Nursing Care Plan

Nursing Care Plan for Diabetes Mellitus

NCP - Nursing Care Plan for Diabetes Mellitus

Diabetes Mellitus

Diabetes mellitus, often simply referred to as diabetes—is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced. This high blood sugar produces the classical symptoms of polyuria (frequent urination), polydipsia (increased thirst) and polyphagia (increased hunger).

There are three main types of diabetes :

Type 1 diabetes: results from the body's failure to produce insulin, and presently requires the person to inject insulin. (Also referred to as insulin-dependent diabetes mellitus, IDDM for short, and juvenile diabetes.)
Type 2 diabetes: results from insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with an absolute insulin deficiency.
Gestational diabetes: is when pregnant women, who have never had diabetes before, have a high blood glucose level during pregnancy. It may precede development of type 2 DM.

Other forms of diabetes mellitus include congenital diabetes, which is due to genetic defects of insulin secretion, cystic fibrosis-related diabetes, steroid diabetes induced by high doses of glucocorticoids, and several forms of monogenic diabetes.

All forms of diabetes have been treatable since insulin became available in 1921, and type 2 diabetes may be controlled with medications. Both type 1 and 2 are chronic conditions that usually cannot be cured. Pancreas transplants have been tried with limited success in type 1 DM; gastric bypass surgery has been successful in many with morbid obesity and type 2 DM. Gestational diabetes usually resolves after delivery. Diabetes without proper treatments can cause many complications. Acute complications include hypoglycemia, diabetic ketoacidosis, or nonketotic hyperosmolar coma. Serious long-term complications include cardiovascular disease, chronic renal failure, retinal damage. Adequate treatment of diabetes is thus important, as well as blood pressure control and lifestyle factors such as smoking cessation and maintaining a healthy body weight.en.wikipedia.org

Causes

The cause of diabetes depends on the type. Type 2 diabetes is due primarily to lifestyle factors and genetics.

Type 1 diabetes is also partly inherited and then triggered by certain infections, with some evidence pointing at Coxsackie B4 virus. There is a genetic element in individual susceptibility to some of these triggers which has been traced to particular HLA genotypes (i.e., the genetic "self" identifiers relied upon by the immune system). However, even in those who have inherited the susceptibility, type 1 diabetes mellitus seems to require an environmental trigger.

Signs and Symptoms

The classical symptoms of diabetes are polyuria (frequent urination), polydipsia (increased thirst) and polyphagia (increased hunger). Symptoms may develop rapidly (weeks or months) in type 1 diabetes while in type 2 diabetes they usually develop much more slowly and may be subtle or absent.

Prolonged high blood glucose causes glucose absorption, which leads to changes in the shape of the lenses of the eyes, resulting in vision changes; sustained sensible glucose control usually returns the lens to its original shape. Blurred vision is a common complaint leading to a diabetes diagnosis; type 1 should always be suspected in cases of rapid vision change, whereas with type 2 change is generally more gradual, but should still be suspected.

People (usually with type 1 diabetes) may also present with diabetic ketoacidosis, a state of metabolic dysregulation characterized by the smell of acetone; a rapid, deep breathing known as Kussmaul breathing; nausea; vomiting and abdominal pain; and an altered states of consciousness.

A rarer but equally severe possibility is hyperosmolar nonketotic state, which is more common in type 2 diabetes and is mainly the result of dehydration. Often, the patient has been drinking extreme amounts of sugar-containing drinks, leading to a vicious circle in regard to the water loss.

A number of skin rashes can occur in diabetes that are collectively known as diabetic dermadromes.

Nursing Care Plan for Diabetes Mellitus

Assessment

Family Health History
Are there families who suffer from illnesses such as client ?
Patient Health History and Previous Treatment
How long suffered from DM client, how to handle, get what kind of insulin therapy, how to take the medicine whether regular or not, what is done to cope with illness clients.
Activity / Rest:
Tired, weak, hard Moves / walking, muscle cramps, decreased muscle tone.
Circulation
Is there a history of hypertension, AMI, claudication, numbness, tingling in the extremities, ulcers on the feet long healing time, tachycardia, changes in blood pressure
Ego Integrity
Stress, anxiety
Elimination
Changes in the pattern of urination (polyuria, nocturia, anuria), diarrhea
Food / Fluids
Anorexia, nausea, vomiting, do not follow the diet, weight loss, thirst, the use of diuretics.
Neurosensori
Dizziness, headache, numbness, muscle weakness numbness, paraesthesia, visual disturbances.
Pain / Leisure
Abdominal strain, pain (is / weight)
Respiratory
Cough with or without purulent sputum
Security
Dry skin, itching, skin ulcer.

