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Physical Examination of Pleural Effusion

Physical Examination of Pleural Effusion

1) Health Status

Need to review the level of consciousness, how the patient's general appearance, facial expressions during the examination, the patient's attitude and behavior toward nurses, how the mood of patients to determine the level of patient anxiety and tension. There should also be measured height and weight of patients.

2) Respiratory System

Inspection in patients with pleural effusion, a sick form of convex hemithorax, horizontal ribs, widened space between the ribs, decreased respiratory movement. Furtherance of the mediastinum toward the contra lateral hemithorax is known from the position of tracheal and cardiac ictus. Respiratory rate tended to increase and examination usually dyspneu.

Vocal Fremitus decreased primarily for the amount of pleural effusion fluid> 250 cc. In addition to palpation of the chest wall movements were also found on the left chest pain.

Percussive sound dim to be sensitive depending on the amount of liquid. If the liquid does not fill the pleural cavity, there is the upper limit of the liquid form of curved lines with the lateral end of the medical patient in a sitting position. This line is called the line "Ellis-Damoiseaux". The line is most obvious in the front of the chest, is less clear in the back.

Sound Auscultation of breath decreases until it disappears. In the sitting position more liquid upwards thinner, and behind it there is compression atelectasis of the lung parenchyma, may be found auscultation signs of compression atelectasis around the upper limit of the liquid. Coupled with the sign "i - e" that is, if the person is asked to utter the words "i", then it will sound "e" nasal, called egofoni.

3) Cardiovascular System

On inspection to note the location of ictus Cordis, normally located in the ICS - 5 on linea medio clavicularis left border of 1 cm. This examination aims to determine the presence or absence of cardiac enlargement. Palpation to calculate the frequency of the heart (health rate) and be aware of the depth and irregular heart beat or not, should also examine the thrill of vibration ictus Cordis. Percussion to determine the limit of the heart where the cardiac region sounded dull. It aims to determine is there any heart or left ventricular enlargement. Auscultation of heart sounds to determine I and II single or gallops and is there a third heart sound that may be symptoms of heart trouble and is there any murmurs that indicate the presence of increased blood flow turbulence.

4) Digestive System

At the inspection need to be considered, whether the abdominal bulge or flat, edge protruding belly or not, the umbilicus prominent or not, but it also needs to be in inspection whether or not there lumps or masses.

Auscultation to listen to the voice in which intestinal peristalsis normal values ​​5-35 times per minute. On palpation should also be noted, is there any abdominal tenderness, is there a mass (tumor, feces), abdominal skin turgor to determine the degree of hydration of the patient, whether the liver is palpable, whether the lien is also palpable. Tympanik normal abdominal percussion, the mass of solid or liquid will cause a dull sound (liver, ascites, vesika urinarta, tumors).

5) Neurological System

On inspection of the level of awareness needs to be studied, In addition to GCS examination is also required. Is there composmentis or somnolence or comma. Pathological reflexes, and how the physiological reflex. Additionally sensory functions also need to be studied such as hearing, sight, smell, touch and taste.

6) Musculoskeletal System

At the inspection should be noted there peritibial edema, palpation at both extremities to determine the level of peripheral perfusion and capillary refil time with a survey. By inspection and palpation examination of muscle strength were compared between the left and right.

7) Integumentary System

Inspection of the general condition of skin hygiene, presence or absence of color in the skin lesions, on examination with pleural effusion will usually be visible cyanosis as a result of failure of oxygen transport system. On palpation should be checked on the warmth of the skin (cold, warm, fever). Then the skin texture (smooth-rough-soft) as well as skin turgor to determine the degree of hydration of a person.

Physical Examination of Pleural Effusion

Nursing Assessment of Pleural Effusion - Patterns of Health Functions

Nursing Assessment of Pleural Effusion

Provision of Nursing Care is a therapeutic process that involves cooperation relations with clients, families or communities to achieve optimal health levels (Canpernito, 2000.2).

Nurses need the scientific method in the therapeutic process of the nursing process. The nursing process is used to assist nurses in nursing practice in a systematic in addressing nursing problems that exist, where the four components influence each other, namely: assessment, planning, implementation and evaluation form a chain.

Pleural Effusion Patterns of Health Functions

Patterns of Health Functions

1) Health Perception and Health Management

The existence of medical and hospital care affect the change in perceptions about health, but it sometimes raises an incorrect perception towards health maintenance. The possibility of a history of smoking, drinking alcohol and drug use can be a predisposing factor of disease onset.

2) Nutritional Metabolic Pattern

In the assessment of nutritional and metabolic patterns, we need to take measurements of height and weight to determine the patient's nutritional status, but also need to be asked eating and drinking habits before and during the hospital, patients with pleural effusion will experience a decrease in appetite as a result of shortness of breath and an emphasis on abdominal structures. Increased metabolism will occur due to the disease process. patients with pleural effusion are generally weak state.

3) Elimination Pattern

In the assessment of the pattern of elimination need to be asked about bowel habits before and after in hospital. Because the patient's general condition is weak, the patient will be more bed rest so that it will cause constipation, but due to digestion on the structure of the abdomen causes a decrease in the peristaltic muscles of the digestive tract.

4) Activity and Exercise Pattern

Due to shortness of breath, tissue oxygen demand will be less satisfied and examination will quickly experience fatigue on minimal activity. Besides, patients will also reduce its activity due to chest pain. And to meet the needs of its most ADL needs of patients assisted by a nurse and family.

5) Sleep Rest Pattern

The presence of chest pain, shortness of breath and increased body temperature will affect the fulfillment of needs sleep and rest, in addition to changes in environmental conditions of a quiet home environment into the hospital environment, where many people are walking around, noisy, and so forth.

6) Role-Relationship Pattern

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

7) Self-Perception-Self-Concept Pattern

Patient's perception of themselves will change. Patients who had been healthy, suddenly experienced 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 might lose a positive image of himself.

8) Cognitive-Perceptual Pattern

Sensory function of patients had no change, so does the thinking process.

9) Sexuality and Reproduction

For patients who do not know the process will experience stress and illness may be a lot of patients ask nurses and doctors who cared for him or anyone who may be more to know about his illness.

10) Coping-Stress Tolerance Pattern

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

11) Value-Belief Pattern

As a religious patient will be closer himself and always pray to God.

Anemia

NANDA Anemia

Nursing Diagnosis for Anemia
Anemia is a condition in which the number of red blood cells or their oxygen-carrying capacity is insufficient to meet physiologic needs, which vary by age, sex, altitude, smoking, and pregnancy status.

There are several types and classifications of anaemia. This is a condition in which the body lacks the amount of red blood cells to keep up with the body's demand for oxygen.

Causes of Anemia
Except for the acute form, anemia is a result of systemic toxemia and acidosis-a condition of poisons, toxins and accumulated waste products floating in the blood - and lymph-streams, and of enervation or lowered nerve-tone. There is either an accumulation of these injurious substances due to failure of eliminative organs to handle a normal amount of such products, or they are produced in such considerable quantities that even normal organs, eliminating a normal amount or more than a normal amount of eliminations can not remove them rapidly enough. They have the effect of poisoning the organs that make the blood cells, which produce a deficient amount of blood cells or altered blood cells.
The signs and symptoms of this disease are:
1. Paleness
2. Headache
3. Irritability
Symptoms of more severe iron deficiency anaemia include:
1. Dyspnea
2. Rapid heartbeat
3. Brittle hair and nails
Treatment of Anemia
Treatment should be directed at the cause of the anemia. In some cases, blood transfusions and the medication erythropoietin will correct anemia. For example, treatment for sickle cell anemia is different than treatment for a diet low in iron or folic acid. Talk to your HCP about the best treatment for the cause of your anemia. Other Treatment Injectable EPO (e.g., PROCRIT®, EPOGEN®) is an alternative to blood transfusion to treat critically ill patients with anemia. Exogenous EPO is identical to the natural hormone in its role of stimulating the bone marrow to produce red blood cells. EPO has been used safely in many clinical settings, including chronic renal failure, oncology, and surgery. In the ICU, use of EPO has been shown to reduce the amount of blood transfused by almost 50%, at the same time significantly increasing hemoglobin levels.
NANDA Anemia



Nursing Diagnosis for Anemia
  1. Activity Intolerance
  2. Impaired oral mucous membrane
  3. Imbalanced Nutrition: Less than Body Requirements
  4. Constipation/Diarrhea
  5. Risk for Infection
  6. Risk for deficient fluid volume
  7. Deficient Knowledge regarding condition, prognosis, treatment, self-care, prevention of crisis, and discharge needs,
  8. Fatigue
  9. Fear
  10. Ineffective coping
  11. Ineffective thermoregulation.

