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Managing Chronic Diseases: Symptoms, Prevention, and Care, Assignments of Nursing

Ateneo de Naga University (ADNU)Nursing

Information on various chronic diseases including kidney disease, liver cirrhosis, diabetes, and chronic obstructive pulmonary disease (COPD). It covers symptoms, prevention, diagnosis, treatment, and management for each condition. Learn about risk factors, tests, and lifestyle modifications to maintain optimal health.

Typology: Assignments

2020/2021

Uploaded on 04/28/2021

hsin-tan-hsu 🇵🇭

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Preparation:

1. End Stage Renal Disease

- occurs when chronic kidney disease the gradual loss of kidney function reaches an advanced state. In end-

stage renal disease, your kidneys are no longer able to work as they should to meet your body's needs.

Your kidneys filter wastes and excess fluids from your blood, which are then excreted in your urine. When

your kidneys lose their filtering capabilities, dangerous levels of fluid, electrolytes and wastes can build up

in your body.

- Signs and symptoms might include:

oNausea

oVomiting

oLoss of appetite

oFatigue and weakness

oSleep problems

oChanges in how much you urinate

oDecreased mental sharpness

oMuscle twitches and cramps

oSwelling of feet and ankles

oPersistent itching

oChest pain, if fluid builds up around

the lining of the heart

oShortness of breath, if fluid builds up

in the lungs

oHigh blood pressure (hypertension)

that's difficult to control

- Risk factors include:

oDiabetes with poor blood sugar control

oKidney disease that affects the

glomeruli, the structures in the

kidneys that filter wastes from the

blood

oPolycystic kidney disease

oKidney disease after a kidney

transplant

oHigh blood pressure

oTobacco use

oAfrican-American descent

oMale sex

oOlder age

oLower level of kidney function when

your doctor first begins regular

measurements of kidney function

- Prevention of ESRD:

Discover Assignments of Nursing Ateneo de Naga University (ADNU)

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Preparation:

End Stage Renal Disease
- occurs when chronic kidney disease the gradual loss of kidney function reaches an advanced state. In end- stage renal disease, your kidneys are no longer able to work as they should to meet your body's needs. Your kidneys filter wastes and excess fluids from your blood, which are then excreted in your urine. When your kidneys lose their filtering capabilities, dangerous levels of fluid, electrolytes and wastes can build up in your body.
- Signs and symptoms might include: o Nausea o Vomiting o Loss of appetite o Fatigue and weakness o Sleep problems o Changes in how much you urinate o Decreased mental sharpness o Muscle twitches and cramps o Swelling of feet and ankles o Persistent itching o Chest pain, if fluid builds up around the lining of the heart o Shortness of breath, if fluid builds up in the lungs o High blood pressure (hypertension) that's difficult to control
- Risk factors include: o Diabetes with poor blood sugar control o Kidney disease that affects the glomeruli, the structures in the kidneys that filter wastes from the blood o Polycystic kidney disease o Kidney disease after a kidney transplant o High blood pressure o Tobacco use o African-American descent o Male sex o Older age o Lower level of kidney function when your doctor first begins regular measurements of kidney function
- Prevention of ESRD:

o Lose weight if you need to o Be active most days o Eat a balanced diet of nutritious, low- sodium foods o Control your blood pressure o Take your medications as prescribed o Have your cholesterol levels checked every year o Control your blood sugar level o Don't smoke or use tobacco products o Get regular checkups

Test and exams to detect ESRD: o A discussion of your health history, including your personal health history and questions about your family's health history. o A physical exam, during which your doctor measures your height, weight and blood pressure and also looks for signs of problems with your heart or blood vessels and conducts a neurological exam. o Blood tests, to measure the amount of waste products, such as creatinine and urea, in your blood. o Urine tests, to check the level of the protein albumin in your urine — a high albumin level may indicate kidney disease. o Imaging tests, such as ultrasound, magnetic resonance imaging or a computed tomography (CT) scan, to assess your kidneys' structure and size and look for abnormalities. o Removing a sample of kidney tissue (biopsy), to examine under a microscope to learn what type of kidney disease you have and how much damage there is.
Treatment may include: o Kidney transplant o Dialysis (peritoneal or hemodialysis) o Supportive care
Management of ESRD: o Connect with other people who have kidney disease o Maintain your normal routine, when possible o Be active most days of the week o Talk with a person you trust
NCP: ASSESSMENT DIAGNOSI RATIONALE PLANNING INTERVENTION RATIONALE EVALUATION

Investigate pain, noting location
Determine client’s usual daily fluid intake 10.Note condition of skin and mucous membranes, color of urine 11.Observe for signs of infection 12.Encourage to verbalize fear/concerns 13.Emphasize the need to adhere with prescribe diet retention
To investigate extent of interference
To help determine level of hydration 10.To assess level of hydration 11.To help in treating urinary alterations 12.Open expression allows client to deal with feelings and begin problem solving

