Nursing Diagnosis for Cerebral Palsy

Nursing Diagnosis for Cerebral Palsy

Cerebral palsy (CP) is an umbrella term encompassing a group of non-progressive, non-contagious motor conditions that cause physical disability in human development, chiefly in the various areas of body movement.

Nursing Diagnosis for Cerebral Palsy
  • Chronic low self-esteem
  • Compromised family coping
  • Deficient knowledge (diagnosis and treatment)
  • Delayed growth and development
  • Disturbed body image
  • Disturbed sensory perception: Visual, hearing
  • Imbalanced nutrition: Less than body requirements
  • Impaired physical mobility
  • Impaired swallowing
  • Interrupted family processes
  • Risk for impaired parenting
  • Risk for impaired skin integrity

How To Find Scholarships To Help You With Nursing School

Statistics show that college costs are rising dramatically. Some schools cost upwards of $30,000 per year, not including textbooks and other supplies. This is leading to a sharp decline in enrollment. Should you give up your dream of becoming a nurse? Perhaps not, there is high demand for nurses. For this reason, nursing school scholarships are easy to find.

Though there are many nursing school scholarships available to men and woman who dream of entering the field of nursing, you do have to do your research. Plan to spend a good deal of time searching for grants and scholarships online, in medical publications, local hospitals, and through university financial departments.

The best place to start searching for nursing school scholarships is at the colleges or universities where you plan to apply. Every college or university has a toll-free phone number. Call the financial department and ask for help in finding scholarships or grants that apply to your needs and financial standing.

In some cases, the institution for higher learning will only give you this information if you have been accepted. If that is the case with one or more of your choices, you may want to start your search online. Check with the federal government as they have many programs available. Many online companies will run the searches for you at no charge, use them to your advantage. Avoid companies who make you pay any fees.

Check with hospitals and medical practices in your area for any grants and nursing school scholarships that are available. They will have lists of grants, scholarships, and even work study programs. They may also be able to help you select the best area colleges and universities. Some hospitals may even agree to pay for your education if you sign a contract with them that states in exchange for your college education you will remain an employee of their hospital for a certain number of years. This is an excellent program that keeps young adults from leaving states after college.

Remember that some scholarships will be restricted to minority groups, low income families, children of labor union organizations, athletic groups, children whose parents are employees of certain businesses, foster children, and honor students. Do not become discouraged when you discover that there is not much out there that fits your needs. Keep searching because you will come across a number of suitable programs. It just takes time.

Being organized is essential when searching for nursing school scholarships and grants. Keep all necessary paperwork on hand and ready to be faxed or mailed to the financial program. Income statements, personal essays, and school transcripts are usually required additions to the application. Make sure you have them handy.

Regardless of your financial or ethnic standings, there are nursing school scholarships available. Stick with it and you can make your dreams of nursing come true.

101 Nursing Tips- NANDA - Video

101 Nursing Tips- NANDA

Nursing Diagnosis for Imbalanced Nutrition : Less than Body Requirements

Nursing Diagnosis for Imbalanced Nutrition : Less than Body Requirements
Definition: Intake of nutrients insufficient to meet metabolic needs
Adequate nutrition is necessary to meet the body’s demands. Nutritional status can be affected by disease or injury states (e.g., gastrointestinal [GI] malabsorption, cancer, burns); physical factors (e.g., muscle weakness, poor dentition, activity intolerance, pain, substance abuse); social factors (e.g., lack of financial resources to obtain nutritious foods); or psychological factors (e.g., depression, boredom). During times of illness (e.g., trauma, surgery, sepsis, burns), adequate nutrition plays an important role in healing and recovery. Cultural and religious factors strongly affect the food habits of patients. Women exhibit a higher incidence of voluntary restriction of food intake secondary to anorexia, bulimia, and self-constructed fad dieting. Patients who are elderly likewise experience problems in nutrition related to lack of financial resources, cognitive impairments causing them to forget to eat, physical limitations that interfere with preparing food, deterioration of their sense of taste and smell, reduction of gastric secretion that accompanies aging and interferes with digestion, and social isolation and boredom that cause a lack of interest in eating. This care plan addresses general concerns related to nutritional deficits for the hospital or home setting.
Defining Characteristics:
  • Loss of weight with or without adequate caloric intake
  • 10% to 20% below ideal body weight
  • Documented inadequate caloric intake
Related Factors:
  • Inability to ingest foods
  • Inability to digest foods
  • Inability to absorb or metabolize foods
  • Inability to procure adequate amounts of food
  • Knowledge deficit
  • Unwillingness to eat
  • Increased metabolic needs caused by disease process or therapy
Expected Outcomes
  • Patient or caregiver verbalizes and demonstrates selection of foods or meals that will achieve a cessation of weight loss.
  • Patient weighs within 10% of ideal body weight.