Ineffective Coping

Ineffective Coping NANDA Definition: Inability to form a valid appraisal of the stressors, inadequate choices of practiced responses, and/or inability to use available resources.

Ineffective Coping Related Factors :
Situational/maturational crises
High degree of threat
Inadequate opportunity to prepare for stressor; disturbance in pattern of appraisal of threat
Inadequate level of confidence in ability to cope/perception of control; uncertainty
Inadequate resources available; inadequate social support created by characteristics of relationships
Disturbance in pattern of tension release; inability to conserve adaptive energies
Gender differences in coping strategies
[Work overload, no vacations, too many deadlines; little or no exercise]
[Impairment of nervous system; cognitive/sensory/perceptual impairment, memory loss]
[Severe/chronic pain]

Ineffective Coping Defining Characteristics

SUBJECTIVE
Verbalization of inability to cope or inability to ask for help
Sleep disturbance; fatigue
Abuse of chemical agents
[Reports of muscular/emotional tension, lack of appetite]

OBJECTIVE
Lack of goal-directed behavior/resolution of problem, including inability to attend to and difficulty with organizing information;
[lack of assertive behavior]
Use of forms of coping that impede adaptive behavior [including inappropriate use of defense mechanisms, verbal manipulation]
Inadequate problem-solving
Inability to meet role expectations/basic needs
Decreased use of social supports
Poor concentration
Change in usual communication patterns
High illness rate [including high blood pressure, ulcers, irritable bowel, frequent headaches/neckaches]
Risk taking
Destructive behavior toward self or others [including overeating, excessive smoking/drinking, overuse of prescribed/OTC medications, illicit drug use]
[Behavioral changes (e.g., impatience, frustration, irritability, discouragement)]

Desired Outcomes/Evaluation
Criteria—Client Will:
• Assess the current situation accurately.
• Identify ineffective coping behaviors and consequences.
• Verbalize awareness of own coping abilities.
• Verbalize feelings congruent with behavior.
• Meet psychological needs as evidenced by appropriate expression of feelings, identification of options, and use of resources.

Acute Pain

Acute Pain NANDA Definition: Unpleasant sensory and emotional experience arising from actual or potential tissue damage or described in terms of such damage (International Association for the Study of Pain); sudden or slow onset of any intensity from mild to severe with an anticipated or predictable end and a duration of less than 6 months

Pain is a highly subjective state in which a variety of unpleasant sensations and a wide range of distressing factors may be experienced by the sufferer. Pain may be a symptom of injury or illness. Pain may also arise from emotional, psychological, cultural, or spiritual distress. Pain can be very difficult to explain, because it is unique to the individual; pain should be accepted as described by the sufferer. Pain assessment can be challenging, especially in elderly patients, where cognitive impairment and sensory-perceptual deficits are more common.

Acute Pain Defining Characteristics
  • Patient reports pain
  • Guarding behavior, protecting body part
  • Self-focused
  • Narrowed focus (e.g., altered time perception, withdrawal from social or physical contact)
  • Relief or distraction behavior (e.g., moaning, crying, pacing, seeking out other people or activities, restlessness)
  • Facial mask of pain
  • Alteration in muscle tone: listlessness or flaccidness; rigidity or tension
  • Autonomic responses (e.g., diaphoresis; change in blood pressure [BP], pulse rate; pupillary dilation; change in respiratory rate; pallor; nausea)
Acute Pain Related Factors:
  • Postoperative pain
  • Cardiovascular pain
  • Musculoskeletal pain
  • Obstetrical pain
  • Pain resulting from medical problems
  • Pain resulting from diagnostic procedures or medical treatments
  • Pain resulting from trauma
  • Pain resulting from emotional, psychological, spiritual, or cultural distress
NOC Outcomes (Nursing Outcomes Classification)
Suggested NOC Labels
  • Comfort Level
  • Medication Response
  • Pain Control
NIC Interventions (Nursing Interventions Classification)
Suggested NIC Labels
  • Analgesic Administration
  • Conscious Sedation
  • Pain Management
  • Patient-Controlled Analgesia Assistance
  • Expected Outcomes
  • Patient verbalizes adequate relief of pain or ability to cope with incompletely relieved pain.

Acute Confusion

Acute Confusion NANDA Definition: Abrupt onset of a cluster of global, transient changes and disturbances in attention, cognition, psychomotor activity, level of consciousness, or the sleep/wake cycle

Acute Confusion Defining Characteristics: Lack of motivation to initiate and/or follow through with goal-directed or purposeful behavior; fluctuation in psychomotor activity; misperceptions; fluctuation in cognition; increased agitation or restlessness; fluctuation in level of consciousness; fluctuation in sleep-wake cycle; hallucinations

Acute Confusion Related Factors: 60 years of age; dementia; alcohol abuse; abuse; delirium; uncontrolled pain; multiple morbidities and medications

NOC Outcomes (Nursing Outcomes Classification)
Suggested NOC Labels
• Distorted Thought Control
• Information Processing
• Memory
• Neurological Status: Consciousness
• Safety Behavior: Personal
• Sleep

Client Outcomes
• Cognitive status restored to baseline
• Obtains adequate amount of sleep
• Demonstrates appropriate motor behavior
• Maintains functional capacity

Asthma

NANDA Asthma

Nursing Diagnosis for Asthma

Asthma is a very serious condition so everyone should be aware of the symptoms. Asthma is a common respiratory disease that affects a person's airways. Asthma affects the individuals ability to breathe normally and can cause tightness in the chest, coughing and wheezing and shortness of breath, in more serious cases it can trigger asthma attacks that can be life threatening to the individual.

Around 7 percent of the US population has asthma, ranging from mild to chronic types. During an asthma attack, the bronchi constricts, obstructing the airflow. In chronic cases, it can cause long term lung inflammation.

When the bronchial tubes are constricted there is less room| for air to flow and you then have trouble breathing naturally. The airways in asthma sufferers can be sensitive and irritable, which means that a trigger can cause the airways to react and start the onset of symptoms. Such triggers vary, but usually it will be animal hair, dust/smoke and pollen.

There are a number of cases of asthma where the symptoms are so severe that they can be life-threatening if not controlled. Having access to the best medications which can be swiftly applied is necessary, which is why a lot of asthma sufferers carry inhalers that can easily dispense Salbutamol and relieve symptoms quickly. Long lasting drug treatments can also lessen the seriousness of attacks when they take place, so make sure that any medicine prescriptions are adhered to rigorously. These medicines are dispensed via the inhalers.

In mild cases, asthma may only manifest with just a few sneezes; though most asthma attacks usually go with wheezing, tightness in the chest, shortness of breath and coughing. These symptoms can be compounded by flu or colds and difficulty sleeping at night due to coughing. Asthma triggers vary from person to person. Allergens like dust, pollen and mold, sudden changes in temperature, stress, exercise, and air pollution can trigger an asthma attack. Early signs of asthma include irregular breathing, coughing, difficulty speaking, plus stuffy nose, fatigue, and itchy throat.

When it comes to treating Asthma symptoms, there are many choices available, from inhalers and medications to steroids and anti-inflammatory's. A nebulizer may be prescribed by your physician if symptoms are particularly bad. A nebulizer is a machine that allows the drugs normally taken as a liquid or through an inhaler to be converted to a mist that you breathe in using a mask for easy and quick absorption.

Asthma

NANDA Asthma Nursing Diagnosis

Nursing Diagnosis for Asthma


  1. Ineffective Airway Clearance

  2. Fatigue

  3. Imbalanced Nutrition: Less than Body Requirements

  4. Deficient Fluid Volume

  5. Anxiety

  6. Interrupted Family Processes

  7. Deficient Knowledge
Asthma Nursing Diagnosis Asthma

Hepatitis

NANDA Hepatitis

Nursing Diagnosis for Hepatitis

Hepatitis is a serious inflammation of the liver and is usually caused by certain types of viruses. Hepatitis is characterized by the destruction of a number of liver cells and the presence of inflammatory cells in the liver tissue caused by excessive alcohol drinking, disorders of the gall bladder or pancreas, including medication side effects, and infections.

There are some types of bacteria that can also cause hepatitis. Hepatitis can be either acute or chronic. Acute is the rapid onset with severe symptoms and for a short time. Chronic is long standing and can come on slowly, with or without any symptoms and last for a long time.

Probably the most well known but not the most common cause is alcohol abuse. However, there are also many drugs that have a toxic effect on the liver and cause inflammation particularly when used in large quantities. One of these is an over the counter pain killer known as acetaminophen. Taken in high doses it can seriously injure the liver. Prescription drugs that cause problems are methyldopa, isoniazid, valproate, and amiodarone.

Most of the known viruses do not affect the liver. When doctors speak about hepatitis, they are usually referring to any of the five viruses identified that primarily attack the liver and are referred to as types A, B, C, D and E.

Hepatitis A is highly contagious and is spread by consuming food or water that has been contaminated by infected fecal material. Improperly cooked shellfish are another source. The period of contagion lasts from six days to six weeks. It usually requires one to two months to recover from the disease. There is a vaccine for Hepatitis A and doctors strongly recommend that anyone planning to travel to an area where Hepatitis A is common be vaccinated. It should also be given to health care workers who may be exposed to the virus such as medical laboratory workers and daycare workers. Travelers to infected areas should drink only bottled water and avoid uncooked and partially cooked foods.
Hepatitis B is spread by infected blood. It may also be transmitted through contact with infected saliva. Drug abusers are at high risk due to the sharing of needles. It is possible to be infected with the Hepatitis B virus but never develop hepatitis. There is also a vaccine available that produces long lasting immunity to hepatitis. The vaccine is recommended for all infants and children under 18, and anyone with a skin puncture from a possibly contaminated implement. People whose work, travels, or lifestyle increases their susceptibility to the virus are also advised to be vaccinated. This group would include health care workers who are exposed to blood, travelers, residents of custodial institutions and the staff.
Hepatitis C is transmitted in the same manner as Hepatitis B and the same people are at risk. However, people who received blood transfusions prior to 1990 are also at risk because the virus had not yet been discovered. Hepatitis D will only result in hepatitis when the B virus is also present. The D virus is spread through close personal contact rather than being exposed to blood. Hepatitis E is somewhat like Hepatitis A but it rarely occurs in the United States.
NANDA Hepatitis



Nursing Diagnosis for Hepatitis

  1. Imbalanced nutrition: Less than body requirements

  2. Impaired skin integrity

  3. Activity Intolerance

  4. Acute pain

  5. Hyperthermia

  6. Risk for Infection

Nursing Care Plan For Tetanus

Nursing Care Plan for Tetanus. Nursing Assessment - Nursing Care Plan for Tetanus History of present illness: a severe injury, burns and inadequate immunization. *Respiratory System: dyspnea, cyanosis and asphyxia due to respiratory muscle contraction.

Nursing Assessment - Nursing Care Plan for Tetanus

  • History of present illness: a severe injury, burns and inadequate immunization.
  • *Respiratory System: dyspnea, cyanosis and asphyxia due to respiratory muscle contraction.
  • Cardiovascular System : dysrhythmias, tachycardia, hypertension and bleeding, initially the body temperature 38-40 ° C or febrile up to the terminal 43-44 ° C.
  • Neurologic System: irritability (early), weakness, convulsions (late), paralysis of one or several nerves of the brain.
  • Urinary System l: urinary retention (bladder distension and urine output does not exist / oliguria)
  • Digestive System: constipation due to no bowel movements.
  • Integument and muskuloskletal System: pain, tingling at the site of injury, sweating, initially trismus, muscle spasms face with increasing contraction eyebrows, risus sardonicus, stiff muscles and difficulty swallowing.
  • If this continues there will be the status of general convulsions and seizures.


Nursing Diagnosis for Tetanus

  1. Ineffective airway clearance related to the accumulation of sputum in the trachea and respiratory muscle spasms.
  2. Breathing pattern disorders related to impaired airway due to spasm of respiratory muscles
  3. Increased body temperature (hyperthermia) related to the effects of toxins (bacteremia)
  4. Changes in nutrition, less than body requirements related to the mastication muscle stiffness
  5. Disturbed interpersonal relationships related to speech difficulties
  6. Impaired daily needs related to the condition of weak and frequent seizures
  7. The risk of fluid and electrolyte imbalances related to intake of less and oliguria
  8. Risk of injury related to frequent seizures
  9. Lack of knowledge of the client and family about tetanus disease related to lack of information.
  10. Lack of rest requirements related to frequent seizures.

Nursing Diagnosis and Nursing Intervention for Neonatal Tetanus

Nursing Diagnosis for Neonatal Tetanus
  1. Ineffective breathing pattern related to respiratory muscle fatigue
  2. Imbalanced nutrition, Less than body requirements related to the baby's sucking reflex is inadequate.
Nursing Intervention for Neonatal Tetanus
Nursing Diagnosis I
Ineffective breathing pattern related to respiratory muscle fatigue
Nursing Intervention:


  • Assess the frequency and pattern of breath
  • Note the presence of apnea, the frequency change of heart, muscle tone and skin color.
  • Perform cardiac and respiratory monitoring continuously.
  • Suction airway as needed.
  • Give the tactile stimulation immediately after apnea.
  • Monitor laboratory tests as indicated.
  • Give oxygenation as indicated.
  • Give medications as indicated.
Nursing Diagnosis II
Imbalanced nutrition, Less than body requirements related to the baby's sucking reflex is inadequate.
Nursing Intervention:
  • Assess the maturity of the reflex with respect to feeding, sucking, swallowing and coughing.
  • Auscultation bowel sounds.
  • Review the signs of hypoglycemia.
  • Give appropriate medication electrolyte supplements.
  • Give parenteral nutrition.
  • Monitor laboratory tests as indicated.
  • Make provision of drinking according to tolerance.

How to Fight PMS Premenstrual Syndrome

Statistic shows that more than 40 %women suffer from premenstrual syndrome (PMS). When these days come we are tense irritated, aggressive and in really bad mood. Additional we don’t feel well with crumps, aches, tender breast and swollen ankles or even constipation.

I would like to share with you some tips, thanks to which you can reduce or eliminate the symptoms of PMS.

Some of the PMS syndrome can affect your daily routine. To fight this effectively you should make minor changes is your diet. To fight with PMS you will need: calcium, magnesium, vitamin B6, A and E. Before you rich for supplement try to include in your diet food rich in substances, mentioned above. Whole grain products, nuts, sunflower seeds are rich in magnesium. Milk and dairy products like cheese, yoghurts contain calcium. Bananas, chicken breast, pistachio nuts, asparagus, avocado, eggs, milk and almonds, carrots mangoes and apricots are rich in vitamins A, E and B6.

Exercise: Don’t stop exercising when you suffer from PMS syndrome. While you exercise body release “happy” hormone endorphin. You will feel relaxed and less tense. Also exercises help maintain healthy circulation and normal water retention. So stop feeling bloated and swollen.


If you smoke cut it down. The same with coffee and salt. Nicotine and caffeine will make you more nerves and your muscles more tensed. Reduce salt. Salt got ability to keep additional water inside your body.

