Sample of Nursing Care Plan for Typhoid Fever - 4 Diagnosis and Interventions

Sample of Nursing Care Plan for Typhoid Fever - 4 Diagnosis and Interventions

Assessment 

Today, Ms.. W age 20, came to the hospital with complaints of high fever (39 0 C) since yesterday. Other complaints: headache, nausea, cough, also complained a few days no bowel movement, the client says insomnia and frequent waking, the client says weak to do an activity, the client complains of pain abdomen, the client says taste in the mouth, and body weakness. After vital sign and physical examination found data: blood pressure: 120/70 mmHg, pulse: 110 x / min, respiration: 30 x / min, typical tongue state (white, dirty, edges hyperemia, chapped lips, face red, lots of sweat). Then the client perform laboratory tests (test widal: 500, check full blood: leukocytes more than 500 / mm3, and SGOT-SGPT) all the results are positive. Client installed oxygenation, the client looks nervous, looking grimacing in pain, weakness, weight decreased, looks bedrest, and assisted activity, faecal mass palpable in the lower abdomen, the portion of food that is provided is not exhausted, vomiting. His family said earlier do not want to be taken to hospital because he felt the disease would heal itself but after the heat higher, clients increasingly anxious and eventually want to be taken to hospital. Also obtained information that the client's father had a history of hypertension.

5 Nursing Diagnosis for Typhoid Fever

Diagnoses that may appear on the client with Typhoid Fever are:

1. Risk for Fluid Volume Deficit related to hyperthermia, a lot of sweat and vomit

characterized by chapped lips, skin turgor ugly.

Goal: fluid volume imbalance does not occur

Expected outcomes:

Mucous membranes moist lips, vital signs (blood pressure, temperature, pulse, respiration) within normal limits, no signs of dehydration.

Intervention:

Assess for signs of dehydration such as dry mouth mucosa, inelastic skin turgor, and increased body temperature, monitor fluid intake and output in 24 hours, measuring body weight each day at a time and at the same time, the report noted such things as nausea, vomiting , stomach pain and distortion. Encourage clients to drink plenty of approximately 2000-2500 cc per day, collaboration in laboratory tests (Hb, Ht, K, Na, Cl) and collaboration with doctors in addition to via parenteral fluids as indicated.

2. Acute Pain

characterized by headache, clients complained of pain in the abdomen, and the patient appears grimaced in pain.

Goal: pain can be reduced.

Intervention:

Assess the location, pain scale, assess the client's ability to withstand pain, distraction, relaxation techniques do to relieve pain, perform a comfortable positioning, collaboration in providing analgesic.

3. Risk for Imbalanced Nutrition, Less Than Body Requirements related to inadequate intake and vomiting

characterized by drop in weight.

Goal: Risk nutrition less than body requirements not happen.

Expected outcomes:

Appetite increased, indicating a stable body weight / ideal, value bowel / intestinal peristalsis normal (6-12 times per minute) normal laboratory values​​, conjunctiva and mucous membranes pale lips.

Intervention:

Assess the client's nutritional patterns, assess eating likes and dislikes on the client, advise bed rest / activity restrictions during the acute phase, weights every day. Encourage clients to eat little but often, record or report things like nausea, vomiting, stomach pain and distention, collaboration with a nutritionist for dietary administration, collaboration in laboratory tests such as hemoglobin, hematocrit and albumin and collaboration with doctors in antiemetic drug.

4. Hyperthermia related to the infection of salmonella thypii

Purpose: Hyperthermia resolved.

Expected outcomes:

Temperature, pulse and respiration within normal limits, free from cold and no complications related to the problem of typhoid.

Intervention:

Observation of body temperature, encourage families to limit the activities of the client, give a cold compress on the area axila, groin, temporal when heat, encourage families to put on clothing that can absorb sweat like cotton, collaboration with physicians in the delivery of anti-pyretic.

Nursing Care in Children with Diarrhea and Typhoid

Nursing Care in Children with Diarrhea and Typhoid

Nursing Care in Children with Disorders of the Digestive System Caused by Diarrhea and Typhoid

Theoretical Overview

Gastrointestinal tract plays a role in a series of processes: the process of food ingestion, digestion of food process, aided by the digestive fluid produced by the salivary glands, liver and pancreas. The results of digestion of nutrients will be absorbed into the body. This process takes place starting from the mouth to the rectum.

