Nursing Diagnosis Knowledge Deficit - Gestational Diabetes Mellitus

Nursing Diagnosis for Gestational Diabetes Mellitus : Knowledge Deficit : the diabetic condition, prognosis and the need for action.

Expected outcomes:

1. Participate in the management of diabetes during pregnancy.
2. Expressing an understanding of the procedures, laboratory tests and activities involving the control of diabetes.
3. Demonstrate proficiency own monitor and insulin administration.

Intervention:

1. Assess knowledge of the processes and actions, including the relationship of the disease with diet, exercise, stress and insulin requirements.
Rational: Gestational Diabetes Mellitus risk of glucose uptake in cells that are not effective, the use of fats and proteins for energy excessively and cellular dehydration when water flows out of the cell by hypertonic glucose concentration in serum.

2. Provide information about the workings and the adverse effects of insulin and review the reasons for avoiding oral hypoglycemic drugs.
Rationale: Metabolic Changes in prenatal causes insulin needs change. First trimester insulin requirement is low but becomes two times and four times during the second and third trimester. Although insulin does not cross the placenta, oral hypoglycemic agents and potential harm to the fetus.

3. Describe normal weight gain.
Rational: calorie restriction caused ketonemia can cause fetal damage and inhibit optimal protein utilization.

4. Provide information about the need for a light training program.
Rationale: Exercise after meals can help prevent hypoglycemia and stabilize glucose irregularities, unless there is excess glucose, which exercise can improve ketoacidosis.

5. Provide information on the effects of pregnancy on diabetic conditions and future expectations.
Rationale: Increased knowledge can reduce fear, increase cooperation, and help reduce fetal complications.

6. Discuss recognize the signs of infection.
Rationale: It is important to seek medical attention early to avoid complications.

7. Encourage maintained home assessment on levels of serum glucose, insulin dose, diet and exercise.
Rationale: When reviewed by the practitioner care giver, the diary can be helpful for evaluation and treatment.

8. Aids to the study of glucose, are instructed to accompany it with milk 8 oz and check the glucose level in 15 minutes.
Rationale: The symptoms of hypoglycemia such as diaphoresis, tingling sensations and palpitations with glucose levels below 70 mg / in need of immediate action. The use of glucagon as a combination of milk may increase serum glucose levels without the risk of turning into hyperglycemia.

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Nursing Diagnosis for Suicide

Nursing Care Plan for Suicide


Definition

Suicide is any activity which, if not prevented can lead to death (Gail w. Stuart, Mental Nursing, 2007).

Suicide is the idea, signaling and suicide attempts, which often accompany depressive disorders and often occurs in adolescents (Harold Kaplan, Synopsis of Psychiatry, 1997).


Etiology

Is universal: due to the inability of individuals to solve problems

Divided into:

1. Genetic factors (based on research):

• 1.5 to 3 times more suicidal behavior occurs in individuals who are first-degree relatives of people with mood disorders / depression / who had made ​​a suicide attempt.
• More common in monozygotic twins than in dizygotic twins.
  

2. Biological factors:
Usually due to chronic diseases / medical conditions, for example:

• Stroke
• Disorders / cognitive impairment (dementia)
• Diabetes
• Coronary artery disease
• Cancer
• HIV / AIDS
• etc.

3. Psychosocial and Environmental Factors:

• Theories Psychoanalytic / psychodynamic: Theory Freud, namely that the lost object associated with aggression and anger, negative feelings about themselves, and the last depression.
• Cognitive Behavioral Theory: Theory Beck, the growing negative cognitive patterns, low self-regard
• Environmental stressors: loss of family, deception, lack of social support systems.

Suicidal behavior is divided into 3 categories:

1. Suicide threats: there are verbal and non-verbal warnings, threats showed ambivalence someone to death, if not get a response it will be interpreted as support for the suicide.

2. Suicide attempts: all actions by individuals against self can lead to death if not prevented.

3. Suicide: going after missed or ignored warning signs, people who commit suicide do not even really want to die may be dead.


Symptom

• Despair
• Self-blame
• Feelings of failure and worthlessness
• Oppression
• Insomnia is settled
• Weight loss
• Speaking of slow, fatigue
• Pulling away from the social environment
• Suicidal thoughts and plans

Assessment of risk factors for suicidal behavior

• Gender: increased risk in men
• Age: older, more problems
• Relationship Status: married to lower the risk, life itself is a problem.
• Family history: increased if there is a family with attempted suicide / substance abuse.
• Originator (life events that just happened): Loss of a loved one, unemployment, gets embarrassed in the social environment, etc..
• Personality factors: more often the introverted personality / shut down.
• Other: Studies show that the white race more at risk of suicidal behavior.

Nursing Diagnosis for Suicide

1. Anxiety
2. Adjustment disorder
3. Low Self-Esteem
4. Ineffective individual coping
5. Ineffective family coping
6. Disturbed Sleep Pattern
7. Social isolation
8. Disturbed Thought Processes
9. Risk for Violence: Self-Directed

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Typhoid Fever - 5 Nursing Diagnosis and Interventions

Nursing Care Plan for Typhoid Fever : Nursing Diagnosis and Interventions

1. Activity intolerance related to mandatory bed rest.

Intervention:
1) Provide assistance to meet their daily needs such as food, drink, change clothes and watch oral hygiene, hair, genetalia, and nails.
Rationale: To provide assistance to the client to avoid the onset of complications associated with the movement who violate program bedrest.

2) Involve the family in the fulfillment of ADL.
Rationale: Participation family is very important to facilitate the nursing process and prevent further complications.

3) Explain the purpose of bed rest to prevent complications and speed up the healing process.
Rationale: Rest decrease intestinal mobility also decreases the rate of metabolism and infection.


2. Risk for fluid volume deficit related to the intake is less, nausea, vomiting / excessive spending, diarrhea, body heat.

Intervention:
1) Monitor the status of hydration (moisture of mucous membranes, skin turgor, adequate pulse, blood pressure orthostatic) if needed.
Rationale: Changes in hydration status, mucous membranes, skin turgor describe the severity of dehydration.

2) Monitor vital signs
Rationale: Changes in vital signs to describe the general state of the client.

3) Monitor the input of food / liquid and count daily calorie intake.
Rationale: Provides guidelines to replace fluids.

4) Encourage the family to help patients eat.
Rationale: Family as the driving fluid needs of clients.

