Nurses Books

Urinary retention is the inability to perform urinary although there is a desire or impulse to it. (Brunner & Suddarth). Urinary retention is a state in the bladder urine buildup and do not have the ability to empty it completely. The signs and symptoms or clinical manifestations of the disease are as follows: Beginning with a slow flow of urine. Then there are the longer polyuria become worse because of inefficient bladder emptying. Abdominal distention occurs due to dilatation of the bladder. Feels there is pressure, sometimes painful and feel the urge to urinate. In severe retention can reach 2000 -3000 cc. 4 Nursing Interventions for Urinary Retention 1. Urinary retention r / t inability of the bladder to contract adequately. expected: Urination by a considerable amount. Not palpable bladder distention. Interventions: Encourage the patient separately urinate every 2-4 hours and if suddenly felt. Ask patients about stress incontinence. Observe the flow ...

Nursing Care Plan for Pericarditis Pericarditis is an inflammation of the outermost layer of the heart (the thin membrane that surrounds the heart) (H. Winter Griffith, MD, 1994). Pericarditis is divided into three, namely acute pericarditis, chronic pericarditis, and chronic constrictive pericarditis. Acute Pericarditis is inflammation of the pericardium (sac lining of the heart) that begins suddenly and often cause pain. Inflammation can cause fluid and produce blood (fibrin, red blood cells and white blood cells) that will meet the pericardium cavity. Chronic Pericarditis is an inflammation of the pericardium (heart sac) which leads to accumulation of fluid or thickening and usually occurs gradually and lasts longer. Chronic constrictive pericarditis is a disease that occurs because there is thickening of the pericardium due to inflammation that occurs before that area of the room the heart is reduced. As a result, decreased cardiac output and reduced filling pressures. Acute pe...

Nursing Care Plan for Endocarditis Endocarditis is an infectious disease caused by microorganisms in the endocardium or heart valve. Endocarditis infections usually occur in the heart that has been damaged. The disease is preceded by endocarditis, usually in the form of congenital heart disease, and acquired heart disease. Formerly the endocardial infection often caused by bacteria that are called bacterial endokariditis. Now the infection is not caused by bacteria, but can be caused by other microorganisms, such as fungi, viruses, and others. Endocarditis is not only happening in the endocardium and valves that have been damaged, but also on the endocardium, and a healthy valve, for example; through intravenous drug abuse or chronic disease. Course of the disease can be; acute, sub-acute, and chronic, depending on the virulence of microorganisms and patient endurance. Subacute infection is almost always fatal, whereas hyperacute / acute, clinically never existed, because the patie...

NCP for Acute Pain related to Myocarditis Myocarditis is an inflammation of the heart muscle wall caused by infection or other causes to which is unknown (idiopathic) (Dorland, 2002). The cause of the inflammation of the myocardium: viral infections mushrooms bacterium parasite protozoa Signs and Symptoms: weary dyspnea irregular heartbeat fever shiver anorexia chest pain Nursing Diagnosis and Interventions Acute Pain related to the imbalance of blood and oxygen supply to the myocardium needs secondary to a decrease in blood supply to the myocardium, increased production of lactic acid. Goal: No complaints and impairment of chest pain response. Expected outcomes: Subjectively: the client states chest pain reduction. Objectively: vital signs within normal limits, face relaxed, not decreased peripheral perfusion, urine more than 600 ml / day. Intervention and Rationale: 1) Record the pain characteristics, location, intensity, duration and deploymen...

Nursing Care Plan for Anxiety Assessment Predisposing Factors Various theories have been developed to explain anxiety: Psychoanalytic Theory. Anxiety is an emotional conflict that occurs between two elements of the personality, the id and the superego. Id represents instinctive impulse, and someone primitive impulses, whereas the superego reflects a person's conscience and controlled by one's cultural norms. Ego or I, serves to mediate resistance of two conflicting elements and functions of the ego anxiety is reminded that there is a danger. Interpersonal Theory. Anxiety arises from the fear of the lack of acceptance of interpersonal relationships. Anxiety is also associated with the development, such as the trauma of separation and loss, giving rise to specific weaknesses. People with low self esteem susceptible to the development of severe anxiety. Behavior Theory. Anxiety is a product of frustration that everything that disrupt a person's ability to achiev...

