Nursing Interventions for Hallucinations or Delusions

A hallucination, in the broadest sense of the word, is a perception in the absence of a stimulus. In a stricter sense, hallucinations are defined as Perceptions in a conscious and awake state in the absence of external stimuli the which have qualities of real perception, in That They are vivid, substantial, and located in external objective space. The latter definition distinguishes hallucinations from the related phenomena of dreaming, the which does not involve wakefulness; illusion, the which involves distorted or misinterpreted real perception; imagery, the which does not mimic real perception and is under voluntary control; and pseudohallucination, the which does not mimic real perception, but is not under voluntary control. [1Hallucinations also differ from "delusional Perceptions", in the which entered correctly sensed and interpreted a stimulus (ie a real perception) is given some additional (and typically bizarre) significance.


Nursing Interventions for Hallucinations or Delusions

Do not focus on hallucinations or delusions. Do interruption to the client by initiating interaction hallucinations one-on-one based on reality.

Tell them that you do not agree with the perception of the client, but the validation that you believe that the hallucinations are real to the client.

Do not argue with the client about the hallucinations or delusions.

Respond to the feelings that the client communicated at the time he was having hallucinations or delusions.

Divert and focus the client on a structured activity or task-based reality.

Move the client to a more quiet, less stimulating.

Wait until the client does not have hallucinations or delusions before starting the counseling session about it.

Explain that hallucinations or delusions are symptoms of psychiatric disorders.
Say that the anxiety or increased stimulus from the environment, can stimulate the onset of hallucinations.

Help clients control the hallucinations by focusing on the reality and take medication as prescribed.

If hallucinations persist, Help clients to ignore it and keep acting remedy properly despite an hallucination.

Teach a variety of cognitive strategies and tell the client to use conversations themselves ("the voices that makes no sense") and the cessation of mind ("I will not think about it").

Nanda NIC NOC for Cataract

Nursing Diagnosis for Cataract

1. Impaired sensory perception (visual) related to Changes in sensory reception or sense organ of vision status.

Cataract Nursing Outcome Classification (NOC) : Vision Compensation Behavior (1611)

After nursing actions during 2x24 hours expected of patients with expected outcomes:
(161 102) Position the patient to improve eyesight.
(161 103) Instruct family members to use the techniques improve eyesight
(161 107) Use visual aids
(161 105) Use goggles

NOC criteria:

1. Not done at all
2. Rarely do
3. Are underway
4. Often performed
5. Always do

Cataract Nursing Interventions Classification NIC : EYE CARE (1650)

• Monitor the redness and the presence of exudate
• Determine the degree of decrease in vision or sharp eyesight test
• Instruct patient not to touch eyes
• Monitor corneal reflex
• Instruct the patient to use glasses cataract
• Take action to help patients deal with limited vision.
• Encourage the patient to express feelings about the loss of vision.

2. Anxiety related to changes in health status

NOC : Anxiety Control (1402)

After nursing actions during 2x24 hours expected of patients with expected outcomes:
(140 206) The use of effective coping strategies
(140 207) Respiratory Rate within the normal range
(140 211) There is an increasing social relationships
(140 214) patients feel as comfortable with the situation
(1402170) The patient was calm

NOC criteria:

1. Not done at all
2. Rarely do
3. Are underway
4. Often performed
5. Always do

NIC: Anxiety Reduction (5820)

• Trying to understand the client's circumstances
• Give information about the diagnosis and action
• Use a calm approach
• Identify the level of anxiety
• Help patients recognize situations that indicate anxiety
• Encourage patients to express feelings and fears
• Give the drug to reduce anxiety
• Assess the level of anxiety and physical reactions at the level of anxiety
• Instruct the patient to reduce anxiety with relaxation techniques

Coping Enhancement (5830)

• Use a calm approach and provide assurance
• Appreciate and discuss alternative responses to situations
• Support the involvement of families in an appropriate manner
• Respect the patient's understanding of disease processes
• Supports the use of appropriate defensive mechanisms
• Provide a realistic choices about aspects of current treatments

3. Low self esteem related to Impaired self-image

NOC: Body Image (1200)

After nursing actions performed in 3 x 24 hours the patient is expected to receive him, with the expected outcomes:

• Receive the body have been affected
• Satisfied with the appearance of the body
• Satisfied with body functions

NOC criteria:

1. Not done at all
2. Rarely do
3. Are underway
4. Often performed
5. Always do

NIC: Self estem enhancement (5400)

• Monitor the patient statement about himself
• Help the patient to improve the assessment itself to award him
• Help the patient to increase her confidence
• Provide a strong impetus for patients
• Encourage eye contact in communication with everyone
• Provide health education to families
• Provide health education to clients about the disease

Nursing Interventions for Dementia

Dementia

Dementia is a decline of reasoning, memory, and other mental abilities (the cognitive functions). This decline eventually impairs the ability to carry out everyday activities such as driving; household chores; and even personal care such as bathing, dressing, and feeding (often called activities of daily living, or ADLs).