5) Collaborate with other medical team for IV fluid administration.
Rationale: Giving IV fluids to meet fluid needs.


3. Imbalanced Nutrition, Less Than Body Requirements
related to less intake due to nausea, vomiting, anorexia, or diarrhea due to excessive output.

Intervention:
1) Monitor the amount of nutrients and calories.
Rationale: Knowing the cause of the less intake so as to determine appropriate and effective intervention.

2) Monitor the weight loss.
Rational: Cleanliness nutrients can be known through increased weight 500 g / week.

3) Monitor the environment during the meal.
Rationale: A comfortable environment can reduce stress and more conducive to eating.

4) Monitor nausea and vomiting.
Rationale: Nausea and vomiting affect nutrition.

5) Involve the family in the client's nutritional needs.
Rationale: Increasing the role of the family in nutrition to accelerate the healing process.

6) Instruct the patient to enhance the protein and vitamin C.
Rationale: Protein and vitamin C to meet nutritional needs.

7) Provide food selected.
Rational: To assist in fulfilling the nutritional needs.

8) Collaboration with a nutritionist to determine the amount of calories and nutrients it needs patients.
Rationale: Helps in the healing process.


4. Acute pain related to inflammation of the small intestine.

Intervention:
1) Assess the level of pain, location, duration, intensity and characteristics of pain.
Rationale: Changes in the characteristics of the pain may indicate the spread of diseases / complications occur.

2) Review the factors that increase pain and decrease pain.
Rational: It can pinpoint the factors that trigger or aggravate (such as stress, food intolerance) or identify the occurrence of complications, as well as help in making the diagnosis and therapeutic needs.

3) Give warm compresses on the area of pain.
Rationale: For the pain disappeared.

4) Collaborate with other medical team in the delivery of analgesics.
Rational: Analgesic can help reduce pain.


5. Knowledge Deficit: conditions of disease, treatment and prognosis needs related to lack of information or inadequate information.

Intervention:
1) Assess the extent of knowledge of the client's family about his illness.
Rationale: Knowing the mother's knowledge about the disease typhoid fever.

2) Give health education about the disease and treatment of clients.
Rationale: In order for the client's mother found out about the disease typhoid fever, causes, signs and symptoms, as well as the care and treatment of typhoid fever.

3) Give the family an opportunity to ask if there is not yet understood.
Rationale: In order to understand more about the family disease.

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Nursing Diagnosis and Interventions for Menstruation Disorders - Dysmenorrhea

Nursing Diagnosis for Dysmenorrhea

Dysmenorrhea is defined as a condition of severe uterine pain during menstruation. All women experience an irregular period once in awhile during their child bearing years. Some women may experience periodic pains during or prior to, or after menstrual periods in the lower abdomen as resulting of over production of certain hormones in the prostaglandins family.

Primary dysmenorrhea is due to disordered or too much prostaglandin production through the secretory endometrium of the uterus within the absence of a structural lesion.

Dysmenorrhea (painful menstruation) can also include symptoms such as headache, fatigue, bloating, and even nausea, vomiting, and/or diarrhea.

Dysmenorrhea can be treated with a variety of drugs, including pain relievers, sedatives, antispasmodics, prostaglandin inhibitors, and oral contraceptives.


Nursing Diagnosis and Interventions for Menstruation Disorders - Dysmenorrhea

1. Acute Pain related to increased uterine contractility, hypersensitivity
2. Imbalanced Nutrition Less Than Body Requirements related to the nausea, vomiting.
3. Ineffective individual coping related to emotional excess.

Nursing Interventions for Dysmenorrhea

1. Acute Pain related to increased uterine contractility, hypersensitivity.

Goal: pain reduced client

Nursing Interventions:
1. Warm the abdomen.
Rational: may cause vasodilation and reduce the spasmodic contractions of the uterus.

2. Massage the abdominal area that feels pain.
Rational: reduce pain due to the stimulus of therapeutic touch.

3. Perform light exercise
Rational: it can improve blood flow to the uterus and muscle tone.

4. Perform relaxation techniques.
Rational: reduce the pressure to get relaxed.

5. Give the natural diuresis (vitamin) sleep and rest.
Rational: reduce congestion.

2. Ineffective individual coping related to emotional excess.

Nursing Interventions:
1. Assess client's understanding of her illness.
Rational: maternal anxiety of the pain will be greatly influenced by knowledge.

2. Determine the additional stress that accompanies it.
Rational: stress can impair the autonomic nervous response, so it is feared to increase the pain.

3. Provide an opportunity to discuss how the pain.

4. Help clients identify coping skills during the period covered.
Rational: the use of behavior management techniques can help clients adapt to the pain they experienced.

5. Give the period of sleep or rest.
Rational: the pain and fatigue due to spending a lot of body fluids tends to be a problem that must mean a lot of the body tends to be significant problems that must be addressed immediately.

6. Push the skills of stress, such as relaxation techniques, visualization, guidance, imagination and deep breathing exercises.
Rational: it can reduce pain and distract the client to pain.

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Nursing Diagnosis for Preeclampsia

Nursing Care Plan for Preeclampsia

Preeclampsia is a collection of symptoms that occur in pregnant women, maternity and childbirth consisting of hypertension, edema and proteinuria, but show no signs of vascular abnormalities or hypertension before, while the symptoms usually appear after age 28 weeks gestation or more.

Predisposing factors

• Molahidatidosa
• Diabetes mellitus
• Multiple pregnancy
• Hydrops fetalis
• Obesity
• Age over 35 years

Clinical manifestations

Signs of preeclampsia usually arise in the order: excessive weight gain, followed by edema, hypertension, and proteinuria eventually. In the mild pre-eclampsia found no subjective symptoms. In the severe pre eclampsia found in the area prontal headache, diplopia, blurred vision, pain in the epigastric region, nausea or vomiting. These symptoms are often found in pre-eclampsia is increased and is an indication that eclampsia will occur.

Diagnosis :

• Clinical features: excessive weight gain, edema, hypertension, and proteinuria occur.
• Subjective symptoms: headache frontal area, epigastric pain; impaired visual acuity; blurred vision, scotoma, diplopia; nausea and vomiting.
• Other cerebral disorders: increased reflexes, and not quietly.
• Examination: high blood pressure, reflexes increased and proteinuria in the laboratory.

