Anxiety and Self-Esteem Disturbances related to Nasal Cavity Cancer

Nursing Care Plan for Nasal Cavity Cancer

Nursing Diagnosis for Nasal Cavity Cancer : Anxiety related to a crisis situation (malignancy), the threat of change in health status-social-economic, function-role changes, changes in social interaction, the threat of death, separation from family.

Nursing Interventions :

1. Orient the client and the people closest to routine procedures and activities are expected.
2. Exploration client anxiety and provide feedback.
3. Emphasize that anxiety is a common problem experienced by many people in the client's current situation.
4. Allow clients accompanied by a family (significant others) during the phase of anxiety and maintain tranquility of the surroundings.
5. Collaboration of sedative drugs.
6. Monitor and record verbal and non-verbal responses that show the client's anxiety.

Rational :

1. Precise information about the situation faced by the clients can reduce anxiety / foreign flavor to the surrounding environment and help the clients to anticipate and accept the situation.
2. Identify trigger factors / ballast anxiety problems and offering solutions that can be done by the client.
3. Indicate that anxiety is normal and not only experienced by the client only in the hope the client can understand and accept his condition.
4. Mobilize support system, prevent feelings of isolation and reduce anxiety.
5. Reduce anxiety, ease of rest.
6. Assessing the development of the client's problem.

Nursing Diagnosis for Nasal Cavity Cancer : Self-Esteem Disturbances related to deformity of the body due to malignancy, effects of radiotherapy / chemotherapy.

Nursing Interventions :

1. Discuss with the client and family influence diagnosis and treatment of the client's personal life and work activities.
2. Explain the side effects of surgery, radiation and chemotherapy are to be anticipated by the client.
3. Discuss on problem-solving efforts in the client's changing role of the family and community associated with the disease.
4. Thank difficulty client adaptation to the problems faced by the client and inform the possible need for psychological counseling
5. Evaluation of the support system that can help the client (family, relatives, social organization, spiritual leaders)
6. Evaluation of the symptoms of hopelessness, helplessness, denial of treatment and feelings of worthlessness that show impaired self-esteem the client.

Rational :

1. Assist the client and the family understand the problems he faced as a first step problem-solving process.
2. Anticipated therapeutic effect further facilitate the process of adaptation to the client's problems that may arise.
3. Changes in health status that brings change socio-economic status-role-function is a problem that often occurs on the client malignancy.
4. Inform alternative professional counseling that may be taken in solving client problems.
5. Identify sources of support that may be used in alleviating the problem the client.
6. Assessing the development of the client's problem.

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Disturbed Body Image and Anxiety NCP for Endophthalmitis

Nursing Diagnosis and Interventions for Endophthalmitis

Endophthalmitis is a medical condition characterized by inflammation on the inside of the eyeball, typically caused by infection with bacteria, viruses or fungi. This condition usually occurs as a complication of surgery in the eye although it can also be caused by penetrating trauma to the eyeball. Regardless of the cause, the condition is dangerous and likely to lead to decreased vision or permanent loss of the eyeball itself. This condition typically arises accompanied by pain in the eye, decreased vision, and swelling of the eyelids. The prognosis of this condition varies depending on the cause, and how quickly acquire the handling and the presence of underlying disease; in general, the earlier the treatment is obtained and the smaller decrease in vision, the better the prognosis. Given the seriousness of the complications that can arise, it is recommended to a person with this condition to immediately consult with a doctor to get treatment.

Causes of endophthalmitis are:

• Eye injury.
• Bacterial infections.
• Fungal infections.
• Virus infection.

Signs and symptoms of endophthalmitis that may arise:

• Fever.
• Suffer from Headaches.
• Eye pain.
• Swelling of the eyes.
• The blood vessels are swollen or dilated on the white part of the eye, which causes the eyes to appear red (red eye).
• Blurred vision.
• Reduced vision.
• Sensitive to light.

Nursing Diagnosis for Endophthalmitis : Disturbed Body Image related to loss of vision.

Goal: body image disturbance does not occur.

Outcomes: Declare and indicate acceptance of the appearance of self-assessment.

Intervention:

1 Provide an understanding of the loss for the individual and those close, with respect to the invisibility of loss, loss of function, and the pent-up emotions.
Rationalization: With the loss of part or function of the body can cause the individual to the rejection, shocked, angry, and depressed.