Ineffective Coping Home Care Interventions

Ineffective Coping Home Care Interventions

  • The interventions described previously may be adapted for home care use.
  • Observe the family for coping behavior patterns. Obtain family and client history as possible.
  • Assess for suicidal tendencies. Refer for mental health care immediately if indicated. Identify an emergency plan should the client become suicidal. Ineffective coping can occur in a crisis situation and can lead to suicidal ideation if the client sees no hope for a solution. A suicidal client is not safe in the home environment unless supported by professional help.
  • Encourage the client to use self-care management to increase the experience of personal control. Identify with the client all available supports and sense of attachment to others.
  • Refer to medical social services for evaluation and counseling, which will promote adequate coping as part of the medical plan of care. If no primary medical diagnosis has been made, request medical social services to assist with community support contacts. If the client is involved with the mental health system, actively participate in mental health team planning. Based on knowledge of the home and family, home care nurses can often advocate for clients. These nurses are frequently requested to monitor medication use and therefore need to know the plan of care.
  • Refer the client and family to support groups.
  • If monitoring medication use, contract with the client or solicit assistance from a responsible caregiver. Prepouring of medications may be helpful with some clients. Caregivers in the home benefit from interventions that promote self-efficacy and provide a nurse for support (Dibartolo, 2002).
  • Institute case management for frail elderly clients to support continued independent living. Difficulties in coping with changes in health care needs can lead to increasing needs for assistance in using the health care system effectively. Case management combines the nursing activities of client and family assessment, planning and coordination of care among all health care providers, delivery of direct nursing care, and monitoring of care and outcomes. These activities are able to address continuity of care, mutual goal setting, behavior management, and prevention of worsening health problems (Guttman, 1999).
  • If the client is homebound, refer for psychiatric home health care services for client reassurance and implementation of a therapeutic regimen. Psychiatric home care nurses can address issues relating to the client's ability to adjust to changes in health status. Behavioral interventions in the home can help the client to participate more effectively in the treatment plan (Patusky, Rodning, and Martinez-Kratz, 1996).
  • NOTE: All of the previously mentioned interventions may be applied in the home setting. Home care may offer psychiatric nursing or the services of a licensed clinical social worker under special programs. Traditionally, insurance does not reimburse for counseling that is not related to a medical plan of care unless it falls under one of the programs just described. Public health agencies generally do not have the clinical support needed to offer psychiatric nursing services to clients. Clients are usually treated in the ambulatory mental health system.
Client/Family Teaching
  • Teach the client to problem solve. Have the client define the problem and cause, and list the advantages and disadvantages of the options.
  • Provide the seriously ill client and his or her family with needed information regarding the condition and treatment.
  • Teach relaxation techniques.
  • Work closely with the client to develop appropriate educational tools that address individualized needs.
  • Teach the client about available community resources (e.g., therapists, ministers, counselors, self-help groups).

Nursing Interventions and Rationales Ineffective Coping

Nursing Interventions and Rationales Ineffective Coping
  • Observe for causes of ineffective coping such as poor self-concept, grief, lack of problem-solving skills, lack of support, or recent change in life situation.
  • Observe for strengths such as the ability to relate the facts and to recognize the source of stressors.
  • Assess the risk of the client's harming self or others and intervene appropriately.
  • Help the client set realistic goals and identify personal skills and knowledge.
  • Use empathetic communication and encourage the client and family to verbalize fears, express emotions, and set goals.
  • Encourage the client to make choices and participate in the planning of care and scheduled activities.
  • Provide mental and physical activities within the client's ability (e.g., reading, television, radio, crafts, outings, movies, dinners out, social gatherings, exercise, sports, games).
  • If the client is physically able, encourage moderate aerobic exercise.
  • Provide information regarding care before care is given. Adequate information and training before and after treatment reduces anxiety and fear (Herranz and Gavilan, 1999).
  • Discuss changes with the client before making them.
  • Discuss the client's and family's power to change a situation or the need to accept a situation.
  • Use active listening and acceptance to help the client express emotions such as sadness, guilt, and anger (within appropriate limits).
  • Encourage the client to describe previous stressors and the coping mechanisms used.
  • Be supportive of coping behaviors; allow the client time to relax.
  • Help the client to define what meaning his or her symptoms might have for the client.
  • Encourage the use of cognitive behavioral relaxation (e.g., music therapy, guided imagery).
  • Use distraction techniques during procedures that cause the client to be fearful. Distraction is used to direct attention toward a pleasurable experience and block the attention to the feared procedure (DuHamel, Redd, and Johnson-Vickberg, 1999).
  • Use systematic desensitization when introducing new people, places, or procedures that may cause fear and altered coping. Fear of new things diminishes with repeated exposure (DuHamel, Redd, and Johnson-Vickberg, 1999).
  • Provide the client and/or family with a video of any feared procedure to view before the procedure. Ensure that the video shows a client of similar age and background. Videos provide the client and/or family with the information necessary to eliminate fear of the unknown (DuHamel, Redd, and Johnson-Vickberg, 1999).
  • Refer for counseling as needed.
  • Engage the client in reminiscence. Reminiscence activates positive memories and evokes well-being (Puentes, 2002).
  • Assess and report possible physiological alterations (e.g., sepsis, hypoglycemia, hypotension, infection, changes in temperature, fluid and electrolyte imbalances, and use of medications with known cognitive and psychotropic side effects).
  • Determine if the individual is displaying a change in personality as a manifestation of difficulty with coping. An older individual's responses to age-related stress will depend on the balance of personality strengths and weaknesses.
  • Increase and mobilize the support available to the elderly client. Encourage interaction with family and friends.
  • Assess for the influence of cultural beliefs, norms, and values on the client's perceptions of effective coping.
  • Assess for intergenerational family problems that can overwhelm coping abilities.
  • Encourage spirituality as a source of support for coping.
  • Negotiate with the client with regard to the aspects of coping behavior that will need to be modified.
  • Identify which family members the client can count on for support.
  • Use an empowerment framework to redefine coping strategies.
  • Assess the influence of fatalism on the client's coping behavior.
  • Assess the influence of cultural conflicts that may affect coping abilities.