14.Emphasize importance of having good hygiene 15.Emphasize importance of adhering to treatment regimen 13.To prevent aggravation of disease condition 14.To promote wellness 15.To promote wellness

Liver Cirrhosis
- is a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism. As cirrhosis progresses, more and more scar tissue forms, making it difficult for the liver to function (decompensated cirrhosis). Advanced cirrhosis is life-threatening. But if liver cirrhosis is diagnosed early and the cause is treated, further damage can be limited and, rarely, reversed.
- Signs and symptoms may include: o Fatigue o Easily bleeding or bruising o Loss of appetite o Nausea o Swelling in your legs, feet or ankles (edema) o Weight loss o Itchy skin o Yellow discoloration in the skin and eyes (jaundice) o Fluid accumulation in your abdomen (ascites) o Spiderlike blood vessels on your skin o Redness in the palms of the hands o For women, absent or loss of periods not related to menopause

o Maintain a healthy weight o Reduce your risk of hepatitis

Test to detect liver cirrhosis: o Laboratory tests o Imaging tests o Biopsy
Treatment: o Treatment for alcohol dependency o Weight loss o Medications to control hepatitis o Medications to control other causes and symptoms of cirrhosis
Management may include: o Don't drink alcohol o Eat a low-sodium diet o Eat a healthy diet o Avoid infections
NCP: ASSESSMENT DIAGNOSI S

RATIONALE PLANNING INTERVENTION RATIONALE EVALUATION

Subjective: “napansin ko na lumalaki ang tiyan ko” as verbalized by the patient Objective:

anasarca
weight gain
oliguria Fluid volume excess related to compromis ed regulatory mechanism Liver Cirrhosis is a chronic disease that causes cell destruction and fibrosis of hepatic tissue. After 4 hours of nursing interventions, the patient will be demonstrating stabilized fluid volume and decreased edema

INDEPENDENT:

measure intake and output, weight daily and note weight gain more than 0.5 kg/ day
assess respiratory
- reflects circulating volume status. Positive balance/weig ht gain often reflects continuing fluid After 4 hours of nursing interventions, the patient was able to demonstrate stabilized fluid volume and decreased edema

status, noting increased respiratory rate, dyspnea

monitor blood pressure
auscultate lungs, noting diminished/ absent breath sounds and developing adventitious sound
assess degree of peripheral/depend ent edema retention
indicative of pulmonary congestion
blood pressure elevation usually associated with fluid volume excess but may not occur because of fluid shifts out of the vascular space
increasing pulmonary congestion may result in consolidation , impaired gas exchange and

Diabetes mellitus
- is a metabolic disease that causes high blood sugar. The hormone insulin moves sugar from the blood into your cells to be stored or used for energy. With diabetes, your body either doesn’t make enough insulin or can’t effectively use the insulin it does make.
- Signs and symptoms of type 1 diabetes and type 2 diabetes include: o Increased thirst o Frequent urination o Extreme hunger o Unexplained weight loss o Presence of ketones in the urine (ketones are a byproduct of the breakdown of muscle and fat that happens when there's not enough available insulin) o Fatigue o Irritability o Blurred vision o Slow-healing sores o Frequent infections, such as gums or skin infections and vaginal infections
- Risk factors for type 1: o Family history o Environmental factors o The presence of damaging immune system cells (autoantibodies)
- Risk factors for type 2: o Weight o Inactivity o Family history o Race or ethnicity o Age o Gestational diabetes o Polycystic ovary syndrome o High blood pressure o Abnormal cholesterol and triglyceride levels.
- Prevention includes: o Eat healthy foods

o Get more physical activity o Lose excess pounds

Diagnosis include: o Glycated hemoglobin (A1C) test o Random blood sugar test o Fasting blood sugar test o Oral glucose tolerance test
Treatment for all types of diabetes: o Healthy eating o Physical activity o Monitoring your blood sugar o Insulin o Oral or other medications o Transplantation o Bariatric surgery
Management for DM: o Make a commitment to managing your diabetes o Choose healthy foods and maintain a healthy weight o Make physical activity part of your daily routine o Schedule a yearly physical and regular eye exam o Keep your vaccinations up to date o Pay attention to your feet o Keep your blood pressure and cholesterol under control o Take care of your teeth o If you drink alcohol, do so responsibly
NCP:

Subjective: “hindi gumagaling ang sugat ko” as verbalized by the patient Objective:

flushed appearance Wound drainage Risk for infection related to high glucose levels, decreased leukocyte function Type 2 diabetes mellitus occurs when the pancreas product produces insufficient amounts of the hormone insulin and the body tissues become resistance to normal or even high levels of insulin. After 5 hours of nursing interventions, the patient will identify interventions to prevent infection

INDEPENDENT:

Observe for signs of infection and inflammation
Promote good handwashing by nurse and patient
Maintain aseptic technique for IV insertion procedure, administration of medications and providing maintenance and site care. Rotate IV sites as indicated
Provide catheter or perineal care. Teach the female patient to clean from front to back after elimination - Patient may be admitted with infection, which could have precipitated the ketoacidosis state - Reduces the risk of cross- contamination - High glucose in the blood creates an excellent medium for bacterial growth - Minimizes the risk for infection After 5 hours of nursing interventions, the patient was able to identify interventions to prevent infection

Coronary Heart Disease
- develops when the coronary arteries become too narrow. The coronary arteries are the blood vessels that supply oxygen and blood to the heart
- signs and symptoms include: o Chest pain (angina) o Shortness of breath o Heart attack
- Cause may include the following: o Smoking o High blood pressure o High cholesterol o Diabetes or insulin resistance o Not being active (sedentary lifestyle)
- Risk factors: o Age o Sex o Family history o Smoking o High blood pressure o High blood cholesterol levels o Diabetes o Overweight or obesity o Physical inactivity o High stress o Unhealthy diet
- Prevention for CHD: o Quit smoking o Control conditions such as high blood pressure, high cholesterol and diabetes o Stay physically active o Eat a low-fat, low-salt diet that's rich in fruits, vegetables and whole grains o Maintain a healthy weight o Reduce and manage stress

Objective Cues: Pain scale 8/ Cool clammy skin Facial grimace Placing fist over mid-sternum Rubbing left arm Restlessness V/S: al * Pulse 121bpm BP: 150/100mmHg supply the heart muscle with oxygen- rich blood. Plaque is made up of fat, cholesterol, calcium, and other substance found in the blood.

Assess reports of pain in jaw, arm or hand
Place patient at complete bed rest during angina attacks
Elevate head of bed if patient is short of breath
Monitor heart rate and blood pressure
Provide light meals COLLABORATIVE:
Provide supplementary vasospasm
Cardiac pain may radiate
Reduces oxygen demand to minimize risk of tissue injury/necrosis
Facilitates gas exchange to decrease hypoxia and resultant shortness of breath
Patient with unstable angina have an increased risk of acute life-threatening dysrhythmias, which occur in response to ischemic changes and stress
Demonstrate relief of pain as evidenced by stable vital signs, absence of muscle tension and restlessness
Pain scale 3/

oxygen as indicated

Administer anti- anginal medications as indicated

Hypertension

High blood pressure (hypertension) is a common condition in which the long-term force of the blood against your artery walls is high enough that it may eventually cause health problems, such as heart disease
Signs and symptoms: o Headaches o shortness of breath or nosebleeds
risk factors include: o Age o Race o Family history o Being overweight or obese o Not being physically active o Using tobacco o Too much salt (sodium) in your diet o Too little potassium in your diet o Drinking too much alcohol o If you drink alcohol, do so in moderation o Stress o Certain chronic conditions
Test may include: o Ambulatory monitoring o Lab tests o Electrocardiogram (ECG or EKG) o Echocardiogram

regimen and keeping follow up appointment

Suggest frequent position changes, leg exercises when lying down
Help patient identify sources of sodium intake
Encourage patient to decrease or eliminate caffeine like tea, coffee, cola and chocolates
Stress importance of accomplishing daily rest periods antihypertensive therapy
Decreases peripheral venous pooling that may be potentiated by vasodilators and prolonged sitting or standing
Moderate low diet may be sufficient to control mild hypertension
Caffeine is a cardiac stimulant and may adversely affect cardiac function
Alternating rest and activity increases tolerance to activity progression
Community resources like health center programs and

COLABORATIVE:

Provide information regarding community resources, and support patients in making lifestyle changes checkups are helpful in controlling hypertension

Chronic obstructive pulmonary disorder

is a chronic inflammatory lung disease that causes obstructed airflow from the lungs. Symptoms include breathing difficulty, cough, mucus (sputum) production and wheezing. It's typically caused by long-term exposure to irritating gases or particulate matter, most often from cigarette smoke.
Signs and symptoms of COPD may include o Shortness of breath, especially during physical activities o Wheezing o Chest tightness o A chronic cough that may produce mucus (sputum) that may be clear, white, yellow or greenish o Frequent respiratory infections o Lack of energy o Unintended weight loss (in later stages) o Swelling in ankles, feet or legs
Risk factors for COPD include o Exposure to tobacco smoke o People with asthma o Occupational exposure to dusts and chemicals o Exposure to fumes from burning fuel o Genetics

Managing Chronic Diseases: Symptoms, Prevention, and Care, Assignments of Nursing

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Partial preview of the text

Download Managing Chronic Diseases: Symptoms, Prevention, and Care and more Assignments Nursing in PDF only on Docsity!

RATIONALE PLANNING INTERVENTION RATIONALE EVALUATION

INDEPENDENT:

INDEPENDENT:

COLABORATIVE: