Priority Nursing Diagnosis for Hepatitis

Nursing Care Plan for Hepatitis

Hepatitis is swelling and inflammation of the liver. It is not a condition, but is often used to refer to a viral infection of the liver. Characterized by the presence of inflammatory cells in the tissue of the organ.

Hepatitis may start and get better quickly (acute hepatitis), or cause long-term disease (chronic hepatitis). In some instances, it may lead to liver damage, liver failure, or even liver cancer.

How severe hepatitis is depends on many factors, including the cause of the liver damage and any illnesses you have. Hepatitis A, for example, is usually short-term and does not lead to chronic liver problems.

The symptoms of hepatitis include:

•     Abdominal pain or distention
•     Breast development in males
•     Dark urine and pale or clay-colored stools
•     Fatigue
•     Fever, usually low-grade
•     General itching
•     Jaundice (yellowing of the skin or eyes)
•     Loss of appetite
•     Nausea and vomiting
•     Weight loss

Many people with hepatitis B or C do not have symptoms when they are first infected. They can still develop liver failure later. If you have any risk factors for either type of hepatitis, you should be tested regularly.


Priority Nursing Diagnosis for Hepatitis

1. Imbalanced Nutrition, Less Than Body Requirements
relate to:
discomfort in the right upper quadrant
impaired absorption and digestion of food metabolism
input failure to meet the metabolic needs due to anorexia, nausea and vomiting.

2. Acute pain
related to:
swelling of the liver, the inflamed liver and portal vein dam.

3. Hyperthermia
related to:
invasion agent in blood circulation secondary to liver inflammation

4. Fatigue
related to:
chronic inflammatory process secondary to hepatitis

5. Risk for skin integrity and tissue damage
related to:
pruritus secondary to the accumulation of the pigment bilirubin in the bile salts

6. Risk for the transmission of infection
related to:
infectious nature of the virus agent

Impaired Physical Mobility NCP Rheumatoid Arthritis

Nursing Care Plan for Rheumatoid Arthritis

Rheumatoid arthritis is an inflammatory arthritis and an autoimmune disease. This is where the body’s immune system attacks healthy tissues in the body, particularly the synovium the membrane joining the joints. The joints fill with fluid, due to this process and cause pain and systematic inflammation.

Rheumatoid arthritis is not only a condition linked with joints. It causes innumerable problems in other organs also such as eyes, lungs, skin and heart. Almost all of these problems are uncommon nevertheless they are crucial too, when they make their presence. Basically rheumatoid arthritis comes under the group of autoimmune diseases and hence it can make its presence in any part of the body once it catches hold of joints.

Rheumatoid arthritis is a chronic disease that may have periods of intense activity followed by a period of inactivity. Some patients may go through continuous activity that becomes worse with time. Organ damage and disability can occur with continuous rheumatoid arthritis.

The symptoms of rheumatoid arthritis come and go, depending on the degree of tissue inflammation. When body tissues are inflamed, the disease is active. When tissue inflammation subsides, the disease is inactive (in remission).

When the disease is active, symptoms can include fatigue, loss of energy, lack of appetite, low-grade fever, muscle and joint aches, and stiffness. Muscle and joint stiffness are usually most notable in the morning and after periods of inactivity.

Nursing Diagnosis: Impaired Physical Mobility

Related to:

• Skeletal deformity
• Painful
• Discomfort
• Activity intolerance
• Decreased muscle strength.

Can be evidenced by:

• Reluctance to try moving / inability to move in with their own physical environment.
• Limiting the range of motion, coordination imbalances, decreased muscle strength / control and mass (advanced stage).

The expected outcomes / evaluation criteria, patients will:

• Maintaining a function of position in the absence / restrictions contractures.
• Maintain or improve strength and function of and / or compensation of the body.
• Demonstrate techniques / behaviors enabling activities

Nursing Intervention Impaired Physical Mobility - Nursing Care Plan for Rheumatoid Arthritis

1. Evaluation / continue monitoring the level of inflammation / pain in the joints
Rationale: The level of activity / exercise depends on the development / resolution of the inflammatory process.

2. Keep the rest - bed rest / activity schedule sit down if necessary to provide a continuous period and nighttime sleep uninterrupted.
Rationale: Systemic Rest is recommended during acute exacerbations, and all phases of the disease is important to prevent exhaustion maintain strength

3. Assist with range of motion active / passive, and resistive exercise also demikiqan isometris if possible
Rationale: Maintain / improve joint function, muscle strength and general stamina.

4. Change positions frequently with sufficient amount of personnel. Demonstrate / removal of technical aids and mobility aid use, eg, trapeze
Rationale: Eliminates stress on the network and improves circulation. Facilitate patient self-care and independence. Proper removal techniques to prevent tearing skin abrasion.

5. Position with pillows, sandbags, rolls trokanter, splint, brace
Rationale: Increase stability (reducing the risk of injury) and maintain the necessary joint position and body alignment, reducing contractor.

6. Use a small pillow / thin below the neck.
Rationale: Preventing neck flexion.

7. Encourage the patient to maintain an upright posture and sitting height, standing, and walking.
Rationale: To maximize joint function and maintain mobility

8. Provide a safe environment, such as raising the chair, using the toilet railings, wheelchair use.
Rationale: Avoiding injury due to accidents / falls

9. Collaboration: consul with physiotherapy.
Rationale: Useful in formulating training programs / activities based on individual needs and identifying tools.