Don’t stay in bed .I know when the PMS syndrome strikes you prefer to be alone doing completely nothing. But it will not help you to fight with bad mood. Go for a walk. Do something active. Don’t give up your normal routine only because your body tells you to do so.

I hope these few tips with help you to fight with monstrous PMS syndrome. Life is too short for having bad mood and giving up all your activity. I wish you all the best.

Read more: http://healthmad.com/health/how-to-fight-pms-premenstrual-syndrome/#ixzz1k082POem

Nursing Care Plan for Urinary Tract Infection UTI

Nursing Care Plan for Urinary Tract Infection. Drinking the recommended 10-12 eight ounce glasses of water everyday.

Urinary tract infection (UTI) is basically an infection that happens anywhere along urinary tract. Thee are several organs that if infected would constitute UTI or bladder infection, these organs are as follows: (1) The Kidneys (2) The Ureters (3) The Urinary Bladder and (4) The Urethra.

Urinary tract infection (UTI) implies multiplication of organisms in the urinary tract, and is defined by the presence of more than 100,000 organisms per ml in a midstream sample of urine (MSU).
Risk factors include urinary tract malformations, pregnancy, calculus or renal stones, urinary tract obstruction, prostatic obstruction, bladder diverticulum, spinal injury, trauma, urinary tract tumor, diabetes mellitus and immunosuppression as in case of AIDS.
Some of the symptoms of urinary tract infections are very similar. For example, while not painful discomfort, total or burning during urination, constant need to urinate are common symptoms of urinary tract infections. This is one of the most frustrating, because the symptoms usually associated with a constant desire to urinate inability to actually produce urine.

As mentioned above the site of infection can cause symptoms of urinary tract infections. If a urinary tract infection (called urethritis), the main symptom is a burning sensation during urination. If a bladder infection (cystitis called) symptoms including abdominal discomfort or pelvic pressure, frequent urination, painful, and can also be blood in the urine.

If symptoms of urinary tract infections, upper and / or lateral (side) pain, high fever, chills, or tremors, can cause nausea or vomiting, urinary tract infections develop into a kidney infection is called pyelonephritis. This is a serious infection and should seek professional medical help as soon as possible.


Nursing Care Plan for Urinary Tract Infection
1. Drinking the recommended 10-12 8 ounce glasses of water everyday can also help your body defeat the urinary tract infection. The levels of acidity in your urine Will be diluted with the increase of the intake of water. Increased water consumption can benefit many areas of your body as well, so be sure to drink plenty of water every day.

2. Unsweetened cranberry juice is one home remedy That almost everyone has heard of. By drinking 16-24 ounces of unsweetened cranberry juice a day you can help your body to protect the lining of your bladder free from bacteria. The cranberry juice makes it virtually impossible for the bacteria to hold on to the walls.

3. Vitamin C is a great deterrent for bacteria growth. Ask your doctor if you are getting enough everyday. If you are not you Should Be Able to take a vitamin supplement to increase of your intake of vitamin C. Or dietary modifications Should Be Made to Ensure you are getting enough vitamin C.

4. If you have the urge to relieve your bladder, do so. Holding it in. Will cause your bladder to stretch the which Will leave small abrasions for bacteria to grow and multiply.

5. There are some herbal supplements Could you check with your doctor about. One of the most popular is the horseradish root. This works wonders on urinary tract infections and it is thought to have antibiotic properties within it. However, some herbs can cause serious damage to other medical conditions, so consult your doctor Should you before you begin an herbal remedy treatment for your urinary tract infection.

Best Way Calorie Controlled Diet Plans

Have you ever wanted to know about calories, but didn’t know where to look? – try to maintain the following guidelines to keep calories under your control!

What is a Calorie?

A unit of energy means a Calorie that measures the amount of energy contributed by food to your body. A calorie is also understood as a measure of energy produced when food is being processed during metabolism in the body.

Good Calories v/s Bad Calories

Good calories are contributed by foods that give you energy as well as nutrition, e.g. a big guava contains 100 calories, but it also stores minerals and vitamins. A small packet of potato chips, on the other hand, will give you 200 calories but no essential nutrients.

Does gaining calories mean Gaining Weight?

Weight gain is determined by the total number of calories consumed, as against the total number of calories burned/used for energy. In other words, if you consume more calories than you burn through exercise or physical activity, your body stores these excess calories as fat, resulting in those extra unwanted kilos!

How to excess Calories affect us?

Living in a modern-day lifestyle with erratic food habits, one tends to consume more calories than what their body needs. And before you realize it, the excess calories have been converted into and stored as fat cells in the body. This results in unnecessary weight gain, unsightly bulges and, worst of all, some quite uncalled for and avoidable serious health and lifestyle-related conditions, such as high cholesterol, diabetes, heart diseases and obesity.

Keep the Calories under Control?

The key to a longer and healthier life is to keep calories under control. Getting rid of those extra calories is not as difficult as you think. A few tips that can help you burn calories without making big changes in your lifestyle:-

· Take stairs instead of lifts

· Park your car further in your parking lot

· Start your day with a 10 minute morning walk

· Play active sports with your kids

· Don’t crash diet

A Lot of Calories in Sugar – Find substitutes the Sugar!

The other way is to replace sugar with sugar substitute that has little or no calories, with the same great taste as sugar. Switching to a sugar substitute will allow you to eat the same food, while allowing you to cut excess calories intake, and thus help you remain fit. This sugar substitute helps you to indulge to your heart’s content in all the sweet delicacies. Take your choice able substitute and make a part of your daily diet and cut down up to 500 calories every day!

Read more: http://healthmad.com/health/best-way-calorie-controlled-diet-plans/#ixzz1k04EP45G

Congestive Heart Failure CHF

Congestive Heart Failure is a condition or patophysiology when the heart as pump is no longer able to provide a good blood supply for the tissue metabolism.
Congestive Heart Failure symptoms often ends up as a fatal condition, because patients with congestive heart failure are just like entering a no-way-out phase. Congestive Heart Failure is the only one disease where the morbidity and mortality increases, even some researches have done to know the patophysiology and the proper treatments. In fact, 50% of patients will die in 5 years. According to the World Health Organization (WHO), the prevalence of congestive heart disease is 22 million at 2002.
There are congestive heart failure symptoms :
  1. The cardinal signs are weakness and shortness of breath.
  2. Dyspneu d'effort: hard to breath (dyspnea) while having activities
  3. Orthopnea: dyspnea while lying
  4. Paroxysmal nocturnal dyspnea: an acute episode of heavy dyspnea, occurs at midnight or while sleeping and make patients awake, followed by dry cough and sometimes wheezing.
  5. Anorexia, nauseous, and a full feeling of the stomach are non specifics complains of the patients.

Congestive heart failure treatments:
There are three basic points of managing patients with congestive heart failure (congestive heart failure symptoms): treatments to the heart itself, treatments of underlying diseases, and treatments to the triggering factors. Medical treatments' goal is to reduce sodium and fluid retention, to increase contractility and to decrease heart preload. General treatments include bed rest, regulation of temperature and humidity, oxygen administration when needed, and diet. Drugs like inotropics (digitalis, digoxine), vasodilators (hidralazine), venodilator (nitrat, nitroglycerines, ISDN), mixed dilators (prazosine, captopril, nitroprusid), diuretics, and antiarythmia drugs. Surgery will be done for some congenital cases (for palliative, corrective) and acquired heart disease (valvuloplasty, valve replacement).

Nursing Care Plan : Nursing Diagnosis for Congestive Heart Failure (CHF)
  1. Decrease Cardiac Output related to :
    • Changes in myocardial contractility or inotropic changes
    • Changes in frequency, rhythm, cardiac conduction
    • Structural changes (eg, valve abnormalities, ventricular aneurysm)
  2. Activity Intolerance related to :
    • Weakness, weakness
    • Changes in vital signs, dysritmia
    • Dyspnea
    • Pale
    • Sweating
  3. Excess Fluid Volume related to
    • The reduced glomerular filtration rate (decrease in cardiac output) or increased production of ADH and sodium and water retention.
  4. Risk for Impaired Skin Integrity related to
    • Bed rest
    • Edema, decreased tissue perfusion.

