Population Pyramid of Pakistan

 

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Hypertension Nursing Care Plans NCP

The definition of hypertension, many raised by health experts. WHO suggests that hypertension occurs when blood pressure above 160/95 mmHg, meanwhile, Smelttzer & Bare (2002:896) suggests that hypertension is a persistent blood pressure or continuous thus exceeding the normal limit in which the systolic pressure above 140 mmHg and diastolic pressure above 90 mmHg.

There are differences about the limits of hypertension as proposed by Kaplan (1990:205), namely men, aged less than 45 years, said hypertension when blood pressure when lying above or equal to 130/90 mm ​​Hg, whereas at the age of 45 years, said hypertension when blood pressure above 145/95 mmHg.Whereas in women with blood pressure above 160/95 mmHg.

Based on these definitions can be concluded that hypertension is an increase in blood pressure where systolic pressure over 140 mmHg or diastolic over 90 mmHg.

The classification of hypertension are also expressed by many experts, including WHO set a classification of hypertension into three levels namely:

Level I: increased blood pressure without symptoms of the disorder or damage to the cardiovascular system.
Level II: blood pressure with symptoms of cardiovascular hypertrophy, but without any symptoms of damage or disruption of the appliance or other organs.
Level III: blood pressure increased with obvious symptoms of damage and disruption of the target organ physiology.

The cause of hypertension varied are: stress, obesity, smoking, hypernatremia, water and salt retention that is not normal, sensitivity to angiotensin, obesity, hypercholesterolemia, adrenal gland disease, kidney disease, toxemia gravidarum, increased intra-cranial pressure, caused by brain tumors, influence of certain drugs eg oral contraceptives, high salt intake, lack of exercise, genetics, obesity, atherosclerosis, kidney abnormalities, but largely unknown cause.

Nursing Care Plan for Hypertension

Nursing Assessment Nursing Care Plan for Hypertension

Self-Esteem, situational low, Amputation NCPs

Nursing Diagnosis

• Self-Esteem, situational low

May be related to

• Loss of body part/change in functional abilities

Possibly evidenced by

• Anticipated changes in lifestyle; fear of rejection/reaction by others
• Negative feelings about body, focus on past strength, function, or appearance
• Feelings of helplessness, powerlessness
• Preoccupation with missing body part, not looking at or touching stump
• Perceived change in usual patterns of responsibility/physical capacity to resume role

Amputation Nursing Care Plans

In general, amputation of limbs is the result of trauma, peripheral vascular disease, tumors, and congenital disorders. For the purpose of this plan of care, amputation refers to the surgical/traumatic removal of a limb. Upper-extremity amputations are generally due to trauma from industrial accidents. Reattachment surgery may be possible for fingers, hands, and arms. Lower-extremity amputations are performed much more frequently than upper-extremity amputations. Five levels are currently used in lower-extremity amputation: foot and ankle, below knee (BKA), knee disarticulation and above (thigh), knee-hip disarticulation; and hemipelvectomy and translumbar amputation. There are two types of amputations: (1) open (provisional), which requires strict aseptic techniques and later revisions, and (2) closed, or “flap.”

Amputation Diagnostic Studies

Studies depend on underlying condition necessitating amputation and are used to determine the appropriate level for amputation.

• X-rays: Identify skeletal abnormalities.
• CT scan: Identifies soft-tissue and bone destruction, neoplastic lesions, osteomyelitis, hematoma formation.
• Angiography and blood flow studies: Evaluate circulation/tissue perfusion problems and help predict potential for tissue healing after amputation.
• Doppler ultrasound, laser Doppler flowmetry: Performed to assess and measure blood flow.
• Transcutaneous oxygen pressure: Maps out areas of greater and lesser perfusion in the involved extremity.
• Thermography: Measures temperature differences in an ischemic limb at two sites: at the skin and center of the bone. The lower the difference between the two readings, the greater the chance for healing.
• Plethysmography: Segmental systolic BP measurements evaluate arterial blood flow.
• ESR: Elevation indicates inflammatory response.
• Wound cultures: Identify presence of infection and causative organism.
• WBC count/differential: Elevation and “shift to left” suggest infectious process.
• Biopsy: Confirms diagnosis of benign/malignant mass.

