NCP Nursing Diagnosis: Risk for Impaired Skin Integrity

Nursing Diagnosis: Risk for Impaired Skin IntegrityPressure Sores; Pressure Ulcers; Bed Sores; Decubitus CareNOC Outcomes (Nursing Outcomes Classification)Suggested NOC Labels * Risk Control * Risk Detection * Tissue Integrity: Skin and Mucous MembranesNIC Interventions (Nursing Interventions Classification)Suggested NIC Labels * Pressure Ulcer Prevention * Skin SurveillanceNANDA

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Risk for Self or Other- Directed Violence - Schizophrenia Care Plan

Nursing Diagnosis for Schizophrenia : Risk for Self or Other- Directed Violence Goal: The patient can control violent behavior, with the following criteria: Bright face, smiling. Want to get acquainted and there is eye contact. Willing to tell the feeling. Telling cause irritation / anger. Can identify signs of violent behavior. Can identify, form of violence that is done. Can be identified as a result of violent behavior. Able to practice taught how to control anger. Able to engage in group activity therapy. Can taking medication with minimal assistance. Clients can continue the relationship in accordance with the responsibilities of the role. Interventions Client Intervention Perform a trusting relationship. Identify the causes of violent behavior. Identify the signs and symptoms of violent behavior. Identification form of violence that is ever done. Identification due to violent behavior. Teach how to control violent behavior, among others: Physically (relaxation, activities and spo...
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Gastroesophageal Reflux Disease (GERD) - Assessment and Physical Examination

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Gastroesophageal Reflux Disease (GERD) - Assessment 1. General condition Covering conditions such as the level of tension / fatigue, qualitative level of consciousness or GCS and client verbal response. 2. Vital signs Includes examining: Blood pressure: should be examined in a different position, assess the pulse pressure, and pathological conditions. Pulse rate. Respiratory rate. Temperature. 3. Main complaint Assessed onset, duration, quality and characteristics, severity. Location, precipitating factors, related manifestations: Typical complaints (esophagus): heartburn, regurgitation, and dysphagia. Atypical Complaints (extra esophagus): chronic cough, hoarseness, pneumonia, pulmonary fibrosis, bronchiectasis, and non-cardiac chest pain. Another complaint: weight loss, anemia, hematemesis or melena, odynophagia. 4. Past medical history/Previous health Other gastrointestinal diseases. Drugs that affect gastric acid. Allergy / immune response reaction. 5. Family medical history Physi...
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Risk for Decreased Cardiac Output - NCP Acute Myocardial Infarction (STEMI)

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Nursing Care Plan for AMI with ST elevation (STEMI) Definition Acute myocardial infarction is the destruction of tissue due to inadequate blood supply so that coronary blood flow is reduced. (Brunner & Suddath, 2002) Acute myocardial infarction is the death of myocardial tissue caused by myocardial coronary blood damage, due to the inadequate blood flow. (Carpenito, 2000) Acute myocardial infarction is ischemia or necrosis of the heart muscle caused by decreased blood flow through one or more coronary arteries. (Doengos, 2000) Etiology According to Noer, 1999; 103 caused by a. Causal factors: 1. Oxygen supply to the heart is reduced due to: a. Vascular factors: Atherosclerosis, spasm, arteritis. b. Circulation Factor: hypotension, aortic stenosis, insufficiency. c. Blood factors: anemia, hypoxemia, polycythemia. 2 Cardiac output increased For example: Activity, emotional, eating too much, anemia, hyperthyroidism. 3. Increased myocardial oxygen demand at: Myocardial damage, myocardi...
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