Nursing Diagnosis : Ineffective Coping

Nursing Diagnosis: Ineffective Coping

Inability to form a valid appraisal of internal or external stressors, inadequate choices of practiced responses, and/or inability to access or use available resources

Defining Characteristics
Lack of goal-directed behavior or resolution of problem, including inability to attend; difficulty with organized information; sleep disturbance; abuse of chemical agents; decreased use of social support; use of forms of coping that impede adaptive behavior; poor concentration; fatigue; inadequate problem solving; verbalized inability to cope or ask for help; inability to meet basic needs; destructive behavior toward self or others; inability to meet role expectations; high illness rate; change in usual communication patterns; risk taking

Related Factors:
Gender differences in coping strategies; inadequate level of confidence in ability to cope; uncertainty; inadequate social support created by characteristics of relationships; inadequate level of perception of control; inadequate resource availability; high degree of threat; situational crises; maturational crises; disturbance in pattern of tension release; inadequate opportunity to prepare for stressor; inability to conserve adaptive energies; disturbance in pattern of appraisal of threat; chronic conditions; alteration in body integrity; cultural variables

Client Outcomes

1. Verbalize ability to cope and ask for help when needed
2. Demonstrate ability to solve problems related to current needs
3. Remain free of destructive behavior toward self or others
4. Communicate needs and negotiate with others to meet needs
5. Discuss how recent life stressors have overwhelmed normal coping strategies
6. Demonstrate new effective coping strategies
7. Have illness and accident rates not excessive for age and developmental level

Treatment for Rheumatoid Arthritis

Nursing Assessment for Rheumatoid Arthritis

There is no known cure for rheumatoid arthritis, but many different types of treatment can alleviate symptoms and/or modify the disease process. Recommendations of the American College of Rheumatology (ACR), published in 2008, followed a trend in supporting earlier, more aggressive treatment of RA, and reflected heightened expectations of treatment effectiveness, including remission or substantial alleviation of symptoms for a rising percentage of patients.

The goal of treatment is twofold: alleviating the current symptoms, and preventing the future destruction of the joints with the resulting handicap if the disease is left unchecked. These two goals may not always coincide: while pain relievers may achieve the first goal, they do not have any impact on the long-term consequences. For these reasons, the ACR recommends that RA should generally be treated with at least one specific anti-rheumatic medication, also named DMARD (see below), to which other medications may be added depending on how long a person has had RA, how active the disease is, and prognostic factors (such as X-ray evidence of bone erosion; elevation of blood factors such as Rheumatoid factor, anti-cyclic citrullinated peptide, C-reactive protein, and erythrocyte sedimentation rate; age and gender; physical functioning; and smoking, for example).

Cortisone therapy has offered relief in the past, but its long-term effects have been deemed undesirable. However, cortisone injections can be valuable adjuncts to a long-term treatment plan, and using low dosages of daily cortisone (e.g., prednisone or prednisolone, 5–7.5 mg daily) can also have an important benefit if added to a proper specific anti-rheumatic treatment.

Pharmacological treatment of RA can be divided into disease-modifying antirheumatic drugs (DMARDs), anti-inflammatory agents and analgesics. Treatment also includes rest and physical activity.wikipedia

Osteoarthritis and Rheumatoid Arthritis. What is the Difference?