Nursing Diagnosis and Nursing Intervention

Fluid volume deficient related to osmotic diuresis from hyperglycemia

Planning

After 8 hours of nursing interventions, the patient will demonstrate adequate hydration.

Intervention

Monitor orthostatic blood pressure changes.
Rational : Hypovolemia may be manifested by hypotension and tachycardia.
Assess peripheral pulses, capillary refill, skin turgor, and mucous membrane.
Rational : Indicators of level of dehydration, adequacy of circulating volume.
Monitor respiratory pattern like Kussmaul’s respirations and acetone breath.
Rational : Lungs remove carbonic acid through respirations, producing a compensatory respiratory alkalosis for ketoacidosis.
Monitor input and output. Note urine specific gravity.
Rational : Provides ongoing estimate of volume replacement needs, kidney function, and effectiveness of therapy.
Promote comfortable environment. Cover patient with light sheets.
Rational : Avoids overheating, which could promote further fluid loss.
Monitor temperature, skin color and moisture.
Rational : Fever, chills, and diaphoresis are common with infectious process; fever with flushed, dry skin may reflect dehydration.

Source : http://nanda-nursing.blogspot.com/2010/10/nursing-care-plan-for-diabetes-mellitus.html

Nursing Care Plan for Hypertension

Hypertension , Nursing Care Plan

Nursing Care Plan for Hypertension

Hypertension

Hypertension (HTN) or high blood pressure is a chronic medical condition in which the systemic arterial blood pressure is elevated. It is the opposite of hypotension. It is classified as either primary (essential) or secondary. About 90–95% of cases are termed "primary hypertension", which refers to high blood pressure for which no medical cause can be found. The remaining 5–10% of cases (Secondary hypertension) are caused by other conditions that affect the kidneys, arteries, heart, or endocrine system.

Persistent hypertension is one of the risk factors for stroke, myocardial infarction, heart failure and arterial aneurysm, and is a leading cause of chronic kidney failure. Moderate elevation of arterial blood pressure leads to shortened life expectancy. Dietary and lifestyle changes can improve blood pressure control and decrease the risk of associated health complications, although drug treatment may prove necessary in patients for whom lifestyle changes prove ineffective or insufficient.

Causes

Essential Hypertension

Essential hypertension is the most prevalent hypertension type, affecting 90–95% of hypertensive patients. Although no direct cause has been identified, there are many factors such as sedentary lifestyle, smoking, stress, visceral obesity, potassium deficiency (hypokalemia), obesity (more than 85% of cases occur in those with a body mass index greater than 25), salt (sodium) sensitivity, alcohol intake, and vitamin D deficiency that increase the risk of developing hypertension. Risk also increases with aging, some inherited genetic mutations, and having a family history of hypertension. An elevated level of renin, a hormone secreted by the kidney, is another risk factor, as is sympathetic nervous system overactivity. Insulin resistance, which is a component of syndrome X (or the metabolic syndrome), is also thought to contribute to hypertension. Recent studies have implicated low birth weight as a risk factor for adult essential hypertension.

Secondary Hypertension

Secondary hypertension by definition results from an identifiable cause. This type is important to recognize since it's treated differently to essential hypertension, by treating the underlying cause of the elevated blood pressure. Hypertension results in the compromise or imbalance of the pathophysiological mechanisms, such as the hormone-regulating endocrine system, that regulate blood plasma volume and heart function. Many conditions cause hypertension, some are common and well recognized secondary causes such as Cushing's syndrome, which is a condition where the adrenal glands overproduce the hormone cortisol. In addition, hypertension is caused by other conditions that cause hormone changes such as hyperthyroidism, hypothyroidism (citation needed), and certain tumors of the adrenal medulla (e.g., pheochromocytoma). Other common causes of secondary hypertension include kidney disease, obesity/metabolic disorder, pre-eclampsia during pregnancy, the congenital defect known as coarctation of the aorta, and certain prescription and illegal drugs.http://en.wikipedia.org