Panic attacks are superfluous body's normal response to fear. Adrenaline normally generated when needed actions such as, for example; run away from danger, fight or even angry, will be produced in excess and the result is the emergence of many unpleasant sensations and the level of fear that is excessive. All of these feelings, given the title "panic attack" word attack refers to a disease, which should be perceived as the sufferer can not avoid or control it. Softer term is increasing the intensity of adrenaline, which actually describe exactly what happened. The cause of panic attacks can be said, among others: Emotional: frazzled nerves that cause anxiety and depression. Physical / Emotional: for example, frazzled nerves causing muscle spasms or wheezing. Physical: for example; diet, tight clothes, stooped posture Psycho: despair, do not look behind the painful reality, phobias, death. Treatment ideally (though rare) is a form of anxiety treatment where it ...

Osteoarthritis is a degenerative bone disease characterized by loss of articular cartilage (joints). Without cartilage as a buffer, the underlying bone will become irritated, which causes degeneration of the joints (Elizabeth J.Corwin, 2009) Osteoarthritis (OA) is a common degenerative joint disease characterized by the breakdown of cartilage in the joints. It primarily affects the hands, knees, hips, and spine, though it can occur in any joint. Here's a comprehensive overview:   Causes : Age: Osteoarthritis becomes more common with age as wear and tear on the joints accumulate. Joint Injury: Previous joint injuries, such as fractures or ligament tears, can increase the risk of developing osteoarthritis. Obesity: Excess weight puts added stress on weight-bearing joints like the knees and hips, increasing the risk of osteoarthritis. Genetics: Some people may inherit a predisposition to developing osteoarthritis. Joint Overuse: Repetitive stress on joints due to certain occupations ...

Osteoarthritis is known as degenerative joint disease or osteoarthritis (even if there is inflammation) is a joint disorder that is the most common and often cause incapacity (disability). (Smeltzer, Suzanne C 2002 case 1087) Joint cartilage is the main target of degenerative changes in osteoarthritis. Joint cartilage has a strategic location that is at the threshold of the bones to perform two functions: 1) ensure the movement almost without friction in the joints, in the presence of synovial fluid, and 2) in the joint as the recipient of the load, spread the load over the surfaces of the joints so that the bone below can receive heavy impact and without damage. Both of these functions require elastic cartilage (ie regain normal architecture after depressed) and has a tensile strength (tensile streghth) high. As in adult bone, joint cartilage is not static, this bone being exchanged, the bone matrix components that wear out, outlined and replaced. This balance is maintained by c...

Nursing Care Plan for Pneumoconiosis Assessment of Basic Data 1. Data that needs to be examined : The identity of the client include (name, age, address, religion, and gender). The main complaint or reason. Family history. The pattern of activity. Coping mechanisms. Knowledge. 2. Assess the factors that cause pneumoconiosis : Trigger factors : Allergens (pollen, dust, skin or fungi). Emotional stress. Excessive physical activity. Air pollution. Respiratory tract infections. Failure of the recommended treatment program. Supporting factors : Smoking tobacco products as the main factor. Live or work areas with heavy air pollution. History of allergy in the family. 3. Physical examination by a focus on the respiratory system include : Assess the frequency and rhythm of breathing. Inspection of skin color and the color of the mucous membranes. Auscultation of breath sounds. Make sure when the patient using accessory muscles when breathing : Shr...

Nursing Care Plan for Malignant Lymphoma Definition of malignant lymphoma, among others according to Danielle, (1999) that lymphoma is a malignancy that arises from the lymphatic system. Another understanding of malignant lymphoma by Susan Martin Tucker, (1998) is a group of neoplasms originating from lymphoid tissues. Meanwhile, according to Suzanne C. Smeltzer, (2001), suggested that malignant lymphoma is a malignancy of cells derived from lymphoid cells. Another understanding of malignant lymphoma by Doenges, (1999) is a cancer of the lymphoid glands. Assessment on the client malignant lymphoma, according to Doenges, (1999) obtained the following data: 1. Activity / rest Symptoms: fatigue, weakness, or general malaise, loss of the productivity and decreased exercise tolerance. Signs: decreased strength, shoulders slumped, walking slowly, and other signs that indicate fatigue. 2. Circulation Symptoms: palpitations, angina / chest pain. Symptoms: tachycardia, dysrh...

