Nursing Care Plan

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Nursing Care Plan for Gastritis

Gastritis

Gastritis occurs when the lining of the stomach becomes inflamed or swollen.

Gastritis can last for only a short time (acute gastritis), or linger for months to years (chronic gastritis)

Nursing Care Plan for Gastritis


Symptoms
Many people with gastritis do not have any symptoms.

Symptoms you may notice are:
  • Loss of appetite
  • Nausea and vomiting
  • Pain in the upper part of the belly or abdomen
If gastritis is causing bleeding from the lining of the stomach, symptoms may include:
  • Black stools
  • Vomiting blood or coffee-ground like material

Gastritis is diagnosed through one or more medical tests:
  • Upper gastrointestinal endoscopy. The doctor eases an endoscope, a thin tube containing a tiny camera, through your mouth (or occasionally nose) and down into your stomach to look at the stomach lining. The doctor will check for inflammation and may remove a tiny sample of tissue for tests. This procedure to remove a tissue sample is called a biopsy.
  • Blood test. The doctor may check your red blood cell count to see whether you have anemia, which means that you do not have enough red blood cells. Anemia can be caused by bleeding from the stomach.
  • Stool test. This test checks for the presence of blood in your stool, a sign of bleeding.

Treating Gastritis

1. Conservatives on state of acute
If severe disease, patients need to be treated and given fluids per infusion.
  • Bed rest
  • Fasting, nasogastric tube pairs
  • Analgesics, antibiotics

2. When conservative treatment fails or there is a progressive toxemia cholecystectomy needs to be done. It is necessary to prevent the occurrence of complications (gangrene, perforation, empyema, pancreatitis dam kalangitis)
Cholecystectomy should be done also in the repeated attacks


Nursing Care Plan for Gastritis


Nursing Diagnosis Acute Pain related to obstruction / spasm of the duct, the inflammatory process and tissue ischemia.

Nursing Interventions for Gastritis

  • Observe and record the location and character of pain (persistent, intermittent, colicky)
  • Record the response to pain
  • Increase bed rest, let the patient make a comfortable position.
  • Control the temperature of the environment
  • Encourage use of relaxation techniques
Collaboration:
  • Anticholinergics: Atropine, Propentelin (Pro-banthine)
  • Sedatives: Phenobarbital
  • Narcotics: meperidine hydrochloride
  • Monoktanoin
  • Relaxation of smooth muscle

Nursing Diagnosis Imbalanced nutrition less than body requirements related to obstruction of bile flow

Nursing Interventions for Gastritis
  • Assess abdominal distension
  • Calculate the calorific intake, keep the comments about the appetite to a minimum.
  • Provide a pleasant atmosphere at mealtime
  • Ambulation and activities corresponding increase tolerance
Collaboration:
  • Add the appropriate diet tolerance, high fiber, low fat
  • Provide an overview of bile
  • Supervise laboratory examination
  • Give local nutritional support as needed

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Nursing Care Plan for Congestive Heart Failure

Heart failure (HF) often called congestive heart failure (CHF) is generally defined as the inability of the heart to supply sufficient blood flow to meet the needs of the body. Heart failure can cause a number of symptoms including shortness of breath, leg swelling, and exercise intolerance. The condition is diagnosed with echocardiography and blood tests. Treatment commonly consists of lifestyle measures (such as smoking cessation, light exercise including breathing protocols, decreased salt intake and other dietary changes) and medications, and sometimes devices or even surgery.

Congestive Heart Failure


Common causes of heart failure include myocardial infarction and other forms of ischemic heart disease, hypertension, valvular heart disease, and cardiomyopathy. The term "heart failure" is sometimes incorrectly used to describe other cardiac-related illnesses, such as myocardial infarction (heart attack) or cardiac arrest, which can cause heart failure but are not equivalent to heart failure.

The symptoms of congestive heart failure vary among individuals according to the particular organ systems involved and depending on the degree to which the rest of the body has "compensated" for the heart muscle weakness.
  • An early symptom of congestive heart failure is fatigue. While fatigue is a sensitive indicator of possible underlying congestive heart failure, it is obviously a nonspecific symptom that may be caused by many other conditions. The person's ability to exercise may also diminish. Patients may not even sense this decrease and they may subconsciously reduce their activities to accommodate this limitation.
  • As the body becomes overloaded with fluid from congestive heart failure, swelling (edema) of the ankles and legs or abdomen may be noticed. This can be referred to as "right sided heart failure" as failure of the right sided heart chambers to pump venous blood to the lungs to acquire oxygen results in buildup of this fluid in gravity-dependent areas such as in the legs. The most common cause of this is longstanding failure of the left heart, which may lead to secondary failure of the right heart. Right-sided heart failure can also be caused by severe lung disease (referred to as "cor pulmonale"), or by intrinsic disease of the right heart muscle (less common)
  • In addition, fluid may accumulate in the lungs, thereby causing shortness of breath, particularly during exercise and when lying flat. In some instances, patients are awakened at night, gasping for air.
  • Some may be unable to sleep unless sitting upright.
  • The extra fluid in the body may cause increased urination, particularly at night.
  • Accumulation of fluid in the liver and intestines may cause nausea, abdominal pain, and decreased appetite.

