Benefits, Role and Function of Nurse Home Care

Benefits, Role and Function of Nurse Home Care

Nursing Home Care   October 31, 2013

Benefits of Nursing Home Care

1. For Clients and Families:

• Program Home Care (HC) can help offset the cost of hospitalization is more expensive, because it can reduce the cost of patient accommodation, transportation and consumption of the family.
• Strengthen family ties, because it can always close when a family member is ill.
• Feel more comfortable being home alone.
• The number of women working outside the home, so the task of caring for the sick mother who is usually done because it is hampered by the presence of a nurse to replace it.

2. For Nurses:

• Provide variety of work environments, so it is not saturated with the environment remains the same.
• Get to know the client and their environment well, so that health education is given in accordance with the client's situation and condition of the house, so the nurse job satisfaction will increase.
• Data and interests of patients.

3. For the Hospital:

• Making the hospital became more famous with the home care service does.
• To evaluate the terms of the service that has been done.
• To promote the hospital to the community.

Role and Function of Nurse Home Care

1. Case manager: manage and collaborate on services, with the function:

• Identifying the needs of patients and families.
• Service plan.
• Coordinate team activities.
• Monitor the quality of service.

2. Executing: provide direct care and services to evaluate the function:

• Conduct a comprehensive assessment.
• Nursing plan.
• Nursing action.
• Observe the patient's condition.
• Assist patients in developing effective coping behavior.
• Involving the family in the service.
• Guiding all members of the family in health care.
• To evaluate the nursing care.
• Documenting nursing care.

Principles of Nursing Home Care

Principles of Nursing Home Care

Nursing Home Care   October 31, 2013

Home care services in order to run smoothly, it is worth noting some of the principles in the service of home care.

Home health care nursing services are provided to patients in the home, which is a synthesis of community nursing services and specific technical skills that come from a particular medical specialty, the individual-focused nursing care to involve the family, with the aim of curing, maintain and improve health physical, mental / emotional patient.

Principles of Home Care, include:

1. Management carried out by the home care nurse.
2. Implementing Home Care is comprised of the existing health professions (doctors, midwives, nurses, dietitians, pharmacists, sanitarian and other professional personnel).
3. Apply the concept as a basis in the decision-making practices.
4. Collect data systematically, accurately and Comprehensive.
5. Using data from assessment and examination results in establishing the diagnosis.
6. Develop a nursing plan based on needs.
7. Provide complete service consisting of preventive, curative, promotive and rehabilitaif.
8. Evaluate the response of patients and their families in nursing interventions, medical and others.
9. Responsible for quality services through management.
10. Maintain and ensure good relationships between team members.
11. Developing a professional capacity.
12. Participate in research activities for the development of home care.
13. Using the code of professional conduct in performing services in home care.

Physical Examination (Head to Toe)

Physical Examination (Head to Toe)

Physical Examination   October 31, 2013

1. Hair and Head

• Inspection: black hair, brown, blonde, smelling.
• Palpation: Easy to fall, scalp dirty, smelly generally indicates the level of a person's hygiene.

2. Skin hydration forehead area

• Palpation: Pressing your thumb on the forehead skin, because they have the basic bones. Dehydration can be found on the "finger print" on the skin of the forehead.

3. Palpebrae

• Inspection: Can be visible buildup of fluid or edema in the palpebrae, but it may also appear sunken in dehydrated patients.
• Palpation: With the touch by using three fingers on palpebrae to sense whether there is a buildup of fluid, or patient dehydration when palpable concave.

4. Sclera and Conjungtiva

• Icterus sclera appear more clearly than in the skin. Check the sclera with palpation technique using both fingers pull palpebrae, the patient looked down inflammation in conjungtiva bulbi, or conjungtiva palpebrae. Anemic state can be checked on pale colors conjungtiva inferior palpebrae.

5. Intra Ocular Pressure

• With two index fingers, check to compare IOP ball left and right eye by changing the pressure in the eyeball with closed eyelids general awareness of glaucoma on patients aged more than 40 years.

6. Nose

• Inspection: Nose symmetrical, the cavity examined whether there is dirt nose, polyps or swelling.