Therapeutic Nursing Interventions Observe the cause of ineffectiveness of countermeasures such as poor self-concept, sadness, lack of skills in problem solving , lack of support , or changes in life. Observe powers such as the ability to tell the reality and identify the source of the pressure. Monitor the risk of harm to self or others and handle them appropriately. Help the patient determine realistic goals and identify personal skills and knowledge. Use empathic communication, and encourage patient / family to express fears, expressing emotions, and set goals. Instruct the patient to make choices and participate in treatment planning and activities scheduled. Provide physical and mental activity which does not exceed the ability of the patient (eg, reading, television, radio, carving, sightseeing, cinema, eating out, social gatherings, exercise, sports, games) If you have the physical ability, suggest that moderate aerobic exercise. Use touch with permission. Give the pat...

Urethritis, Cystitis and Pyelonephritis Ureteritis Urethritis is an infection of the urethra, the canal that carries urine from the bladder out of the body. Urethritis usually show symptoms : Mucosal reddening and edema. There purulent exudate fluid. There is ulceration of the urethra. The presence of itching. The presence of pus early micturition. Dysuria (painful urination time). Difficulty starting urination, less heavy and stopped while micturition (prostatism). Pain in the lower abdomen (supra pubic). Cytitis Cystitis is the medical term for inflammation of the bladder. Most of the inflammation caused by a bacterial infection, in this case can be referred to as a urinary tract infection (UTI). Bladder infections can be painful and annoying, and can be a serious health problems if the infection spreads to the kidneys. Cystitis usually show symptoms : Dysuria (painful urination time). Increased frequency of urination. Frequent urination at night (noctu...

Urinary tract infection is the presence of pathogenic micro-organisms in the urinary tract, with or without signs and symptoms. (Brunner & Suddarth 2001) Urinary tract infections can occur in the upper urinary tract (pyelonephritis), or at the bottom (cystitis, urethritis). Urinary tract infections (UTIs) during pregnancy are relatively common and can pose risks to both the mother and the developing fetus if left untreated. Here are some key points to consider:   Causes: Hormonal Changes: During pregnancy, hormonal changes can make women more susceptible to UTIs. Physical Changes: As the uterus expands, it can put pressure on the bladder, leading to difficulty emptying it completely and increasing the risk of bacterial growth. Urinary Stasis: Slowed urinary flow due to the pressure of the uterus can contribute to bacterial growth in the urinary tract. Immune System Changes: Pregnancy can weaken the immune system, making pregnant women more vulnerable to infections, includi...

Nursing Diagnosis and Interventions for Urinary Retention Urinary retention is the inability to empty the bladder completely during the process of urine. (Brunner and Suddarth 2010). Urinary retention is a state of the buildup of urine in the bladder and do not have the ability to empty completely. Urinary retention is the difficulty of micturition due to the failure of urine from the bladder. Causes of urinary retention, among others, diabetes, an enlarged prostate gland, urethra abnormalities (tumors, infection, calculus), trauma, childbirth or neurological disorders ( troke, spinal cord injury, multiple sclerosis and Parkinson's). Some medications can cause urinary retention either by inhibiting the contraction of the bladder or bladder increased resistance. (Karch, 2008) Signs and Symptoms Beginning with a slow flow of urine. Then there are the longer polyuria become worse because of inefficient bladder emptying. Abdominal distention occurs due to dilatation of th...

Urinary incontinence (UI) is a common condition characterized by the involuntary leakage of urine. It can range in severity from occasional leakage to a complete loss of bladder control. UI can significantly impact a person's quality of life, leading to embarrassment, social isolation, and reduced self-esteem. There are several types of urinary incontinence, each with its own causes and treatment approaches: Stress Incontinence: This occurs when pressure on the bladder increases, leading to leakage of urine. It commonly occurs during activities such as coughing, sneezing, laughing, or exercising. Weakness of the pelvic floor muscles, often due to childbirth, menopause, or prostate surgery, is a common cause of stress incontinence. Urge Incontinence: Also known as overactive bladder, urge incontinence involves a sudden and intense urge to urinate, followed by involuntary leakage of urine. It is often associated with an overactive detrusor muscle in the bladder, which contracts invo...