The term arthritis actually describes over 100 related conditions, but among these the most common are osteoarthritis and rheumatoid arthritis.

There is a huge difference between these two diseases so we'll go into the main ones here.

Osteoarthritis is mainly confined to people over the age of fifty. Exceptions to this are people who have put a large strain on their joints for a prolonged period of time, for example athletes, or those whose jobs demand a lot of repetitive physical movements, for example carpenters and even computer keyboard users.

Osteoarthritis then is a disease of wear and tear. The cartilage that supports the joints becomes broken down by excessive use, causing the joints to become stiff and sore. Osteoarthritis can be painful but it is not life threatening and there are many natural ways that we can help keep pain under control.

Those suffering with osteoarthritis are usually prescribed anti inflammatory pain killers, the disadvantage is that these can sometimes have a negative effect on our general health and at best only help the symptoms while doing nothing to arrest the progress of the disease.

Rheumatoid Arthritis is a different disease altogether. It can attack any age group, even manifesting in children where it is commonly known as Juvenile Arthritis or JRA. Rheumatoid Arthritis is caused by an immune disorder, in which the immune system attacks parts of the body including joint tissue. Typical symptoms of rheumatoid arthritis are pain, inflammation, swelling and heat. Rheumatoid arthritis can go into remission and then flare up again which can be very frustrating!

Why this happens is not clear, however rheumatoid arthritis can occur after a viral disease or after a period of intense stress. A person suffering with RA will have the 'Tumor Necrosis Factor' in their system which can be found using a simple testing

Mainstream medicine claims there is no known cure for either disease, however significant progress has been made in alternative medicine with sometimes amazing results.

Exercise has multiple benefits for arthritis sufferers. It prevents stiffening of the joints while strengthening the muscles. Exercise also releases endorphins (nature's natural pain killers) into the system. Swimming is great as it puts no strain on sore joints. However a weight bearing exercise, such as walking helps to keep our bones strong.

A positive attitude is always a good idea. It takes practice but with patience we can train our thoughts to support us. This benefits our health as well as other areas of our lives.

And finally the modern enemy, stress, can exacerbate the symptoms of arthritis. A high level of stress can negatively affect out health in so many ways. Yoga can be very calming and also helps to stretch the muscles. Relaxation techniques such as deep breathing and meditation will help a lot too.

In conclusion, no matter what form of arthritis is causing the problem, natural remedies go a long way to make us feel better. Light exercise, a good diet, a positive attitude and natural medication will make our lives easier. Give it a try!

Controlling Pain with Rheumatoid Arthritis Exercises

If you are suffering from stiff, swollen joints and have been diagnosed with the condition known as rheumatoid arthritis, there is hope.

In most instances, you can continue to do the hobbies and activities you enjoy without being plagued with pain and limited mobility through a variety of treatment options.

Speak with your primary health care provider about medications and alternatives, including rheumatoid arthritis exercises to control your condition.

These alternatives are excellent ways of not only controlling your pain and regaining motion, but also enhancing your life.

Consider enrolling in a gym that offers special rheumatoid arthritis exercises and classes in order to start your treatment.

Before you decide upon any rheumatoid arthritis exercises, be sure to contact your primary health care provider.

He or she will be able to recommend special techniques that will best benefit your situation, but also provide you with a gym or physical therapist to ensure you are working out in the proper method.

Aquatic Exercises & A Medicine Ball?

Many doctors recommend arthritis patients attempt some sort of aquatic work out, since water allows you to be weightless and your joints to experience no friction or resistance.

Another great work out is Pilates, which works with hoops and balls to stretch your body and improve your mobility.

When using these work out techniques as a treatment for your stiff and painful joints, remember to enter into your program slowly.

Tackling any activity too enthusiastically can potentially injure your body and worsen your condition.

This is especially important when using any weights, medicine balls, or other apparatus that can cause muscle strains or pulls.

If you are unsure on the correct techniques for using the apparatuses, seek help from a professional to ensure you are doing the activity correctly.

This is the same for aquatic activities, which are much more than simply swimming laps. Consider enrolling in a specific class just for these activities in order to broaden your horizons and control your pain.

By using any physical activity to your advantage, arthritis sufferers of all ages are rewarded by minimized pain and stiffness.

Additionally, physical activities will allow individuals suffering from this common problem by increasing mobility.