7. Hygiene of the oral cavity, teeth, tongue, tonsils and pharynk

• Oral cavity: bad breath examined, mocosa inflammation (stomatitis), and the aphtae.
• Dental examination: checked the food, tartar, caries, root rest, missing teeth, bleeding, abscess, foreign body, (false teeth), the state of the gums, inflamed.
• Tongue: dirty / coated, will be found in the state: the lack of oral hygiene, typhoid fever, do not like to eat, coma patients, note the type hipertemik tongue that can be encountered in patients typoid fever.
• Tonsils: measured.
• Tonsils examined whether there is swelling or not.
• Pharinx: back wall oro pharynx examined for inflammation, enlarged adenoids, and lenders / secret that there

8. Cervical lymph nodes

• Enlarged lymph nodes can occur due to infection, toxoplasmosis infection provide symptomatic enlarged neck lymph.

9. Thyroid gland

• Inspection : shape and size when enlargement was real.
• Palpation : one hand or two hands on the side of the back, fingers touching the surface of the gland and the patient is asked to swallow feel if there is any swelling of the surrounding tissues.

10 . Abdomen

• Inspection : the inspection needs to be listened to if abdomen swollen / bulging or flat, edges or protruding belly , protruding umbilicus or not , whether there is a shadow venous observe , observe whether the abdominal area looks lumps of mass . Report form and the positioning.
• Auscultation : bowel peristaltic hear , normal range 5-35 times per minute : peristaltic sounds were loud and long called borborygmi , found in gastroenteritis or intestinal obstruction in the early stages . Reduced peristaltic encountered in paralytic ileus . If after 5 minutes there was no sound peristaltic , at all , then we say peristaltic negative ( in patients post- surgery ).
• Palpation : palpate prior to first ask the patient whether the pain area if there is then it should be palpated last , general palpation of the entire abdominal wall to see if there are common pain ( peritonitis , pancreatitis ) . Then look for the presence or absence of palpability mass / lump ( tumor ) . Check also turgor Kullit stomach to assess patient hydration . After that check the pressure region suprapubika ( cystitis ) , Burney MC point ( appendicitis ) , region epigastrica ( gastritis ) , and region iliaca ( adnexitis ) then in particular we palpate the liver. Palpation of the liver is done with the right hand and fingers , starting from the bottom right kuadrant , gradually rising to the rhythm of the breath . Feel for any enlargement of the liver or not .

11. Anus

• Position the patient lying on her side with knees bent stick to the stomach / chest
• Examined the :

• Hemhoroid externa
• Fisurra
• Fistula
• Signs of malignancy

Clinical Manifestations of Tuberculosis

Clinical Manifestations of Tuberculosis

Tuberculosis   October 30, 2013

Tuberculosis is often called "the great imitator" is a disease that has many similarities with other diseases are also common symptoms such as weakness and fever. In some patients the symptoms are not clear so overlooked sometimes even asymptomatic.

Clinical Manifestations of pulmonary tuberculosis can be divided into 2 groups, symptoms of respiratory and systemic symptoms:

1. Respiratory symptoms, including:

a. Cough
Most cough symptoms arise early and is a disorder that most often complained. At first is non-productive, then phlegm, even mixed with blood, when there is tissue damage.

b. Coughing up blood
Blood in the sputum varied issued, may appear in the form of lines or patches of sputum, or blood clots in the amount of fresh blood very much. Coughing up blood occurs due to rupture of blood vessels. Severity of coughing up blood depends on the size of a ruptured blood vessel.

c. Shortness of breath
These symptoms are found when the damage is extensive lung parenchyma or because there are things that accompany such as pleural effusion, pneumothorax, anemia and others.

d. Chest pain
Chest pain in pulmonary TB include pleuritic pain is mild. These symptoms occur when the neural systems in the pleural exposed.

2. Systemic symptoms, include:

a. Fever
Is a common symptom that usually occur in the afternoon and evening influenza like fever, and intermittent attacks grew longer being free period shorter attack.

b. Other systemic symptoms
Other systemic symptoms are night sweats, anorexia, weight loss and malaise.
Gradual onset of symptoms is usually within a few weeks and months, but with the appearance of acute cough, heat, shortness of breath although rare can also arise resemble symptoms of pneumonia.