Nursing Care Plan for Hypertension

Nursing Diagnosis for Hypertension

Risk for decrease cardiac output related to increased vasoconstriction, myocardial ischemia, ventricular hypertrophy.
Impaired sense of comfort : pain (headache) are related to increased cerebral vascular pressure

Nursing Intervention for Hypertension

1. Risk for decrease cardiac output related to increased vasoconstriction, myocardial ischemia, ventricular hypertrophy.

Goal :
vasoconstriction did not occur, myocardial ischemia did not occur

Expected Results :
Patients participating in activities that lower blood pressure / workload of the heart, maintaining normal blood pressure, heart frequency showed stable within the normal range of patients.

Nursing Intervention :

Monitor blood pressure, measured on both hands, use the cuff and appropriate measurement techniques.
Note the presence, quality of central and peripheral pulses.
Auscultation heart tone, and breath sounds.
Observe skin color, moisture, temperature and capillary filling time.
Note the general edema.
Provide quiet environment, comfortable, reduce the activity.
Maintain restrictions on activities such as rest in bed / chair.
Helps perform self-care activities as needed.
Perform good actions such as back and neck massage
Encourage relaxation techniques, guide the imagination, the transfer activity
Monitor response to medication to control blood pressure
Give the restriction of fluid and sodium diet as indicated.
Collaboration for the provision of drugs as indicated.

2. Impaired sense of comfort : pain (headache) are related to increased cerebral vascular pressure

Goal :
Cerebral vascular pressure did not increase.

Expected Results :
Patients did not reveal a headache and looked comfortable.

Nursing Intervention :

Maintain bed rest, quiet environment, a little illumination
Minimize environmental disturbances and stimulation.
Limit activities.
Avoid smoking or using nicotine.
Give the analgesic and sedative drugs to order.
Give a fun action according to indications such as an ice pack, comfortable position, relaxation techniques, guidance imagination, avoid constipation.

Source : http://nanda-nursing.blogspot.com/2011/01/nursing-care-plan-for-hypertension.html

Nursing Care Plan for Glomerulonephritis

Glomerulonephritis , Nursing Care Plan

Nursing Care Plan for Glomerulonephritis
Glomerulonephritis is a type of kidney disease in which the part of your kidneys that helps filter waste and fluids from the blood is damaged.

Symptoms of Glomerulonephritis

Common symptoms of glomerulonephritis are:

Blood in the urine (dark, rust-colored, or brown urine)
Foamy urine
Swelling (edema) of the face, eyes, ankles, feet, legs, or abdomen

Symptoms that may also appear include the following:

Abdominal pain
Cough
Diarrhea
General ill feeling
Fever
Joint aches
Muscle aches
Loss of appetite
Shortness of breath

nlm.nih.gov

Nursing Assessment for Glomerulonephritis

Genitourinary
- Turbid urine
- Proteinuria
- Decrease in urine output
- Haematuria
Cardiovascular
- Hypertension
Neurological
- Lethargy
- Irritability
- Seizures
Gastrointestinal
- Anorexia
- Vomitus
- Diarrhea
Hematology
- Anemia
- Azotemia
- Hyperkalaemia
Integumentary
- Pale
- Edema

Ineffective Tissue Perfusion related to water retention and hypernatremia
Risk for Imbalanced Fluid Volume related to oliguric
Risk for Imbalanced Nutrition: Less than Body Requirements related to anorexia.
Activity Intolerance related to fatigue.
Risk for Disturbed Sleep Pattern related to immobilization and edema.

Read More : Nursing Diagnosis for Glomerulonephritis

Nursing Intervention for Glomerulonephritis
Ineffective Tissue Perfusion related to water retention and hypernatremia

Expected Results :
Clients will demonstrate normal cerebral tissue perfusion is marked with blood pressure within normal limits, decreased water retention, no signs of hypernatremia.

Blood Pressure Monitor and record every 1-2 hours per day during the acute phase.
Rational: to detect early symptoms of blood pressure changes and determine further intervention.
Keep the airway hygiene, prepare suction
Rational: n happen due to lack of oxygen to the brain perfusion.
Set of anti-hypertension, monitor client reactions.
Rationale: Anti-Hypertension can be due to uncontrolled hypertension can cause kidney damage.
Monitor the status of the volume of liquid every 1-2 hours, monitor urine output (N: 1-2 ml / kg / hr).
Rational: The monitor is very necessary because the expansion of the volume of fluid can cause blood pressure to rise.
Assess neurological status (level of consciousness, reflexes, pupil response) every 8 hours.
Rational: To detect early changes in neurological status, facilitate subsequent intervention.
Set of diuretics: Esidriks, Lasix appropriate orders.
Rational: Diuretic can increase the excretion of fluids.