Nursing Priorities - Amputation Nursing Care Plans

1. Support psychological and physiological adjustment.
2. Alleviate pain.
3. Prevent complications.
4. Promote mobility/functional abilities.
5. Provide information about surgical procedure/prognosis and treatment needs.

Discharge Goals - Amputation Nursing Care Plans

1. Dealing with current situation realistically.
2. Pain relieved/controlled.
3. Complications prevented/minimized.

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5 Thyroidectomy Nursing Care Plan (NCP)

Thyroidectomy, although rare, may be performed for patients with thyroid cancer, hyperthyroidism, and drug reactions to antithyroid agents; pregnant women who cannot be managed with drugs; patients who do not want radiation therapy; and patients with large goiters who do not respond to antithyroid drugs. The two types of thyroidectomy include:
Total thyroidectomy: The gland is removed completely. Usually done in the case of malignancy. Thyroid replacement therapy is necessary for life.
Subtotal thyroidectomy: Up to five-sixths of the gland is removed when antithyroid drugs do not correct hyperthyroidism or RAI therapy is contraindicated.

5 Thyroidectomy Nursing Care Plan (NCP)

Acute Pain — Thyroidectomy Nursing Care Plan (NCP)
Ineffective Airway Clearance — Thyroidectomy Nursing Care Plan (NCP)
Impaired Verbal Communication — Thyroidectomy Nursing Care Plan (NCP)
Risk for Injury — Thyroidectomy Nursing Care Plan (NCP)
Knowledge Deficit — Thyroidectomy Nursing Care Plan (NCP)

Nursing Priorities
Reverse/manage hyperthyroid state preoperatively.

Prevent complications.
Relieve pain.
Provide information about surgical procedure, prognosis, and treatment needs.
Discharge Goals Complications prevented/minimized.
Pain alleviated.
Surgical procedure/prognosis and therapeutic regimen understood.
Plan in place to meet needs after discharge.

Depression Nursing Diagnosis and Interventions- Nursing Care Plan

Risk for Violence: Self-Directed or Other-Directed


Nursing Interventions for Depression

1. The general objective: There was no violence for Self-Directed or Other-Directed
2. Specific objectives
   • Clients can build a trusting relationship
     
     Action:
     
     
     • Introduce yourself to the patient
     • Do interactions with patients as often as possible with empathy
     • Listen to the notice of the patient with empathy and patient attitude more use non-verbal language. For example: a touch, a nod.
     • Note the patient talks and give a response in accordance with her wishes
     • Speak with a low tone of voice, clear, concise, simple and easy to understand
     • Accept the patient is without comparing with others.
   • Clients can use adaptive coping
     
     Action:
     
     
     • Give encouragement to express feelings and say that nurses understand what patients perceived.
     • Ask the patient the usual way to overcome feeling sad / painful
     • Discuss with patients the benefits of commonly used coping
     • Together with patients looking for alternatives, coping.
     • Give encouragement to the patient to choose the most appropriate coping and acceptable
     • Give encouragement to patients to try coping that have been selected
     • Instruct the patient to try other alternatives in solving problems.
   • Clients are protected from violent behavior to self and others.
     
     Action:
     
     
     • Monitor carefully the risk of suicide / violence themselves.
     • Keep and store the tools that can be used by patients for violent behavior, self / others, in a safe place and locked.
     • Keep materials that endanger the patient's appliance.
     • Supervise and place the patient in the room that easily monitored by peramat / officer.
   • Clients can improve self-esteem
   Action:
   • Help to understand that the client can overcome despair.
   • Assess and mobilize internal resources of individuals.
   • Help identify sources of hope (eg, peer relationships, beliefs, things to be resolved).
   • Clients can use the social support
     
     Action:
     
     
     • Review and make use of individual external sources (the people closest to, the health care team, support groups, religion).
     • Assess support system beliefs (values, past experiences, religious activities, religious beliefs).
     • Make referrals as indicated (eg, counseling, religious leaders).
   • Clients can use the drug correctly and precisely
     
     Action:
     
     
     • Discuss about the drug (name, dosage, frequency, effect and side effects of taking medication).
     • Help using the drug with the principle of 5 correct (right patient, medication, dose, manner, time).
     • Encourage talking about effects and side effects are felt.
     • Give positive reinforcement when using the drug properly.