Causes and Care Plan of Diarrhea in Infants

Nursing Care Plan of Diarrhea in Infants

Diarrhea is not a topic that is often discussed, except when it occurs in infants. Every parent would be concerned about all things unusual happened to the baby, ranging from problems of diarrhea, food, until sleep patterns. And that was troublesome was the baby can not express what they feel except with the language of tears. So, inevitably every parent should be a good researcher for their children.

Feces during diarrhea in infants may appear in the texture, color and smell different. Such differences in the texture of the stool usually depends on what the baby feeding (breast milk, formula or solids).

One or two times a watery stool that comes out on the baby may not have to worry about. It usually occurs in the first weeks or months of the baby. However, if too frequent or severe diarrhea, this is no longer the time for you to hold a nursing home, you should immediately take the baby to the doctor.


Causes of Diarrhea in Infants

Babies with diarrhea can be caused by many factors, among others:

• Food allergies or are sensitive to a drug.
• Drinking too much fruit juice.
• Poisoning.
• Infections caused by viruses, bacteria and parasites.

Diarrhea occurs because the causes above that goes into the baby's digestion (by mouth). It could be the baby food and drink was contaminated / polluted with bacteria, parasites or viruses, toxins to chemicals. Do not just oriented on food and beverages consumed by the baby alone, hands touch the baby against something, then the baby put his hand into the mouth, is also a driveway for the causes of diarrhea.

Baby feeding equipment must also be assured of cleanliness, clean of bacteria / viruses and chemicals / pharmaceuticals. It's useless if you maintain the cleanliness of food and his hands but not keeping his dishes. Generally, mothers of households use chemicals / sort of detergent sold in the market for washing utensils. Well, the rinsing process must be done properly, make sure the cutlery has been rinsed clean to prevent chemicals washers are no longer living in tableware. The best thing after that is boiling all his dishes. And do not forget to give sense to the person who washes tableware your family, especially baby equipment. If you are in doubt, you should do yourself.

The mother / baby sitter alone should have to frequently wash their hands before and after eating, after changing diapers, after using the bathroom. These are all important to prevent diarrhea.

If you are breastfeeding your baby, you should not use laxatives because most of laxatives will go to the baby through breast milk will eventually cause diarrhea for the baby.


Effect of Diarrhea in Infants

Diarrhea will obviously disrupt the normal balance of water and salt (electrolytes) in infants. When the water and electrolytes lost in significant amounts (for diarrhea), babies will become dehydrated. And the loss of water and electrolytes in infants should get a replacement as soon as possible. In infants, dehydration can occur very quickly. Can directly take place on the day he diarrhea or the next day and it was very dangerous, especially for newborns.

Here are the signs of dehydration in infants:

• Urinate more often than usual.
• Irritability (fussy).
• Dry mouth.
• No tears when crying.
• Lethargic and often sleepy (unconventional).
• Sunken soft spot (fontanel concave).
• Inelastic skin (the skin is not immediately return after pressed or pinched).

When there is the above symptoms, do not wait any longer, let alone still would defer to care for her at home, immediately go to the doctor. Also, immediately go to the doctor if your baby has these symptoms:

• Fever over 38.8 degrees Celsius.
• Abdominal pain (toddlers who can express her feelings).
• Blood or pus in the stool, or black stools, white or red.
• Lethargy.
• Vomiting.

Nursing Diagnoses of Diarrhea

1. Deficient Fluid Volume r / t excessive loss through the feces and vomit and limited intake (nausea).
2. Imbalanced Nutrition: less than body requirements r / t disruption of nutrient absorption and increase intestinal peristalsis.
3. Pain (acute) r / t Hiperperistaltik, irritation perirektal fissure.
4. Anxiety: family r / t changes in the health status of children.
5. Knowledge deficit: family: about the condition, prognosis and therapy needs r / t exposure limited information, misinterpretation of information and or cognitive limitations.

Eye Cancer: Types, Symptoms and Nursing Diagnosis

Eye Cancer

Eye cancer is a lump in or around the eyes caused by abnormal cell growth and uncontrolled. Although quite rare, eye cancer can be about anyone and any age.


Type of Eye Cancer

Eye cancer is divided into several types. Cancer that develops in the eye called intraocular cancer, while cancer that develops around the eyes called the extra ocular cancer.

