Ineffective Individual Coping related to Bulimia Nervosa

Ineffective Individual Coping related to Bulimia Nervosa

Nursing Care Plan for Bulimia Nervosa

Bulimia nervosa is a disorder in eating habits. Eating disorders are a psychiatric syndrome that is characterized by eating patterns associated with aberrant psychological characteristics associated with eating, body shape and weight. eating disorders occur due to several reasons in eating behavior, such as consumption of less healthy foods or eating too much.

Bulimia nervosa is a feast of food, followed by washing stomach or vomiting. Eating disorders usually occur together with other diseases such as depression, being part of a violent, and anxiety disorders. In this case, people who suffer from eating disorders can experience physical health complications further, including the problem of the working conditions of liver and kidney failure, which can lead to death. Many people with bulimia have a normal weight and seem to be no significant problems in life. Their regular people who look healthy, successful in his field, and tend ferfeksionis. However, behind it, have low self-esteem and often depressed.


Nursing Diagnosis : Ineffective individual coping

Goal: ineffectiveness of individual coping can be met.

Expected outcomes:

• Identify methods that are not associated with less food in the face of stress or crisis.
• Expressed feelings of guilt, anxiety, anger, or excessive need for control.
• Shows a more satisfying interpersonal relationships.
• Revealed more realistic body image.
• Addressing an alternative method of dealing with stress or crisis.
• Revealed an increase in self-esteem and confidence.

Interventions :

• Assess client's eating habits.
• Encourage clients to eat with other clients or their families, if tolerated.
• Encourage clients to express their feelings (anxiety and guilt about eating).
• Encourage clients to keep a diary to write down the type and amount of food eaten, identify feelings experienced before and after eating, especially about excessive eating behavior and depletion.
• Discuss the client's preferred food and reduce anxiety.
• Help clients explore ways to overcome the emotions (anger, anxiety, and frustration).
• Give positive feedback to the client.
• Teach client about the use of problem-solving process.
• Exploration with the client about personal power.
• Discuss with the client about the idea of receiving underweight "ideal".
• Encourage clients to express their feelings, about the family members and those closest, role and relationship with them.

Rationale :

• Preventing overeating behavior that includes eating secretly and swallow food, helps clients quickly and return to normal diet (three times daily).
• Prevent secrecy about eating, though at first anxiety, the client may be too high to join the meal together.
• Helps reduce feelings verbally can reduce anxiety and reducing the depletion of food behaviors.
• Helping clients examine food intake and feelings they experienced.
• Helping clients looking at using food to cope with feelings or make it comfortable.
• Helping clients to separate emotional issues of food and eating behavior.
• Increase efforts to clients in the face of anxiety, anger, and other emotions honestly and openly.
• Helps clients improve self-esteem and confidence of clients.
• Helping clients find strength.
• Change the client's perception of ideal body weight may be unrealistic and unhealthy.
• Helping clients identify, accept, and cope with their feelings in a proper way.

Pathophysiology and Early Symptoms of Dementia

Pathophysiology and Early Symptoms of Dementia

Dementia is not a specific disease. Dementia is a term used to describe a collection of symptoms that can be caused by a variety of disorders that affect the brain. A person with dementia have impaired intellectual functioning and causes disruption in daily activities or relationships with people around. People with dementia also lose the ability to solve problems, control emotions, and can even experience personality changes and behavioral problems such as irritability and hallucinations. A person diagnosed with dementia when two or more brain functions, such as memory and language skills, decreased significantly without loss of consciousness.

Pathophysiology of dementia usually begins gradually and increasingly worse, so that this situation did not at first realize. A decline in memory, the ability to remember the time and the ability to recognize people, places and objects. Patients have difficulty in finding and using the right words and the abstract thinking (eg in the use of numbers). Frequent changes in personality and behavior disorders.

Early symptoms usually are oblivious to what just happened but it could also begin as depression, fear, anxiety, decreased emotion, or other personality changes. There is a change in the pattern of speaking lightly so people use words more simple, using words that are not appropriate or not being able to find the right words. Inability to interpret the signs could pose difficulties in driving. In the end, patients are unable to perform their social functions.