Glomerulonephritis is a disease characterized by inflammation of the renal glomerulus, with proteinuria, erythrocytes, leukocytes in urine and salt retention, water and nitrogen in varying degrees. Epidemiology / incident cases Estimated at more than 90 % of children who suffer from this disease recover completely. In adults, the prognosis is not good (30 % to 50 %). 2 % to 5 % of all cases of acute death. The rest of the other patients can progress to rapidly progressive glomerulonephritis / chronic. Clinical Symptoms Proteinuria Hematuria Digouria Edema Hypertension Fatigue Anorexia Fever Headache Nausea, vomiting. 5 Nursing Diagnosis for Glomerulonephritis 1. Ineffective breathing pattern related to the inflammatory process, characterized by : the patient complained of shortness. 2. Altered urinary elimination related to decreased bladder capacity or irritation secondary to infection, characterized by : oliguric / anuria. 3. Excess fluid volume relat...

Nursing Diagnosis : Impaired Gas Exchange related to Pneumonia factors. Intervention and implementation : 1. Monitor respiratory status every 8 hours, vital signs every 4 hours and the results of blood gas analysis , x-rays and pulmonary function tests. Rationale: To identify the progress or deviations from expected results. 2. Give an expectorant in accordance with the recommendation, review of all drugs given and avoid the side effects of drug interactions between each other and schedule delivery of drugs to each other as well as to schedule the delivery of drugs. Rational : expectorant helps thin the secretions so that secretions can exit when coughing. 3. Encourage parents to give breast milk. Rationale: To help remove secretions can also help drain the drugs in the body. 4. Provide supplemental oxygen as recommended, if using an oxygen mask to grow agitated patients consult respiratory therapists. Rationale: The provision of supplemental oxygen can reduce the wor...

Bronchopneumonia , also known as lobular pneumonia, is a type of pneumonia characterized by inflammation and infection of the bronchioles (small airways) and surrounding lung tissue. It is typically caused by bacteria, viruses, fungi, or other microorganisms that infect the lower respiratory tract and spread to the smaller airways and alveoli (air sacs) of the lungs. Bronchopneumonia often affects multiple areas or lobes of the lungs and can lead to symptoms ranging from mild to severe.   Causes: Bacterial Infections: Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, and Klebsiella pneumoniae are common bacterial pathogens associated with bronchopneumonia. Viral Infections: Influenza viruses, respiratory syncytial virus (RSV), adenovirus, and parainfluenza virus can cause viral bronchopneumonia. Fungal Infections: Fungal pathogens such as Candida species, Aspergillus species, and Pneumocystis jirovecii can cause fungal bronchopneumonia, particularly in immuno...

Tonometry is a technique for measuring the intra-ocular pressure (IOP). Tonometry Schiozt wear hand-held metal instrument (tonometer) is placed on the surface of the anesthetized cornea. The results vary, but good enough to estimate the IOP. Other pressure measuring devices, applanation tonometry of Goldman, associated with the slit lamp to measure IOP. Considered a form of IOP measurement tool most accurate. Provision of fluorescent dyes and topical anesthesia is required before applanation tonometry. IOP can also be measured by pneumotonometer, which gives a small air spray into the eye to measure the pressure. This method is especially useful when unwanted contact with the cornea. Assessing IOP is a regular component in a comprehensive eye examination and pressure should be measured frequently in patients with glaucoma or are at risk of intra-ocular hypertension. Determination general IOP can be done by providing a light finger pressure on the sclera eyes closed. The two middl...

Nursing Interventions for Eye Disorders The main target patients include pain relief, control anxiety, visual deterioration prevention, understanding and acceptance of handling, fulfillment of self-care activities, including drug treatment, prevention of social isolation and without complications. Nursing Interventions for Eye Disorders 1. Relieves pain. Pain can be caused by trauma, such as corneal scratches or increased pressure in the eye. Wrap the eye can help limit the movement of the eyes and reduce the pain they cause. The eyes are not closed also should be rested for the eyes to move in sync. Because light can cause pain in a variety of eye conditions, and because the eyes rested can facilitate healing after eye surgery, it is necessary to use lighting that is darker than necessary. If the patient requires light to do an activity, it can be used artificial lights dim. Patients were given instructions to avoid reading for some time after surgery or eye disease. Anal...

Information displayed on each nursing diagnosis include the following: Definition. Referring to the definition used in the NANDA nursing diagnoses predetermined. Etiology possibility ("related to"). This section states the possible causes for the problems that have been identified. Which is not expressed by NANDA, given the brackets [...]. Related factors / risk is given to high-risk diagnoses. Defining characteristics ("evidenced by"). This section covers the signs and symptoms are clear enough to indicate the existence of a problem. Again as in the definition and etiology. Which is not expressed by NANDA, bracketed. Goals / Objectives. These statements are written in accordance with the client's objective behavior. Goals / objectives must be measurable, is the long and short term goals, to be used in evaluating the effectiveness of nursing interventions to address the problems that have been identified. Maybe there will be more than a short-term goals, an...

NANDA Nursing Diagnosis and Nursing Process A nursing diagnosis is a clinical judgment about individual, family, or community responses to actual or potential health problems / life processes. Nursing diagnoses provide the basic for selection of nursing interventions to achieve outcomes for which the nurse is accountable (NANDA, 1992 p.5) So the nursing diagnosis is a clinical decision about the response of individuals, families and communities about the actual or potential health problems, which is based on education and experience, nurses can identify and provide accountability for certain interventions to maintain, decrease, limit, preventive and change the client's health status (Carpenito, 2000; Gordon, 1976 & NANDA). Nursing diagnosis is an integral part of the nursing process. This is a component of the analysis steps, where nurses identify individual responses to the problems of the actual and potential health. Some countries diagnose identified in nursing practi...

According Videbeck (2008) Assessment for children who have Attention Deficit Hyperactivity Disorder (ADHD), among others: 1. Assessment of disease history. Parents may report that the child is fussy and having problems during infancy or hyperactive behavior disappear unnoticed until the child is old toddler or go to school or daycare. Children may have difficulty in all major areas of life, such as school or play and showed overactivity or even dangerous behavior at home. Being out of control and they find it impossible to face the child's behavior. Parents may report their efforts to discipline a child or change the behavior of children and all of it was largely unsuccessful. 2. The general appearance and behavior of the motor. Children can not sit quietly in a chair and wriggled and jiggled when trying to do so. Children may run around the room from one object to another with little purpose or without a clear purpose. Disturbed child's ability to speak, but can ...

Data Collection Techniques - Interview (Nursing Assessment) So that data can be collected with a good and purposeful, the data classification should be done, based on the identity of the client, the main complaints, medical history, physical, psychological, social, spiritual, intelligence, test results and other special circumstances. Method used to collect data on clients include: interviews, observation, physical examination (pshysical assessment) and study documentation. Interview The interview is to ask or make a question and answer related to the problems faced by the client, also called anamnesis. The interview lasted for queries relating to issues facing clients and a planned communication. The purpose of the interviews was to obtain data on health issues and problems nursing clients, as well as to establish the relationship between nurses and clients. In addition, the interview also aims to help clients obtain information and participate in the identification of prob...

Stages of Interview / Communication There are four stages in the interview / communication, as follows : 1. Preparation. Prior to communicate with the client, the nurse must make arrangements with the client to read status. Nurses are expected to have no prejudice to the client, because it would interfere with the relationship of trust with clients. If the client is not willing to communicate, nurses should not be forced or give an opportunity to the client, when the client is able. Rearranging the seating and techniques that will be used in the interviews should be structured in such a way as to facilitate the interview. 2. Opening or Introduction. The first step taken by a nurse, in initiating the interview is to introduce ourselves nurse : name, status, purpose of the interview, the time required and the factors that becomes a moot point. Nurses need to provide information to clients on the data collected and will be stored where, how to store it, and anyone who may kno...

Nursing Management of Osteomyelitis The affected area should be immobilized to reduce discomfort and prevent fractures. Can do warm saline baths for 20 minutes several times a day to increase the flow area. Initial target of therapy is to control and stop the process of infection, blood and swab cultures and abscess cultures performed to identify the organism and choose the best antibiotic. Sometimes, infections caused by more than one pathogen. Once the culture specimens were obtained, starting intravenous antibiotic therapy, assuming that the staphylococcus infection-sensitive semi-synthetic penicillin or cephalosporins. The goal is to control the infection before the blood flow to the area declined due to the occurrence of thrombosis. Continuous dosing of antibiotics appropriate time is crucial to achieve the levels of antibiotics in the blood are constantly high. Antibiotics are the most sensitive to the causative organism is given when known for culture and sensitivity. If ...