Intraocular Eye Cancer

Intraocular eye cancer types include:

• Ocular Melanoma : Cancer usually is developing in a layer of the eyeball, muscles that focus the eye, the iris (the colored part of the eye), or the inner surface of the conjunctiva (the eyelids). Melanoma be one type of cancer is the most common intraocular eye.
• Retinoblastoma : Cancer generally develops in the nerve cells of the retina, and can be one or both eyes. This condition is often an inherited condition and develop in children, mostly children under five years old. The good news, more than nine out of 10 children with retinoblastoma cured with proper treatment.
• Non-Hodgkin's lymphoma : Usually develops in the lymph nodes. Lymph nodes are glands throughout the body that are part of the body's natural immune system. However, non-Hodgkin's lymphoma are sometimes also progressed in the eye.

Extraocular Eye Cancer

Extraocular eye cancer include:

• Basal cell carcinoma: A type of skin cancer most commonly occurs. Usually develops near the eyes, especially in the lower eyelids. Growing small red pimples on the skin. This cancer usually does not spread to other body parts, but if left untreated can affect the surrounding tissue.
• Rhabdomyosarcoma: Is a type of eye cancer that is very rare that develops in the muscles that move the eyes. Rhabdomyosarcoma cases mostly occur in children.
• Optic nerve tumors: Also includes rare tumor that develops in the eye optic nerve, the nerve that connects the eye to the brain.
• Squamous cell carcinoma: This cancer usually develops on the surface of the eyelids.

Secondary Eye Cancer

Sometimes the cancer can spread from other parts of the body to the eye. This condition is called secondary cancer of the eye. Secondary eye cancer is most likely to occur in women with breast cancer, and in men with lung cancer.


Symptoms of Eye Cancer

Symptoms of eye cancer varies depending on the type and location. If someone intraocular cancer, such as ocular melanoma, is usually not accompanied by symptoms and be detected in a routine eye examination. That is why it is very important to check the eyes to an eye specialist at least once every two years.



Symptoms of eye cancer include:

• Vision (sight) lost partial or complete.
• See flashing lights or spots.
• A dark spot on the iris grow.
• Bumps visible on the eyelids with crusting or bleeding.
• Watery eyes.
• Pain in or around the eye.

But keep in mind, these symptoms are not caused by the absolute eye cancer because it can also be caused by other health problems, but if you experience any of these symptoms, immediately consult an ophthalmologist.


Nursing Diagnosis of Eye Cancer

1) Disturbed Sensory Perception (visual)
2) Disturbed Body Image

4 Nursing Diagnosis for Amyotrophic Lateral Sclerosis (ALS)

Nursing Care Plan for Amyotrophic Lateral Sclerosis (ALS)

Amyotrophic Lateral Sclerosis, Lou Gehrig's disease, motor neuron disease is a neurological disease that attacks the neurons that control skeletal muscle.

Motor neurons located in the brain, brain stem and bone marrow, and serves as a control and communication unit that connects the nervous system with the striated muscle. Motor signals carried neurotransmitter from motor neurons in the brain, known as the "upper motor neuron", forwarded to the motor neurons in the bone marrow, which is known as the "lower motor neurons", and further forwarded to the relevant striated muscle. Motor neuron motoneuron often called, is a function of neurons under the control synaptothrophic of nerve growth factor (NGF).

Cause of Amyotrophic Lateral Sclerosis:

• The exact cause is unknown (genetic component of about 10% of all patients).
• Autoimmune disorder that attacks the immune complexes in renal glomerular and basement membrane (basemant).
• Metabolic interference in the production of nucleic acids by nerve fibers.
• Nutritional deficiencies associated with disturbances in metabolism enzymes.
• Viruses that cause metabolic disturbances in motor neurons.

Signs and Symptoms of Amyotrophic Lateral Sclerosis:

• Fasciculations accompanied by atrophy and weakness, especially in the muscles of the upper arm and hand.
• Speech disorders.
• Difficulty chewing, swallowing and breathing.
• Choking feeling.
• Discharge of excessive salivation.

Diagnostic Test:

• Electromyography showed electrical abnormality in the muscles that were attacked.
• Muscle biopsy may show atrophic fibers that criss between normal fibers.
• The content of protein in the cerebrospinal fluid rise in one-third of patients, but this finding alone can not ensure the occurrence of ALS disease.

Nursing Diagnosis for Amyotrophic Lateral Sclerosis (ALS)

1. Ineffective breathing pattern.
2. Risk for Imbalanced Nutrition: less than body requirements.
3. Impaired verbal communication.
4. Impaired physical mobility.