Health Perception and Health Management

Health Perception and Health Management.

It’s focused on the person’s perceived level of health and well-being, and on practices for maintaining health. Also evaluated Habits including smoking and alcohol or drug use.

  • Contamination
  • Disturbed energy field
  • Effective therapeutic regimen management
  • Health-seeking behaviors (specify)
  • Ineffective community therapeutic regimen management
  • Ineffective family therapeutic regimen management
  • Ineffective health maintenance
  • Ineffective protection
  • Ineffective therapeutic regimen management
  • Noncompliance (ineffective Adherence)
  • Readiness for enhanced immunization status
  • Readiness for enhanced therapeutic regimen management
  • Risk for contamination
  • Risk for infection
  • Risk for injury
  • Risk for perioperative positioning injury
  • Risk for poisoning
  • Risk for sudden infant death syndrome
  • Risk for suffocation
  • Risk for trauma
  • Risk-prone health behavior

11 Gordon’s Functional Health Patterns - Health Perception and Health Management

Diabetes

NANDA Diabetes

Nursing Diagnosis for Diabetes

Diabetes mellitus is a metabolic disorder characterized by hyperglycemia (high blood sugar). Diabetes is a disease in which the body doesn't produce or properly use insulin. Insulin is a hormone produced in the pancreas, an organ near the stomach. Insulin is needed to turn sugar and other food into energy.

Many doctors and researching call the rise in diabetes cases an epidemic of the world. Constant research is being performed to seek out new person with diabetes treatments to control blood sugar and reduce the health related side effects associated with the condition.

There is no known cause for the onset of diabetes. However, there are certain factors that place a person at higher risk of contracting diabetes.
The risk factors of diabetes can include:
  • A family history of diabetes
  • Obesity
  • Poor diet
  • Physical inactivity
Three main forms of diabetes: type 1, type 2, and gestational diabetes (occurring during pregnancy),[1] which have similar signs, symptoms, and consequences, but different causes and population distributions. Ultimately, all forms are due to the beta cells of the pancreas being unable to produce sufficient insulin to prevent hyperglycemia.[2] Type 1 is usually due to autoimmune destruction of the pancreatic beta cells which produce insulin. Type 2 is characterized by tissue-wide insulin resistance and varies widely; it sometimes progresses to loss of beta cell function. Gestational diabetes is similar to type 2 diabetes, in that it involves insulin resistance; the hormones of pregnancy cause insulin resistance in those women genetically predisposed to developing this condition.

Common Causes of Diabetes

There are some common diabetes causes that include genetic causes as well as environmental causes. The risk of diabetes is higher if there is a family history of diabetes. Environmental factors that can lead to the onset of diabetes include poor diet, lack of exercise, obesity, and stress. Diabetes is a disease that can be prevented -or controlled once a diagnosis has been made.

Symptoms of Diabetes

People with diabetes often complain of having some of the following vague unexplained concerns, which may indicate that you perhaps could be exhibiting diabetic type symptoms:

• Unexplained weight loss
• Deep breathing while not exerting yourself
• Insatiable hunger and thirst
• Fatigue or tiredness
• Frequent urination
• Vomiting or nausea
• Sores that take longer than usual to heal
• Itchy or crawl sensation on your skin

The list above is not an inclusive list by any means but they are symptoms that are should be investigated further by your medical professional. An early diagnosis of diabetes can then get you not only relief from the symptoms you are displaying but proper treatment to keep your diabetes in hand in order for you to remain well.

While the symptoms of diabetes are not life threatening, diabetes can lead to other more serious diseases and illnesses. People who have been diagnosed with diabetes are at a higher risk of diseases and illnesses such as heart disease, stroke, kidney disease, neuropathy and nerve damage, foot conditions, and blindness. It is extremely important to control your diabetes in order to avoid the onset of these more serious and sometimes life-threatening illnesses.
There are medications that can be used in the control of diabetes, as well as many natural remedies. However, the single most important aspect of a diabetic management plan is a healthy diet and exercise. A healthy diet should consist of fresh fruits, fresh vegetables, carbohydrates in healthy portions, Omega-3 fatty acids, proteins in healthy portions, and fiber. A healthy diet not only helps your overall health, but also can be a major factor in offsetting the symptoms of diabetes. The longer you can prevent the symptoms of diabetes, the longer you can decrease the risks of more serious illnesses associated with diabetes.

NANDA Diabetes



Nursing Diagnosis for Diabetes
  1. Impaired Skin Integrity

  2. Impaired Physical Mobility

  3. Pain (Acute / Chronic)

  4. Imbalanced Nutrition, Less Than Body Requirements

  5. Risk for Infection

  6. Disturbed Sleep pattern

  7. Impaired Physical Mobilization

  8. Knowledge deficient

  9. Anxiety
Nursing Diagnosis for Diabetes


Hypertension / High Blood Pressure Causes, Symptoms and Treatment

Hypertension / High Blood Pressure Causes, Symptoms and Treatment

Hypertension / High Blood Pressure Causes, Symptoms and Treatment

Hypertension means the chronic elevation of blood pressure in the arteries. The heart pumps blood to the other organs of the body with every heart beat through the arteries.

High blood pressure (also known as hypertension) is a dangerous and deadly disease. Many people each year die from this disease because they never knew they were affected by it. High blood pressure makes the heart work harder to pump the blood and this in turn leads to organ damage and the onset of many illnesses like: heart attack, stroke, heart failure, aneurysm, and renal failure.

Hypertension is considered to be present when a patient's systolic blood pressure is consistently 140 mmHg or greater, and/or their diastolic blood pressure is consistently 90 mmHg or greater. This is also known as 140/90 when the nurse or doctor tells you what your blood pressure is during a checkup.

Hypertension / High Blood Pressure Causes

The major cause is due to fast paced lifestyles and unhealthy eating habits. Hypertension causes damage to the vital organs of the body and the preventive factor would be to be aware of hypertension causes and take preventive measures.

The causes of hypertension are often complicated, numerous and far reaching. In some medically straightforward cases the cause of hypertension is some other illness or disease. For example, diabetes, kidney disease and certain cancerous tumors will directly cause hypertension. But in the majority of cases, hypertension is caused by a half dozen or so different factors. Heredity, salt consumption, obesity and how much caffeine and alcohol you consume are very common contributing factors to hypertension. Even stress at work, at home, your age, race, occupation and how much noise you are exposed to contribute to increasing your blood pressure. But perhaps the most pervasive contributing factor to hypertension in our world today is high cholesterol.

Hypertension / High Blood Pressure Symptoms

The signs and symptoms of hypertension, or high blood pressure as it is also known as, include blood pressure readings that are consistently more than 140/90. Pre-hypertension is present when your blood pressure readings are consistently between 120-139/80-89. Although this does not mean you have hypertension, it is a good indicator that you will most likely develop high blood pressure in the future.

Some of the symptoms of hypertension can include:
  • headaches
  • being tired all the time
  • blurred vision
  • nosebleeds
  • ringing in the ears
  • chest pain
  • irregular heartbeat
  • feeling of confusion off and on
  • heart failure
If you experience any of these signs and symptoms of hypertension, get to your doctor immediately. Don't wait until it's too late. Your doctor can perform tests and get you on treatment that will reduce the risks of this deadly disease.

Hypertension / High Blood Pressure Treatment

Treatment of hypertension can include a continuous intravenous infusion of prostacyclin. This improves exercise capacity, quality of life, hemodynamics and long-term survival in patients with primary pulmonary hypertension. Management of secondary pulmonary hypertension includes correction of the underlying cause and reversal of hypoxemia. Treatment with a non-selective beta blocker is often commenced once portal hypertension has been diagnosed, and almost always if there has already been bleeding from esophageal varices. Typically, this is done with either propranolol or nadolol . Common beta blockers include acebutolol (Sectral), atenolol (Tenormin), bisoprolol (Zebeta), metoprolol (Lopressor), nadolol (Corgard), and timolol (Blocadren), nebivolol (Bystolic). Treatment may involve angioplasty and stenting of the renal arteries.