Nursing Assessment for Rheumatoid Arthritis

Nursing Assessment for Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disorder that may affect many tissues and organs, but principally attacks synovial joints. The process produces an inflammatory response of the synovium (synovitis) secondary to hyperplasia of synovial cells, excess synovial fluid, and the development of pannus in the synovium. The pathology of the disease process often leads to the destruction of articular cartilage and ankylosis of the joints. Rheumatoid arthritis can also produce diffuse inflammation in the lungs, pericardium, pleura, and sclera, and also nodular lesions, most common in subcutaneous tissue. Although the cause of rheumatoid arthritis is unknown, autoimmunity plays a pivotal role in both its chronicity and progression, and RA is considered a systemic autoimmune disease.(wikipedia)

Nursing Assessment for Rheumatoid Arthritis

Assessment of patients depending on the severity and the involvement of other organs (eg eye, heart, lungs, kidneys), for example stages of remission and exacerbation of acute or existence with other forms of arthritis.

Activity / Rest
Symptoms: Joint pain due to movement, tenderness, worsened by stress on the joints; stiffness in the morning, usually bilateral and symmetrical. Functional limitations that affect lifestyle, leisure, work, fatigue.
Symptoms: Malaise, limited range of motion; atrophy of muscles, skin, contractors / abnormalities in the joints.

Symptoms: Raynaud's phenomenon fingers / legs (eg intermittent pallor, cyanosis, and redness of the fingers before the color returned to normal).

Ego integrity
Symptoms: Acute stress factors / chronic: eg, financial, employment, disability, relationship factors. Decisions and powerlessness (inability situation), Threats to the self-concept, body image, personal identity (eg dependence on others).

Food / fluid
Symptoms: Inability to produce / consume food / fluids adequate: nausea, anorexia, difficulty to chew.
Signs: Weight loss, dryness of mucous membranes.

Symptoms: The difficulties to carry out personal care activities. Dependence

Neuro Sensory
Symptoms: numbness, tingling in hands and feet, loss of sensation in the fingers.
Symptoms: Swollen joints symmetrically.

Pain / comfort
Symptoms: The acute phase of pain (may not be accompanied by soft tissue swelling in joints).

Symptoms: Skin shiny, taut, subcutaneous nodules. Skin lesions, leg ulcers. Mild difficulties in handling the task / maintenance of the household. Persistent mild fever. Drought in the meta and mucous membranes.

Social interaction
Symptoms: Damage of social interaction with family / others; changing role; isolation.

Guidance / learning
Gajala History of rheumatoid arthritis (RA) in the family (at the onset of adolescence). The use of health foods, vitamins, "cure" arthritis without testing. History of pericarditis, valve lesions, pulmonary fibrosis, pleuritis.

Nursing Careers: Becoming a Licensed Practical Nurse

If you're interested in the Nursing profession, you might be aware that there is more than one type of nurse and designation. One is the Licensed Practical Nurse, or LPN. Training to become an LPN is a one year program in most instances, involving classroom education and supervised clinical practice. Training must be acquired at a state-approved school, and graduates must pass a licensing examination, the NCLEX-PIN, to become qualified to practice. LPNs are qualified to perform a range of services in hospitals, doctor's offices, skilled nursing home facilities, and in a number of other healthcare settings.

The duties of a Licensed Practical Nurse are performed under the supervision of a Registered Nurse (RN), and encompass a variety of patient bedside care tasks, such as checking vital signs, preparing and administering injections and enemas, applying bandages and dressings, monitoring catheters, and treating pressure sores. In some states, Licensed Practical Nurses are allowed to administer medications prescribed by a physician and to start intravenous fluids. Collecting samples and performing routine laboratory tests are also among the duties of an LPN, as are monitoring and recording patient food and fluid intake. In a nursing home setting, experienced Licensed Practical Nurses can be responsible for supervising care given by Nursing Assistants, and aid in developing resident care plans.

There is a demand for Licensed Practical Nurses in a variety of settings throughout the healthcare industry. Demand for LPNs in hospital settings has declined in recent years, but has increased in many other segments of the health care industry. Among the fastest growing areas is the home health care field, due to an increase in older patients with disabling conditions that choose to be treated at home, and advanced technology that makes home care more feasible, even for more complex medical conditions. Nursing homes are next in line as far as job growth for Licensed Practical Nurses, due to a growing number of elderly and disabled persons requiring long-term care. Nursing home facilities are also seeing a significant increase in rehabilitation patients, released from the hospital before they are able to function sufficiently for self-care - another area in which LPNs are used.

Licensed Practical Nursing can be a very rewarding choice for many, as well as the fast track to job security in a profession that is increasingly in demand. Nursing care is required worldwide, ensuring that the nursing professional can practice in nearly any location of their choice. With the broad range of settings and specializations to choose from, Licensed Practical Nurses can easily find their perfect health care niche, ensuring long-term career growth and satisfaction.

Nursing Scholarship Types

Are you considering a nursing school scholarship? Great! Then, this is your first step to achieving your goal. Find out what types of scholarships are out there. The internet is a good place to start. The information highway is certainly a cornucopia of information. But be careful to review where certain websites get their information. Not everything you read on the internet is a fact.