Nursing Care Plan for Nephrotic Syndrome

Nephrotic Syndrome , Nursing Care Plan

Nursing Care Plan for Nephrotic Syndrome

Nephrotic Syndrome

Nephrotic syndrome is a group of symptoms including protein in the urine (more than 3.5 grams per day), low blood protein levels, high cholesterol levels, high triglyceride levels, and swelling.

Causes of Nephrotic Syndrome

Nephrotic syndrome is caused by various disorders that damage the kidneys, particularly the basement membrane of the glomerulus. This immediately causes abnormal excretion of protein in the urine.

The most common cause in children is minimal change disease, while membranous glomerulonephritis is the most common cause in adults.

This condition can also occur as a result of infection (such as strep throat, hepatitis, or mononucleosis), use of certain drugs, cancer, genetic disorders, immune disorders, or diseases that affect multiple body systems including diabetes, systemic lupus erythematosus, multiple myeloma, and amyloidosis.

It can accompany kidney disorders such as glomerulonephritis, focal and segmental glomerulosclerosis, and mesangiocapillary glomerulonephritis.

Nephrotic syndrome can affect all age groups. In children, it is most common from age 2 to 6. This disorder occurs slightly more often in males than females.

Symptoms of Nephrotic Syndrome

Swelling (edema) is the most common symptom. It may occur:

In the face and around the eyes (facial swelling)
In the arms and legs, especially in the feet and ankles
In the belly area (swollen abdomen)

Other symptoms include:

Foamy appearance of the urine
Weight gain (unintentional) from fluid retention
Poor appetite
High blood pressure

nlm.nih.gov

Nursing Diagnosis for Nephrotic Syndrome

Ineffective tissue perfusion: Renal
Risk for Deficient Fluid Volume
Imbalanced nutrition: Less than body requirements
Disturbed body image
Excess fluid volume
Risk for injury
Risk for Infection

http://nandanursingdiagnosis.blogspot.com/2011/05/nursing-diagnosis-for-nephrotic.html

Nursing Care Plan for Myocardial Infarction

Myocardial Infarction , Nursing Care Plan

Nursing Care Plan for Myocardial Infarction

A heart attack (also known as a myocardial infarction) is the death of heart muscle from the sudden blockage of a coronary artery by a blood clot. Coronary arteries are blood vessels that supply the heart muscle with blood and oxygen. Blockage of a coronary artery deprives the heart muscle of blood and oxygen,causing injury to the heart muscle. Injury to the heart muscle causes chest pain and chest pressure sensation. If blood flow is not restored to the heart muscle within 20 to 40 minutes, irreversible death of the heart muscle will begin to occur. Muscle continues to die for six to eight hours at which time the heart attack usually is "complete." The dead heart muscle is eventually replaced by scar tissue.

Approximately one million Americans suffer a heart attack each year. Four hundred thousand of them die as a result of their heart attack.

Symptoms of a heart attack

Although chest pain or pressure is the most common symptom of a heart attack, heart attack victims may experience a variety of symptoms including:

Pain, fullness, and/or squeezing sensation of the chest
Jaw pain, toothache, headache
Shortness of breath
Nausea, vomiting, and/or general epigastric (upper middle abdomen) discomfort
Sweating
Heartburn and/or indigestion
Arm pain (more commonly the left arm, but may be either arm)
Upper back pain
General malaise (vague feeling of illness)
No symptoms (Approximately one quarter of all heart attacks are silent, without chest pain or new symptoms. Silent heart attacks are especially common among patients with diabetes mellitus.)

