Care Planning – NCP – for nurses

DEMENTIA OF THE ALZHEIMER’S TYPE/VASCULAR DEMENTIA I. Pathophysiology a. Cognitive disorder characterized by impaired memory, language, thinking, and perception b. Dementia of the Alzheimer’s type (DAT) (Hausman, 2006; Nelson-Marsh, 2005) i. Characterized by structural and chemical changes in the brain, causing a steady and global decline in function ii. Degenerative process occurring primarily in the cells located at the base ...

PSYCHOSOCIAL ASPECTS OF CARE I. Mind-Body-Spirit Connection a. When a physiological response occurs, there is a corresponding psychological response (Anandarajah & Hight, 2001). i. Emotional instability associated with steroid therapy or Cushing’s syndrome ii. Irritability of hypoglycemia iii. Anxiety associated with impaired oxygenation b. Emotional response during illness is of extreme importance. i. The stress of illness is well recognized; however, ...

I. Procedure a. Transfer of whole or partial organs—including heart, lung, kidney, liver, pancreas, and intestines—and tissues or cells from one location to another b. Long considered experimental, heart and other transplant procedures are successfully moving to domain of conventional therapy; however, others, such as hand and limb transplants, are still at the experimental stage c. Bone, bone ...

I. Pathophysiology a. Systemic inflammatory process originating in the synovium or synovial fluid involving connective tissue and characterized by destruction and proliferation of the synovial membrane b. Phagocytosis produces enzymes within the joint, causing inflammation c. Collagen is destroyed over time and pannus formations occur, narrowing the joint space d. May result in joint destruction, ankylosis, and deformity, with ...

I. Pathophysiology a. End result of infection with a retrovirus—the human immunodeficiency virus (HIV) b. Progression from HIV infection to AIDS is highly variable: It may take weeks to years, with median rate of 9 to 11 years after infection in the absence of antiretroviral therapy (United Nations Programme on HIV/AIDS [UNAIDS] & World Health Organization [WHO], ...

I. Pathophysiology a. Infection by a subgroup of retroviruses with a high affinity for CD4 T-lymphocytes and monocytes, with viral DNA incorporating itself into host DNA (Dubin, 2008) b. Following successful transmission of HIV, the course of subsequent infection is variable and dependent on a number of factors. c. Main consequence of infection is damage to the ...

I. Pathophysiology (Cunha, 2008; Kleinpell, 2006; Sharma & Mink, 2007; Wood & Lavieri, 2007) a. Presence of a systemic inflammatory response to documented or presumed infection, which may progress along a continuum i. Systemic inflammatory response syndrome (SIRS) 1. Infection with release of endo- or exotoxins activating the inflammatory cascade—local release of cytokines into the circulation in ...

I. Pathophysiology—Local and systemic response affecting skin and/or other tissues depending on cause of burn injury and physiological response (Hettiaratchy, 2004) a. Local responses i. Coagulation: Occurs at the point of maximum damage, causing irreversible tissue loss due to coagulation of the constituent proteins. ii. Stasis: Area characterized by decreased tissue perfusion that is potentially salvageable unless additional ...

I. Purpose a. Definitive treatment for advanced, irreversibly damaged joints with loss of function and unremitting pain b. Commom conditions: degenerative and rheumatoid arthritis (RA); selected fractures, such as with hip and femoral neck; joint instability; congenital hip disorders; avascular necrosis II. Procedures a. Performed on any joint except the spine, with hip and knee replacements the most ...

I. Pathophysiology—Partial or complete detachment of body part with residual extremity covered with well-vascularized muscle and skin, although reattachment surgery may be possible for fingers, hands, and arms a. Primarily two types of amputations i. Open or provisional: requires subsequent revisions ii. Closed or flap: all surgical revision is performed and the wound closed in one procedure b. ...

I. Pathophysiology a. Discontinuity or break in a bone b. May be associated with serious injury to nerves, blood vessels, muscles, and/or organs c. More than 150 fracture classifications with five major types: incomplete, complete, closed, open, and pathologic II. Etiology a. Common causes: trauma, including abuse; overuse injury; osteoporosis; bone tumors; infections b. Severity of fracture increases with ...

I. Purpose a. Removal of breast tissue due to presence of malignant or cancerous tumor changes b. Surgical procedures: dependent on tumor type, size, and location as well as clinical characteristics or staging i. Breast-conserving therapy ii. Lumpectomy iii. Partial or segmental mastectomy iv. Lymph node surgery v. Mastectomy (Mayo Clinic, 2007) 1. Simple or total 2. Modified radical 3. Radical 4. Skin-sparing ...

I. Indications—surgical removal of the uterus a. Malignancies: 11% of hysterectomies b. Nonmalignant conditions, such as endometriosis, fibroid tumors; pelvic relaxation with uterine prolapse that leads to disabling levels of pain, discomfort, uterine bleeding, emotional stress c. Life-threatening bleeding or hemorrhaging, such as obstetric or traumatic complication; irreparable rupture of the uterus d. Treatment of intractable pelvic infection II. Procedures a. ...

I. Pathophysiology a. Presence of stones anywhere in the urinary tract i. Most commonly found in the renal pelvis and calyces 1. Stones forming in the kidney—nephrolithiasis 2. Stones formed in the ureters—ureterolithiasis ii. May be single or multiple calculi, ranging in size from a grain of salt to the size of a pebble or staghorn ...

I. Indications a. Benign prostatic hyperplasia (BPH)-related complications i. Urinary retention ii. Frequent urinary tract infections iii. Bladder stones iv. Recurrent gross hematuria v. Kidney damage from long-standing blockage vi. Failure to respond to medical or minimally invasive treatments b. Prostate cancer is the second leading cause of cancer death in the United States. II. Procedures a. Minimally invasive prostatectomy i. Transurethral therapy ...

I. Pathophysiology a. Overgrowth of normal, nonmalignant cells that cause progressive enlargement of the prostate gland, resulting in bladder outlet obstruction with urinary retention, leakage, and frequency (Shiller, 2007) b. Additional complications: bladder wall trabeculation, detrusor muscle enlargement, narrowing of urethra, incontinence, and acute or chronic renal failure (Springhouse, 2005) II. Classification (American Urological Association [AUA], 2003) a. International scoring ...

I. Procedure a. Diversion of urine out of the body through an opening in the abdominal wall bypassing the bladder, which requires a pouch to be worn outside the body; or, a continent diversion involving the creation of a pouch or bladder inside the body, usually using part of the digestive tract b. Types i. Incontinent urinary ...

I. Procedure a. Removal of urea and other toxic products and correction of fluid and electrolyte imbalances b. Blood is shunted through an artificial kidney or membrane (dialyzer) for removal of toxins and excess fluid and then returned to the venous circulation. c. Requires placement of vascular access i. Arteriovenous (AV) fistula: usually requires at least 2 ...

I. Procedure a. Requires a surgically placed abdominal catheter and uses the peritoneum to filter toxins and excess fluid from the body b. Fluid removal is controlled by adjusting the dextrose concentration in the dialysate (e.g., 1.5%, 2.5%, 4.25%) to create an osmotic gradient for water with higher dextrose concentrations and more frequent exchanges increasing the rate of ...

I. Procedure a. Process that substitutes for kidney function by removing excess fluid and accumulated endogenous or exogenous toxins b. Type of fluid and solute removal depends on the client’s underlying pathophysiology, current hemodynamic status, vascular access, availability of equipment and resources, and healthcare providers’ training II. Indications a. Treatment for acute renal failure (ARF) or chronic end-stage renal ...