10. Collaboration: Provide foam mat / converter pressure.
Rationale: Reducing the pressure on the fragile tissue to reduce the risk of immobility.

Nursing Diagnosis for Hydatidiform Mole

Definition of Hydatidiform Mole

A hydatidiform mole is a relatively rare condition in which tissue around a fertilized egg that normally would have developed into the placenta instead develops as an abnormal cluster of cells. A molar pregnancy is a gestational trophoblastic disease that grows into a mass in the uterus that has swollen chorionic villi. These villi grow in clusters that resemble grapes.

Causes of Hydatidiform Mole

The specific cause behind the occurrence of Hydatidiform mole still remains to be found out. Nevertheless, the doctors point at some reasons like abnormalities in the egg, nutritional deficiencies during pregnancy. If a woman follows a diet which is low in protein, carotene and folic acid she can also contract this malady.

Symptoms of Hydatidiform Mole

• Abnormal growth of the womb (uterus) ; Excessive growth in about half of cases, Smaller-than-expected growth in about a third of cases
• Nausea and vomiting that may be severe enough to require a hospital stay
• Vaginal bleeding in pregnancy during the first 3 months of pregnancy
• Symptoms of hyperthyroidism ; Heat intolerance, Loose stools, Rapid heart rate, Restlessness, nervousness, Skin warmer and more moist than usual, Trembling hands, Unexplained weight loss
• Symptoms similar to preeclampsia that occur in the 1st trimester or early 2nd trimester -- this is almost always a sign of a hydatidiform mole, because preeclampsia is extremely rare this early in a normal pregnancy ; High blood pressure, Swelling in feet, ankles, legs

Diagnosis of Hydatidiform Mole

The physician may not suspect a molar pregnancy until after the third month or later, when the absence of a fetal heartbeat together with bleeding and severe nausea and vomiting indicates something is amiss.
First, the physician will examine the woman's abdomen, feeling for any strange lumps or abnormalities in the uterus. A tubal pregnancy, which can be life threatening if not treated, will be ruled out. Then the physician will check the levels of human chorionic gonadotropin (hCG), a hormone that is normally produced by a placenta or a mole. Abnormally high levels of hCG together with the symptoms of vaginal bleeding, lack of fetal heartbeat, and an unusually large uterus all indicate a molar pregnancy. An ultrasound of the uterus to make sure there is no living fetus will confirm the diagnosis.

Treatment of Hydatidiform Mole

Hydatidiform moles should be treated by evacuating the uterus by uterine suction or by surgical curettage as soon as possible after diagnosis, in order to avoid the risks of choriocarcinoma.[19] Patients are followed up until their serum human chorionic gonadotrophin (hCG) level has fallen to an undetectable level. Invasive or metastatic moles (cancer) may require chemotherapy and often respond well to methotrexate. The response to treatment is nearly 100%. Patients are advised not to conceive for one year after a molar pregnancy. The chances of having another molar pregnancy are approximately 1%.

Management is more complicated when the mole occurs together with one or more normal fetuses.

Carboprost (PGF2α) medication may be used to contract the uterus.



Nursing Diagnosis for Hydatidiform Mole

1. Acute Pain

2. Activity Intolerance

3. Disturbed Sleep Pattern

4. Hyperthermia

5. Anxiety

Nursing Management for Hospitalization

Definition of Hospitalization

Hospitalization is a form of individual stressors that lasted for the individual to be hospitalized.

Hospitalization is a threatening experience for individuals as stressors encountered can lead to feelings of insecurity, such as:

1. Foreign environment.
2. Parting with the people who matter.
3. Lack of information.
4. Loss of freedom and independence.
5. Experiences related to health care, more often associated with hospitals, the smaller the form of anxiety or even vice versa.

Focus on Nursing Management for Hospitalization

1. Minimize the stressor.
2. Maximizing the benefits of hospitalization provide psychological support to family members.
3. Preparing the child before entering the hospital.

1. Efforts to minimize the stressor or stressors, can be done by:

• Prevent or reduce the impact of separation.
• Prevent feelings of loss of control.
• Reduce / minimize the fear of injury and body pain.

2. Efforts to prevent / minimize the impact of separation

• Involving parents take an active role in childcare.
• Modification of the treatment room.
• Maintain contact with school activities.
• Correspondence, meeting school friends.

3. Prevent feelings of loss of control

• Avoid physical restrictions if the child can be cooperative.
• If the child in isolation doing environmental modifications.
• Create a schedule for therapeutic procedures, practice, play.
• Giving children the opportunity to make decisions and involve parents in planning activities.

4. Minimizing the fear of bodily injury and pain

• Psychologically prepare children and parents for action procedures that cause pain.
• Make the game before the child's physical preparation.
• Bringing parents whenever possible.
• Show empathy. In elective action whenever possible actions performed by telling stories, pictures. Need to do a psychological assessment of the child's ability to receive this information openly.

5. Maximizing the benefits of child hospitalization

• Help the development of children by giving parents the opportunity to learn.
• Provide opportunities for parents to learn about the child's illness.
• Improving the ability of self-control.
• Provide opportunities for socialization.
• Giving support to family members.

6. Preparing children for treatment in hospital

• Prepare wards according to the stage of the child's age.
• Orient the hospital situation.

On the first day you should take:

1. Recommend nurses and doctors.
2. Recommend on another patient.
3. Give the identity of the child.
4. Explain the rules of the hospital.