Hypertension / High Blood Pressure Causes, Symptoms and Treatment

Hypertension

Hypertension

Nursing Diagnosis for Hypertension

Hypertension is the medical term used to describe high blood pressure. Blood pressure is a measurement of the force against the walls of the arteries as blood pumps cycles from the heart through the rest of the body. Blood pressure readings are given as two numbers. The first number is called the systolic blood pressure. Systolic pressure is amount of pressure that blood exerts on vessels while the heart is beating. Diastolic blood pressure measures the pressure in blood vessels between heartbeats, or when the heart is resting. A person with hypertension with has a systolic reading of over 140 and a diastolic reading of over 90.

There is Primary Hypertension - which for the most part causes are unknown and then there is Secondary Hypertension - which could be the result of underlying conditions.
1. High Sodium Intake - Sodium causes smooth vascular muscle to constrict smaller blood vessels creating more resistance to blood flow thereby elevating your pressure. Also Sodium causes the body to retain water, With the additional water, more pressure is exerted against the blood vessels causing your pressure to rise.
The daily recommended salt intake is 5g. Americans consume 2 - 4 times that amount.
2. Genetics - If hypertension runs in the family, it is advisable to see your doctor to monitor your pressure.
3.Medications - Herbal supplements and some allergy medications can also elevate your pressure for e.g. Aleve, Motrin, Advil, nasal decongestants and sprays, also birth control pills. These can interfere with your blood pressure medication.
4. Alcohol - Excessive drinking is another Hypertension Cause, studies have shown that when heavy drinkers reduce their alcohol consumption their high blood pressure drops a couple of points.
5. Smoking - Tobacco nicotine causes narrowing of the blood vessels, whereby putting more strain on the heart making your pressure go up, also smoking causes plaque build up which causes an increase in blood pressure.
6. Aging Factor - This is one factor we have no control over - As you get older your blood pressure tends to increase.
7. Race - Studies have shown that Black Americans are at a higher risk for hypertension than White Americans. Those with the lowest risk are white females, the highest risk black females.
While many patients would prefer just being given a prescription and continuing their current lifestyle, this course of action is not ideal. The best way to treat high blood pressure is through lifestyle changes. The patient needs to begin exercising. The popular opinion is that thirty minutes of exercise three times a week is enough. If a patient needs to lower his blood pressure, this is probably not enough exercise. Aim for at least thirty minutes six days a week. Walking is a great exercise. If you live in an area with cold weather, a treadmill is a wise investment. The second step a patient should take is diet modification. Studies have shown that a diet high in sodium contributes to high blood pressure. Limiting the sodium can help.

In addition to lifestyle changes, there are several types of medications that reduce hypertension. These medications, called antihypertensive drugs, reduce the pressure of blood. Doctors often prescribe multiple types of medications to manage high blood pressure including, ACE inhibitors, alpha blockers, angiotesin II receptor antagonists, betablockers, calcium channel blockers, diuretics, direct rennin inhibitors and glyceryl trinitrates.


NANDA Hypertension


Nursing Diagnosis for Hypertension
  1. Risk for Decreased Cardiac Output related to increased afterload, vasoconstriction, myocardial ischemia, ventricular hypertrophy

  2. Pain: headache related to increased cerebral vascular pressure

  3. Ineffective Tissue perfusion : cerebral, renal, cardiac related to circulatory disorder

  4. Knowledge Deficit related to lack of information about the disease process and self-care.


Tuberculosis

NANDA Tuberculosis
Tuberculosis is a common and very dangerous as well as a contagious disease which can be caused by a range of strains of mycobacteria. Tuberculosis is known to exist even before the year 2000BC, and writings from Egypt and Babylon mention it. Even the in the Greek literature there can be found information about phthisis and local doctors considered this disease to be very dangerous for citizens.

Many people in the world are being infected with this disease as it is one of the most frequent and a fearsome disease and it can be measured as one third of the total world population who are now almost infected with this disease. According to WHO estimation in the year 2007, there were 13.7 million chronic active cases, which had been seen mostly in the developing countries and out of all there were 9.3 million new cases, and 1.8 million deaths were in the estimation report.

The Tuberculosis is a disease caused by the infection by a bacterium known as Mycobacterium tuberculosis. This disease has been around since the Neolithic times. The cure was recently developed and has ever since saved many lives across the globe. The bacteria causing the disease were first identified in the year 1882 by Robert Koch. He described them under the microscope as rod-shaped germs/ bacilli. The Tuberculosis can also afflict the cattle only that it is caused by Mycobacterium bovis. The bacteria from infected cattle can be transmitted via the taking of the infected milk.

The bacteria causing Tuberculosis can be spread from one person to the next via particles in the air. However, it is not a guarantee that one will get infected after the inhalation. The infection chances are determined by ones immune system whether it can be able to destroy the bacteria before it enters the body. Some people develop latent infection where they carry the bacteria but will neither present the symptoms and neither will they be contagious.

Symptoms
The important symptoms of Tuberculosis are chest pain, coughing up blood, and a productive and lingering cough for more than three weeks. There are some of the systematic symptoms of this disease too and these are continuous fever, chills, frequently getting night sweats, immediate appetite loss, weight loss, whiteness, and feeling exhausted in most of the time. The infected person has odorous mucus. Some of the extra pulmonary infections can be included, like the pleura in tuberculosis pleurisy for which the central nervous system gets affected.

NANDA Tuberculosis



Nursing Diagnosis for Tuberculosis

  1. Ineffective Airway Clearance

  2. Risk for impaired Gas Exchange

  3. Imbalanced Nutrition: Less than Body Requirements

  4. Risk for Infection

  5. Fatigue

  6. Ineffective Coping

  7. Risk for Injury

  8. Deficient Knowledge [Learning Need] regarding condition, treatment, prevention.


COPD

NANDA COPD

Nursing Diagnosis for Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease or COPD is a disease that causes destruction of airways in the lungs. In the United States, it's the fourth highest cause of death. Every year, more than 85,000 people die from COPD.

Chronic obstructive pulmonary disease (COPD) is one of the most common lung diseases. It generally defines the conditions which consist of regular difficulty in expelling or exhaling air from the lungs. There are two major forms of COPD: chronic bronchitis and emphysema. Chronic bronchitis consists of a long term cough with mucus. Emphysema is a gradual destruction of the lungs. Most people who have COPD have a combination of these forms because smoking is a major cause of both of them.

In most of cases, the root cause for COPD is smoking or consumption of tobacco. Naturally, COPD causes a number of health problems and reduces the life expectancy of those who suffer from it. If detected and treated early, life expectancy can be greatly increased, and if smoking is stopped immediately, lung has the capacity to recover dramatically. This, in turn, increases the life expectancy.

The pathophysiology of COPD is not entirely understood. Chronic inflammation of the cells lining the bronchial tree plays a major role. Smoking and, seldom, other inhaled irritants, perpetuates an ongoing inflammatory response that results in airway narrowing and hyperactivity. Airways become edematous, excessive mucus production occurs and cilia function weakly. Patients face increasing difficulty clearing secretions with disease progression. Accordingly, they develop a chronic productive cough, wheezing and dyspnea.

The basic pathophysiologic process in COPD consists of increased resistance to airflow, loss of elastic recoil and decreased expiratory flow rate. The alveolar walls frequently break because of the increased resistance of air flows. The hyper inflated lungs flatten the curvature of the diaphragm and enlarge the rib cage. The altered configuration of the chest cavity places the respiratory muscles, including the diaphragm, at a mechanical disadvantage and impairs their force-generating capacity. Consequently, the metabolic work of breathing increases, and the sensation of dyspnea heightens.