However, it is still a good place to begin to get a feeling for what types of scholarships are out there. Many people that are going into the nursing field are older than those who attended nursing school twenty or thirty years ago. With the older group of students, many feel that they just don't qualify for scholarships. Actually the reverse is true. There are many scholarships out there for people that are older. Some scholarships are even bestowed on some just because of their age. This is indeed a wonderful country that we live in.

The careful planner can certainly plan their finances for nursing school without having to pay anything back when they graduate, or very little if that. Before we look at some of the nursing scholarships that are out there, let us first look at the professional nursing organizations that participate in many of the scholarships offered, and serve as excellent reliable resources for the pre-student nurse, the student nurse, and the graduate nurse. Here is a list of the following nursing organizations, you may want to take some time later and look into the background of each of these organizations. You will find it very enlightening and encouraging.

You may not consider yourself eligible, but you will be surprised to find that there are nursing scholarships out there that are just for you. When considering a career in nursing, most of seek out financial aid only to find the resulting funds are usually never sufficient. This is the reason that scholarships were created. You have a specific ethnicity that predisposes you to a number of scholarships. Many people wonder if you get a nursing scholarship, can you apply for another.

The answer is yes, you can apply for as many scholarships as you want. Whether or not you will get them depends on a number of factors. Some of which are, have you filled out the proper forms, submitted the correct documents, and have the necessary qualifications. These are all factors which must be looked at carefully when applying for a nursing scholarship. If you follow to the letter all of the requirements then you should have no trouble obtaining a scholarship for nursing school.

Signs and Symptoms of Myasthenia Gravis

Signs and Symptoms of Myasthenia Gravis
The hallmark of myasthenia gravis is fatigability. Muscles become progressively weaker during periods of activity and improve after periods of rest. Muscles that control eye and eyelid movement, facial expressions, chewing, talking, and swallowing are especially susceptible. The muscles that control breathing and neck and limb movements can also be affected. Often, the physical examination yields results within normal limits.

The onset of the disorder can be sudden. Often symptoms are intermittent. The diagnosis of myasthenia gravis may be delayed if the symptoms are subtle or variable.
In most cases, the first noticeable symptom is weakness of the eye muscles. In others, difficulty in swallowing and slurred speech may be the first signs. The degree of muscle weakness involved in MG varies greatly among patients, ranging from a localized form that is limited to eye muscles (ocular myasthenia), to a severe and generalized form in which many muscles - sometimes including those that control breathing - are affected. Symptoms, which vary in type and severity, may include asymmetrical ptosis (a drooping of one or both eyelids), diplopia (double vision) due to weakness of the muscles that control eye movements, an unstable or waddling gait, weakness in arms, hands, fingers, legs, and neck, a change in facial expression, dysphagia (difficulty in swallowing), shortness of breath and dysarthria (impaired speech, often nasal due to weakness of the velar muscles).

In myasthenic crisis a paralysis of the respiratory muscles occurs, necessitating assisted ventilation to sustain life. In patients whose respiratory muscles are already weak, crises may be triggered by infection, fever, an adverse reaction to medication, or emotional stress.[5] Since the heart muscle is only regulated by the autonomic nervous system, it is generally unaffected by MG.

From Wikipedia

Nursing Diagnosis for Ineffective Breathing Pattern

Nursing Diagnosis for Ineffective Breathing Pattern

Definition: The exchange of air inspiration and / or expiration inadequate.

  • Decrease pressure inspiration / expiration
  • Decrease in air changes per minute
  • Using additional respiratory muscle
  • Nasal flaring
  • Dyspnea
  • Orthopnea
  • Changes in chest deviation
  • Shortness of breath
  • Assumption of 3-point position
  • Breathing pursed-lip
  • Phase lasts very long expiratory
  • Increased anterior-posterior diameter
  • Respiratory average / minimum
    • Infants: less than 25 or more than 60
    • Age 1-4: less than 20 or more than 30
    • Age 5-14: less than 14 or more than 25
    • Age over 14: less than 11 or more than 24
  • Depth of respiration
    • Adult tidal volume of 500 ml at rest
    • Infant tidal volume of 6-8 ml / kg
  • Timing ratio
  • Decrease in vital capacity

Related Factors:
  • Hyperventilation
  • Bone deformities
  • Chest wall deformity
  • Decreased energy / fatigue
  • Destruction / impairment musculoskeletal
  • Obesity
  • Body position
  • Fatigue of respiratory muscles
  • Hypoventilation syndrome
  • Pain
  • Anxiety
  • Neuromuscular dysfunction
  • Damage to the perception / cognition
  • Injury to spinal nerve tissue
  • Neurological immaturity

Source :

Nursing Diagnosis for Risk for Deficient Fluid Volume

Nursing Diagnosis for Risk for Deficient Fluid Volume

Risk for Deficient Fluid Volume

Definition: The decrease intravascular fluid, interstitial, and / or intrasellular. This leads to dehydration, loss of fluids with sodium expenditure.