• Dementia is most common in elderly people; it used to be called senility and was considered a normal part of aging.
• We now know that dementia is not a normal part of aging but is caused by a number of underlying medical conditions that can occur in both elderly and younger persons.
• In some cases, dementia can be reversed with proper medical treatment. In others, it is permanent and usually gets worse over time.

About 4-5 million people in the United States have some degree of dementia, and that number will increase over the next few decades with the aging of the population.

• Dementia affects about 1% of people aged 60-64 years and as many as 30-50% of people older than 85 years.
• It is the leading reason for placing elderly people in institutions such as nursing homes.

Dementia is a very serious condition that results in significant financial and human costs.

• Many people with dementia eventually become totally dependent on others for their care.
• Although people with dementia typically remain fully conscious, the loss of short- and long-term memory are universal.
• People with dementia also experience declines in any or all areas of intellectual functioning, for example, use of language and numbers; awareness of what is going on around him or her; judgment; and the ability to reason, solve problems, and think abstractly.
• These losses not only impair a person's ability to function independently, but also have a negative impact on quality of life and relationships.

Many older people fear that they are developing dementia because they cannot find their glasses or remember someone's name.

• These very common problems are most often due to a much less serious condition involving slowing of mental processes with age.
• Medical professionals call this "benign senescent forgetfulness," or "age-related memory loss."
• Although this condition is a nuisance, it does not impair a person's ability to learn new information, solve problems, or carry out everyday activities, as dementia does.

Types of Dementia

The Different Types of Dementia

Dementing disorders can be classified many different ways. These classification schemes attempt to group disorders that have particular features in common, such as whether they are progressive or what parts of the brain are affected. Some forms of dementia are classified as either primary or secondary dementia. Examples of primary dementia include:

• Alzheimer's disease
• Vascular dementia
• Lewy body dementia
• HIV-associated dementia
• Huntington's disease
• Creutzfeldt-Jakob disease and more.

Examples of secondary dementiainclude:

• Progressive supranuclear palsy
• Multiple sclerosis
• ALS dementia
• Normal pressure dementia

Nursing Care Plan for Dementia

Nursing Interventions for Dementia

Nursing Interventions in depressed elderly patients with impaired thought processes; dementia / forgetfulness.

Nursing Interventions Dementia for patients:

Objectives allow the patient to:

• Know / oriented towards people's time and place.
• Perform daily activities optimally.

Action :

• Give an opportunity for patients to know their personal belongings such as beds, cupboards, clothes etc..
• Give the opportunity for patients to know the time by using a large clock, a calendar that has a large sheet of paper per day with.
• Give the opportunity for patients to mention his name and closest family members
• Give the opportunity for clients to know where it is located.
• Give praise if the patient when the patient can answer correctly.
• Observation of the patient's ability to perform daily activities
• Give the opportunity for patients to choose the activities that can be done.
• Help the patient to perform activities that have been chosen
• Give praise if the patient can perform activities.
• Ask if the patient feel able to perform its activities.
• With patients to schedule their daily activities.

Nursing Interventions Dementia for Family

Objectives:

• Families are able to orient the patient to time, people and places.
• Provides advice needed to conduct patient-oriented reality.
• Assist patients in performing daily activities.

Action :

• Discussions with family oriented ways of time, people and places on the patient.
• Encourage families to provide a large clock, a calendar with a big sign.
• Discussions with the family that once owned the ability of the patient.
• Helps families who do choose the ability of patients at this time.
• Encourage the family to give praise to the ability of the capabilities that are still owned by the patient.
• Encourage the family to monitor the elderly carried out in accordance capabilities.
• Encourage the family to monitor the daily activities of patients in accordance with a schedule that has been created.
• Encourage families to give praise to the capabilities that are still owned by the patient
• Encourage families to help patients perform activities according to capabilities.
• Encourage the family to give a compliment if the patient carried out in accordance with the schedule of activities that have been made.

Reference :

www.emedicinehealth.com

www.medicinenet.com

Nursing Interventions for Gastritis

Gastritis is not a single disease, but means inflammation of the stomach lining. Gastritis can be caused by drinking too much alcohol, prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs), or infection with bacteria such as Helicobacter pylori. Sometimes gastritis develops after major surgery, traumatic injury, burns, or severe infections. Certain diseases, such as pernicious anemia, autoimmune disorders, and chronic bile reflux, can cause gastritis as well.



Symptoms of Gastritis

The most common symptoms are abdominal upset or pain. Other symptoms are belching, abdominal bloating, nausea, and vomiting or a feeling of fullness or of burning in the upper abdomen. Blood in your vomit or black stools may be a sign of bleeding in the stomach, which may indicate a serious problem requiring immediate medical attention.

Nursing Diagnosis and Nursing Interventions for Gastritis

1. Acute pain related to obstruction / spasm of the duct, the inflammatory process and tissue ischemia.

Nursing Interventions for Gastritis

• Observe and record the location and character of pain (persistent, intermittent, colicky)
• Record the response to pain
• Increase bed rest, let the patient make a comfortable position.
• Control the temperature of the environment
• Encourage use of relaxation techniques

Collaboration:

• Anticholinergics: Atropine, Propentelin (Pro-banthine)
• Sedatives: Phenobarbital
• Narcotics: meperidine hydrochloride
• Monoktanoin
• Relaxation of smooth muscle

2. Imbalanced nutrition less than body requirements related to obstruction of bile flow

Nursing Interventions for Gastritis

• Assess abdominal distension
• Calculate the calorific intake, keep the comments about the appetite to a minimum.
• Provide a pleasant atmosphere at mealtime
• Ambulation and activities corresponding increase tolerance

Collaboration:

• Add the appropriate diet tolerance, high fiber, low fat
• Provide an overview of bile
• Supervise laboratory examination
• Give local nutritional support as needed

Nursing Interventions for Imbalanced Nutrition Less than Body Requirements

Imbalanced Nutrition Less than Body Requirements

NANDA 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.


Nursing Intervention for Imbalanced Nutrition Less than Body Requirements

1. Determine daily calorie needs are realistic and adequate. Consultation on nutrition expert.
2. Weigh the body weight every day, monitor the results of laboratory examination.
3. Explain the importance of adequate nutrition.
4. Teach individuals to use flavorings to help improve the taste and smell of food (lemon, mint, clove, cinnamon, rosemary)
5. Give encouragement of individuals to eat with others (food served in the family room or group)
6. Plan maintenance procedures have an unpleasant or painful not done before eating.
7. Give a fun, relaxed atmosphere (not visible potty, do not busy)
8. Adjust the treatment plan to reduce or eliminate odors that cause wanted to vomit or procedure performed near the time of eating.
9. Teach or assist individuals to rest before eating.
10. Teach individuals to avoid the smell of fried food-eating, coffee-cooked if possible.
11. Maintain oral hygiene before and after chewing.
12. Offer to eat small portions but frequently to reduce feelings of tension in the stomach (six times per day with little food)
13. Set to get the nutrients protein / high calorie, which is presented to individuals when they want to eat. (Eg, if the chemotherapy is done early morning and serve meals in the evening before eating).
14. Instruct individuals who experience decreased appetite for:
    • Eating dry foods waking.
    • Eating salty foods if there are no restrictions.
    • Avoid foods that are too sweet, fattening, greasy.
    • Try to drink clear, warm.
    • Sip through a straw.
    • Eat whenever tolerated.
    • Eat small meals low in fat and eat more often.
15. Try commercial supplements are available in many forms (powder, pudding, liquid)
16. If individuals experiencing eating disorders (Townsend, 1994)
    • Set goals with the client's input, doctors and nutritionists.
    • Talk about the benefits of compliance and the consequences of disobedience.
    • If the input of food that must be rejected, remind the doctor.
    • Sitting accompany individuals during the meal, limit the time to eat up to 30 minutes.
    • Observe at least 1 hour before. Accompany client when to the bathroom.
    • Weigh the client body when he woke up and after the first micturition.
    • Give encouragement to repair, but do not focus the conversation on food or way of eating.
    • Along the improvement of individual, explore issues of self-image, weigh again, and watched over.
17. For individuals who are hyperactive
    • Provide food and beverages that are high in protein, high calorie.
    • Offer more frequent smaller meals. Avoid foods that contain no calories (eg, soda)
    • Take a stroll along individual when given little food.

Nursing Interventions for Pain

Pain is a feeling triggered in the nervous system. Pain may be sharp or dull. It may come and go, or it may be constant. You may feel pain in one area of your body, such as your back, abdomen or chest or you may feel pain all over, such as when your muscles ache from the flu.

