psychologically, for example by doing regular exercise.
  • Fostering a previous sexual life that takes place in harmony.
  • Realize and accept menopause as part of our life.
  • Do not use drugs or chemicals intended to improve sexual function without a clear indication and without the guidance of a health professional or doctor.
  • Need to do both behavioral and mood variation in sexual intercourse so it does not get bored.
  • Maintain good communication with his wife, including sexual problems.
  • Immediately consult with experts when experiencing sexual problems to immediately get proper treatment.

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Physical and Psychic Changes In The Menopause

Physical and Psychic Changes In The Menopause

Physical Changes In The Menopause

Due to the cessation of menstruation, various reproductive organs will be amended. Uterus having anthropic, penile length, and wall thinning. Myometrial tissue (uterine muscle) becomes less and contains more fibrotic tissue (fibrous nature of the excess). Neck of the womb (cervix) to shrink, not protruding into the vagina, even after a long time will be evenly distributed to the vaginal wall.

The folds of the oviduct becomes shorter, thinner, and puckered. Hair shakes that existed at the end of the fallopian tubes or fimbria disappear.

Due to changes in the reproductive organs and the body's hormones during menopause affects various physical state of a woman's body. This state of discomfort in the form of complaints that arise in everyday life.

Physical Changes In The Menopause :


1) Hot flushes

It is an incredible burning sensation on the face and upper body (such as the neck and chest). By touching hands will feel an increase in temperature in the area. Hot flushes occur due to the sensitive tissues or that depend on estrogen to be affected when estrogen levels decline. Radiant heat is thought to be a result of the influence of hormones in the brain that is responsible for regulating body temperature.

2) Excessive Sweat

How it works exactly is not known, but the radiant heat in the body due to the influence of the hormones that regulate the body's thermostat at a lower temperature. As a result, the air temperature felt comfortable initially, suddenly became too hot and the body starts to heat and sweat to cool itself. In addition, the life of a woman, vaginal tissues become thinner and reduced humidity as estrogen levels decline. Other symptoms experienced by women are sweating at night.

3) Dry Vagina

Changes in the reproductive organs, such as the vaginal area which can cause pain during intercourse. In addition, due to lack of estrogen causes vaginal epithelial disruption complaints, supporting tissue and the elasticity of the vaginal wall. In fact, vaginal epithelium contains many estrogen receptors which help reduce pain in intercourse.

4) Unable to hold urine

As age increases, urine is often not arrested at the time of sneezing and coughing. This is due to decreased estrogen so any impact is urinary incontinence (unable to control bladder function). Keep in mind, the walls and the female urethral smooth muscle layer also contains many estrogen receptors. Estrogen deficiency leads to impaired urethral closure and the changing patterns of abnormal flow of urine becomes so easy to avoid infection in the lower urinary tract.

5) The loss of supporting tissue

Low levels of estrogen in the body affects the collagen tissue that serves as the supporting tissue of the body. The loss of collagen causes dry skin and wrinkles, hair split apart, falling out, teeth easily shake and bleeding gums, canker sores, broken nails, and the onset of pain and soreness in the joints.

6) Weight gain

When she started at the age of 40, his body is usually easy to be fat, but otherwise very difficult to lose weight. According to the study, each of the past 10 years, will increase weight or body gradually widens laterally. This is apparently something to do with the decline in estrogen and Substance exchange disorders of fat metabolism.

7) Eye Disorders

Lack and loss of estrogen production affects tear glands so that eyes feel dry and itchy.

8) bone and joint pain

Along with the increasing age of the organ no longer hold some remodeling, including bone. Fact, undergo a process of decline due to the effect of changes in other organs. In addition, with increasing age diseases arising increasingly diverse. This is of course related to women's fitness and health.


Psychic Changes In The Menopause :


In addition to the physical, psychological changes also affect the quality of life of a woman in undergoing the menopause. Indeed, psychological changes during the menopause greatly depends on each individual. The effect is highly dependent on the views of each woman's menopause. Enough knowledge will help them understand and prepare himself through this period better.

Psychic Changes In The Menopause :

1. Psychological changes that appear

In women pramenoupose emerging concerns, caused by physical and hormonal changes, which resulted in the sensitive emotions. On the basis of emotion towards activities are divided into four types, namely: fear, anger, love and depression.