Disorders of the gastrointestinal tract in infants and children can be caused by congenital abnormalities. Disorders caused by abnormalities that can be caused by either trauma or infection of the gastrointestinal tract or the outside of the gastrointestinal tract. Congenital abnormalities can occur in the mouth, esophagus, pylorus, and duodenum in the passage disorder, rectal atresia, and imperforate anus, Hirschsprung disease, biliary obstruction, and omphalocele. While the disorder can be caused by an infection caused by a fungus "Candida albicans"; bacillus coli "Escherichia coli", viruses; germ: Salmonella, Shigella, Vibrio cholerae and parasites.

Various gastrointestinal disorders are common in children such as diarrhea and typhoid, the disease can affect gastrointestinal function and immune reaction that would lead to acute symptoms and complications that will stimulate the occurrence of changes in the digestive tract itself.

Diarrhea can be caused by various infections, in addition to other causes such as malabsorption. Diarrhea especially in infants need to get immediate action because it can lead to disaster if tackled late. Food and drinks were contaminated as stale food and toxic, is one of the factors causing diarrhea, so the disease is considered to be highly vulnerable to children going through a period of growth and development.

Diarrhea


Definition of Diarrhea

Diarrhea is a state frequency of bowel movements more than 4 times in infants and more than 3 times in children, with the consistency of watery, green can be, or can be mixed with mucus and blood or mucus alone.

Diarrhea is a symptom that occurs because of abnormalities involving the functions of digestion, absorption, and secretion. Diarrhea is caused by the transport of water and electrolytes in the gut abnormal. In the world there are approximately 500 million children suffering from diarrhea each year, and 20% of all deaths in developing countries living associated with diarrhea and dehydration. Diarrheal disorders can involve disorders of the stomach and intestines (gastroenteritis), small intestine (enteritis), colon, or the colon and intestines. Diarrhea is usually classified as acute and chronic diarrhea. (Dona L.Wong, 2008)

Clinical Manifestation

At first the patient whiny, insecure, body temperature usually increases, decreased appetite or no, then arise diarrhea. Liquid stool, possibly with mucus, or mucus and blood. The longer the stool color turns greenish because it is mixed with bile. Anus and surrounding area blisters arise due to frequent defecation and fecal increasingly acidic as a result of the more lactic acid derived from lactose that is not absorbed by the intestine during diarrhea. Symptoms of vomiting can occur before or after the diarrhea and stomach can be caused by inflammation or due to interference contribute acid-base and electrolyte balance. If the patient has a lot of fluid and electrolyte loss, dehydration symptoms begin to appear, ie weight loss, reduced turgor, eyes and large fontanel becomes concave (in infants, lips and mucous membranes of the mouth and the skin looks dry.


Typhoid

Definition of Typhoid

Typhoid fever is an acute infectious disease that usually affects the gastrointestinal tract with symptoms of fever more than a week, digestive disorders and disorders of consciousness. The cause of this disease is Salmonella typhi, gram-negative bacillus that moves with fur shakes, no spores.

Clinical Manifestation

Clinical Manifestation of typhoid fever in children are usually milder than in adults. Future shoots 10-20 days. The shortest 4 days if the infection occurs through food, whereas if through drink longest 30 days. During the incubation period may be found prodromal symptoms, ie feeling of malaise, lethargy, headache, dizziness not excited and lack of appetite.

Clinical features commonly found are:

1. Fever
In the typical case, the fever lasts 3 weeks, and remittances are febrile temperature is not very high. During the first week, the temperature gradually increased each day, usually down in the morning and rose again on the afternoon and evening. In the second week the patient continues to be in a state of fever, in the third week of temperatures going down and back to normal by the end of the third week.

2. Disorders of the gastrointestinal tract.
In the mouth there is a breath smells, lips dry and chapped. Tongue covered with dirty white membrane (coated tongue), red tip and edges, often accompanied by tremors. Abdominal bloating can be found condition (meteorismus). Enlarged liver and spleen accompanied by pain on palpation. Usually frequent constipation or diarrhea, but can also be normal.

3. Disorders of consciousness
Patient awareness generally decreased, although not in the apathetic until somnolence, rare sopor, coma or nervous (except severe illness and delayed treatment).Clinical Manifestation
Clinical Manifestation of typhoid fever in children are usually milder than in adults. Future shoots 10-20 days. The shortest 4 days if the infection occurs through food, whereas if through drink longest 30 days. During the incubation period may be found prodromal symptoms, ie feeling of malaise, lethargy, headache, dizziness not excited and lack of appetite.