In many cases, when COPD is in its final stages, even oxygen therapy may not help the patient. In such cases transplantation of the lungs may be the only way of increasing life expectancy. Transplantation is suggested to those patients whose life expectancy is felt to be less than two to three years. However, at this stage, there is no average to determine the life expectancy of a patient.

If COPD is detected in a person, giving up smoking is the best way to increase life expectancy. Other treatments like oxygen therapy, exercise and transplantation will also help, but you cannot fight COPD unless you quit smoking.

NANDA COPD

Nursing Diagnosis for COPD

Chronic Obstructive Pulmonary Disease

Ineffective Airway Clearance related to bronchoconstriction, increased sputum production, ineffective cough, fatigue / decreased energy and bronkopulmonal infection.

Ineffective Breathing Pattern related to shortness of breath, mucus, bronchoconstriction and airway irritants.

Impaired Gas Exchange related to ventilation perfusion inequality.

Activity Intolerance related to imbalance between supply with oxygen demand.

Imbalanced Nutrition: Less than Body Requirements related to anorexia.

Disturbed Sleep Pattern related to discomfort, the setting position.

Self-Care Deficit Bathing / Hygiene, Dressing / Grooming, Feeding, toileting related secondary fatigue due to increased respiratory effort and the insufficiency of ventilation and oxygenation.

Anxiety related to threat to self-concept, the threat of death, unmet needs.

Ineffective Individual Coping related to lack of socialization, anxiety, depression, low activity levels and inability to work.

Knowledge Deficit related to lack of information, do not know the source of information.


Arthritis Treatment: Another Cause of Knee Pain - Medial Plica Syndrome

Knee pain is one of the most common problems patients come in with to a rheumatologists office. There are multiple causes of knee pain ranging from arthritis to bursitis to tendonitis and so on.
One type of knee pain that is rarely mentioned is the pain from an inflamed medial plica. This is considered an arthritis condition.
In order to understand this type of knee pain, it's important to have an understanding of basic knee anatomy.
The knee is a joint consisting of four bones, the femur (upper leg bone), tibia (the larger of two lower leg bones), the fibula (the smaller of the two lower leg bones), and the patella (the knee cap).
All the articulating (interacting) surfaces of the knee bones are covered with a thin layer of hyaline cartilage, a tough type of gristle, that helps with cushioning and shock absorption.
This entire system is enclosed inside a joint capsule. The capsule is lined with synovium, a type of tissue that provides nourishment and lubrication for the joint.
On occasion, the synovium can form a fold of tissue. This fold can occur above the knee cap, below the knee cap, and between the knee cap and femur, along the inside part of the knee.
When the fold occurs along the inside part of the knee between the patella and the femur, it can cause problems. This is called medial plica syndrome.
Pain in the region of the patella is the most common symptom. A person may also note snapping, clicking, locking, and even a sense of instability. This latter symptom is relatively rare.
Inflammation of the knee capsule, as may occur with arthritis, or trauma can aggravate the pain. In addition, bending and straightening the knee (eg. Stair climbing) can also aggravate the pain of a medial plica.
The diagnosis can be suspected clinically by the history. On examination, the patient may complain of pain located over the medial (inside) part of the joint. A sensation of snapping may be felt when the knee is flexed and straightened.
The diagnosis can be confirmed by magnetic resonance imaging (MRI) scanning.
Usually, a patient will undergo arthroscopy (insertion of a telescope inside the knee joint). At the time of arthroscopy, the medial plica will appear to be thickened and inflamed. The treatment is also rendered arthroscopically.
By introducing a motorized trimmer, the arthroscopist can carefully trim the inflamed plica so it no longer becomes trapped. This procedure is usually curative. We have seen a number of symptomatic medial plica cases that were essentially cured by this arthroscopic approach.
Nathan Wei, MD, FACP, FACR is a rheumatologist and Director of the Arthritis Treatment Center http://www.arthritistreatmentcenter.com. He is a former Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine and consultant to the National Institutes of Health. For more info: http://www.arthritis-treatment-and-relief.com

Pneumonia

NANDA Pneumonia

Pneumonia
is an illness that affects one or both lungs and that used to be one of the main causes of death 2 centuries ago. It is caused by microorganisms that attack the tissue from the lungs, causing it to inflammate and leading to a severe condition if the infection is not treated in time.

Pneumonia can be caused by bacteria, a virus or fungi and leads to an infection in either one or both of the lungs. In the United States, Approximately three million people will develop pneumonia each year, with about a half million having to be admitted to a hospital for treatment. Five percent of those who contract pneumonia die from it, making the illness the sixth principal cause of death in the United States. In this article, we look at how nutrition, protein and a well-balanced diet can help in preventing pneumonia infections.

Viral pneumonia is very common form of pneumonia affecting children, teenagers and the elderly. It can sometimes be mistaken for either the flu or a cold. Viral pneumonia presents the following symptoms: inflammation of the throat, productive or non-productive cough, a swelling in the lymph nodes, chest discomfort during breathing, mild to severe headache and a generalized feeling of fatigue. The cough may or may not produce varying amounts of mucus. You may also experience a mild fever and chills.

Some pneumonia is diagnosed only after an examination by a doctor reveals crackling sounds or coarse breathing in the chest. There may also be breathlessness, wheezing or the breathing sounds may be diminished in certain parts of the chest. A chest x-ray is the definitive way to diagnose the pneumonia, however sputum samples, blood tests and bronchoscopies can typically be ordered as well. The sputum samples can determine what the exact cause of the pneumonia is and determine the course of medical treatment. The blood work can help to determine how serious the infection is and may also provide a clue as to whether it is caused by a virus, bacteria or fungi.

NANDA Pneumonia

Nursing Diagnosis for Pneumonia
  1. Impaired Gas Exchange related to impaired oxygen delivery.

  2. Risk for Infection related to inadequate primary defenses.

  3. Ineffective airway clearance related to the formation of edema.

  4. Activity Intolerance related to insufficiency of oxygen for everyday activities.

Type 1 Diabetes Causes and Treatment

Type 1 Diabetes is a form of diabetes mellitus that results from autoimmune destruction of insulin-producing beta cells of the pancreas.

Type 1 diabetes is Diabetes mellitus type 1, T1DM, IDDM, or, formerly, juvenile diabetes.

This is the result of injury to most of the beta cells within your pancreas which usually creates insulin. In cases where these cells are destroyed, the pancreas will not be able to manufacture insulin any longer, and as a consequence it is going to have to be given via injections.

Autoimmune Disease

One of the chief reasons that generate type one diabetes is autoimmune. Brought on by autoantibodies damaging most of the 'beta' cells inside of the pancreas, they will likely stop operating. The number of 'beta' cells you might have may likely be normal when born, nevertheless months or maybe years following your birth the formation of autoantibodies will start to annihilate them.

How much time it's going to take for them to be wiped out can vary with every person. At least ninety-five percent of individuals suffering from diabetes type 1 get this affliction by the time they're just twenty five years old. The onset of diabetes type one occurs quickly, it typically requires a couple of days or maybe weeks to finally develop.

The chief trait of type one diabetes is definitely the destruction of over eighty percent of the beta cells inside the pancreas. The pancreas could actually keep working to supply you with insulin in the event that, at the minimum, twenty percent of these beta cells are performing. On the other hand, in the event that the actual number drops down below twenty percent this is the time the individual actually starts to develop the indications of diabetes.

Heredity

Family genes could also be one of many reasons for type one diabetes, however the connection is not necessarily as strong as with diabetes type 2. The occurrence of diabetes type one found in the two individuals in a pair of identical twins, ranges somewhere within thirty percent and seventy percent which shows that that there can be a probable association to inherited factors.

The chance of getting type one diabetes is ten times greater for people with a 1st degree family member suffering from this particular type of diabetes. In the event that your dad or mom has this type of diabetes, the odds of you and your sisters and brothers getting it is anywhere between five percent to fifteen percent.