medicinenet.com

Nursing Diagnosis Nursing Care Plan for Myocardial Infarction

Acute Pain related to ischemic tissue, secondary to clogged arteries.
Decreased Cardiac Output related to changes in power factors, reduction miocard characteristics.
Activity Intolerance related to the imbalance between oxygen supply and demand miocard, the ischemic / necrotic tissue miocard.
Imbalanced Nutrition: Less than Body Requirements related to decreased renal perfusion, increased sodium / water retention, increased hydrostatic pressure, decreased plasma proteins.
Ineffective Tissue Perfusion related to ischemic heart muscle damage, narrowing / blockage of coronary arteries.
Anxiety related to actual threats to biological integrity.
Ineffective Coping
Ineffective Sexuality Patterns

Nursing Care Plan for Alzheimer's Disease

Alzheimer's Disease , Nursing Care Plan

Nursing Care Plan for Alzheimer's Disease

Alzheimer's disease (AD) is the most common form of dementia among older people. Dementia is a brain disorder that seriously affects a person's ability to carry out daily activities.

AD begins slowly. It first involves the parts of the brain that control thought, memory and language. People with AD may have trouble remembering things that happened recently or names of people they know. A related problem, mild cognitive impairment(MCI), causes more memory problems than normal for people of the same age. Many, but not all, people with MCI will develop AD.

In AD, over time, symptoms get worse. People may not recognize family members or have trouble speaking, reading or writing. They may forget how to brush their teeth or comb their hair. Later on, they may become anxious or aggressive, or wander away from home. Eventually, they need total care. This can cause great stress for family members who must care for them.

AD usually begins after age 60. The risk goes up as you get older. Your risk is also higher if a family member has had the disease.

No treatment can stop the disease. However, some drugs may help keep symptoms from getting worse for a limited time.

NIH: National Institute on Aging
nlm.nih.gov

Nursing Assessment for Alzheimer's Disease

Activity / rest
Signs: anxiety, helplessness, sleep pattern disturbance, lethargy and impaired motor skills.
Symptoms: feeling melting
Circulation
Symptoms: History of cerebral vascular disease / systemic, hypertension, embolic episodes
Ego integrity
Signs: hide incompetence, sit down and
watch the other, the first activity might accumulate
objects are not moving and emotional stability
Symptoms: suspicious or afraid of the situation / person fantasies, misperceptions of the environment, loss of multiple.
Elimination
Signs: Incontinence of urine / feaces
Symptoms: The urge to urinate

Read More : Nursing Assessment for Alzheimer's Disease

Nursing Diagnosis for Alzheimer's Disease

Change the thought process related to :
- Irreversible neuronal degeneration
- Memory Loss
- Psychological Conflict
- Sleep deprivation
Changes in sensory perception related to :
- Changes in perception, transmission and / or sensory integration
- Limitations related to the social environment
Changes in sleep patterns related to :
- Changes in sensory
- Psychological pressure
- Changes in activity patterns
The risk of trauma related to :
- The inability to recognize / identify hazards in the environment
- Disorientation, confusion, impaired decision making
- Weakness, the muscles are not coordinated, the presence of seizure activity.

Read More : Nursing Diagnosis for Alzheimer's Disease

Nursing Intervention for Alzheimer's Disease

Nursing Diagnosis for Alzheimer's Disease

Risk for Injury related to:

Unable to recognize / identify hazards in the environment.
Disorientation, confusion, impaired decision making.
Weakness, the muscles are not coordinated, the presence of seizure activity.

Nursing Intervention for Alzheimer's Disease

Assess the degree of impaired ability of competence emergence of impulsive behavior and a decrease in visual perception.
Help the people closest to identify the risk of hazards that may arise.
Eliminate / minimize sources of hazards in the environment
Divert attention to a client when agitated or dangerous behaviors like getting out of bed by climbing the fence bed.

Rational:

Impairment of visual perception increase the risk of falling. Identify potential risks in the environment and heighten awareness so that caregivers more aware of the danger.
An impaired cognitive and perceptual disorders are beginning to experience the trauma as a result of the inability to take responsibility for basic security capabilities, or evaluating a particular situation.
Maintain security by avoiding a confrontation that could improve the behavior / increase the risk for injury.

Nursing Diagnosis for Alzheimer's Disease

Disturbed Thought Processes related to :

Irreversible neuro degeneration
Memory Loss
Psychological Conflict
Deprivation lie

Nursing Intervention for Alzheimer's Disease

Assess the level of cognitive disorders such as changes orientasiterhadap people, places and times, range, attention, thinking skills.
Talk with the people closest to the usual behavior change / length of the existing problems.
Maintain a nice quiet neighborhood.
Face-to-face when talking with patients.
Call patient by name.
Use a rather low voice and spoke slowly in patients.