2 Instruct individuals in response to the shortcomings are not the denial, shock, anger, and distress.
Rationalization: So that patients can receive shortcomings with more sincere.

3 Be aware of the influence of the reactions of other people on the shortcomings and push share that feeling with others.
Rationalization: When good family reactions can increase the confidence of individuals and can share that feeling with others.

4 Teach individuals to monitor their own progress.
Rationalization: Knowing how far the ability of individuals with its shortcomings.



Nursing Diagnosis for Endophthalmitis : Anxiety related to:

• Physiological factors, changes in health status: the possibility / reality of vision loss.
• Talk negatively about yourself.
• Eyelashes falling fast.

Possibility evidenced by:

• Fear.
• Expressed concerns about the changes in life events.

Outcomes:

• Looks relaxed and report anxiety levels decreased to be overcome.
• Demonstrate problem solving skills.

Intervention:

1 Assess the level of anxiety. Help the patient identify coping skills that have been done successfully in the past.
R /: Integrating therapeutic intervention and participation in self-care, coping skills in the past to reduce anxiety.

2 Instruct to express feelings. Give feedback.
R /: Creating a therapeutic relationship. Helping people closest in identifying problems that cause stress

3 Give accurate and real information about what actions are performed.
R /: patient involvement in care planning gives a sense of control and help reduce anxiety

4 Provide quiet environment and rest.
R /: Move the patient from external stress, improve relaxation, help reduce anxiety.

5. Encourage the patient / person closest to claim attention, attention behavior.
R /: The act of support can help patients feel stress is reduced, allowing for directed energy on healing.

6 Provide information about disease process and anticipation of action.
R /: Knowing what to expect can reduce anxiety.

7 Collaboration of sedative drugs.
R /: Can be used to reduce anxiety and facilitate rest.


Nursing Care Plan for Endophthalmitis

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Disturbed Sleep Pattern, Knowledge Deficit and Anxiety - NCP Nasopharyngeal Carcinoma

Nursing Care Plan for Nasopharyngeal Carcinoma

Nasopharyngeal carcinoma is a malignant tumor derived from epithelial nasopharyngeal mucosa or glands found in the nasopharynx.

Nasopharyngeal carcinoma is the most carcinomas in the ENT.

It was found more in men than in women, with a ratio of 3: 1 by age / average age of 30 -50 years.


1. Nursing Diagnosis for Nasopharyngeal Carcinoma : Disturbed Sleep Pattern related to pain in the head.

Goal: Impaired sleep pattern of patients will be resolved.

Outcomes :

• Patients easily sleep within 30-40 minutes.
• Patients calm and fresh faces.
• Patients can express rested.

Interventions:
1 Create a comfortable and quiet environment.
Rationale: A comfortable environment can help improve sleep / rest.

2 Assess the patient's sleep habits at home.
Rationale: Knowing the change of the things that a patient when sleeping habits will affect the patient's sleep patterns.

3 Assess the causes of sleep disorders such as anxiety, effects of drugs and bustling atmosphere.
Rationale: Knowing the causes of other sleep disorders experienced and perceived patient.

4 Instruct the patient to use at bedtime and relaxation techniques.
Rational: Introduction to sleep will allow the patient to fall into sleep, relaxation techniques will reduce tension and pain.

5. Assess for signs of lack of sleep to meet the needs of patients.
Rationale: To determine whether requirements are met or the patient's sleep due to disruption of sleep patterns so that appropriate action can be taken.




2. Nursing Diagnosis for Nasopharyngeal Carcinoma : Knowledge Deficit: about the disease process, diet, care and treatment related to a lack of information.

Goal: Patient obtaining clear and correct information about the disease.

Outcomes :

• Patients learn about the disease process, diet, care and treatment and able to explain again if asked.
• Patients can perform self-care based on the knowledge gained.

Interventions:
1 Assess the level of knowledge of the patient / family about diabetes disease and Nasopharyngeal Cancer.
Rationale: To provide information on the patient / family, nurses need to know the extent to which the information or knowledge that is known to the patient / family.

2 Assess the patient's educational background.
Rationale: In order for nurses to provide explanations using words and sentences that can be understood according to the level of patient education patient.