2. Range of emotions resulting from psychic change woman in the face menopause:
  • Angry, frustrated people to move against the source.
  • Anxiety, the move left the source of frustration.
  • Depression, people stop opening responses and emotions turned into his own

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10 Basic Principles of Nursing Management


Basic Principles of Nursing Management - In the world of nursing course, the implementation of nursing management is one of the main things that affect all of the nursing process. And nursing actions and all things related to nursing can not be separated from these nursing management. This time of Nursing blog will try to share a little about the management of nursing and hopefully useful and can provide benefits.

The process in accordance with the nursing management of open systems approach in which each of the components are interrelated and interact and be influenced by the environment. Because it is a system that will consist of five elements of input, process, output, control and feedback mechanisms.

Input from the nursing management among other information, personnel, equipment and facilities. The process in nursing management is the manager of the highest level of nursing management to implementing nurse have a duty and authority for planning, organizing, directing and monitoring the implementation of the nursing service. Output is nursing care, staff development and research.

Controls used in the budget process, including nursing management of the nursing, nursing job performance evaluations, standards and accreditation procedures. Feedback mechanism in the form of financial statements, audit of nursing, quality control and performance survey of nurses.

The principles underlying nursing management are:

1. Nursing management should be based on planning because through the planning, leaders can reduce the risk of decision-making, effective problem solving and planning.

2. Nursing management implemented through effective use of time. Nursing managers who appreciate the time will develop a well-rounded program planning and implementing activities in accordance with a pre-determined time.

3. Nursing management will involve decision making. Various situations and problems that occur in the management of nursing activities require decision making at various managerial levels.

4. Meet the nursing care needs of patients is the focus of attention of the nurse manager to consider what the patient saw, thought, believe and desire. Patient satisfaction is the main point of the whole purpose of nursing.

5. Nursing management should be organized. Organizing conducted in accordance with the needs of the organization to achieve goals.

6. The briefing is an element of nursing management activities covering the delegation, supervision, coordination and control of the implementation of the plans that have been organized.

7. Good nursing division motivate employees to demonstrate a good working performance.

8. Nursing management using effective communication. Effective communication will reduce misunderstandings and provide shared vision, direction and understanding among employees.

9. Staff development is important to be implemented as a preparatory effort implementing nurses occupy a higher position or manager attempts to improve employee knowledge.

10. Control is an element of nursing management that includes an assessment of the implementation of the plan has been created, providing instruction and establish principles - principles through standard-setting, comparing performance with standards and correct deficiencies.

Leadership in Nursing

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Nursing Care Plan for Pneumonia with Diagnosis Interventions

3 Nursing Diagnosis for Pneumonia

Nursing Care Plan for Pneumonia


Definition

Pneumonia is a breathing (respiratory) condition in which there is an infection of the lung.


Causes

Pneumonia caused by bacteria tends to be the most serious kind. In adults, bacteria are the most common cause of pneumonia.
  • The most common pneumonia-causing germ in adults is Streptococcus pneumoniae (pneumococcus).
  • Atypical pneumonia, often called walking pneumonia, is caused by certain other bacteria.
  • Pneumocystis jiroveci pneumonia is sometimes seen in people whose immune system is not working well.

Many other bacteria can also cause pneumonia.

Viruses are also a common cause of pneumonia, especially in infants and young children.


Signs and Symptoms

Symptoms of pneumonia caused by bacteria usually come on quickly. They may include:
  • Cough.
  • Fever.
  • Fast breathing and feeling short of breath.
  • Shaking and "teeth-chattering" chills. You may have this only one time or many times.
  • Chest pain that often feels worse when you cough or breathe in.
  • Fast heartbeat.
  • Feeling very tired or feeling very weak.
  • Nausea and vomiting.
  • Diarrhea.

Pathogenesis

Pathogenesis of pneumonia include interactions between microorganisms (MO) causes that go through various avenues, with patient endurance. Germs reach the alveoli by inhalation, aspiration of oropharyngeal bacteria, hematogenous spread from another focus of infection, or direct spread from the site of infection. At the lower respiratory tract, the bacteria encounter in the form of immune defense system mukosilier, cellular resistance alveolar macrophages, bronchial lymphocytes and neutrophils. Also humoral immune IgA and IgG from bronchial secretions.
The occurrence of pneumonia depends on the virulence of MO, the ease and extent of endurance.