Rational:

Provide the basis for the evaluation / comparison that will come, and influencing the choice of intervention.
Noise, crowds, the crowds are usually the excessive sensory neurons and can increase interference.
Cause concern, especially in people with perceptual disorders.
The name is a form of self-identity and lead to recognition of reality and the individual.
Increasing the possibility of understanding.

Read More :

Nursing Intervention for Alzheimer's Disease

Nursing Care Plan for Hepatitis

Hepatitis , Nursing Care Plan

Nursing Care Plan for Hepatitis

Hepatitis is an inflammation of the liver, most commonly caused by a viral infection. There are five main hepatitis viruses, referred to as types A, B, C, D and E.

Hepatitis A and E are typically caused by ingestion of contaminated food or water. Hepatitis B, C and D usually occur as a result of parenteral contact with infected body fluids (e.g. from blood transfusions or invasive medical procedures using contaminated equipment). Hepatitis B is also transmitted by sexual contact.

The symptoms of hepatitis include jaundice (yellowing of the skin and eyes), dark urine, extreme fatigue, nausea, vomiting and abdominal pain.
www.who.int

Nursing Assessment for Hepatitis

1. Main complaint

No appetite, malaise, fever (more frequent in hepatitis A). Taste stiff, and headache on Hepatitis B.

2. Health Assessment

a. Activity

* Weakness
* Fatigue
* Depression

b. Circulation

* Bradycardia (hiperbilirubin weight)
* Jaundice in the sclera of skin, mucous membranes

c. Elimination

* Dark urine
* Diarrhea stool, color clay

d. Food and Fluids

* Anorexia
* Weight loss
* Nausea and vomiting
* Increased edema
* Ascites

e. Neuro Sensory

* Be sensitive to stimuli
* Tend to sleep
* Lethargy
* Asteriksis

f. Pain / Leisure

* Abdominal Cramps
* Pain hit the right quadrant
* Myalgia
* Atralgia
* Headache
* Itching (pruritus)

g. Security

* Fever
* Urticaria
* Erythema
* Splenomegaly
* Enlarged posterior cervical nodes

Nursing Diagnosis for Hepatitis

Imbalanced nutrition: Less than body requirements related to anorexia, nausea and vomiting.
Impaired skin integrity related to pruritis
Activity Intolerance related to fatigue and generalized malaise
Acute pain related to the tender, Enlarged liver
Hyperthermia related to the body's defensive reaction to invading organisms.
Risk for Infection

Source : http://nandanursingdiagnosis.blogspot.com/2011/05/nursing-diagnosis-for-hepatitis.html

Nursing Intervention for Hepatitis

Nursing Diagnosis for Hepatitis

Activity Intolerance related to fatigue and generalized malaise.

Expected outcome :

Exhibits increased ability to carry out desired activities and allow sufficient periods for rest and relaxation.

Nursing Intervention for Hepatitis

Encourage the patient to limit activity when fatigue
Assist the patient in planning periods of rest and activity when symptoms begin to subside.
Encourage gradual resumption of activities and mild excercise during recovery.

Abdominal pain related to tender, enlarged liver.

Expected outcome :

Report a decrease or absence of abdominal pain and tenderness;restrict activities if pain occurs;participates in planned activities when free of pain; take prescribed analgesic if necessary.

Nursing Intervention for Hepatitis

Asses and record presence or absence of abdominal pain or tenderness, hepatomegally and splenomegally.
Encourage the patient to maintain bedrest or restrict activities if abdominal pain or tenderness is present.
Administer analgesic as prescribed.
Notify the physian of sudden occuraence or increase in pain or tenderness.

Source : http://nursinginterventions-diagnosis.blogspot.com/2011/05/nursing-intervention-for-hepatitis.html

Nursing Care Plan

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Nursing Care Plan for Diabetes Mellitus

Nursing Care Plan for Hypertension

Nursing Care Plan for Glomerulonephritis

Nursing Care Plan for Nephrotic Syndrome

Nursing Care Plan for Myocardial Infarction

Nursing Care Plan for Alzheimer's Disease

Nursing Intervention for Alzheimer's Disease

Nursing Care Plan for Hepatitis

Nursing Intervention for Hepatitis

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