Some people can hide their deficiencies well. They avoid complex activities (such as reading or working). Patients who do not succeed in changing his life may experience frustration because of inability to perform everyday tasks. Patients forget to perform the essential duties or wrong in doing the task.

Dementia is quite common in the elderly, afflicts about 16% of the age group above 65 years of age and 32-50% in the age group above 85 years. In about 10-20% of cases of dementia are reversible or treatable. The most frequent cause of dementia is Alzheimer's disease. Causes of Alzheimer's disease is unknown, but is thought to involve genetic factors, because the disease seems to be found in some families and are caused or influenced by several specific gene abnormalities. In Alzheimer's disease, some parts of the brain decline, resulting in cell damage and reduced response to a chemical that transmits signals in the brain. In the brain found abnormal tissue (called senile plaques and irregular nerve fibers) and abnormal proteins, which can be seen at autopsy. Lewy Body dementia closely resembles Alzheimer's disease, but have differences in microscopic changes that occur in the brain.

Prompts for Patients with Hordeolum (Stye)

Prompts for Patients with Hordeolum (Stye)

Hordeolum can affect anyone, from children to the elderly. Stated that the incidence in adults more than children. There is no difference in the incidence (incidence rate) between men and women. Sometimes a person is really experiencing hordeolum (recurring). Supposing, just recovered that one, then reappear somewhere else.

Hordeolum is an infection or inflammation of the gland at the edge of the upper eyelid and the lower part caused by bacteria, usually by staphylococcus bacteria (Staphylococcus aureus).

Hordeolum may arise in one or more of the eyelid glands. Eyelid glands include Meibomian glands, the glands of Zeis and Moll.
Based on the place, hordeolum is divided into 2 types:

Internal hordeolum, occurred on Meibomian glands. At this internal hordeolum bump leads to the conjunctiva (the inner lining of the eyelid).
External hordeolum, occurred at Zeis glands and Moll glands. Lump visible from the outside on the outside of the eyelid skin.


Symptoms of Hordeolum

• Signs hordeolum is easily recognized, namely visible lump on the eyelid the top or bottom, reddish. Sometimes appear whitish or yellowish spots accompanied by swelling of the eyelids.
• On the internal hordeolum, the lump will appear more clearly with open eyelid.
• Complaints are often felt by people hordeolum, including lump on the eyelid flavor, tenderness and increasing pain when bent. Sometimes watery eyes and sensitive to light.
• Hordeolum can form an abscess in the eyelid and broken by removing the pus.

Prompts for Patients with Hordeolum (Stye)

• Avoid scratching or tapping hordeolum.
• Do not squeeze the hordeolum. Let hordeolum broke by itself, then wipe with a sterile gauze when out pus or fluid from the hordeolum.
• Close your eyes while cleaning hordeolum.
• To temporarily stop using makeup on the eyes.
• Remove contact lenses during the treatment period.

Causes and How to Prevent LBP (Low Back Pain)

Causes and How to Prevent LBP (Low Back Pain)

Low Back Pain (LBP) is pain that occurs in the lower back and can spread to the foot, especially the rear and outer side. These complaints can be so severe that patients have difficulty in every movement and the patient should rest and hospitalized.

LBP complaint turned out ranks the second most common after headache. From the data on patients who went to the clinic of Neurology shows that the number of patients over the age of 40 years who present with low back pain turned out to be quite a lot.

Given that low back pain is actually just a symptom, then the most important thing is to find the causes, so that appropriate treatment can be given.

Causes of LBP

Basically the onset of pain is due to pressure on the nervous edge of the lumbar region (pinched nerve). Pinching the nerves can occur due to disturbances in muscle and surrounding tissue, nerve disorders in themselves, spinal abnormalities and abnormalities in other places, such as an infection or kidney stones and others.

Muscle spasms (muscle tension) is the most common cause of LBP. This spasm can occur due to movement of the waist is too sudden or excessive beyond the power of the muscle. For example during exercise with no we realize we move too sudden, and excessive time chasing or hitting the ball (badminton, tennis, golf, etc.). Likewise, when we lift things a bit heavy with the wrong position, such as moving a table, a chair, lifting luggage, pushing the car, even when we are very excited lift our children or grandchildren will be able to happen LBP. Calcification of the spine around the waist that can result in pinching of the nerves that lead to severe back pain.