Nursing Diagnosis for Preeclampsia

1. Ineffective Cerebral Tissue Perfusion related to decreased cardiac output secondary to vascular vasopasme.
2. Impaired Gas Exchange related to accumulation of fluid in the lungs: pulmonary edema.
3. Decreased Cardiac Output related to decreased venous return, cardiac trouble.
4. Excess Fluid Volume related to glomerular function impairment secondary to the decrease of cardiac output.
5. Activity Intolerance related to weakness.
6. Impaired Urinary Elimination related to impaired glomerular filtration: anuria and oliguria.
7. Imbalanced Nutrition Less Than Body Requirements related to inadequate intake.
8. Acute Pain related to injury of biological agents: Hydrogen ion accumulation and an increase in HCl.
9. Risk for Injury: the mother related to diplopia, increased intra-cranial: seizures.
10. Knowledge Deficit: the management of therapy and treatment related to misinterpretation of information.

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2 Nursing Diagnosis Interventions for Anemia

Nursing Care Plan for Anemia

Anaemia is a condition in which the number of red blood cells or their oxygen-carrying capacity is insufficient to meet physiologic needs, which vary by age, sex, altitude, smoking, and pregnancy status.

There are several types and classifications of anaemia. This is a condition in which the body lacks the amount of red blood cells to keep up with the body's demand for oxygen.

Symptoms of Anemia

According to John Hopkins Point-of-Care Information Technology Center, (The John Hokins POC-IT Center), the most common causes of anemia include:

• dizziness,
• weakness and fatigue,
• shortness of breath with activity,
• dizziness,
• occasional chest pains, and
• cold, clammy skin.
  

Having nerve pain may also point to the presence of this problem.

Causes of Anemia

There are several causes of anemia, which include:

• Iron deficiency
• Kidney disease
• Pregnancy
• Poor nutrition
• Deficiency of vitamin B12 known as pernicious anemia
• Sickle cell anemia
• Thalassemia
• Alcohol
• Bone marrow related anemia
• Aplastic anemia
• Hemolytic anemia
• Active bleeding, eg. heavy bleeding during menstration.

Treatments of Anemia

Once the doctor determines the cause he or she will initiate a treatment program for you. Here are some causes along with their treatment protocol. Blood Loss: the source of the bleeding will be determined and stopped. For example you may be given a blood transfusion and iron to build up your red blood cell count. Iron Deficiency: If you have inadequate iron levels you most likely will be prescribed iron supplements.

Do not do this on your own but under the care of a physician because consuming too much iron can be dangerous. Red blood cell destruction: Known as hemolytic anemia, there are various causes for it. So the treatment would of course depend on the cause. Follow up care: You need to stay under your doctor's care and have repeated blood work done to determine if the anemia has gone away. Your response to the treatments prescribed will determine what the next steps are to take. The hopeful outcome is that you have overcome your anemia.

If not, with continued care over time you should be able to do so. Before doing any dietary or lifestyle changes always consult with your health care provider, particularly if you have been diagnosed with a disease or are taking any prescription medication.

2 Diagnosis Nursing Interventions for Anemia

1. Ineffective Tissue Perfusion

Objectives:

• Adequate tissue perfusion

Nursing Intervention for Anemia :

• Monitor vital signs, capillary refill, skin color, mucous membranes.
• Exalt the position of head of in bed
• Examine and document the presence of pain.
• Observation of a delay in verbal response, confusion, or restlessness
• Observe and document the presence of the cold.
• Maintain the ambient temperature to keep warm the body needs.
• Provide oxygen as needed.

2. Activity Intolerance

Objectives:

• Tolerant of activity

Nursing Intervention:

• Assess the capability of doing the activity
• Monitor vital signs during and after activity, and noted a physiological response to activity (increased heart rate increased blood pressure, or rapid breathing).
• Provide information to the patient or family to stop doing activities if teladi symptoms of increased heart rate, increased blood pressure, rapid breathing, dizziness or fatigue).
• Provide support to perform their daily activities according to the ability of the child.
• Creating a schedule of activities involving other health team.

Related Articles :
Nursing Diagnosis for Anemia
Nursing Intervention for Anemia
Nursing Care Plan for Anemia
Management of Anemia
NCP for Anemia
Ineffective Tissue perfusion related to Anemia
Nanda Anemia

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3 Nursing Diagnosis and Interventions for Hepatitis

Hepatitis is a class of diseases That impact the liver. Hepatitis can cause inflammations of the liver and can cause its function to diminish. When this Happens liver scarring can occur, the which is known as cirrhosis, and in severe cases, cancer can develop. Hepatitis can be attributed to Certain types of medication, toxins, alcohol, hereditary conditions, viruses, and autoimmune disorders. Hepatitis can be classified as viral or non viral.

There are five types of viral hepatitis to play, and each has Their Own transmission methods, effects, and symptoms. These five types are categorized, A, B, C, D, and E. The most common of these types are A, B, and C.

In the viral hepatitis and non viral forms may show mild, moderate, or severe symptoms. Some Patients may not show any symptoms at all. Fatigue is usually the only symptom in very mild cases. Other symptoms include: jaundice, headaches, fever, joint pain, muscle aches, a lack of appetite, pale stools, dark urine the color of tea, vomiting, nausea, abdominal pain, diarrhea, drowsiness, circulatory problems, and dizziness.

3 Nursing Diagnosis and Interventions for Hepatitis

1. Nursing Diagnosis: Acute Pain related to swelling of the liver is inflamed.

Expected outcomes :

• Showed signs of physical pain and pain behavior (do not wince in pain, cry intensity and location)

Nursing Interventions for Acute Pain - Nursing Care Plan for Hepatitis:

• Collaboration with patients, to determine the method can be used for pain intensity.
• Indicate the client's acceptance of the client's response to pain
  • Acknowledge the pain.
  • Listen attentively to the client about pain expression.
• Provide accurate information and explain the causes of pain, how long the pain will end, if known.
• Discuss with your doctor the use of analgesics that do not contain hepatotoxic effects.

2. Nursing Diagnosis : Ineffective Breathing Pattern related to intra-abdominal fluid collections, ascites decreased lung expansion and accumulation of secretions.

Expected outcomes :

• Adequate breathing pattern

Nursing Interventions for Ineffective Breathing Pattern - Nursing Care Plan for Hepatitis:

• Monitor the frequency, depth and respiratory effort
• Auscultation of breath sounds additional
• Give the semi-Fowler position
• Give a deep breath and coughing exercises effective
• Give oxygen as needed

3. Nursing Diagnosis: Imbalanced Nutrition Less Than Body Requirements related to failure to meet the metabolic needs of entry: anorexia, nausea / vomiting and disturbances of digestion absorption and metabolism: a decrease in peristalsis (visceral reflex), retained bile.