3 Explain the disease process, diet, care and treatment in patients with language and words are easy to understand.
Rationale: In order for the information can be received easily and precisely so as to avoid misunderstandings.

4 Describe the procedure performed, the benefits to the patient and involve the patient.
Rationale: With explanatory and there and participate directly in the action taken, the patient will be more cooperative and less anxiety.

5 Use the images to provide an explanation (if there is / enable).
Rational: The pictures can help recall the explanation that has been given.



3. Nursing Diagnosis for Nasopharyngeal Carcinoma : Anxiety related to lack of knowledge about the disease.

Goal: anxiety is reduced / lost.

Outcomes :

• Patients can identify the cause of anxiety.
• Volatile emotions, calm the patient.
• Adequate rest.

Interventions:
1 Assess the level of anxiety experienced by the patient.
Rationale: To determine the level of anxiety experienced by patients so that nurses could provide rapid and appropriate intervention.

2 Give the opportunity for patients to express a sense of anxiety.
Rational: It can lighten the burden of the patient's mind.

3 Use therapeutic communication.
Rationale: To be built up trust between the nurse-patient so that the patient cooperative in nursing actions.

4 Give accurate information about the disease and encourage patients to participate in the act of nursing.
Rationale: Accurate information about the disease and the patient's participation in taking action to reduce the burden of the patient's mind.

5. Give confidence to patients that nurses, physicians, and other health team always strive to provide the best relief and optimal as possible.
Rationale: A positive attitude of the health care team will help reduce the anxiety felt by the patient.

6 Provide opportunities for families to accompany the patient in turn.
Rationale: The patient will feel calmer when there are family members who wait.

7 Create a quiet and comfortable environment.
Rationale: a quiet and comfortable environment can help reduce patient anxiety.

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Nursing Diagnosis : Impaired Physical Mobility, Anxiety and Knowledge Deficit

Nursing Care Plan for Guillain-Barre Syndrome


1. Impaired Physical Mobility related to neuromuscular damage.

Goal / Outcomes:
Maintain body function with no complications (contractures, pressure sores).

Nursing Intervention :

Independent

1. Assess the strength of the motor / functional abilities using a scale of 0-5.
R /: Specifies the development / re-emergence of signs that hinder the achievement of goals / expectations of the patient.

2. Provide patient positioning lead to a sense of comfort.
R /: Reduce fatigue, enhance relaxation, reduce the risk of ischemia / damage to the skin.

3. Chock extremities and joints with pillows.
R /: Maintaining the limb in a position fisilogis, prevent contractures and loss of joint function.

4. Perform passive range of motion exercises.
R /: Stimulates circulation, improve muscle tone and increase joint mobilization.

Collaboration

5. Confirm with / refer to the physical therapy / occupational therapy.



2. Anxiety related to situational crisis.

Goal / Outcomes:
Appear relaxed and report anxiety is reduced to the level can be overcome.

Nursing Interventions:

Independent

1. Place the patient near the nurses' station, check the patient regularly.
R /: To provide assurance that immediate assistance can be done if the patient suddenly becomes not have the ability.

2. Provide primary care / nurse relationships are consistent.
R /: Improve mutual trust of patients and help to reduce anxiety.

3. Provide alternative forms of communication if necessary.
R /: Reduce feelings of helplessness and feelings of isolation.

4. Discuss the change in self-image, fear of losing the ability to settle, loss of function, death, problems regarding the need penyebuhan / repair.

Collaboration

5. Provide a brief description of the treatment, the patient's treatment plan, including the closest.
R. /: A good understanding can increase the need for patient cooperation activities and the involvement of patients and also the closest in care planning will be able to maintain some sense of control over themselves for life which will further enhance the self-esteem.



3. Knowledge Deficit related to less remembering, cognitive limitations.

Goal / Outcomes:
Patients know and understand about the disease.

Nursing Interventions:

Independent
1. Determine the patient's knowledge and ability to participate in the rehabilitation process.
R /: Influencing choice of interventions that will be done.

2. Review the patient's knowledge about the disease and its prognosis.
R /: The knowledge base is an important thing to make informed choices and participate in rehabilitation efforts.

3. Suggest to reveal what is in the natural, social, and increase independence.
R /: Increasing returns to normal and the development of his feelings on the situation.

4. Identify safety measures to find defeswit sensory-motor individually.
R /: Reduce the risk of injury / lower the actual risk of complications can still be prevented.

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Acute Pain and Anxiety - NCP for Intestinal Obstruction

Intestinal obstruction (ileus) is a disorder passage of intestinal contents due to blockage resulting in accumulation of fluid and air in the proximal part of the blockage. As a result of the blockage, an increase in intraluminal pressure and intestinal disturbances resorption and increased intestinal secretion. Combined with vomiting as a result of an obstruction or reflux due to regurgitation of stomach full of lead to dehydration, febrile and shock. Obstruction ileus is also an urgency in abdominal surgery is often encountered, is 60-70% of all cases of acute abdomen that is not acute appendicitis. Obstructive ileus also called mechanical ileus.

Based on the mechanism of the obstruction, then the mechanical obstruction can be divided into:
A. Obstruction of the bowel lumen (Intra luminaire), namely:

• Polypoid tumor.
• Intussusception.
• Gallstone ileus.
• Feces, meconium bezoar (infants).

B. Abnormalities of the intestinal wall (Intramural), mostly congenital in infants:

• Atresia.
• Stenosis.
• Duplication.

In adult patients:

• Neoplasms.
• Inflammation.
• Crohn's disease.
• Post radiation.
• Gut connection.

C. Abnormalities outside the colon (Luminaire)

• Adhesion.
• External hernia.
• Neoplasms.
• Abscess.

Clinical Manifestations : Small Bowel Obstruction

Complaints arising in patients with intestinal obstruction is typical:

• Abdominal pain, vomiting, obstipation, abdominal distention, no flatus and bowel movement.
• These painful cramps can be repeated at intervals of 4-5 minutes on intestinal obstruction proximal part. In intestinal obstruction distal part of the frequency increases rarely.
• After a long obstructed the cramping pain will diminish or disappear because of intestinal distention or movement will be reduced after the strangulation with peritonitis, abdominal pain became severe and continuous.
• At the proximal intestinal obstruction occurred profuse vomiting with mild distension.
• At the distal intestinal obstruction, vomiting rarely with vomit the contents of feces, but more severe distension.
• Increased abdominal circle occurs because of the removal of liquids and gases within the lumen of the intestine due to obstruction in the distal part of the intestine and colon, or paralytic ileus.
• In the early stages, normal vital signs. Along with the loss of fluid and electrolytes, dehydration will occur with the clinical manifestations of tachycardia and postural hypotension. The body temperature is usually normal but sometimes it can be increased.
• Physical examination found the presence of fever, tachycardia, hypotension and severe dehydration symptoms.
• Fever indicates obstruction strangulate. On examination the abdomen appeared distended abdomen obtained and increased peristaltic (sounds borborygmi). In advanced stages where the obstruction continues, peristaltic will weaken and disappear. The presence of feces mixed with blood on rectal examination can toucher suspected malignancy and intussusception.

Nursing Diagnosis : Acute Pain related to an increase in intestinal intraluminal pressure.

characterized by: grimacing expression, complained of feeling pain in the abdominal area.

Goal: expected pain is resolved or controlled.

Outcomes:

• Revealed a decrease in discomfort.
• Stating pain at a tolerable level, indicating relaxed.
• Showed pain control measures.

Intervention:

1) Assess pain with PQRST technique.
Rationale: Monitor and provide an overview of the characteristics of the client and the pain indicators in subsequent interventions.

2) Maintain bed rest in a comfortable position.
Rationale: Bed rest reduces energy use and help control pain and reduce muscle contractions.

3) Teach relaxation or distraction techniques such as listening to music or watching tv.
Rational: to help clients feel more relaxed until the pain can be reduced.

4) Collaboration of analgetic drugs.
Rational: analgesic drugs will block the pain receptors so that pain can not be perceived.



Nursing Diagnosis : Anxiety related to change in health status.

characterized by: increasing the pain of powerlessness, expressed concern.

Goal: expected to decrease anxiety.

Outcomes:

The client will use relaxation techniques to relieve anxiety.

Intervention:
1) Assess the client's level of anxiety.
Rationale: Knowing the coping abilities of individuals.