Pain can be helpful in diagnosing a problem. Without pain, you might seriously hurt yourself without knowing it, or you might not realize you have a medical problem that needs treatment. Once you take care of the problem, pain usually goes away. However, sometimes pain goes on for weeks, months or even years. This is called chronic pain. Sometimes chronic pain is due to an ongoing cause, such as cancer or arthritis. Sometimes the cause is unknown.

Fortunately, there are many ways to treat pain. Treatment varies depending on the cause of pain. Pain relievers, acupuncture and sometimes surgery are helpful.
nlm.nih.gov


Nursing Interventions for Pain

1. Increase knowledge
   • Explain the causes of pain to the individual, if known.
   • Linking how long the pain will last, if known.
   • Explain diagnostic tests and procedures in detail with a connecting discomfort and sensation will be felt, and the estimated duration of pain occur.
2. Provide accurate information to reduce fear.
3. Connect your acceptance of individual response to pain.
   • Recognizing the existence of pain.
   • Listen with full attention on the pain.
   • Shows that the pain you are because you want to understand better (not to determine if the pain is really there).
4. Assess the family to know the concept of error handling or painful.
5. Discuss the reasons why individuals may experience an increase or decrease in pain (eg, increasing fatigue pain, distraction reduce pain).
   • Give encouragement to family members telling each other personally feel concerned.
   • Assess whether painful family dispute and discuss the impact on individuals who experience pain.
   • Encourage families to continue to give attention to pain, although not shown.
6. Provide opportunities for individuals to rest during the day and time of uninterrupted sleep at night.
7. Talk with individuals and families use distraction therapy, along with other methods to reduce pain.
8. Teach methods of distraction for acute pain, with regular breathing.
9. Teach noninvasive pain reduction
10. Give individuals the optimal reduction of pain with analgesics.
11. After granting a reduction of pain, returned 30 minutes later to assess its effectiveness.
12. Provide accurate information to correct errors on a family concept (eg, addiction, hesitant about the pain).
13. Give the individual the opportunity to talk about fear, anger, and frustration in place, difficulty understanding the situation.
14. Give encouragement of individuals to talk about the pain experience.

Nursing Intervention for Diabetes

Diabetes mellitus is a disorder in which the level of blood glucose is persistently raised above the normal range. Diabetes mellitus is a syndrome with disordered metabolism and inappropriate hyperglycemia due to either a deficiency of insulin secretion or to a combination of insulin resistance and inadequate insulin secretion to compensate. Diabetes mellitus occurs in two primary forms: type 1, characterized by absolute insufficiency, and the more prevalent type 2, characterized by insulin resistance with varying degrees of insulin secretory defects. Diabetes mellitus is a group of metabolic diseases characterized by elevated levels of glucose in the blood (hyperglycemia) resulting from defects in insulin secretion, insulin action, or both (ADA], Expert Committee on the Diagnosis and Classification of Diabetes Mellitus, 2003.

Nursing Intervention for Diabetes

Nursing Diagnosis

Impaired nutrition: less than body requirements related to the reduction of oral input, anorexia, nausea, increased metabolism of protein, fat.

Nursing Intervention

Objective :
The patient's nutritional needs are met

Result Criteria :
Patients can digest the amount of calories or nutrients appropriate
Stable weight or additions to the range usually

Intervention :

• Weigh the body weight per day or according to the indication.
• Determine the diet and eating patterns of patients and compare it with foods that can be spent on patients.
• Auscultation bowel sounds, record the existence of abdominal pain / abdominal bloating, nausea, vomit that has not had time to digest food, maintain a state of fasting according to the indication.
• Give the liquid diet containing foods (nutrients) and the electrolyte immediately if the patient has to tolerate it orally.
• Involve the patient's family at this meal digestion according to the indication.
• Observation of the signs of hypoglycemia, such as changes in level of consciousness, skin moist / cold, rapid pulse, hunger, sensitive to stimuli, anxiety, headaches.
• Collaboration examination of blood sugar.
• Collaboration of insulin treatment.
• Collaboration with dietitians.

Source : http://ncp-blog.blogspot.com/2010/09/ncp-for-dm-diabetes-mellitus.html

Nursing Interventions for Pneumonia

Pneumonia, acute infection of the lung parenchyma, interstitial lung tissue in which fluid and blood cells escape into the alveoli. that often impairs gas exchange. Pneumonia classified in several ways.

Based on microbiological etiology origin:

• Viral
• Bacterial
• Fungal
• Protozoa
• Mycobacterium
• Mycoplasmal
• Rickettsial

Based in location, pneumonia can be classified:

Bronchopneumonia, Bronchopneumonia involves distal airways and alveoli
Lobular pneumonia or lobar pneumonia. In this pneumonia involves part of a lobe; and lobar pneumonia, an entire lobe

The infection is also classified as one of three types:

Primary pneumonia

Primary pneumonia results directly from inhalation or aspiration of a pathogen, such as bacteria or a virus; it includes pneumococcal and viral pneumonia.