Expected outcomes :

• The patient will show behavioral changes in lifestyle to improve / maintain appropriate weight.
• Patients will show improvement with a goal weight and value-free laboratory signs of malnutrition.

Nursing Interventions Imbalanced Nutrition Less Than Body Requirements - Nursing Care Plan for Hepatitis

• Monitor the inclusion of diet / calories. Give a little meal in the frequency often, and offer the greatest breakfast.
• Provide oral care before meals.
• Encourage eating in an upright sitting position.
• Encourage intake of orange juice, beverage and candy carbonate heavy throughout the day.
• Consult an expert on diet, nutrition support teams to provide appropriate dietary needs of patients, with the input of fat and protein as tolerated.
• Keep an eye on blood glucose.
• Give extra food / nutrient total support when needed.

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Nursing Diagnosis and Interventions for Jaundice

Jaundice is a yellow discoloration of the skin, the mucous membrane and the white of the eyes. Jaundice is most commonly found in babies and newborns. Jaundice newborn is an infant with a condition caused by the extensive amount of bilirubin in blood.

Jaundice newborn represents a large group of newborns, approximately 60% of full term (physiological or normal jaundice) and 90% of premature babies (jaundice of prematurity). There is also breastfeeding jaundice which occurs when a newborn is not getting enough milk to drink.

There are a number of possible causes for jaundice in babies and newborns. The most common cause is over-feeding with breast milk. Since the baby's liver is too small, it can rarely cope with the enzymes, present in the milk, especially if the baby is overfed. Other causes include diseases, anemia, or a physical defect in the liver.

Newborn jaundice usually lasts 10 -14 days and it retreats in reverse to the development process, legs looking normal first leaving the little face colored the longest. This process can last up to one month in the premature babies. The same may occur in the breast- fed babies, where the substances contained in mother's milk cause slower development of the enzymes responsible for the digestion of the bilirubin. This condition is called breast milk jaundice and it may take up to 12 weeks to improve.


Nursing Diagnosis for Jaundice and Nursing Intervention for Jaundice

1. Deficient Fluid Volume related to inadequate fluid intake, photo-therapy, and diarrhea.

Goal:
Adequate neonatal body fluids

Intervention:

• Record the number and quality of stools,
• Monitor skin turgor,
• Monitor intake output,
• Give water between breast-feeding or give bottle.

2. Hyperthermia related to the effects of phototherapy

Goal:
The stability of the baby's body temperature can be maintained

Intervention:

• Give a neutral ambient temperature,
• Keep the temperature between 35.5 ° - 37 ° C,
• Check vital signs every 2 hours.

3. Impaired skin integrity related to hyperbilirubinemia and diarrhea

Goal:
The integrity of the baby's skin can be maintained

Intervention:

• Assess skin color every 8 hours,
• Monitor direct and indirect bilirubin,
• Change position every two hours,
• Massage the area that stands out,
• Keep skin clean and moisture.

4. Anxiety related to medical therapy given to the baby.

Goal:
Parents know about treatment, symptoms can be identified to deliver the health care team.

Intervention:

• Review knowledge of the client's family,
• Give the cause of yellow health education, therapy and treatment process.
• Give health education on infant care to home.
  

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Nursing Diagnosis for Stomach Cancer

Stomach cancer or gastric cancer is a disease in which tumors are found in the stomach. Stomach cancer is common throughout the world and affects all races, it is more common in men than women, and has its peak age range between 40 and 60 years old. If it is not diagnosed quickly, it may spread to other parts of your stomach as well as to other organs. There are twice as many males with this disease than females. The majority of people with stomach cancer are between fifty and seventy years old. It is more prevalent in Japan, Korea, Great Britain, South America and Iceland than in the United States.

Signs and Symptoms of Stomach Cancer

Nausea and vomiting

Nausea and vomiting are symptoms that you can find in almost any disease not just in digestive system disorders. The reason that it is on this list is because nausea and vomiting, as related to stomach cancer, might also be caused by tumor growth. Persistent nausea and vomiting can also cause trauma to your esophagus.

Abdominal Pain

This pain could be caused by the growth of a tumor in your stomach. Usually with stomach cancer, the pain is somewhere near the upper part of your stomach and can either be persistent or intermittent.

Anorexia

Anorexia also known as loss of appetite. Not being hungry for a day to two might be considered normal, but if it persists for more than that, it could be a serious problem. Take note that anorexia, or loss of appetite, is not a telltale sign of cancer alone. It could also be an indicator of other diseases.

Unintended weight loss

Now, a lot of people have been wondering just why a patient with cancer seems to tend to lose weight even without trying. The answer to that is simple. The cancer cells take in the nutrients that are really meant for the body. In essence, they are the ones getting healthier while the body suffers.

Causes of Stomach cancer

The exact cause is unknown although the presence of the Helicopter pylori bacterium seems to be a major factor. Predisposing factors include environmental influences such as smoking and high alcohol intake. Because stomach cancer is more common amongst those with a family history and with people with type A blood, genetic factors are also implicated. Dietary factors, particularly methods of food preservation such as pickling, smoking or salting also have an influence on the prevalence.

Types of Stomach cancer

There are several different types of stomach cancer, some of which are very rare. The most common types start in the glandular cells of the stomach lining (adenocarcinomas), this is where stomach acid and digestive enzymes are made, and where most cancers start. When the tumor becomes more advanced, it can travel through the bloodstream and spread to organs such as the liver, lungs, and bones. Cancers that start in the lymphatic tissue (lymphoma), in the stomach's muscular tissue (sarcoma) or in the tissues that support the organs of the digestive system (gastrointestinal stromal tumors) are less common and are treated in different ways.


Nursing Diagnosis for Gastric Cancer

Preoperative

1. Acute pain related to the growth of cancer cells

2. Anxiety related to plan surgery

3. Imbalanced Nutrition Less Than Body Requirements related to nausea, vomiting and no appetite

4. Activity intolerance related to physical weakness.

Postoperative

1. Ineffective breathing pattern related to the influence of anesthesia.

2. Acute pain related to interruption of the body secondary to invasive procedures or surgical intervention.

3. Imbalanced Nutrition Less Than Body Requirements related to fasting status.

4. Risk for infection related to an increased susceptibility secondary to the procedure.

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Nursing Diagnosis for Intestinal Obstruction

Intestinal Obstruction is complete or partial blockage in the intestines. This blockage prevents the solids, fluids and the gases from moving from the intestines normally. The obstruction may occur either in the small intestine or large intestine. Blockage of bowel may trouble you a lot if not taken care properly. A complete intestinal obstruction may cause complete absence of gas or stool. Partial blockage may cause diarrhea.