Assessment - Nursing Care Plan for Pneumonia


A. Subjective Data
  • Sudden onset of fever accompanied by convulsions
  • Clients complained weak
  • Shortness of breath
  • Complaining tired when on the move
  • Insomnia
  • Coughing up phlegm
  • Nausea, vomiting, no appetite
  • Sometimes diarrhea
  • Weight loss

B. Objective Data
  • Cyanosis of the mouth and nose
  • Dry skin with poor turgor
  • Clients look tired
  • Breathing fast (tachypnea) and shallow accompanied nostril
  • Dyspnoea, bronchial breath sounds, crackles.
  • Breathing using accessory muscles
  • Dullness found in percussion
  • Awareness of decreased / lethargy
  • Communication substandard
  • Orientation to person, place and time poor
  • Laboratory results: leukocytosis, increased erythrocyte sedimentation rate, abnormal blood gas analysis
  • Photos chest: there are patches lobe infiltrates.


Nursing Diagnosis for Pneumonia


1.Ineffective Airway Clearance related to inflammation, the accumulation of secretions,
characterized by:
  • Tachypnea / rapid breathing, shallow accompanied nostrils.
  • Bronchial breath sounds, crackles wet, accessory muscle use.
  • Dyspnoea, cyanosis
  • Cough with sputum production.

2.Impaired Gas Exchange related to alveolar capillary membrane changes
characterized by:
  • Dyspnea, cyanosis
  • Tachycardia
  • Restless

3.Imbalanced Nutrition Less Than Body Requirements related to the lack of oral intake
characterized by:
  • Decreased appetite
  • Weight loss: weakness, decreased muscle tone

4. Hyperthermia related to inflammatory processes
characterized by:
  • Increased body temperature


Outcome :

1. Effective airway,
with the following criteria:
  • Adequate ventilation
  • No buildup

2. Optimal gas exchange, adequate oxygenation to the tissue,
with the following criteria:
  • No dyspnoea
  • No cyanosis

3. Clients can meet the needs adequate nutrition,
with the following criteria:
  • Increased appetite
  • Maintain / increase weight

4. No fever
with the following criteria:
  • Body temperature fell within normal limits


Nursing Interventions for Pneumonia

Ineffective Airway Clearance

Independent:

Assess the frequency / depth of breathing and chest movement
R :/ takipneu, shallow breathing, and asymmetrical chest movements often occur because of discomfort or movement of the chest wall and lung fluid.

Help patients breathing exercises frequently. Show / aids patients studied did cough, such as chest presses and effective cough while sitting high
R :/ Breath in facilitating the maximum expansion of the lung / airway smaller. Coughing is a natural cleaning mechanism of airway / help the cilia to maintain a patent airway. Emphasis lower chest discomfort and breathing effort seating position allows deeper and more powerful.

Exploitation as indicated
R :/ Stimulate cough or mechanical airway clearance in patients who are unable to perform because of ineffective cough or a decreased level of consciousness.

Give fluids at least 2500 ml / day (unless contraindicated). Offer warm water rather than cold.
R :/ liquids (especially warm) mobilize and remove secretions.

Collaboration

Assist to monitor the effects of treatment and physiotherapy another nebuliser. For example, an incentive spirometer, blowing bottles, percussion, postural drainage. Take action in between meals and limit fluids when possible.
R :/ Facilitate dilution and removal of secretions. Postural drainage is not effective in causing interstitial pneumonia or alveolar exudate or damage. Coordination of treatment / schedule and oral input vomit degrade because of cough, sputum spending.

Give medications as indicated: mucolytics, expectorants, bronchodilators, analgesic
R :/ equipment for lowering the mobilization of secretions bronchospasm. Analgesics are given to improve the cough by decreasing discomfort but should be used with caution, because it can reduce the effort cough / depress respiration.


7 Nursing Diagnosis Care Plan for Pneumonia

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Hyperthermia - Nursing Diagnosis Interventions for Meningitis

Nursing Care Plan Hyperthermia - Diagnosis Interventions for Meningitis


Hyperthermia Definition: The body temperature rises above the normal range.