Secondary pneumonia

Secondary pneumonia may follow initial lung damage from a noxious chemical or other insult (superinfection) or may result from hematogenous spread of bacteria from a distant area.

Aspiration pneumonia

Aspiration pneumonia results from inhalation of foreign matter, such as stomach contents vomitus or food particles, into the bronchi. It’s more likely to occur in elderly or debilitated patients, those receiving nasogastric tube feedings, higher prevalence those with an impaired gag reflex, poor oral hygiene, or a decreased level of consciousness.

Nursing Interventions for Pneumonia

Intervention and Rationale:
I. Assess for:

• Respiratory status including rate, depth, ease, shallow or irregular breathing, dyspnea, use of accesory muscles, and diminished breath sounds, rhonchi or crackles on auscultation - provides data baseline.
• Changes in mental status, skin color, cyanosis - indicates possible decrease in oxygenation.
• Quality of cough and ability to raise secretions including consistency and characteristics od sputum - removal of secretions prevents obstruction of airways and stasis leading to further infection and consolidation of lungs; clearing airways facilitates breathing.

II. Monitor, record, describe:
Respiratory rate, quality and breath sounds q2-q4 - indicates airway resistance, air movement, severity of disease.

• ABGs, oximeter reading - decreased oxygen levels result in hypoxemia.

III. Administer:

• Oxygen therapy via cannula - maintain optimal oxygen level.
• Antitussives/expectorants (terpin hydrate, guaifenesin) - acts on bronchial cells to increase fluid production and promote expectoration; guaifenesin reduces surface tension of secretions; both relieve non-productive cough
• Mucolytic (acetylcysteine) - decrease viscosity of mucus for easier removal.
• Antibiotic (ampicillin, cephalexin) - acts by binding to cell wall organisms preventing synthesis and destroying pathogens.

IV. Perform or Provide:

• Position of comfort in semi or high fowlers and change position q2h - facilitates breathng and allows for full expansion of lungs.
• Encourage coughing if sounds is moist; if dry and hacking, increase fluid intake and administer cough suppresant - reduces continual irritation to throat and liquefies secretions.
• Coughing and deep breathing exercise q2h; use incintive spirometer 5-10 breaths if tolerated - coughing clears airway by propelling secretions to mouth deep breathing promoes ventilation and prolongs expiratory phase.
• Assist with coughing by splinting chest; humidified air with cool mist - loosens seretions and improves ventilation, moistens mucous membranes
• Postural drainage and percussion PRN - mobilizes secretion.
• Suction secretions if cough ineffective - removal if unable to bring up secretions.
• Oral care after expectoration and provide tissues and bag for disposal - promotes comfort and prevents transmission of organisms to others.

Nursing Interventions for Acute Pain

NANDA Definition: Unpleasant sensory and emotional experience arising from actual or potential tissue damage or described in terms of such damage (International Association for the Study of Pain); sudden or slow onset of any intensity from mild to severe with an anticipated or predictable end and a duration of less than 6 months

Pain is a highly subjective state in which a variety of unpleasant sensations and a wide range of distressing factors may be experienced by the sufferer. Pain may be a symptom of injury or illness. Pain may also arise from emotional, psychological, cultural, or spiritual distress. Pain can be very difficult to explain, because it is unique to the individual; pain should be accepted as described by the sufferer. Pain assessment can be challenging, especially in elderly patients, where cognitive impairment and sensory-perceptual deficits are more common.

NIC Interventions (Nursing Interventions Classification)

• Analgesic Administration
• Conscious Sedation
• Pain Management
• Patient-Controlled Analgesia Assistance

NOC Outcomes (Nursing Outcomes Classification)

• Comfort Level
• Medication Response
• Pain Control

Nursing Interventions Classification

The Nursing Interventions Classification (NIC) is a care classification system which describes the activities that nurses perform as a part of the planning phase of the nursing process associate with the creation of a nursing care plan. The NIC consists of a standardized list which contains 433 different interventions. Each intervention is defined and the definition describes a set of activities a nurse performs in order to perform one of the interventions. Each of the 433 interventions is coded into a three-level taxonomic structure consisting of 27 classes and 6 domains. The taxonomic structure allows for easy selection of an intervention and to classify them by means of a computer. The NIC also allows for the implementation of a Nursing Minimum Data Set (NMDS). The terminology is an American Nurses' Association-recognized terminology, is included in the UMLS, and is HL7 registered.

wikipedia

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