Symptoms of Intestinal Obstruction :

• Cramping and pain
• Abdominal fullness
• Bad breath
• Abdominal bloating
• Constipation
• Diarrhea
• Vomiting
  

Causes of Intestinal Obstruction :

• Fetal and neonatal blockages are caused by the intestinal atresia where there is an absence of a part of intestine or a narrowing.
• Non mechanical obstructions are caused due to inflammation or due to the side effects or infections of certain medicines.
• Other causes are hernias, cancer and Crohn's disease.
• Sometimes a change in the food habits and life styles also causes such issues. It may make the waste material get harder and it becomes difficult to be eliminated.
• It may be due to tumors.
• Narrowing or twisting of intestines or scar tissues may be one of the reasons. Such blockages are mechanical blockage.
• In addition to changed food habits, changes in the water intake as well as exercise changes may also lead to bowel obstruction sometimes.
• Bowel obstruction may sometimes be due to the changes within the walls of abdomen area, bowel lumen or external to the belly area.

Nursing Diagnosis for Intestinal Obstruction

1. Deficient Fluid Volume related to nausea, vomiting, fever or diaphoresis.

Goal:

• Fluid requirements are met

Expected outcomes are:

• Normal vital signs
• Balanced input and output
  

2. Acute Pain related to distention, rigidity.

Goal:

• The pain is resolved or controlled
  

Expected outcomes are:

• Patients revealed a decrease discomfort
• States pain level can be tolerated,
• Indicate relaxed.

3. Ineffective Breathing Pattern related to abdominal distension and or rigidity.

Goal:

• The pattern of breathing becomes effective.
  

Expected outcomes are:

• Patients showed the ability to do breathing exercises
• Breathing deeply and slowly.

4. Anxiety related to crisis situations and changes in health status.

Goal:

• Anxiety is resolved

Expected outcomes are:

• Patients expressed an understanding of current disease
• Demonstrating positive kooping skills in dealing with anxiety.

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4 Nursing Diagnosis Interventions for Hypertension

Nursing Diagnosis for Hypertension - Nursing Care Plan for Hypertension

1. Risk for decreased cardiac output related to increased afterload, vasoconstriction, myocardial ischemia, ventricular hypertrophy.

Purpose: afterload is not increased, there was no vasoconstriction, and myocardial ischemia does not occur.

Expected outcomes:

• Maintaining blood pressure within an acceptable range.
• Showed stable cardiac rhythm and frequency.
• Participate in activities that lower blood pressure.

Nursing interventions:

• Monitor and measure blood pressure in both hands, using a cuff and proper techniques in terms of measuring blood pressure.
• Auscultation of breath sounds and heart tone. Observe skin color, moisture, temperature and capillary refill time.
• Note the presence, quality of the central and peripheral pulses.
• Maintain restrictions on activities such as rest in bed or chair.
• Assist in performing self-care activities as needed.
• Provide a quiet environment, convenient, and therapeutic and reduce activity. Note the general edema.
• Monitor response to medication to control blood pressure. Give fluid and dietary sodium restriction as indicated.
• Medical collaboration in the provision of drugs as indicated.

2. Acute pain: headache related to increased cerebral vascular pressure.

Purpose: The pressure does not increase cerebral vascular

Expected Outcomes: Patients revealed the absence of headache and looked comfortable.

Nursing interventions:

• Maintain bed rest, quiet neighborhood, a little light.
• Limit of patients in the activity.
• Minimize disruption and environmental stimuli.
• Give a fun action according to indications such as ice packs, the position of comfort, relaxation techniques, counseling imagination, avoid constipation.
• Medical collaboration in providing analgesic and sedative drugs.

3. Ineffective Tissue Perfusion: cerebral, renal, cardiac related to impaired circulation.

Purpose: The circulation of the body is not impaired.

Expected outcomes :

• Patients demonstrating an improved tissue perfusion as indicated by: blood pressure within acceptable limits, no complaints of headache, dizziness, laboratory values ​​within normal limits.
• Stable vital signs.
• Urine output 30 ml / min.

Nursing interventions:

• Maintain bed rest, elevate the head position in bed patients.
• Assess blood pressure at admission in both arms, sleeping, sitting with arterial pressure monitoring if it is available.
• Measure the input and discharge.
• Observe the sudden hypotension.
• Ambulation within your means and avoid fatigue in patients.
• Monitor electrolytes, creatinine according to medical advice.
• Maintain fluids and medications according to medical advice.

4. Knowledge deficit related to lack of information about the disease process and self-care.

Purpose : patients are met in terms of information about hypertension.

Expected outcomes :

• Patients can express their knowledge and skills of the management of early treatment of hypertension.
• Reported the use of drugs according to medical advice.

Nursing interventions:

• Describe the nature of the disease and the purpose of the procedure and the treatment of hypertension.
• Explain the importance of a peaceful environment and theraupetik, and management of stressors.
• Discuss the importance of maintaining a stable weight.
• Discuss the need for low-calorie diet, low in sodium to order.
• Discuss the importance of avoiding fatigue in the activity.
• Explain the need to avoid constipation in the bowel movement.
• Explain penetingnya maintain proper fluid intake, amount allowed, restrictions such as caffeinated coffee, tea and alcohol.
• Discuss the symptoms of relapse or progression of complications reported to the doctor: headache, dizziness, fainting, nausea and vomiting.
• Talk about drugs: the name, dosage, time of administration, purpose and side effects or toxic effects.
• Explain the need to avoid drug-free, without a doctor's examination.

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2 Nursing Care Plan for Rheumatic Heart Disease - Assessment, Diagnosis and Interventions

Nursing assessment is done in providing nursing care in rheumatic heart disease beginning to collect data on the following matters:

• About heart function.
• Nutritional status of patients.
• Tolerance to the activities and attitudes of patients toward limiting the activities undertaken.
• Disturbances in sleep patterns.
• Level of discomfort felt by rheumatic fever patients.
• Ability of the patient in terms of troubleshooting.
• Knowledge of patients and families will be suffered by rheumatic heart disease.