Nursing Care Plan for Conjunctivitis

Conjunctivitis is an inflammation of the conjunctiva, the mucous membrane that covers the white part of the eye and the inner eyelid. Condition characterized by red eyes is the most common eye disorder in children.

Types of Conjunctivitis

Conjunctivitis can be caused by bacterial infections, viral infections, allergies or irritation.:

• Bacterial conjunctivitis : infections caused by bacteria, such as staphylococci, streptococci or Haemophilus. Eyes are usually issued dung eyes yellow / greenish yellow which may spread to the lashes and cause a sticky eyelids, especially in the morning.
• Viral conjunctivitis : an infection caused by a virus called adenovirus, often associated with the common cold. Types of conjunctivitis are very contagious among humans and can cause epidemics. Eye redness and discharge may be watery. Often the swollen eyelids. This type of conjunctivitis may also spread to the cornea and cause blurred vision.
• Allergic Conjunctivitis : allergy due to objects such as pollen, dust mites, or dust. Itchy eyes and redness that may be accompanied by many tears, eyelid crusting and photophobia (eye glare). This condition can occur at certain times of the year, for example during a drought when a lot of pollen and dust flying through the air. Children who have a history of allergic conjunctivitis often have other atopic diseases such as allergic rhinitis, eczema or asthma.
• Irritation Conjunctivitis : caused by chlorine in the pool, smoke, or steam.

In addition, the newborn child called neonatal conjunctivitis or ophthalmia neonatorum which is transmitted during the birth process and including sexually transmitted diseases such as gonorrhea or chlamydia infection. In small infants, symptoms of watery eyes and more eyes droppings caused by tear drainage problems that have not evolved than conjunctivitis. The condition is known as the naso-lacrimal duct obstruction, which will disappear when the baby is getting older.


Nursing Diagnosis for Conjunctivitis

1. Acute pain related to inflammation of the conjunctiva.
2. Anxiety related to lack of knowledge about the disease process.
3. Risk of spread of infection associated with inflammatory processes.
4. Impaired self-concept (body image decreases) related to the change of the eyelids (swelling / edema).
5. Risk for injury related to limited vision.

5 Nursing Diagnosis for Meningitis

Meningitis is a severe inflammation of the lining of the brain. Inflammation that may occur after the attacks of otitis media, mastoid inflammation, brain abscess, even inflamed tonsils. Something cracked in the skull or a penetrating head injury that may result in meningitis. (Clifford R Anderson: 1975)

Meningitis is an acute infection of the lining of the meninges (the membranes covering the brain and spinal cord). These infections can be caused by:
Bacteria, such as : pneumococcus, meningecoccus, stapilococcus, streptococcus, salmonella, etc..
Viruses, such as : Haemophilus influenza and herpes simplex.

Signs and Symptoms

1. Changes in cerebral tissue perfusion related to cerebral edema / obstruction of blood flow.
2. Acute pain associated with the infection process.
3. Damage to physical mobility related to neuromuscular damage.
4. High risk of trauma / injury associated with generalized seizure activity.
5. Associated with an increased risk of exposure to infection, the immune system is weak.

Characterized by symptoms of refusing to eat, less to suck reflexes, vomiting, diarrhea, lack of muscle tone, weak cry. In children and adolescents usually there are signs and symptoms of high fever, headache, vomiting, sensory changes, seizures, easily stimulated, photo phobia, delirium, hallucinations, manic, stupor, coma, neck stiffness, positive Kernig and Brudzinski, ptechial (show meningococcal infection).


1. Ineffective tissue perfusion (cerebral)
related to:
cerebral edema,
hypovolemia.

2. Risk for injury
related to:
generalized seizures / focal,
general weakness,
vertigo.

3. Acute Pain
related to:
inflammatory process,
toxin in the circulation.

4. Impaired physical mobility
related to:
Neuromuscular damage,
decrease in strength.

5. Anxiety
related to:
crisis situation,
threat of death.

Nursing Diagnosis and Interventions for Pain

Nursing Diagnosis for Pain

1. Acute Pain
related to physical injury, reduction of blood supply, process of giving birth

2. Chronic Pain
related to the malignancy

3. Anxiety
related to pain that is felt

4. Ineffective individual coping
related to chronic pain

5. Impaired physical mobility
related to musculoskeletal pain

6. Risk for injury
related to lack of perception of pain


Nursing Interventions for Pain

Nurses develop a plan of nursing diagnoses that have been made. Nurses and clients together to discuss realistic expectations of action to overcome the pain, the degree of recovery of the expected pain, and the effects that must be anticipated in the client's lifestyle and function. Expected outcomes and goals of nursing and nursing diagnoses were selected based on the client's condition. The general objective of nursing care with pain are as follows:

• Clients feel healthy and comfortable
• Clients retain the ability to perform self-care
• Clients maintain physical function and psychological currently owned
• Client describes the factors that cause pain
• Clients use the therapy given safely at home

Source : http://nursing-care-plan.blogspot.com/2011/11/nursing-care-plan-for-pain-assessment.html

Nursing Diagnosis for Premature Rupture Membranes : Risk for Infection

Nursing Care  Plan for Premature Rupture of Membranes

Premature rupture of membranes (PROM) is a rupture (breaking open) of the membranes (amniotic sac) before labor begins. If PROM occurs before 37 weeks of pregnancy, it is called preterm premature rupture of membranes (PPROM).

PROM occurs in about 8 to 10 percent of all pregnancies. PPROM (before 37 weeks) accounts for one fourth to one third of all preterm births.

The management of PPROM is among the most controversial issues in perinatal medicine. Points of contention include:

• Expectant management versus intervention
• Use of tocolytics
• Duration of administration of antibiotic prophylaxis
• Timing of administration of antenatal corticosteroids
• Methods of testing for maternal/fetal infection
• Timing of delivery.

Risk Factors and Causes:

Certain types of infections appear to be able to cause preterm PROM, and in rare cases procedures such as amniocentesis can cause PROM, but researchers do not believe there is a single cause of the condition. The following are some known risk factors:

• Lower socioeconomic status
• history of PPROM
• bleeding during pregnancy
• Smoking
• Prior preterm birth
• Sexually transmitted diseases
• Multiple pregnancy
• Polyhydramnios

The following are the most common symptoms of PROM. However, each woman may experience symptoms differently. Symptoms may include:

• Leaking or a gush of watery fluid from the vagina
• Constant wetness in underwear

If you notice any symptoms of PROM, be sure to call your doctor as soon as possible. The symptoms of PROM may resemble other medical conditions. Consult your doctor for a diagnosis.


Nursing Diagnosis for Premature Rupture of Membranes : Risk for Infection related to invasive procedures, recurrent vaginal examination, and amniotic membrane rupture.

Goal: maternal infection does not occur

Expected outcomes: Mother states / shows are free of any signs of infection.

Nursing Interventions for Premature Rupture of Membranes:

1. Perform initial vaginal examination, when the contraction pattern repeat, or maternal behavior indicates progress.
R /: Repeated vaginal examinations play a role in the incidence of ascending tract infections.

2. Monitor temperature, pulse, respiration, and white blood cells as indicated.
R /: Within 4 hours after membrane rupture, chorioamnionitis incidence increased progressively in accordance with the time indicated by vital signs.

3. Give prophylactic antibiotics when indicated.
R /: Antibiotic may protect against the development of chorioamnionitis in women at risk.

Source : http://nandahealth.blogspot.com/2013/09/risk-for-infection-related-to-premature.html

Nursing Diagnosis for Risk for Suicide

Nursing Diagnosis: Risk for Suicide Application of NANDA, NOC, NIC

Nursing Diagnosis: Risk for Suicide
Gail B. Ladwig

NANDA Definition: At risk for self-inflicted, life-threatening injury

Related Factors:

Behavioral

History of previous suicide attempt; impulsiveness; buying a gun; stockpiling medicines; making or changing a will; giving away possessions; sudden euphoric recovery from major depression; marked changes in behavior, attitude, school performance

Verbal

Threats of killing oneself; states desire to die/end it all

Situational

Living alone; retired; relocation, institutionalization; economic instability; loss of autonomy/independence; presence of gun in home; adolescents living in nontraditional settings (e.g., juvenile detention center, prison, half-way house, group home)

Psychological

Family history of suicide; alcohol and substance use/abuse; psychiatric illness/disorder (e.g., depression, schizophrenia, bipolar disorder); abuse in childhood; guilt; gay or lesbian youth

Demographic

Age: elderly, young adult males, adolescents; race: Caucasian, Native American; gender: male divorced, widowed

Physical

Physical illness; terminal illness; chronic pain

Social

Loss of important relationship; disrupted family life; grief, bereavement; poor support systems; loneliness; hopelessness; helplessness; social isolation; legal or disciplinary problem; cluster suicides

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NOC Outcomes (Nursing Outcomes Classification)