Characteristics :
  • Increase in body temperature above the normal range
  • Attacks or convulsions (seizures)
  • Skin redness
  • Increase respiratory rate
  • Tachycardia
  • Hands felt warm to the touch

Meningitis means swelling of the lining around the brain and spinal cord. Septicaemia is blood poisoning caused by the same germs. Meningitis and septicaemia can occur together or separately. Symptoms can appear in any order, but the first symptoms are usually fever, vomiting, headache and feeling unwell, just like many mild illnesses


Nursing Diagnosis for Meningitis : Hyperthermia related to the infection process

Expected outcomes:
  • Normal body temperature is 36.5 to 37, 5o C.
  • Normal vital signs.
  • Good skin turgor.
  • Expenditures are not concentrated urine, electrolytes within normal limits.


Nursing Intervensi Hyperthermia - Nursing Care Plan for Meningitis :


1. Monitor the temperature every 2 hours.
R /: Knowing the temperature of the body.

2. Monitor vital signs.
R /: Effect of temperature increase is a change in pulse, respiration and blood pressure.

3. Monitor for signs of dehydration.
R /: The body can lose water through the skin and evaporation.

4. Give anti pyrexia.
R /: Reduce body temperature.

5. Give the drink a pretty 2000 cc / day.
R /: Prevent dehydration.

6. Perform a cold compress and warm.
R /: Reduce body temperature through conduction.

7. Monitor signs of seizures.
R /: hot body temperature risk for a seizure.

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Impaired Physical Mobility - Nursing Care Plan for Meningitis

Nursing Interventions for Meningitis - Impaired Physical Mobility

Nursing Care Plan for Meningitis - Impaired Physical Mobility

Meningitis is an inflammation of the membranes that cover the brain and spinal cord. Symptoms of meningitis are fever, headache, and stiff neck. Meningitis can be caused by a variety of things, including bacteria (the most serious cases), viruses, fungi, reactions to medications, and environmental toxins such as heavy metals. Cerebrospinal fluid can be tested to determine the type of meningitis causing the symptoms. Such identification is important in selecting effective antibiotics for treating bacterial meningitis cases.

In other patients, the symptoms can be severe and begin suddenly with fever, headache and stiff neck accompanied by some combination of other symptoms: decreased appetite, nausea, vomiting, sensitivity to bright light, confusion and sleepiness.

Impaired Physical Mobility - Nursing Care Plan for Meningitis

Impaired Physical Mobility related to general weakness, neurologic deficit.

Characterized by:
  • Patients said weakly.
  • Paralysis, parese, hemiplegia, tremor.
  • Less muscle strength.
  • Contractures, atrophy.

Expected outcomes:
  • Patients can maintain an optimal mobilization.
  • Skin integrity intact.
  • Did not happen atrophy.
  • Did not happen contractures.

Intervention:
1. Assess the ability to mobilize.
R /: Hemiparese may occur.

2. Instead of positioning the patient every 2 hours.
R /: Avoid skin damage.

3. Perform masage depressed parts of the body.
R /: Smooth flow of blood and prevent pressure sores.

4. Perform passive ROM.
R /: Avoiding contractures and atrophy.

5. Monitor thromboembolism, constipation.
R /: Complications of immobility.

6. Consul at physiotherapist if necessary.
R /: Planning more important.

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10 Nursing Diagnosis for Guillain-Barre Syndrome

Nursing Care Plan for Guillain-Barre Syndrome : 10 Nursing Diagnosis 


Guillain-Barre Syndrome is a problem with nervous system. It is a serious disorder that occurs when the body's defense (immune) system mistakenly attacks part of the nervous system. It causes muscle weakness, loss of reflexes, and numbness or tingling in your arms, legs, face, and other parts of your body. Exactly what triggers Guillain-Barre syndrome is unknown. The syndrome may occur at any age, but is most common in people of both sexes between ages 30 and 50.

Guillain-Barre syndrome may occur along with viral infections such as:
  • AIDS
  • Herpes simplex
  • Mononucleosis

Symptoms of GBS include:
  • Numbness or tingling in your hands and feet and sometimes around the mouth and lips.
  • Muscle weakness in legs and arms and the sides of your face.
  • Trouble speaking, chewing, and swallowing.
  • Not being able to move your eyes.
  • Back pain.