Assessment of the above are generally aware of what is known by the patient and the family of rheumatic heart disease. Now the next step in the assessment in terms of nursing as one of the nursing process. Next examined the nursing care in rheumatic heart disease are:

• History of rheumatic heart disease.
• Monitor cardiac complications in the event.
• Auscultation of heart sounds, usually typical in patients with rheumatic heart was weakened heart sounds with the rhythm of galloping diastole.
• Assessment of the patient's vital signs.
• Assessment of pain.
• Assessment of the presence of markers of inflammation in the joints.
• Assessment of the presence of lesions on the skin.

Nursing Care Plan for Rheumatic Heart Disease

Next is the nursing diagnosis of rheumatic heart disease. Some nursing diagnoses that may arise in providing nursing care in rheumatic heart disease, among which are:

1. Decreased cardiac output related to valvular stenosis

Goals to be achieved is to increase cardiac output.

Expected outcomes are:

• Patients showed reduced levels of dyspnoe experienced.
• Patients participating in participating in the activity and demonstrate increased tolerance.

Nursing interventions:

• Monitor vital signs such as: blood pressure, apical pulse and peripheral pulse.
• Monitor cardiac rhythm and frequency.
• Semifowler bed rest in a position that is 45 degrees.
• Encourage the patient to stress management techniques (quiet environment, meditation).
• Bantu patient activity as indicated when the patient is able.
• Medical collaboration in terms of oxygen delivery and therapy.

2. Activity intolerance related to decreased cardiac output, oxygen supply and demand imbalance.

Goals to be achieved is an optimal patient can tolerate the activity does.

Expected outcomes are:

• Verbal response to reduced fatigue
• Conducting activities within the limits of his ability (pulse activity should not be more than 90X/mnt, no chest pain).

Nursing interventions:

• Energy saving during the acute patients.
• Maintain bed rest until the results of laboratory and clinical status of patients improved.
• In line with the good general condition, monitor the gradual increase in the level of activity undertaken.
• Teach to participate in activities of daily necessities.
• Create a schedule of activities and also the breaks.

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5 Nursing Diagnosis for Colon Cancer and Rectal Cancer - Care Plan

Nursing Diagnosis for Colon Cancer and Rectal Cancer

1. Diarrhea related to inflammation, irritation, intestinal malabsorption or partial narrowing of the intestinal lumen, secondary to the process of intestinal malignancy.

Characterized by:

• Increased bowel sounds / peristaltic
• Improved liquid defecation
• Stool color changes
• Pain / cramping abdominal

2. Imbalanced Nutrition Less Than Body Requirements related to impaired absorption of nutrients, hypermetabolic state, secondary to the process of intestinal malignancy.

Characterized by:

• Weight loss, decreased subcutaneous fat / muscle mass, poor muscle tone
• Increased bowel sounds
• Pale conjunctiva and mucous membranes
• Nausea, vomiting, diarrhea

3. Anxiety (describe level) related to psychological factors (the threat of changes in health status, socio-economic status, functions, roles, interaction patterns) and sympathetic stimulation (neoplastic process)

Characterized by:

• Acute phase of disease exacerbation
• Increased tension, distress, fear
• iritabel
• Narrows the focus of attention

4. Ineffective individual coping related to the intensity and repetition stesor adaptive threshold exceeded (chronic illness, death threats, the vulnerability of individuals, severe pain, no adequate support system)

Characterized by:

• Declare an inability to face problems, hopelessness, anxiety
• Declared worthless
• Depression and dependence

5. Knowledge Deficit: about condition, prognosis and treatment needs related to less exposure and or misinterpretation of information.

Characterized by:

• Ask questions, request information or a statement of the concept of fault
• Does not accurately follow the instructions
• Complications / exacerbations can be prevented.

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3 Nursing Diagnosis and Interventions for Bladder Cancer

1. Nursing Diagnosis for Bladder Cancer: Risk for infection related to inadequate defenses, secondary and immune system (the effect of chemotherapy / radiation), malnutrition, invasive procedures.

Goals:

• Patients are able to identify and participate in infection prevention measures.
• Showed no signs of infection and wound healing normally takes place.

Nursing Interventions for Bladder Cancer:

• Wash hands before taking action. Visitors are also encouraged to do the same.
• Maintain a good personal hygine
• Monitor the temperature
• Examine all the systems to look for signs of infection
• Avoid / limit invasive procedures and maintain aseptic procedures
• Collaborative
• Give antibiotics when indicated.

2. Nursing Diagnosis for Bladder Cancer: Risk for Sexual Dysfunction related to deficit of knowledge / skills about alternative responses to health transition, decreased function / structure, the effects of treatment.

Goals:

• Patients may express its understanding of the effects of cancer and treatment on sexuality.
• Maintaining sexual activity within your limits

Nursing Interventions for Bladder Cancer:

• Discuss with patients and families about sexuality and the reaction process and its relationship with disease
• Give advise on the effect of treatment on sexuality
• Give privacy to the patient and her partner. Knock before entering.

3. Nursing Diagnosis for Bladder Cancer: Risk for Impaired Skin Integrity related to the effects of radiation and chemotherapy, immunologic deficits, decreased nutrient intake and anemia.

Goals:

• Patients can identify interventions related to specific conditions
• Participate in the prevention of complications and accelerated healing

Nursing Interventions for Bladder Cancer:

• Assess the integrity of the skin to see any side effects of cancer therapy, wound healing observed.
• Instruct patient not to scratch the itch
• Change the position of the patient on a regular basis
• Give advise patients to avoid the use of skin creams, oils, powders without medical advice

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10 Nursing Care Plan for Liver Cirrhosis : Diagnosis

Nursing Care Plan for Liver Cirrhosis

Liver cirrhosis is a degenerative inflammatory disease that results in hardening and scarring of liver cells. The loss of liver cells interferes with the organ's ability to process nutrients, hormones, and drugs and slows the production of protein other important substances manufactured in the liver. Liver becomes unable to function properly due to the scarred tissue, which prevents the normal passage of blood through the liver.

Some main physical indications of liver cirrhosis are jaundice and yellow discoloration of the skin. However, patients do display some other symptoms such as itching, which is medically termed as pruitus and fatigue. There are many reasons behind liver cirrhosis condition; some of the main ones are extreme alcohol intake, hepatitis B and C infections, and fatty liver, exposure to insecticides.