HNP (spinal disc herniation). This happens because the involuntary (trauma / accident) and the pain may spread to either the right or left foot (ischialgia). The other reason we need to consider are: tumors, infections, kidney stones, and others. All of which can lead to pressure on the nerve fibers.

Should not be forgotten for mental stress, namely: a mental state that causes the patient to feel very depressed. The clinical symptoms of psychological stress transferred into LBP, although previously had no vulnerability factors of the composition of the organs in the back.


How To Prevent LBP

Here's how to prevent LBP:

1. Regular exercise where the frequency / number and intensity should be enough, do not overdo it. For those who usually LBP, recommended for swimming, and should not be jumping up and down.

2. Set the food by avoiding foods that contain a lot of fat, uric acid, etc., in order to slow down the calcification of the spine. Besides, try not to happen overweight.

3. Living in a healthy environment with clean air and avoid excessive pollution.

Nursing Care Plan for Kawasaki Disease

Nursing Care Plan for Kawasaki Disease

Kawasaki disease (mucocutaneous lymph node syndrome) is a form of vasculitis identified by an acute febrile illness with multiple systems affected. Kawasaki fever is a fever in children is associated with vasculitis especially coronary blood vessels and other systemic complaints.

Kawasaki disease, also known as Kawasaki syndrome, lymph node syndrome, and mucocutaneous lymph node syndrome.

Kawasaki disease was described by and named after Japanese pediatrician Tomisaku Kawasaki in 1967. It is also called mucocutaneous lymph node syndrome or Kawasaki syndrome.

Kawasaki disease is largely seen in children under five years of age. Kawasaki disease affects many organ systems, mainly those including the blood vessels, skin, mucous membranes, and lymph nodes. Its rarest but most serious effect is on the heart, where it can cause fatal coronary artery aneurysms in untreated children.

The exact cause of Kawasaki disease is still unknown. Some studies suggest that it may be caused by the immune system’s reaction to an infectious agent, such as a virus. The condition itself is not contagious.

Early symptoms may include:

• High fever
• Bloodshot eyes (also known as “conjunctivitis without discharge”)
• Rash
• Swollen lymph nodes
• Swollen, bright red tongue
• Swollen hands and feet
• Red palms and soles of the feet

Later symptoms may include:

• Diarrhea
• Peeling skin on the hands and feet
• Vomiting
• Pain in the joints

Nursing Diagnosis for Kawasaki Disease :

1. Chronic pain related to inflammation of the myocardium or pericardium.
2. Risk for decreased cardiac output related to accumulation of fluid in the pericardial sac.
3. Activity intolerance related to inflammation and degeneration of myocardial muscle cells.

Hyperthermia related to Urinary Tract Infections

Hyperthermia related to Urinary Tract Infections

Nursing Care Plan for Urinary Tract Infections

A urinary tract infection (UTI) is an infection that affects part of the urinary tract. A urinary tract infection (UTI) (also known as acute cystitis or bladder infection). Urinary tract infections (UTIs) are very common – particularly in women, babies and the elderly. Around one in two women and one in 20 men will get a UTI in their lifetime.

The infection can occur at different points in the urinary tract, including:

• Urethra. An infection of the tube that empties urine from the bladder to the outside is called urethritis.
• Kidneys. An infection of one or both kidneys is called pyelonephritis or a kidney infection.
• Ureters. The tubes that take urine from each kidney to the bladder are rarely the only site of infection.
• Bladder. An infection in the bladder is also called cystitis or a bladder infection.

Some of the symptoms include:

• Burning pain or a ‘scalding’ sensation when urinating
• Pain above the pubic bone
• Wanting to urinate more often and urgently, if only a few drops
• A feeling that the bladder is still full after urinating
• Blood in the urine.