Characteristics :

  • Weakness

  • Thirst

  • Decreased skin turgor / tongue

  • Mucous membrane / dry skin

  • Increased pulse rate, decreased blood pressure, decrease in volume / pulse pressure

  • Completion of decreased venous

  • Changes in the mental position

  • The concentration of urine increased

  • Increased body temperature

  • Elevated hematocrit

  • Weight loss immediately (except on third spacing)

Related Factors :
  • Loss of active fluid volume

  • Failure of regulatory mechanisms

Source :

The Signs And Symptoms Of Hypertension

The signs and symptoms of hypertension, or high blood pressure as it is also known as, include blood pressure readings that are consistently more than 140/90. Pre-hypertension is present when your blood pressure readings are consistently between 120-139/80-89. Although this does not mean you have hypertension, it is a good indicator that you will most likely develop high blood pressure in the future.

For either hypertension, or pre-hypertension, your doctor will usually suggest changes in your lifestyle to get it down to a more normal range. You'll be told to adjust your eating habits and begin to eat more healthy foods, as well as get on an exercise program if you're not already doing so.

While this may not sound like something fun or what you really want to hear, it's your life we're talking about. High blood pressure is known as the "silent killer". You don't feel like anything is wrong so you may be inclined to simply ignore the signs and symptoms of hypertension.

This can prove to be a fatal mistake. Left untreated and ignored, hypertension will lead to strokes, heart failure, heart attacks, aneurysms or death. It is a very serious health issue.

Some of the symptoms of hypertension can include: -headaches

-being tired all the time

-blurred vision


-ringing in the ears

-chest pain

-irregular heartbeat

-feeling of confusion off and on

-heart failure

If you experience any of these signs and symptoms of hypertension, get to your doctor immediately. Don't wait until it's too late. Your doctor can perform tests and get you on treatment that will reduce the risks of this deadly disease.

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All-Natural High Blood Pressure Medications Could Make A Difference

Our heart, it is a muscle which is almost similar to the size of our fist, is among the hardest working of all our body organs. Over our life's course, it beats at more than two billion times completely without taking even a single break. Our daily choices in life determine our heart's ability to function properly.
High blood pressure could often lead to heart disease. A condition like this that isn't controlled properly or is undetected could lead to heart attack or failure, stroke, or kidney failure. It has few symptoms that occur early which many people are not aware of.
Add obesity, diabetes, or smoking to the mix of causes, the risk of stroke, heart attack, or kidney disease increases dramatically for those people with this medical condition. This is why it is important to know what how your blood's condition is, and at this point, you will need medications for this. There are many natural high blood pressure medications out there.
Are you over-weight? Even some little extra weight could raise blood pressure. Try to drop a few pounds to improve your health greatly. One more thing, exercise is very good for high blood pressure, but not too much.
Do you have lots of stress right now in your life? Try to avoid the sources of your stress. Then if that is not possible for you, go try other ways, at least for reducing it. Yoga, meditation, breathing or even having vacations are methods to lower your stress level. Make sure you're getting enough sleep too.
Vitamins and minerals, and herbs are also natural methods that you could use for reducing high blood pressure. These natural herbs are gaining recognition rapidly because of their great ability to lower High Blood Pressure without the risk of having different side-effects that ordinary or usual prescription medicines give our bodies.
Most of the doctors are really educated from medical schools that focus on products of the major pharmaceutical companies. Although it is great that these schools prepare them for curing of most sickness, thousands of them still complain because they are not educated about natural ways of curing sickness.
Natural and Herbal medicines are the best blood pressure medications to complement your proper diet and positive lifestyle. Aside from the fact that they are side-effects free, they are also chemical free, they are all-natural.
Though there are many medications out there, always remember that the best medications for high blood pressure are doing them naturally.

5 Preventative Measures A Diabetic Can Take Against Cardiovascular Disorders

There are many complications that are the direct result of having diabetes. But sometimes there are illnesses that may not stem by diabetes, but instead was the result of other bad health problems.

Such an example is when you develop complications of your heart and your circulatory system. However, because you have diabetes, you are more likely to suffer from heart and circulatory problems. The good news is that the risks can be significantly lowered by maintaining a healthy lifestyle and self-care.