Emergency symptoms :
  • Breathing temporarily stops
  • Can't take a deep breath
  • Difficulty breathing
  • Difficulty swallowing
  • Drooling
  • Fainting
  • Feeling light-headed when standing

Symptoms usually start with numbness or tingling in the fingers and toes. Over several days, muscle weakness in the legs and arms develops. After about 4 weeks, most people begin to get better.

Nursing Care Plan for Guillain-Barre Syndrome



10 Nursing Diagnosis for Guillain-Barre Syndrome

1. Ineffective Breathing Pattern, Ineffective Airway Clearance, Impaired Gas Exchange related to respiratory muscle weakness or paralysis, decreased cough reflex, immobilization.

Characterized by:

Subjective Data:
  • The patient said it was hard to breathe.
  • Families of patients said that patients experienced loss of consciousness.

Objective Data:
  • Patients seen trouble breathing.
  • Decreased breath sounds.
  • Changes in the value of blood gas analysis.
  • Changes in skin color (pale)
  • Loss of consciousness.
  • Changes in respiratory rate, shortness of breath.
  • Accumulation of secretions.

2. Impaired Physical Mobility related to paralysis, ataxia.

Characterized by:

Subjective Data:
  • Patients say weakness and paresthesia.

Objective Data:
  • The inability to perform the activity.
  • Muscle weakness spreads upward.
  • Decreased muscle strength.
  • Atrophy.
  • Sensory loss.
  • The loss of tendon reflexes.

3. Risk for Impaired Skin Integrity: pressure sores related to muscle weakness, paralysis, impaired sensation, changes in nutrition, incontinence.

Characterized by:

Subjective Data:
  • Patients say weakness and paresthesia.

Objective Data:
  • The inability to perform the activity.
  • Muscle weakness spreads upward.
  • Decreased muscle strength.
  • Atrophy.
  • Sensory loss.
  • The loss of tendon reflexes.
  • Changes in nutrition.
  • Incontinence.

4. Imbalanced Nutrition, Less Than Body Requirements related to difficulty chewing, swallowing, fatigue, limb paralysis.

Characterized by:

Subjective Data:
  • The patient stated, can not chew and swallow.
  • Patients say, the hand can not be moved.

Objective Data:
  • The inability to perform the activity.
  • Patients using the NGT.
  • Diet food, nutritional value.
  • Weight loss.
  • Albumin and hemoglobin values​​.
  • Signs of malnutrition.
  • The presence of nausea.
  • Intake of the food intake is not in proportion.


5. Impaired Elimination: constipation, diarrhea, related to inadequate food intake, immobilization.

Characterized by:

Subjective Data:
  • Patients said they could not defecate or diarrhea.

Objective Data:
  • The inability to perform activities / lack of mobilization.
  • Muscle weakness spreads upward.
  • Decreased muscle strength.
  • The pattern of bowel movements in the house.
  • Increased or decreased bowel sounds.
  • Low-fiber diet.
  • Hard or liquid stool.

6. Impaired Verbal Communication related to the VII cranial nerve paralysis, tracheostomy.

Characterized by:

Subjective Data:
  • Families of patients said that patients have problems in speaking.

Objective Data:
  • Difficulties in communication.
  • The use of sign language.
  • Facial nerve paralysis.
  • The existence of tracheostomy.

7. Ineffective Coping related to the patient's disease state.

Subjective Data:
  • Families of patients said that patients have difficulty sleeping.

Objective Data:
  • Apathy.
  • Sensitive.
  • withdraw

8. Knowledge Deficit: patients / families related to disease, treatment, prognosis and treatment.

Characterized by:

Subjective Data:
  • Patient / family said they did not know the disease.

Objective Data:
  • Patient / family was not cooperative in patient care.
  • Patient / family inquire about his illness.

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Role and Function of Nursing Home Care

Nursing Home Care - Role and Function

Home Care (HC)

Home health services are nursing services provided to patients in the home, which is synthesized from community nursing services and specific technical skills that come from certain health specialties, the individual-focused nursing care, involving family, with the goal of healing, maintain and improve health physical, mental / emotional patients.

Home Care (HC) by Habbs and Perrin, 1985 is a health services performed at the patient's home (Lerman D. & Eric B.L, 1993) so that home care nursing services in a nursing home patient who has gone through a long history.