Nevertheless, it needs to be mentioned that majority people that acquire diabetes type one don't have any previous record of this condition in their family.

The Environmental

Several environmental variables have likewise been implied as among the reasons behind diabetes type one even though this hasn't been verified. The main factor why it’s really hard to distinguish environmental components, as among the contributing causes, is due to the fact these factors could quite possibly have preceded the emergence of diabetes by years.

A handful of probable environmental factors that cause diabetes may include elements like viruses, or simply a unique protein contained in cow’s milk.

Additional Factors

Conditions that sometimes damage the pancreas, which includes pancreatitis, pancreatic surgery as well as distinct industrial chemical compounds might be factors that cause diabetes. Some inherited disorders, including Klinefelter syndrome, Cushing syndrome plus Huntington’s chorea, might additionally strengthen the likelihood of diabetes.


Type 1 Diabetes Treatment

Type 1 treatment must be continued indefinitely in all cases. Treatment is not intended to significantly impair normal activities, and can be done adequately if sufficient patient training, awareness, appropriate care, discipline in testing and dosing of insulin is taken. However, treatment remains quite burdensome for many people. Complications may be associated with both low blood sugar and high blood sugar, both largely due to the non-physiological manner in which insulin is replaced. Low blood sugar may lead to seizures or episodes of unconsciousness and requires emergency treatment. High blood sugar may lead to increased fatigue and can also result in long term damage to organs.

Treatment of Dissociative Amnesia

Treatment of Dissociative Amnesia

a. Anamnesa

Client a 27-year-old woman, who has a pressure and bad experiences in the past. Clients have lost the memory of past information. The family was told what he had experienced days of her past clients and provide the information needed therapist in exploring the information to the client.

b. Rapport

Therapists try to make the client feel comfortable first. Through a lightweight approach like asking the identity of the subject. Providing drinking subjects and a comfortable seat for the subject.

c. Identification

The therapist began by asking questions to deepen the experience of the past. Therapists explore the experiences of past clients who have experienced. The client was unable to recall the events of the past have ever experienced. Can be diagnosed that the client has dissociative amnesia. Someone who experienced dissociative amnesia becomes unable to name the personal information that matters, usually involving a traumatic experience or a stressful, in a form that can not be considered ordinary forgetting. Memory is lost in dissociative amnesia can return. Recalling the dissociative amnesia can occur gradually, but often appear suddenly and spontaneously.

d. Choosing Therapy

Interviews can provide clinical guidance, the originator of a psychologically traumatic. Short-acting barbiturates and work, such as thiopental (pentothal) and amobarbital sodium given intravenously and benzodiazepines can be useful to help patients recover lost memories. Hypnosis can be used primarily as a way to make the client remember what has been forgotten.

e. Doing Therapy

Therapists conduct in-depth interviews of clients psychologically. Provide thiopental (pentothal) and amobarbital sodium given intravenously and benzodiazepines. Hypnosis can be used primarily as a way to make clients relax enough to remember what has been forgotten. Clients placed in a state where somnonen on mental inhibition eliminated and forgotten material arising into consciousness and then remembered again. If the memory loss has been obtained, the therapist is usually recommended to help patients enter into a state of mind consciousness.

f. Evaluation

At the time of treatment has ended, the therapist evaluate the client's development.
· The initial phase
The client has lost his memory of his past and can not recall.
· When implemented treatment
Client driven by drugs and hypnosis is given. The client was assisted by the therapist put back in a state of conscious recollection.
· The last stage
Clients sufficiently progressed, many clients to recall what had happened to the days past. Need assistance in remembering and facing family memories have been forgotten.

Septic Shock Emergency Nursing

Septic Shock Causes

Septic shock occurs most often in the very old and the very young. It also occurs in people who have other illnesses.

Any type of bacteria can cause septic shock. Fungi and (rarely) viruses may also cause the condition. Toxins released by the bacteria or fungi may cause tissue damage, and may lead to low blood pressure and poor organ function. Some researchers think that blood clots in small arteries cause the lack of blood flow and poor organ function.

The body also produces a strong inflammatory response to the toxins. This inflammation may contribute to organ damage.

Risk factors for septic shock include:
  • Diabetes
  • Diseases of the genitourinary system, biliary system, or intestinal system
  • Diseases that weaken the immune system such as AIDS
  • Indwelling catheters (those that remain in place for extended periods, especially intravenous lines and urinary catheters and plastic and metal stents used for drainage)
  • Leukemia
  • Long-term use of antibiotics
  • Lymphoma
  • Recent infection
  • Recent surgery or medical procedure
  • Recent use of steroid medications
Septic shock is a serious condition that occurs when an overwhelming infection leads to low blood pressure and low blood flow. The brain, heart, kidneys, and liver may not work properly or may fail.

Most common of this case may it’s happened to the patients with Meningococcemia, Waterhouse-Friderichsen syndrome, DIC (disseminated intravascular coagulation), Multiple organ dysfunction syndrome (MODS), Acute Respiratory Distress Syndrome (ARDS).

Septic Shock Symtomps are :
similar to hypovolaemic shock except in the first stages:
  • Pyrexia and fever, or hyperthermia, due to overwhelming bacterial infection.
  • Vasodilation and increased cardiac output due to sepsis.
Therapy are include :
  • Restore intravascular volume via I.V fluid
  • Give supplemental O2 therapy
  • Identify and control source of infection
  • Administer antibiotic
  • Remove risk factor for infection
Septic Shock Treatment

Septic shock is a medical emergency. Patients are usually admitted to the intensive care unit of the hospital.

Treatment may include:

  • Breathing machine (mechanical ventilation)
  • Drugs to treat low blood pressure, infection, or blood clotting
  • Fluids given directly into a vein (intravenously)
  • Oxygen
  • Surgery

There are new drugs that act against the extreme inflammatory response seen in septic shock. These may help limit organ damage.

Hemodynamic monitoring -- the evaluation of the pressures in the heart and lungs -- may be required. This can only be done with special equipment and intensive care nursing.


Septic Shock Emergency Nursing

Always use the ABCDE approach.

Airway
  • Make sure the airway clearance.
  • Give the tool a respirator if necessary (nasopharyngeal).
  • If a decline in respiratory function immediately contact the anesthesiologist and the patient may be brought immediately to the ICU.

Breathing
  • Assess the amount of breathing, more than 24 times / minute is a significant symptom.
  • Assess oxygen saturation.
  • Check arterial blood gases to assess the oxygenation status and the possibility of acidosis.
  • Give 100% oxygen via non re-breath mask.
  • Chest auscultation, to determine the presence of chest infection.
  • Photo thoracic radiograph.

Circulation
  • Assess heart rate, more than 100 times / minute is a significant sign.
  • Monitoring blood pressure.
  • Check the capillary refill time.
  • Attach infusion using a large canul.
  • Replace catheter.
  • Perform a complete blood.
  • Record the temperature.
  • Prepare the urine and sputum examination.

Disability
  • Confused is one of the first signs of sepsis patients, whereas previously there were no problems (healthy and good).
  • Assess level of consciousness

Exposure
  • If the source of infection is unknown, look for the existence of injuries, cuts and the injection site and the source of other infections.
  • Sign of the threat to life.

Five Minutes of Exercise Could Help Smokers Quit


London: As little as five minutes of exercise could help smokers quit, says new study. Research published in the international medical journal Addiction showed that moderate exercise, such as walking, significantly reduced the intensity of smoker’s nicotine withdrawal symptoms. “ If we found the same effects in a drug, it would immediately be sold as an aid to help people quit smoking, “Said Dr Adrian Taylor, this study’s lead author and Professor exercise and health psychology at the university of Exeter.

Taylor and colleagues received 12 papers looking at the connection between exercise and nicotine deprivation. They focused on exercises that could be done outside a gym, such as walking and isometrics, or the flexing and tensing of muscles. According to they research, just five minutes of exercise was often enough to help smokers overcome their immediate need for nicotine fix. After various types of moderate physical exercised reported reduced a desire.