Most urinary tract infections are caused by bacteria that live in the digestive system. Bacteria that enter the urethra and then the bladder. Women tend to get them more often because their urethra is shorter and closer to the anus than in men.
The most common culprit is a bacterium common to the digestive tract called Escherichia coli (E. coli).
Other micro-organisms, such as mycoplasma and chlamydia, can cause urethritis in both men and women.


Nursing Care Plan for Urinary Tract Infections

Hyperthermia related to infection.
Goal: the patient's body temperature to normal.

Expected outcomes:

• The patient's body temperature is normal.
• Acral feel warm.
• Patients calm / relaxed.

Interventions and Rationale :

Independent

1. Assess increase in body temperature through laboratory tests.
R /: To determine the factors causing an increase in body temperature and to establish further therapy program.

2. Perform a cold or warm compresses on the body.
R /: Warm compresses can enhance vasodilation of blood vessels while cold compress increase vasoconstriction of blood vessels.

Collaboration

3. Implement treatment programs: Management of antipyretics as indicated.
R /: Antipyretics reduce fever.

Observation

4. Monitoring of vital signs.
R /: To know the state of the patient.

5. Monitor fluid intake and output.
R /: Intake and output were less able to stimulate the growth of bacteria in the urinary vesica.

Nursing Assessment for Hypertensive Heart Disease

Nursing Assessment for Hypertensive Heart Disease

Hypertensive heart disease is heart disease caused by hypertension. Hypertension that is not controlled for a long time causing the left ventricle hypertrophy (LVH).

The main causes of hypertensive heart disease is chronic hypertension. Hypertension in adults is caused by several things including:
Essential hypertension occurred in 90% of cases of hypertension in adults.
Secondary hypertension 10% of cases of hypertension in adults is caused by abnormalities in the kidneys, endocrine disorders, increased ICT, etc.

In the early stages of hypertension, will appear the signs as a result of chronic sympathetic stimulation. Heart beat faster and stronger. Occurred hyper circulation that may result from increased activity and neurohumoral system accompanied by hipervolumia. At an advanced stage, there will be a compensation mechanism in the form of heart muscle hypertrophy of the left ventricle and increased peripheral vascular resistance. Will appear shortness of breath in patients by the presence of diastolic interference.

The assessment focused on the physical and psychological disorders caused by HHD. The existence of a long history of hypertension and a history of hypertension and heart disease in the family.

Data base assessment:

1. Activity / rest
Symptoms: There is weakness, fatigue, shortness of breath.
Signs: Heart rate increases, changes in heart rhythm, tachypnea.

2. Circulation
Symptoms: A history of hypertension, atherosclerosis, coronary heart disease and cerebrovascular disease.
Symptoms: Increased blood pressure, pulse clear the area of the carotid, jugular and radial. Femoral pulse slowed, while the pulse popliteal, tibial and dorsalis pedis becoming weaker.
Arising tachycardia and dysrhythmias, audible voice S4 atrial gallop.
Skin discoloration occurs in the extremities, cold temperatures, pale skin, cyanosis.

3. Ego integrity
Symptoms: The change of personality, anxiety, depression, anger, multiple stress factors.
Symptoms: Restlessness, narrowing the field of attention, crying, facial muscle tension, increased speech patterns, often sighed.

4. Elimination
Symptoms: The presence of disorders of the kidneys.

5. Food / liquids
Symptoms: The habit of eating foods high in salt, fat and cholesterol. Feelings of nausea and vomiting, weight changes, use of diuretics.
Signs: Normal weight or obese. Arising edema (general or specific).

6. Neuro sensory
Symptoms: The existence of complaints of dizziness, throbbing head, sub-occipital headache, weakness on one side of the body, impairments, and epistaxis may occur.

7. Pain / discomfort
Symptoms: There angina, intermittent pain in the legs as indications of arteriosclerosis, severe occipital headache, abdominal pain.

8. Breathing
Symptoms: dyspnoea associated with the activity, tachypnea, orthopnea, cough with or without sputum, a history of smoking.
Signs: The use of accessory respiratory muscles, the additional breath sounds, cyanosis.

9. Learning
Symptoms: Risk factors family history of hypertension, atherosclerosis, heart disease, diabetes, cerebrovascular disease / kidney. Race factor, the use of drugs / alcohol.