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Nursing Care Plan - Admission/Application Essay Example

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NURS 401 NURSING CARE PLAN Part 1 _ Date submitted:_ Patient Initials:_H.S._Age/Sex_48 yo/ Male Medical Diagnosis:_Diverticulitis_ I. Etiology and Pathophysiology: Diverticulitis is an acute inflammation of a diverticulum resulting from an obstruction by fecal matter…
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Download file to see previous pages Smoking has also been linked to diverticulitis as it suppresses the immune system that would allow the proliferation of bacteria in the diverticula. Areas in the colon where nerves, arteries, and other connective tissue sheaths penetrate the inner circular muscle coat, focal weaknesses of the entire length of the colon are formed. These areas are prone to herniate and produce diverticula. In most cases, the inflamed diverticulum ultimately results into abscess formation (Smeltzer & Bare, 2006, p. 1037). Consequently, fecal matter and bacteria invading these outpouchings can cause local infection that can proceed into systemic infection as the condition progresses. Tissue edema and local irritation cause spasticity of the entire colon and disrupt its normal function. If left uncontrolled, the inflamed diverticulum can perforate and extrude fecal matter and bacteria to the surrounding organs in the abdominal cavity. Massive bleeding can also result when large blood vessels are disrupted. II. Clinical Manifestations (Signs & Symptoms): Diverticular diseases frequently do not cause distinct clinical features, and patients often only have a history of chronic constipation. In fact, lesions are most often discovered incidentally. Despite the ambiguity of clinical manifestations, symptomatic diverticulitis present intermittent cramping, continuous lower abdominal discomfort, distention, and a sensation of never being able to completely empty the rectum. Patients sometimes experience alternating constipation and diarrhea. Occasionally there may be minimal chronic or intermittent blood loss, or, in extremely rare cases, massive hemorrhage. With systemic infection, patients experience nausea, vomiting, a low-grade fever, and an abrupt onset of crampy pain. Longitudinal studies have shown that diverticula can regress early in their development or, more commonly, become more numerous and prominent over time (Smeltzer & Bare, 2006, p. 1038). III. Treatment and Nursing Management: Surgical management of H.S. includes a bowel resection and colon reversal. Nursing interventions focus primarily on preventing infection by proper wound care and monitoring for signs of infection, routinely changing urinary catheter, and ensuring drains do not touch the floor and kept clean. H.S. response to pain medication as ordered by physician should be appropriately recorded. IV: Diagnostic Studies/Lab analysis: Essentially normal and results indicate H.S. is allowed to undergo operation. Discharge Planning and Client Teaching Continue medications as prescribed by the physician. HS and his caregiver should be taught of proper wound care and should be asked for a return demonstration to ensure complete understanding. NURS 401 NURSING CARE PLAN Growth and Development According to Erickson Stage: 7 Crisis: Generativity vs Stagnation (Videbect, 2007, p. 53) I. Describe your patient’s ability to achieve growth and development tasks. Prior to admission, the H.S. was performing his role and job as an auto mechanic and a baseball coach. These activities helped him achieve the sense of creativity, productivity, and fulfillment that he is able to help establish the next generation. Specifically, his job as an auto mechanic enabled him to be a productive member of the society and thus achieve generativity, as indicated by Erikson’s psychosocial stages. Furthermore, his career as a baseball coach gave him the opportunity to teach and rear children, ...Download file to see next pagesRead More
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