Nursing Care Plan

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)



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

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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.



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.

Non-Hodgkin's lymphoma


Causes

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

Gangrene is a serious and potentially life-threatening condition that arises when a considerable mass of body tissue dies (necrosis). This may occur after an injury or infection, or in people suffering from any chronic health problem affecting blood circulation. The primary cause of gangrene is reduced blood supply to the affected tissues, which results in cell death. Diabetes and long-term smoking increase the risk of suffering from gangrene.

There are different types of gangrene with different symptoms, such as dry gangrene, wet gangrene, gas gangrene, internal gangrene and necrotising fasciitis. Treatment options include debridement (or, in severe cases, amputation) of the affected body parts, antibiotics, vascular surgery, maggot therapy or hyperbaric oxygen therapy.


Nursing Care Plan for Diabetic Gangrene

Nursing diagnosis that appear in diabetic foot gangrene patients are as follows:

Impaired tissue perfusion related to the weakening / decreased blood flow to the area of ​​gangrene due to obstruction of blood vessels.

Objective:

Impaired verbal communication is defined as decreased, delayed, or absent ability to receive, process, transmit, and use a system of symbols.

Related to :

• Physiologic conditions
• Alteration of central nervous system
• Impaired neurologic development or dysfunction
• Disturbance in attachment/bonding with the parent/caregiver

Characterized by :

• Language delay or total absence of language
• Immature grammatic structure; pronoun reversal; inability to name objects
• Stereotyped or repetitive use of language (echolalia, idiosyncratic words, inappropriate high-pitched squealing/giggling, repetitive phrases, sing-song speech quality)
• Lack of response to communication attempts by others

Outcome :

• Communicate in words/gestures that are understood by others

Interventions and Rationales

1. Use one-on-one interactions to engage the client in nonverbal play.
   R/: The nurse enters the client’s world in a nonthreatening interaction to form a trusting relationship.


2. Recognize subtle cues indicating the client is paying attention or attempting to communicate.
   R/: Cues are often difficult to recognize (glancing out of the corner of the eye).


3. Describe for the client what is happening, and put into words what the client might be experiencing.
   R/: Naming objects and describing actions, thoughts, and feelings helps the client to use symbolic language.


4. Encourage vocalizations with sound games and songs.
   R/: Children learn through play and enjoyable activities.


5. Identify desired behaviors and reward them (e.g., hugs,treats,tokens,points,or food).
   R/: Behaviors that are rewarded will increase in frequency. Desire for food is a powerful incentive in modifying behavior.


6. Use names frequently, and encourage the use of correct pronouns (e.g., I,me,he). R: Problems with self-identification and pronoun reversal are common.


7. Encourage verbal communication with peers during play activities using role modeling, feedback, and reinforcement.
   R/: Play is the normal medium for learning in a child’s development.


8. Increase verbal interaction with parents and siblings by teaching them how to facilitate language development.
   R/: Play is the normal medium for learning in a child’s development.

Pleural effusion

Pleural effusion is excess fluid that accumulates in the pleura, the fluid-filled space that surrounds the lungs. Excessive amounts of such fluid can impair breathing by limiting the expansion of the lungs during respiration.

Pulmonary embolism (PE)

A pulmonary embolism is a sudden blockage in a lung artery. The cause is usually a blood clot in the leg called a deep vein thrombosis that breaks loose and travels through the bloodstream to the lung. Pulmonary embolism is a serious condition that can cause

• Permanent damage to the affected lung
• Low oxygen levels in your blood
• Damage to other organs in your body from not getting enough oxygen

If a clot is large, or if there are many clots, pulmonary embolism can cause death.





Nursing Care Plan for Pulmonary Embolism