2) Take time to listen to express anxiety and fear; provide calming.
Rationale: The client will feel better when heard. trusting relationship can be established with the client.

3) Maintain a quiet environment.
Rationale: quiet surroundings make the client more relaxed and can reduce anxiety.

4) Provide diversion through television, radio, games for lowering anxiety.
Rational: to divert the mind from stress and anxiety.

5) Describe the procedures and actions and give an explanation of the strengthening of disease, and prognosis action.
Rationale: patient involvement in care planning can provide a sense of control and helps reduce anxiety.

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Acute Pain and Anxiety - NCP for Bladder Cancer

Bladder cancer is a cancer of the bladder organ. Bladder is the organ that serves to accommodate the urine from the kidneys. If the bladder is full of urine then it will be removed.

The exact cause of bladder cancer is not known. But studies have shown that these cancers have multiple risk factors, namely:

• Age, the risk of bladder increases with age.
• Smoking is a major risk factor.
• Work environment, some workers have a higher risk of developing this cancer because of its place works found carcinogenic substances (cancer-causing).
• Race, white people have a 2 times greater risk, there is the smallest risk among Asians.
• Men, are at risk 2 - 3kali greater.
• Family history, people whose family is suffering from bladder cancer have a higher risk of developing this cancer. Researchers are studying the change of certain genes that may increase the risk of this cancer.

Nursing Diagnosis and Interventions for Bladder Cancer

1. Acute Pain
related to:

• disease process (suppression / destruction of nerve tissue, nerve supply system infiltration, nerve pathway obstruction, inflammation),
• side effects of cancer therapy

characterized by:

• clients say pain,
• clients have difficulty sleeping,
• not able to focus, expressions of pain, weakness.

Goal:

• Clients are able to control pain through activity.
• Reported experiencing pain.
• Following treatment program.
• Demonstrate techniques of relaxation and diversion of pain through activity.

Interventions:

• Determine history of pain, location, duration and intensity.
• Evaluation of therapy: surgery, radiation, chemotherapy, biotherapy, teach the client and family about how to deal with.
• Give diversion such as repositioning and fun activities such as listening to music or watching TV.
• Encourage stress management techniques (relaxation techniques, visualization, guidance), happy, and provide therapeutic touch.
• Evaluation of pain, provide treatment if necessary.
• Discuss pain management with doctor and also with clients.
• Give analgesics as indicated.

Rational:

• Provide the necessary information for planning care.
• To determine the appropriate therapy is carried out or not, or even cause complications.
• To improve the comfort of the clients distract from pain.
• Improving self-control over side effects by lowering stress and anxiety.
• To determine the effectiveness of pain management, pain levels and to the extent the client is able to withstand, and to investigate the needs of the client will be anti-pain medication.
• In order for a given targeted therapy.
• To cope with the pain.

2. Anxiety
related to:

• crisis situations (cancer),
• changes in health,
• socio-economic,
• roles and functions,
• forms of interaction,
• preparation for death,
• separation of the family

characterized by:

• increase in tension,
• fatigue,
• express awkwardness role,
• feeling dependent,
• inadequate ability to help themselves,
• sympathetic stimulation.

Goal:

• Clients can relieve anxiety.
• Relax and be able to see themselves objectively.
• Demonstrate effective coping and able to participate in treatment.

Interventions:

• Determine the client's previous experience of the illness.
• Provide accurate information about prognosis.
• Give the client a chance to express anger, fear, confrontation. Give the information with reasonable emotions and expressions appropriate.
• Explain the treatment, the purpose and side effects. Help clients prepare for the treatment.
• Record ineffective coping as less social interaction, lack of empowerment, etc..
• Encourage to develop interaction with the support system.
• Provide a quiet and comfortable environment.
• Maintain contact with clients, talk and touch with the fair.

Rational:

• Data about previous client experience will provide a basis for extension and avoid duplication.
• Provision of information to assist clients in understanding the disease process.
• Can reduce client anxiety.
• Assist the client in understanding the need for treatment and side effects.
• Knowing and explore coping patterns and handle client / provide solutions in an effort to improve the strength in overcoming anxiety.
• So that clients receive support from the closest person / family.
• Give the client a chance to think / contemplate / break.
• Clients gain confidence and belief that he really helped.

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