NANDA 2011

Sleep Pattern Disturbance Related To Impaired oxygen transport Impaired elimination Impaired metabolism Immobility Medication Hospitalization Lack of exercise Anxiety response Life-style disruptions As evidenced by Major : Difficulty falling or remaining a sleep Minor : Fatigue on awakening or during the day Dozing during the day Agitation Mood alterations Outcome : The patient will: Demonstrate an optimal balance of rest and activity A.E.B. ___ hours of uninterrupted sleep at night. Remain awake during the day. Nursing Interventions Explore with patient potential contributing factors. Maintain bedtime routine per patient preference. Takes sleeping pill as ordered by a physician. Provide comfort measures to induce sleep: Void before retiring. Coordinate treatment/meds to limit interruptions during sleep period. Limit the amount and length of daytime sleeping Increase daytime activity

Pneumonia is an infection of one or both lungs which is usually caused by bacteria, viruses, or fungi. Prior to the discovery of antibiotics, one-third of all people who developed pneumonia subsequently died from the infection. Currently, over 3 million people develop pneumonia each year in the United States. Over a half a million of these people are admitted to a hospital for treatment. Although most of these people recover, approximately 5% will die from pneumonia. Pneumonia is the sixth leading cause of death in the United States. Signs and Symptoms Symptoms vary depending on the age of the child and the cause of the pneumonia, but common ones include: fever chills cough nasal congestion unusually rapid breathing (in some cases, this is the only symptom) breathing with grunting or wheezing sounds labored breathing that makes the rib muscles retract (when muscles under the ribcage or between ribs draw inward with each breath) and causes nasal flaring vomiting chest pai

Why was Florence Nightingale called 'The lady of the lamp' ? Florence was very dedicated to her job. She would often visit the soldiers at night when every one was asleep just to make sure they were ok. She was then referred to as “The Lady of the Lamp” because she hardly took time off to sleep. Florence became a true hero to the soldiers and everyone back home in England. Florence Nightingale became a living legend as the 'Lady with the Lamp'. She led the nurses caring for thousands of soldiers during the Crimean War and helped save the British army from medical disaster. This was just one of Florence's many achievements. She was also a visionary health reformer, a brilliant campaigner, the most influential woman in Victorian Britain and its Empire, second only to Queen Victoria herself. At the start of Pope Benedict XVI visit to Britain in September 2010, he praised Florence's achievements in his Holyroodhouse speech. "We find many e

1. Adjust the amount of carbohydrate with caution Affected Diabetes does not mean you should avoid eating carbohydrates altogether. Carbohydrates provide energy for the body whether it be from whole grains, nuts, beans, fresh vegetables and fruits. And you can also eat the fruit even though it tastes sweet. It's about eating right by setting the amount of carbohydrate at each meal. A dietitian can certainly help you manage and learn how many calories and nutrients that are right for you. 2. Lose weight if necessary Lose weight slowly and start from the smallest of about 4-6 kg can reduce the risk of complications from diabetes. This helps lower blood sugar and blood pressure. Surely you will also have more energy. The goal is to burn more calories that you eat. To start, try cutting back on food with high fat content such as chips or fries. 3. Getting Enough Sleep Very little sleep can increase your blood glucose levels and encourage you to eat foods with high carbohydrat

Clinical manifestations of Hypertension Elevation of blood pressure is sometimes the only symptom. If so, new symptoms appear after complications in the kidneys, eyes, brain or heart. Other symptoms that are often found are headache, epitaksis, angry, buzzing ears, heaviness in the neck, difficulty sleeping, eyes dazed and dizzy. Diagnostic examination of Hypertension a. Hemoglobin / Hematocrit: Not diagnostic but examine the relationship of cells to the volume of fluid and can indicate risk factors such as hypercoagulability, anemia. b. Glucose: Hyperglycemia (DM is the precipitating factors of hypertension) may be caused by increased levels of ketokolamin (increased hypertension). c. Calcium serum: Increased levels of calcium may increase hypertension. d. VMA urine (metabolites ketokolamin): The increase may indicate the presence of phaeochromocytoma (cause); 24-hour urinary VMA can be done to assess if hypertension intermittent phaeochromocytoma. e. Uric acid: implications

Acute pain related to ischemic tissue Goal: decrease pain / no pain Expected outcomes: 1. Patients verbally say, pain is reduced / lost. 2. Patients can perform the methods or actions to overcome or reduce pain. 3. Expanding patient movement. 4. No cold sweat, vital signs within normal limits. (Temperature: 36 to 37.5 0C, Pulse: 60 - 80 x / min, blood pressure: 100-130 mmHg, RR: 18 - 20 x / min).  Nanda Acute Pain - Action plan: 1. Assess the level, frequency, and reaction to pain experienced by patients. Rational: to find out how many patients experienced severe pain. 2. Explain to the patient about the causes of pain. Rational: the patient's understanding of the causes of pain that occurs will reduce the tension of patients and allows patients to be invited to cooperate in taking measures. 3. Create a calm environment. Rational: Rangasangan excess of the environment will aggravate the pain. 4. Teach distraction and relaxation techniques. Rational: distraction an