Tuesday, April 15, 2014

Nursing Care Plan for Mastoiditis

Mastoiditis is the result of an infection that extends to the air cells of the skull behind the ear.

Causes of Mastoiditis

Acute mastoiditis:
  • Haemophilus influenzae.
  • Streptococcus pneumoniae.
  • Streptococcus pyogenes.
  • Moraxella catarrhalis.
  • Staphylococcus aureus, including methicillin-resistant Staphylococcus aureus infection (MRSA).
Chronic mastoiditis:
  • Staphylococcus aureus, including MRSA.
  • Infection is often polymicrobial.
  • Gram-negative organisms such as Escherichia coli, Proteus, or Pseudomonas.
  • Anaerobic bacteria: Peptostreptococcus species, anaerobic Gram-negative bacilli (ie, pigmented Prevotella, Porphyromonas, and Bacteroides species) and Fusobacterium species.
  • Mycobacterium tuberculosis, nontuberculous mycobacteria, and Mycobacterium bovis are rare causes.

Symptoms of Mastoiditis
  • Ear pain or discomfort
  • Drainage from the ear
  • Headache
  • Fever, may be high or suddenly increase
  • Redness of the ear or behind the ear
  • Hearing loss
  • Swelling behind ear, may cause ear to stick out

Nursing Diagnosis for Mastoiditis
  1. Acute pain related to inflammation process.
  2. Disturbed Sensory perception related to obstruction, infection of the middle ear or auditory nerve damage.
  3. Anxiety related to the inability to communicate.
  4. Risk for injury related to vertigo and a decrease in body balance
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Friday, April 11, 2014

Pleural Effusion - Functional Health Pattern Assessment

Functional Health Pattern Assessment

1. Health Perception and Management

The presence of medical treatment and hospitalization affect change perceptions about health, but also raises sometimes wrong perception of health care. The possibility of a history of smoking, drinking alcohol and drug use may be a predisposing factor of disease.

2. Nutritional metabolic pattern

In the study of nutrition and metabolic patterns, we need to take measurements of height and weight to determine the nutritional status of the patient, as well as eating habits need to be asked and drinking before and during hospital admission of patients with pleural effusion will decrease appetite and shortness of breath as a result of emphasis on the structure of the abdomen. Increased metabolism will occur as a result of the disease process. patients with pleural effusion generally weak state.

3. Elimination pattern

In the assessment of the pattern of elimination have any questions about illusion and defecation habits before and after hospital admission. Because the patient's general condition is weak, the patient will be much bed rest so will cause constipation, digestive apart due to the structure of the abdomen causing a decrease in the peristaltic muscles degestivus tract.

4. Activity exercise pattern

Due to shortness of breath, tissue oxygen demand will be less fulfilled and the patient will quickly experience fatigue on minimal exertion. Besides, patients will also reduce its activity due to a chest pain. And to meet the needs of the ADL, the needs of patients assisted by nurses and patients' families.

5. Sleep rest pattern

The presence of chest pain, shortness of breath and an increase in body temperature will affect the fulfillment of the needs of sleep and rest, other than that due to changes in the environmental conditions of a quiet home environment to the hospital setting, where many people are walking around, noisy and so forth.

6. Cognitive-perceptual pattern

As a result of illness, the patient will experience a direct role changes, eg a housewife patient, the patient can not function as a mother who must care for their children, taking care of her husband. In addition, the patient's role in society is also changing and all that affects the patient's interpersonal relationships.

7. Self perception/self concept pattern

Patients' perception of him will change. Patients who are otherwise healthy, a sudden onset of pain, shortness of breath, chest pain. As a layman, the patient may be assumed that the disease is dangerous and deadly disease. In this case the patient may have lost a positive image of him.

8. Role-Relationship Pattern

Sensory function of patients did not change, as well as thought processes.

9. Sexuality-Reproductive Pattern

Sexual needs of the patient in this case sexual intercourse will be disturbed for a while because the patient was in the hospital and his physical condition is still weak.

10. Coping-stress tolerance

For patients who do not know the disease process may be experiencing stress and many patients will ask nurses and doctors who cared for him or anyone who may know more about the disease considered.

11. Value-Belief pattern

As a religion, a patient will be praying to God.

Anxiety related to Pleural Effusion
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Anxiety related to Pleural Effusion

Pleural effusion is an abnormal amount of fluid around the lung. Pleural effusion is excess fluid that accumulates between the two pleural layers, the fluid-filled space that surrounds the lungs.

Some of the more common causes are:
  • Congestive heart failure
  • Pneumonia
  • Liver disease (cirrhosis)
  • End-stage renal disease
  • Nephrotic syndrome
  • Cancer
  • Pulmonary embolism
  • Lupus and other autoimmune conditions
Symptoms of pleural effusions
  • Shortness of breath
  • Chest pain, especially on breathing in deeply (pleurisy, or pleuritic pain)
  • Fever
  • Cough

Nursing Diagnosis for Pleural Effusion : Anxiety or fear in relation to the threat of death imaginable (inability to breathe).

Goal : Patient is able to understand and accept the situation so there is no anxiety .

  • Able to breathe normally, able to adapt to the situation.
  • Client's non-verbal response seemed more relaxed and at ease , the breath regularly with a frequency of 16-24 times per minute , pulse 80-90 times per minute.

Interventions :

1. Provide a pleasant position for the patient . Usually with a semi -Fowler.

2. Explain about the disease and diagnosis.
Rationale: The patient is able to receive and understand the circumstances that might be used in the treatment of co-operation.

3. Teach relaxation techniques.
Rationale : Reduce muscle tension and anxiety.

4. Aids in finding the source of the existing coping.
Rational Utilization of existing resources constructively coping very useful in overcoming stress.

5. Maintain a trusting relationship between nurse and patient.
Rationale : The relationship of mutual trust help the therapeutic process.

6. Assess the factors that cause anxiety.
Rationale : Appropriate action is necessary to address the problems faced by clients and build trust in reducing anxiety.

7. Aids patients recognize and acknowledge a sense of anxiety.
Rationale : Anxiety is an emotion that effect when they are well identified, disturbing feelings be known.
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