Rice. R, (2001) identify the types of cases that can be served in the home care program that covers common cases of post-treatment in hospitals and clinics special cases and are usually found in the community. Common case is the post-treatment in hospital are:
  1. Clients with COPD
  2. Clients with heart failure
  3. Clients with impaired oxygenation
  4. Clients with chronic injury suffered
  5. Clients with diabetes
  6. Clients with urinary dysfunction
  7. Clients with medical conditions of recovery (rehabilitation)
  8. Clients with home infusion therapy
  9. Clients with impaired function persyarafan
  10. Clients with AIDS

While cases with special conditions, include:
  1. Clients with post partum
  2. Clients with mental health disorders
  3. Clients with conditions of old age
  4. Clients with terminal condition (Hospice and Palliative care)
(Rice R, 2001., Allender & Spradley, 2001)

1. Case manager: manage and collaborate on services, with the function:
  • Identifying the needs of patients and families
  • Service plan
  • Coordinate the activities of the team
  • Monitor the quality of service

2. Implementing provide direct services and evaluate the service with the function:
  • Conduct a comprehensive assessment
  • Nursing plan
  • Nursing action
  • Observe the patient's condition
  • Assist patients in developing effective coping behavior
  • Involve families in service
  • Guiding all family members in health maintenance
  • To evaluate the nursing care
  • Documenting nursing care.

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Deep Breathing and Effective Cough

Deep Breathing and Effective Cough Exercise

Deep Breathing and Effective Cough

The Concept of Deep Breathing Exercises

Practice deep breathing is to breathe slowly and using the diaphragm, allowing abdominal and chest lifted slowly inflate fully. The purpose is to achieve a deep breath ventilation more controlled and efficient and to reduce the work of breathing, increased maximal alveolar inflation, increase muscle relaxation, relieve anxiety, get rid of the pattern of activity of respiratory muscles useless, uncoordinated, slow the breathing frequency, reduce air trapped and reduce labor breathing.

Practice deep breathing is not a form of physical exercise, it is a technique of soul and body that can be added in a variety of routines to get the relaxing effect. Long-term practice of breathing exercises will improve in health. Breathe slowly is the healthiest form of deep breathing (Brunner & Suddarth, 2002).

a. Respiratory Diaphragm
  • Administration of oxygen if the patient received oxygen therapy at home.
  • Position the patient can sit, supine, half sitting, sleeping on your left or right, horizontal or semi-Fowler.
  • Patients put one hand on the center of the abdomen, the other in the chest. Will be felt on the upper abdomen and rib cage expands the bottom opening. Patients need to be aware that the diaphragm was down at the time of inspiration. When movement (excursion) minimal chest. Chest wall muscles and breathing aids relaxation.
  • Patients inhale through nose and slowly expiratory time through the mouth (lips pursed breathing), during inspiration, the diaphragm and maximize active deliberately protrusion (development) of the abdomen. Made the front abdominal muscles contract during inspiration to facilitate the movement of the diaphragm and increase the expansion of the lower thoracic cage.
  • During the expiratory patients can use abdominal muscle contraction to move the diaphragm higher. Load weighing 0.51 kg can be placed on the wall of the stomach to help this activity.

b. Pursed Lips Breathing
  • Breathing (inspiration) was used a few seconds through the nose (not a deep breath) with the mouth closed
  • Then exhale (expiration) slowly through the mouth with a whistling position
  • PLB performed with or without abdominal muscle contraction during expiration
  • During PLB no expiratory air flow through the nose
  • With pursed lips breathing (PLB) will increase the pressure in the oral cavity, then the pressure will be passed through the bronchial branches so as to prevent air trapping and small airway collapse during expiration.

Concepts of Effective Cough

Effective Cough and Deep Breathing

Definition
Effective cough: a cough with correct method, where clients can save energy so tired and can not easily remove phlegm optimally.

Destination
Effective coughing and deep breathing is an effective cough techniques that emphasize maximal inspiration starting from expiration, which aims to: stimulate the opening of the collateral system, Improving the distribution of ventilation, lung volume Boost, facilitate airway clearance (Jenkins, 1996).
The ineffective cough causes:
  1. Respiratory collapse
  2. Rupture of alveoli walls
  3. Pneumothorax

Indication
Performed on patients such as: COPD, Emphysema, Fibrosis, asthma, chest infection, bedrest or postoperative patients

Effective Cough

Huff coughing is a technique that can be used to control cough in patients suffering from lung diseases such as COPD, emphysema or cystic fibrosis.