Suggested NOC Labels

· Cognitive Ability

· Depression Control

· Distorted Thought Control

· Impulse Control

· Self-Mutilation Restraint

· Suicide Self-Restraint

· Will to Live

Client Outcomes

· Does not harm self

· Expresses decreased anxiety and control of hallucinations

· Talks about feelings; expresses anger appropriately

· Obtains no access to harmful objects

· Yields access to harmful objects

NIC Interventions (Nursing Interventions Classification)

Suggested NIC Labels

· Anxiety Reduction

· Coping Enhancement

· Crisis Intervention

· Suicide Prevention

· Surveillance

Nursing Interventions and Rationales

· Establish a therapeutic relationship with client This study demonstrated the importance of this relationship in identifying and preventing suicide (Rudd et al, 2000).

· Monitor, document, and report client's potential for suicide. Traits such as impulsivity, poor social adjustment, and mood disorders are associated with adolescent suicide attempts (Brent et al, 1994).

· Be alert for warning signs of suicide:

o Verbalizations such as, "I can't go on," "Nothing matters anymore," "I wish I were dead"

o Becoming depressed or withdrawn

o Behaving recklessly

o Getting affairs in order and giving away valued possessions

o Showing a marked change in behavior, attitudes, or appearance

o Abusing drugs or alcohol

o Suffering a major loss or life change

Suicide is rarely a spur-of-the-moment decision. In the days and hours before people kill themselves, there are usually clues and warning signs (Befrienders International, 2001).

· Assess for suicidal ideation when the history reveals:

o Depression

o Alcohol or other drug abuse

o Other psychiatric disorder

o Attempted suicide

o Recent divorce and/or separation

o Recent unemployment

o Recent bereavement

o Chronic pain

Clinicians should be alert for suicide when the above factors are present in asymptomatic persons (National Guideline Clearing House, 2001). This study revealed that clients with chronic pain and depression expressed suicidal ideation (Fisher et al, 2001). The process leading to suicide in young people is often untreated depression (Houston, Hawton, Shepperd, 2001).

· Refer to mental health counseling and possible hospitalization if there is evidence of suicidal intent, which may include evidence of preparatory actions (e.g., obtaining a weapon, making a plan, putting affairs in order, giving away prized possession, preparing a suicide note).

· Question family members regarding the preparatory actions mentioned. Clinicians should be alert for suicide when these factors are present in asymptomatic persons (National Guideline Clearing House, 2001).

· Refer family members and friends to local mental health agencies and crisis intervention centers if client has suicidal ideation or there is a suspicion of suicidal thoughts. Clients at risk should receive evaluation and help (National Guideline Clearing House, 2001).

· Consider outpatient commitment for actively suicidal client. Involuntary outpatient commitment can improve treatment, reduce the likelihood of hospital readmission, and reduce episodes of violent behavior in persons with severe psychiatric illnesses (Torrey, Zdanowicz, 2001).

· Counsel parents and homeowners to restrict unauthorized access to potentially lethal prescription drugs and firearms within the home. Identifying teens at high risk of firearm suicide and limiting access to firearms is a type of public health intervention likely to be successful in preventing firearm suicides (Shah, Hoffman, Wake, Marine, 2000).

· See care plan for Risk for self-directed Violence.

Multicultural

· Assess for the influence of cultural beliefs, norms, and values on the individual's perceptions of suicide. What the individual believes about suicide may be based on cultural perceptions (Leininger, 1996).

· With the client's consent, facilitate family-oriented crisis intervention. Family-oriented crisis intervention can clarify stresses and allow assessment of family dynamics (Baker, 1988).

· Facilitate modeling and role-playing for client and family regarding healthy ways to start a discussion about the client's suicide attempt. It is helpful for families and the client to practice communication skills in a safe environment before trying them in a real-life situation (Rivera-Andino, Lopez, 2000).

· Identify and acknowledge the stresses unique to culturally diverse individuals. Financial difficulties and maintaining cultural values are two of the most common family stressors cited by women of color (Majumdar, Ladak, 1998).

· Encourage the family to demonstrate and offer caring and support to each other. The familial characteristics of care and support may be associated with fostering resiliency in African-American families. Resilience is the ability to experience adverse conditions and successfully overcome them (Calvert, 1997).

· Validate the individual's feelings regarding concerns about current crisis and family functioning. Validation lets the client know that the nurse has heard and understands what was said, and it promotes the nurse-client relationship (Stuart, Laraia, 2001; Giger, Davidhizer, 1995).