There are primary risk factors for the development of cardiovascular disease (stroke, heart attacks, peripheral vascular disease, and arteriosclerosis) and those risk factors include smoking tobacco, obesity, high levels of fat and cholesterol within the blood, high blood pressure, a lack of exercise, and a history of heart and circulatory disease within the family.

Doctors also believe that having high levels of insulin circulating through a person's blood can also be a contributing factor when it comes to the development of cardiovascular disease. Those people that have type 2 diabetes typically went through years of raised blood insulin levels before being diagnosed.

It is not difficult to start and maintain a prevention program that will benefit your heart and circulatory system. In fact, a very thorough diabetic program of nutrition and exercise should already contain the necessary steps towards prevention. They are fundamental health tips that can be beneficial to anyone, whether you have diabetes or not. Below is a list of those health tips:

1. Reduce your sodium intake to less than 4000 mg per day if you have high blood pressure.

2. Start an aerobic conditioning program, such as walking or running, and participate in a more active lifestyle on a daily basis.

3. Become conscious of your body weight and strive to maintain a healthy balance of increased muscle mass and lower body fat levels.

4. Completely eliminate the life-threatening habit of smoking cigarettes. If you currently smoke, then stop. It's that simple.

5. Do not eat foods that contain high amounts of saturated fat and bad cholesterol.

Sometimes the best offense against diabetes is a good defense.

Treatment for Diabetes Mellitus

Treatment for Diabetes Mellitus
Treatment for Diabetes Mellitus
  1. Treatment with Diet and Activity
    • Diet
      Restriction or reduction in salt intake. Losing weight can lower blood pressure accompanied by a decrease in plasma renin activity and levels in plasma adosteron.

    • Activity
      Clients are advised to participate in activities and adjusted with medical restrictions and in accordance with abilities such as walking, jogging, cycling or swimming.

  2. Treatment with Drugs
    Broadly speaking, there are several things to note in the provision or selection of antihypertensive drugs, namely:
    • Have high effectiveness.
    • Have the toxicity and side effects are mild or minimal.
    • Allows the use of oral medication.
    • No cause of intolerance.
    • Relatively low drug prices so affordable by the client.
    • Allows the use of long-term.

    Class of drugs given to clients with hypertension, such as type diuretics, beta blockers class, class of calcium antagonists, class renin inhibitor angitensin conversion.

Nursing Intervention Nursing Care Plan for Children with Diabetes Mellitus

Nursing Intervention Nursing Care Plan for Children with Diabetes Mellitus

Expected Results:
  • Prevent injury and infection
  • Eliminate fear when giving insulin
  • Maintenance of adequate nutrition
  • Positive self-concept
  • Does not depend
  • To keep the child's family does not happen hypoglycemia, insulin nutrition for children
  • For children to learn to treat diabetes in order to avoid complications.

Prevent injury
  • Monitoring blood glucose levels, 2 times a day, before breakfast and dinner.
  • Help express feelings of fear when performed blood glucose test (finger stick).
  • Monitor signs of hyperglycemia

Improve family coping in the management hypoglikemia and hyperglikemia:
  • Education about the signs and hyperglikemia hypoglikemia and how the handling necessary to overcome.
  • How to handle if blood sugar <60 mg / dl, juice, sugar, non-diet soda, if glucose is not checked give simple carbohydrates if there are signs of hypoglycemia.
  • If the child received therapy glucagon or dextrose from doctors, teach how the intra-muscular administration of glucagon.
  • Encourage children to bring lunch and eat if there are signs of hypoglycemia (his lunch complex carbohydrates such as cakes, crakers, bread, beans).
  • Note the pattern of occurrence of hypoglycemia and create a schedule plan for decision making in order to avoid hypoglycemia
  • If the child has a sore (fever, infection, vomiting, nausea, did not eat) call the doctor.
  • Teach how subcutan insulin administration.

Ensuring appropriate and inadequate nutrition
  • Involve children in planning nutrition.
  • Helping children to get involved in a diet program.
  • If the child will come home late for lunch are encouraged to bring the food complex carbohydrates.
  • Can recommend how to overcome eating in school and social environment.

Prevent infection and skin damage
  • Teach them how to observe, determine the skin every day (after a shower) typically are susceptible to damage at folds (axilla, groin)
  • Note the use of a good shoe.
  • Observation of both feet for cracked, cut nails according to the line, use clean socks.
  • Infection often is the urinary system and respiratory system of teaching known mark urinary infection; itching, burning sensation in the urinary system in case of medical attention.

Reducing the anxiety of children and families
  • Suggest to the child and family to express his feelings (guilt, anger, rejection).
  • Encourage a lot of reading to increase understanding about the disease.
  • Give an honest and clear information.

Improve self care and positive self esteem
  • Encourage child to visit one another among the sick.
  • Explain that children with diabetes can do the same activities as other children.

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