The most common symptoms are loss of appetite, loss of body weight, nausea, pain in abdominal area in the location of liver, weakness in body and itchy skin. Severe conditions include yellow discoloration of skin, cramps, mental imbalance and confusion and difficulty in absorption of alcohol and drugs.


10 Nursing Diagnosis for Liver Cirrhosis

1. Imbalanced Nutrition Less Than Body Requirements related to anorexia.

2. Activity Intolerance related to muscle weakness.

3. Fluid and electrolyte imbalances related to portal hypertension.

4. Ineffective Tissue Perfusion related to hematemesis and melena.

5. Anxiety related to hematemesis and melena.

6. Ineffective Breathing Pattern related to decreased lung expansion.

7. Impaired Verbal Communication related to neurological disturbances talking.

8. Risk for injury related to uncontrolled movements.

9. Impaire Physical Mobility related to the effect of muscle stiffness.

10. Self-care deficit related to a state of coma.

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Nursing Diagnosis for Pain (Acute / Chronic) related to Osteoarthritis

Osteoarthritis (OA) is the most common form of arthritis and affects more than 20 million Americans. Osteoarthritis is a serious and painful condition. It is a condition that adversely affects hyaline articular cartilage, the tough gristle that caps the ends of long bones. This degenerative disease of the joints can result in considerable pain, the loss of cartilage as well as varying levels of tenderness.

Symptoms of Osteoarthritis (OA)
1. Mild or acute pain after a simple or even a difficult activity.
2. Great distress and discomfort, specifically when the weather changes.
3. Emergence of lumps in middle finger and at the bottom of the thumb.

Nursing Diagnosis: Pain (Acute / Chronic) related to distention of the tissues by the accumulation of fluid / inflammation, joint destruction.

Nursing Interventions for Osteoarthritis - Pain (Acute / Chronic)

• Assess complaints of pain; note the location and intensity of pain (scale 0-10). Note that accelerating factors and signs of non-verbal pain.
• Give a hard mattress, a small pillow. Elevate the bed when a client needs to rest / sleep.
• Help clients take a comfortable position when sleeping or sitting in a chair. Depth of bed rest as indicated.
• Monitor the use of pillows.
• Encourage clients to frequently change positions.
• Help clients to a warm bath at the time of waking.
• Help clients to a warm compress on the sore joints several times a day.
• Monitor the temperature compress.
• Give a gentle massage.
• Encourage the use of stress management techniques such as progressive relaxation bio feedback therapeutic touch, visualization, self hypnosis imagination guidance and control of breath.
• Engage in entertainment activities appropriate to individual situations.
• Give the drug before the activity / planned exercise as directed.
• Help clients with physical therapy.

Expected outcomes / evaluation criteria

• The pain showed reduced or controlled
• Looks relaxed, can rest, sleep and ability to participate in appropriate activities.
• Follow the treatment program.
• Using the skills of relaxation and entertainment activities in a pain control program.
  

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Nursing Diagnosis: Acute Pain related to Testicular Cancer

Nursing Diagnosis and Interventions : Acute Pain related to Testicular Cancer

Testicular cancer

Testicular cancer is a form of cancer that can be located in either or both of a man's testicles. Also referred to as the testes or the gonads, the testicles are located in the scrotum that is a sack like area found under the penis.

Testicular cancer occurs most often in men between the ages of 20 and 39, and is the most common form of solid tumour in men between the ages of 15 and 34. It may also occur in young boys, but only about 3% of all testicular cancer is found in this group. Tumors usually occur in one testicle, however, 2-3% of tumors can occur in both testicles, either simultaneously or at a later date.

Signs and Symptoms

The first sign is usually a firm, pain, smooth testicular mass which is sometimes accompanied by a feeling of heaviness in the testicles. Other symptoms of testicular cancer include: a feeling of swelling in the scrotum, discomfort or pain in the scrotum, ache in the lower back, pelvis or groin area, collection of fluid in the scrotum, gynecomastia and nipple tenderness. In advanced stages symptoms include: ureteral obstruction, abdominal mass, coughing, shortness of breath, weight loss, fatigue, pallor and lethargy.


Nursing Diagnosis for Testicular Cancer : Acute Pain related to the disease process (suppression / destruction of nerve tissue, infiltration of the nerve supply systems, neural pathway obstruction, inflammation), the side effects of cancer therapy.

Goal:

• Clients are able to control pain through activity.
• Reported pain experienced.
• Follow the treatment program.
• Demonstrate techniques of relaxation and diversion of pain through activities that may be.

Nursing Interventions for Testicular Cancer - Acute Pain

• Determine the pain history, location, duration and intensity.
• Evaluation of therapies: surgery, radiation, chemotherapy, bio-therapy, teach clients and families on how to deal with it.
• Give the transfer of such repositioning and fun activities such as listening to music or watching TV
• Recommends stress management techniques (relaxation techniques, visualization, guidance), happy, and provide therapeutic touch.
• Evaluation of pain, provide treatment if necessary.

Collaborative:

• Disusikan pain management by physicians and also with clients.
• Give analgesics as indicated.

Rational:

• Provide information needed for planning care.
• To find appropriate therapy is carried out or not, or even complications.
• To enhance client comfort by diverting attention from pain.
• Enhance self-control over side effects by lowering stress and anxiety.
• To find out the effectiveness of pain management, pain level and to what extent the client is able to hold him and know the needs of the client will be anti-pain medication.
• In order for a given therapeutic target.
• To overcome the pain.

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7 Nursing Diagnosis for Cellulitis

Nursing Care Plan for Cellulitis

Cellulitis is a skin infection brought by certain types of microorganism. The bacteria called Staphylococcus aureus and Group A Streptococcus are usually responsible for this kind of infection.

Streptococci and Staphylococci can enter the skin to cause cellulitis infection through scrapes, cuts, wounds, blisters, insect bites and ulcers and find their way into the dermal and subcutaneous layers of the skin.

Typical symptoms that indicate a cellulitis infection include sudden reddish swelling of the skin, headache, nausea,fever along with multiple small reddish colored dots appearing on the surface of the skin.

Cellulitis caused by the Group A beta-hemolytic streptococci is rapid spreading because of the enzymes produced by the bacteria that breaks down the cellular components responsible for localized infection.




7 Nursing Diagnosis for Cellulitis

1. Acute pain related to irritation of the skin, impaired skin integrity, ischemic tissue.

2. Impaired Skin Integrity related to the presence of gangrene in the extremities.

3. Anxiety related to lack of knowledge about the disease.

4. Imbalanced Nutrition Less Than Body Requirements related to poor food intake.

5. Disturbed Body Image related to changes in the form of one limb.

6. Sleep Pattern Disturbance related to pain in a leg wound.

7. Knowledge Deficit: the prevention of symptoms and treatment of conditions related to inadequate information.

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3 Nursing Care Plan Diabetes Mellitus - Diagnosis, Interventions and Rational

Nursing Diagnosis for Diabetes Mellitus
1. Nursing Diagnosis : Fluid Volume Deficit related to osmotic diuresis.

Goal:
Demonstrate adequate hydration evidenced by stable vital signs, palpable peripheral pulse, skin turgor and capillary refill well, individually appropriate urinary output, and electrolyte levels within normal limits.

Nursing Intervention:
1.) Monitor vital signs.
Rational: hypovolemia can be manifested by hypotension and tachycardia.
2.) Assess peripheral pulses, capillary refill, skin turgor, and mucous membranes.
Rational: This is an indicator of the level of dehydration, or an adequate circulating volume.
3.) Monitor input and output, record the specific gravity of urine.
Rational: To provide estimates of the need for fluid replacement, renal function, and effectiveness of the therapy given.
4.) Measure weight every day.
Rational: To provide the best assessment of fluid status of ongoing and further to provide a replacement fluid.
5.) Provide fluid therapy as indicated.
Rational: The type and amount of liquid depends on the degree of lack of fluids and the response of individual patients.

2. Nursing Diagnosis : Imbalanced Nutrition Less than Body Requirments related to insufficiency of insulin, decreased oral input.

Goal:
Digest the amount of calories / nutrients right
Shows the energy level is usually
Stable or increasing weight.

Nursing Intervention:
1.) Determine the patient's diet and eating patterns and compared with food that can be spent by the patient.
Rationale: Identify deficiencies and deviations from the therapeutic needs.
2.) Weigh weight per day or as indicated.
Rational: Assessing an adequate food intake (including absorption and utilization).
3.) Identification of preferred food / desired include the needs of ethnic / cultural.
Rational: If the patient's food preferences can be included in meal planning, this cooperation can be pursued after discharge.
4.) Involve patients in planning the family meal as indicated.
Rationale: Increase the sense of involvement; provide information on the family to understand the patient's nutrition.
5.) Give regular insulin treatment as indicated.
Rational: regular insulin has a rapid onset and quickly and therefore can help move glucose into cells.

c. Nursing Diagnosis : Risk for Infection related to hyperglikemia.

Goal:
Identify interventions to prevent / reduce the risk of infection.
Demonstrate techniques, lifestyle changes to prevent infection.

Nursing Intervention:
1). Observed signs of infection and inflammation.
Rationale: Patients may be entered with an infection that usually has sparked a state of ketoacidosis or may have nosocomial infections.
2). Improve efforts to prevention by good hand washing for all people in contact with patients including the patients themselves.
Rationale: Prevents cross infection.
3). Maintain aseptic technique in invasive procedures.
Rational: high glucose levels in blood would be the best medium for the growth of germs.
4). Give your skin with regular care and earnest.
Rational: the peripheral circulation may be disturbed that puts patients at increased risk of damage to the skin / skin irritation and infection.
5). Make changes to the position, effective coughing and encourage deep breathing.
Rational: memventilasi Assist in all areas and mobilize pulmonary secretions.


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Nursing Management and Diagnosis for CHF

Definition :

A state of pathophysiological abnormalities in cardiac function resulting in heart failure to pump blood to meet the metabolic needs of tissues and or ability only if accompanied by elevation of left ventricular filling pressure.

Etiology :
A. mechanical abnormalities

• Increased burden of the central (aortic stenosis), peripheral (systemic hypertension)
• Increase in volume load (initial load increase)
• Obstruction of the ventricular filling (stenosis mitralis / trikuspidalis)
• Pericardial tamponade
• Restriction endocardium / myocardium
• Ventricular aneurysm.

B. Abnormalities of the myocardium
1. Primary

• Cardiomyopathy
• Myocarditis
• The metabolic abnormalities
• Toxicity (alcohol, cobalt)

2. Dis-dynamic abnormalities, secondary

• K (-) O2
• The metabolic abnormalities
• Inflammation
• Systemic Diseases
• COPD

C. Changes in heart rhythm

• Cardiac arrest
• Fibrillation
• Tachycardia / bradycardia
• Electric Asinkroni

Signs and symptoms of CHF

1. Left heart failure

• Fatigue
• Weak
• Cyanosis
• Dyspnea
• Cough
• Orthopnea
• Anorexia
• Tachypnea
• The first heart sound decreases
• Wet crackles pleural effusion

2. Right heart failure

• Weight loss
• Ankle edema
• Abdominal distention
• Pain subkostal
• Pulsation neck region
• Jaundice
• Tired
• Edema, ascites
• Increased jugular venous pressure

Complication

• Cardiac asthma? due to bronchospasm occurs at night or in the activity
• Non-productive cough due to lung congestion
• Haemoptysis
• Dysphagia due to distension of the pulmonary venous atrium or
• Containment of systemic veins - JVP increased
• Hepatomegaly
• Peripheral edema
• Ascites and anasarka
• Increase in body weight due to water retention and sodium
• Peripheral vasoconstriction? release of body heat (-)
• Abnormalities of liver function, prothrombin time emanjangan light.

Nursing Management of CHF

Goal :
- Reducing the workload of the heart
- A third of selective manipulation of the main determinants of myocardial function, namely:

• the initial load
• the load end
• contractility

- Achieve the desired clinical response

Guidelines:
1. Limitation of physical activity

• Avoid strenuous work
• Stop the heavy exercise

2. sodium restriction
3. digitalis glycosides
4. diuretics

• Diuretics
• Potassium-sparing diuretics

5. vasodilator
6. inotropic agents
7. specific actions:

• Consideration tranpalntasi
• Assisted circulation:

Nursing Diagnosis for CHF

1. Decreased cardiac output related to mechanical factors (preload, afterload, contractility)
2. Impaired gas exchange related to alveolar capillary membrane due to increased pulmonary capillary pressure
3. Changes in nutritional status: less than body requirement related to the absorption of nutrients secondary to decreased cardiac output.
4. Activity intolerance related to decreased cardiac output.

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