Huff Coughing:
  • To prepare the lungs and airways of huff coughing technique, remove all the air out of the lungs and airways. Start by breathing slowly. Take a breath slowly, ending with secar exhale slowly for 3-4 seconds.
  • Inhale the diaphragm, Do it quietly and comfortably, not to overventilasi lungs.
  • After perpetually inhale slowly, hold the breath for 3 seconds, is to control the breath and prepare effectively perform huff cough.
  • Lift your chin slightly up, and use your abdominal muscles to perform a quick exhalation 3 times with the airway and mouth open, take out the sound Ha, ha, ha or huff, huff, huff. This helps to open and facilitate expenditure epligotis mucus.
  • Control breath, then slowly breathe 2 times.
  • Repeat the above techniques cough up mucus to the back of the throat
  • After that batukkan and remove mucus / phlegm.

Post-surgical Deep Coughing

Step 1:
Sitting in the corner of a bed or chair, but can also help lay on your back with your knees slightly bent.
Grasp / hold pillow or rolled towel against the wound with both hands
Breathe normally

Step 2:
Breathe slowly and deeply through your nose.
Then exhale through your mouth full, Repeat for the second time.
For the third time, Take a slow, deep breath through your nose, Fill your lungs until they felt full as possible.

Step 3:
Batukkan 2-3 times in a row. Try to remove the air from your lungs semaksimalkan possible when coughing.
Relax and breathe as usual
Repeat the above action.

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Impaired Gas Exchange related to Pneumonia

Nursing Care Plan Impaired Gas Exchange related to Pneumonia

Pneumonia

Pneumonia is an inflammatory condition of the lung—especially affecting the microscopic air sacs (alveoli)—associated with fever, chest symptoms, and a lack of air space (consolidation) on a chest X-ray. Pneumonia is typically caused by an infection but there are a number of other causes. Infectious agents include: bacteria, viruses, fungi, and parasites.

Pneumonia is due primarily to infections, with less common causes including irritants and the unknown. Although more than one hundred strains of microorganisms can cause pneumonia, only a few are responsible for most cases. The most common types of infectious agents are viruses and bacteria, with its being less commonly due to fungi or parasites. Mixed infections with both viruses and bacteria may occur in up to 45% of infections in children and 15% of infections in adults. A causative agent is not isolated in approximately half of cases despite careful testing. The term pneumonia is sometimes more broadly applied to inflammation of the lung (for example caused by autoimmune disease, chemical burns or drug reactions), however this is more accurately referred to as pneumonitis.


Impaired Gas Exchange

Impaired Gas Exchange a nursing diagnosis approved by the North American Nursing Diagnosis Association, defined as excess or deficit in oxygenation and/or carbon dioxide elimination at the alveolocapillary membrane. Etiological and contributing factors include an altered oxygen supply, changes in the alveolar-capillary membrane, altered blood flow, and altered oxygen-carrying capacity of the blood. Defining characteristics include changes in mental status such as confusion, somnolence, restlessness, and irritability; ineffective coughing and inability to move secretions from the air passages; hypercapnia; and hypoxia.


Nursing Diagnosis and Interventions for Pneumonia

Nursing Diagnosis for Pneumonia : Impaired Gas Exchange related to changes in the alveolar-capillary membrane (inflammatory effect), the oxygen-carrying capacity of blood disorders (fever, displacement curves of oxyhemoglobin), impaired oxygen delivery (hypoventilation).

Goal: Demonstrate improved ventilation and oxygenation of tissues with blood gas analysis within the normal range and no symptoms of respiratory distress.

Expected outcomes: Participate in actions to maximize oxygenation.

Nursing Interventions:
  1. Assess the frequency / depth and ease breathing.
  2. Observation color skin, mucous membranes and nails, record the cyanosis
  3. Assess mental status and level of anxiety
  4. Monitor heart rate and body temperature
  5. Keep resting-sleeping
  6. Elevate the head and thrust frequently change position, breath deeply and cough effectively
  7. Give oxygen properly as indicated.

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