We must make sure that the bleeding from the nasopharynx by way of distinguishing characteristics as follows:
1. Coughing up blood

• Coughed blood with a burning sensation in the throat.
• Frothy blood mixed with air.
• Pink fresh blood.
• Blood is alkaline.
• Anemia is sometimes the case.
• Benzidine test negative.

2. Vomiting blood

• Blood spewed by nausea.
• Blood mixed with leftovers.
• Black blood, because stomach acid mixed.
• Blood is acidic.
• Anemia often occurs.
• Benzidine test positive.

3. Epistaxis

• Blood dripped from his nose.
• Cough out slowly sometimes.
• Fresh red blood.
• Blood is alkaline.
• Anemia is rare.

Impaired Physical Mobility - NCP for Guillain-Barre Syndrome

Impaired Physical Mobility - NCP for Guillain-Barre Syndrome

Nursing Care Plan   October 30, 2013

Nursing Care Plan for Guillain-Barre Syndrome

Guillain-Barre syndrome or GBS is a severe inflammatory disorder of the peripheral nerves.

Guillain-Barre Syndrome is an inflammatory disorder in which the body's immune system attacks the nerves, causing severe weakness and numbness and eventually leading to muscular paralysis.

The symptoms of Guillain-Barre syndrome are lack of feeling, weakness or itchiness in arms or legs, and possible loss of feeling and movement in the upper body, face, arms and legs. The symptoms can remain in this phase and can cause little difficulty in walking. However, in some cases the illness can progress resulting in entire paralysis of arms and legs.

Nursing Diagnosis: Impaired Physical Mobility related to neuromuscular damage

Goals:
To maintain the position of function with no complications (contractures, pressure sores).

Outcomes:
Clients can improve the strength and function of the affected part

Nursing Interventions and Rationale:
1. Assess motor strength / functional ability by using a scale of 0-5.
R / Define the development / re-emergence of signs that hinder the achievement of goals / expectations of the patient.

2. Give the patient a position that causes a sense of comfort. Make changes to the position on a regular schedule as needed on an individual basis.
R / Reduce fatigue, increase relaxation. Reduce the risk of ischemia / damage to the skin.

3. Chock extremities and joints with a pillow.
R / Maintain extremity in a physiological position, prevent contractures.

4. Perform passive range of motion exercises. Avoid active exercise during the acute phase.
R / Stimulates circulation, improve muscle tone and increase joint mobilization.

5. Coordinate care provided and the period of uninterrupted rest.
R / Excessive use of muscles can increase the time it takes to remielinisasi, arena may extend the time for healing.

6. Encourage you to do the exercise that continues to be developed and depend on individual tolerance.
R / exercise activities in the affected areas gradually improved / fixed, improve organ function normally and have a positive psychological effect

7. Give lubrication / oil artificially within their needs.
R / Prevent from drying the client's body.

Collaboration

1. Confirm with / refer gets physical therapy / occupational therapy.
R / Helpful in creating individual muscle strength / exercise conditioned and running training programs and identify tools to maintain the mobilization and independence in performing daily activities.

Disturbed Body Image - Nursing Care Plan for Brain Tumor

Disturbed Body Image - Nursing Care Plan for Brain Tumor

Nursing Care Plan   October 29, 2013

A brain tumor is an intracranial solid neoplasm, a tumor within the brain or the central spinal canal.

The most common primary brain tumors are:

• Gliomas (50.4%)
• Meningiomas (20.8%)
• Pituitary adenomas (15%)
• Nerve sheath tumors (8%)

The most frequent symptoms of brain tumors include:

• Headaches that tend to be worse in the morning and ease during the day
• Seizures or convulsions
• Nausea or vomiting
• Weakness or loss of feeling in the arms or legs
• Stumbling or lack of coordination in walking
• Abnormal eye movements or changes in vision
• Drowsiness
• Changes in personality or memory
• Changes in speech

Nursing Care Plan for Brain Tumor

Nursing Diagnosis : Disturbed Body Image related to hair loss, and changes in the structure and function of the body.