Nursing Assessment for Congestive Heart Failure

a. Identity

b. Food or liquid
Symptoms:
  • Loss of appetite
  • Nausea and vomiting
  • Swelling of the extremities
  • Diit high salt or fat, sugar and caffeine

c. Elimination
Symptoms:
  • Decreased urination, dark urine
  • Urination at night
  • Diarrhea or constipation

d. Activity / rest
Symptoms:
  • Fatigue or tiredness constantly throughout the day
  • Insomnia
  • Chest pain with activity

e. Circulation
Symptoms:
  • History of hypertension
  • Cardiac surgery
  • Anemia
  • Endocarditis

f. Ego integrity
Symptoms:
  • Anxiety, worry and fear
  • Stress-related illnesses

g. Comfort
Symptoms:
  • Chest pain, acute or chronic angina
  • Muscle pain

h. Respiratory
Symptoms:
  • Dyspnea on exertion, while sitting or sleeping with multiple pillows

i. Social interaction
Symptoms:
  • Decreased participation in usual social activities

j. Security
Symptoms:
  • Changes in mental function
  • Loss of strength or muscle tone
  • skin blisters

Nursing Diagnosis for Congestive Heart Failure

Decreased cardiac output related to
  • Changes in myocardial contractility or inotropic changes.
  • Changes in frequency, rhythm, cardiac conduction.
  • Structural changes. (eg, valve abnormalities, ventricular aneurysm)

Activity intolerance related to
  • Weakness, fatigue.
  • Changes in vital signs, presence of dysritmia.
  • Dyspnea.
  • Pale.
  • Sweating.

Excess fluid volume related to
  • The decline in glomerular filtration rate (decrease in cardiac output) or increased production of ADH and sodium and water retention.

Risk for impaired skin integrity related to
  • Bed rest.
  • Edema, decreased tissue perfusion.

Nursing Care Plan for Non-Hodgkin's Lymphoma

Non-Hodgkin's lymphoma

Non-Hodgkin's lymphoma is cancer of the lymphoid tissue, which includes the lymph nodes, spleen, and other organs of the immune system.


Causes

White blood cells called lymphocytes are found in lymph tissues. They help prevent infections. Most lymphomas start in a type of white blood cells called B lymphocytes, or B cells.
For most patients, the cause of this cancer is unknown. However, lymphomas may develop in people with weakened immune systems. For example, the risk of lymphoma increases after an organ transplant or in people with HIV infection.

There are many different types of non-Hodgkin's lymphoma. It is classified according to how fast the cancer spreads.
  • The cancer may be low grade (slow growing), intermediate grade, or high grade (fast growing). Burkitt's tumor is an example of a high-grade lymphoma. Follicular lymphoma is a low-grade lymphoma
  • The cancer is further sub-classified by how the cells look under the microscope, for example, if there are certain proteins or genetic markers present.
According to the American Cancer Society, a person has a 1 in 50 chance of developing non-Hodgkin's lymphoma. Most of the time, this cancer affects adults. However, children can get some forms of lymphoma. High-risk groups include those who have received an organ transplant or who have a weakened immune system.
This type of cancer is slightly more common in men than in women.


Signs and symptoms of NHL include the following:
  • Swollen, painless lymph nodes in the neck, armpits, or groin
  • Unexplained weight loss
  • Fever
  • Night sweats
  • Coughing, trouble breathing, or chest pain
  • Weakness and tiredness that don't go away (fatigue)
  • Abdominal pain or swelling, or a feeling of fullness in the abdomen
  • Itching of the skin

Treatment
Treatment depends on:
  • The type of lymphoma
  • The stage of the cancer when you are first diagnosed
  • Your age and overall health
  • Symptoms, including weight loss, fever, and night sweats
  • Radiation therapy may be used for disease that is confined to one body area.

Chemotherapy is the main type of treatment. Most often,multiple different drugs are used in combination together.

Another drug, called rituximab (Rituxan), is often used to treat B-cell non-Hodgkin's lymphoma.

Radioimmunotherapy may be used in some cases. This involves linking a radioactive substance to an antibody that targets the cancerous cells and injecting the substance into the body.

People with lymphoma that returns after treatment or does not respond to treatment may receive high-dose chemotherapy followed by an autologous bone marrow transplant (using stem cells from yourself).

Additional treatments depend on other symptoms. They may include:
  • Transfusion of blood products, such as platelets or red blood cells
  • Antibiotics to fight infection, especially if a fever occurs

Nursing Care Plan for Non-Hodgkin's Lymphoma

Priority Nursing
  • Providing physical and psychological support for diagnostic tests and treatment programs.
  • Preventing complications
  • Eliminate pain
  • Provides information about the disease / prognosis and treatment needs

Purpose
  • Complications prevented / decreased
  • Receive real situation.
  • Pain relief / control
  • The disease process / prognosis, possible complications and treatment programs understand.

Nursing Diagnosis Nursing Care Plan for Non-Hodgkin's Lymphoma
  • Ineffective Breathing Pattern
  • Ineffective Airway Clearance

Risk factors include
Tracheobronchial obstruction, mediastinal node enlargement or edema and airway path (Hodgkin's and non-Hodgkin's), superior vena cava syndrome (non-Hodgkin's)

Possible evidenced by
(not applicable, the existence of signs and symptoms make the actual diagnosis)

Expected Result / Patient Evaluation Criteria will
Maintaining Normal Breathing Pattern / Effective Free Dyspnea, cyanosis or Signs Other Respiratory distress