Goal:

• Patients express a positive self-image with the criteria of patients receiving changes to body image.

Interventions:

1. Assess the patient's reaction to body changes.
2. Observation of patient social interaction.
3. Maintain a therapeutic relationship with the patient.
4. Instruct the patient to open communication with health care or other important person.
5. Help patients find effective coping about body image.

Rational:

1. Determine the patient's reaction to changes in body image.
2. Social withdrawal may occur due to rejection.
3. Facilitate a therapeutic relationship that is open.
4. Expression of fears openly to reduce anxiety.
5. Help patients find coping strategies that can reduce anxiety and fear.

Risk for Injury - Multiple Sclerosis Care Plan

Risk for Injury - Multiple Sclerosis Care Plan

Risk for Injury   October 27, 2013

Multiple Sclerosis (MS) is a progressive and chronic disease that attacks the central nervous system.

More than 2.5 million people around the world are said to be affected by multiple sclerosis. Disease onset is usually seen more in young adults, and it is more common in women. Almost 98% of the MS population is Caucasian. MS is generally more common in people living in temperate zones.

MS can be difficult to diagnose since its signs and symptoms may be similar to other conditions. A number of specialized tests may be necessary for accurate diagnosis. Medical organizations have set diagnostic criteria to standardize the process. Currently diagnosis is based on The McDonald criteria which focus on a demonstration with clinical, laboratory and radiological data.

Nursing Diagnosis for Multiple Sclerosis : Risk for Injury
related to :

• sensory impairment and vision,
• effects of prolonged bed rest and spastic weakness.

Goal :
Risk for Injury did not occur

Outcomes:

1. Clients want to participate to the prevention of trauma.
2. Decubitus : no.
3. Joint contractures : no.
4. Clients do not fall out of bed.

Intervention and Rational :
1. Maintain bed rest and immobilization as indicated.
Rational : Minimize the pain caused by stimulation of grit between the bone fragments with the surrounding soft tissue.

2. Give goggles that fit with the client.
Rational : Eye shields or goggles cover implus can be used to block vision in one eye when a client is experiencing diplopia or double vision.

3. Minimize the effects of immobility.
Rational: Because physical activity and immobilization often occur in multiple sclerosis, the complications which connect with immobilization and rare covers to prevent pressure sores.

4. Modification of injury prevention.
Rational: Injury prevention is done on the client if the motor dysfunction of multiple sclerosis causes no problems in coordination and any stiffness or if there's ataxia, the risk of falling.

5. Environmental modifications.
Rational: the inability to cope, to encourage clients with empty legs on a vast space to provide a broad base and to improve the ability to walk steadily.

6. Teach walking technique.
Rational: if the loss of sensation to the body position, encourage clients to see the foot while walking.

7. Provide occupational therapy.
Rational: Occupational therapy is a resource that helps individuals to provide advice and assistance to ensure increased independence.

8. Minimize the risk of decubitus.
Rational: Because of sensory loss can lead to increased loss of motoric move. Continue to be addressed to inegritas decubitus skin. Wheelchair use increases the risk.

9. Distal section of skin inspection, every day (monitor skin and mucous membranes to irritation, redness, or blisters).
Rational : early detection of circulatory disorders and loss of sensation of the high risk of damage to skin integrity possible complications of immobilization.

10. Minimize spasticity and contractures .
Rational : Muscle spasticity is common and occurs at an advanced stage , which is visible in the form of heavy addukor on hips, with a spasm of the hip and knee flexors.

11. Teach exercise techniques.
Rational: Exercise every day to strengthen the muscles supplied to minimize joint contractures. Special attention is given to the thigh muscles, the gastrocnemius muscle, adductor, biceps and wrists, and fingers flexors.

12. Maintain a 90-degree joints of the foot board.
Rational: The soles of the feet in position 90 degrees to prevent footdrop.

13. Evaluation of signs / symptoms of the expansion of tissue injury (inflammation of local / systemic, just as increased pain, edema and fever).
Rational: Assessing the development of the client's problem.