Postingan

NCP Ventilatory Assistance (Mechanical)

Many patients on ventilators are now being transferred from the intensive care unit (ICU) to medical-surgical units with problems including (1) neuromuscular deficits, such as quadriplegia with phrenic nerve injury or high C-spine injuries, Guillain-Barré syndrome, and amyotrophic lateral sclerosis (ALS); (2) COPD with respiratory muscle atrophy and malnutrition (inability to wean); and (3)

NCP Urolithiasis (Renal Calculi)

Kidney stones (calculi) are formed of mineral deposits, most commonly calcium oxalate and calcium phosphate; however, uric acid, struvite, and cystine are also calculus formers. Although renal calculi can form anywhere in the urinary tract, they are most commonly found in the renal pelvis and calyces. Renal calculi can remain asymptomatic until passed into a ureter and/or urine flow is obstructed

NCP Urinary Diversions / Urostomy (Postoperative Care)

Incontinent urinary diversions: These ostomies require permanent stoma care and external collecting devices.Ileal conduit: Ureters are anastomosed to a segment of ileum, resected with the blood supply intact (usually 15–20 cm long). The proximal section is closed, and the distal end brought to skin opening to form a stoma (a passageway, not a storage reservoir).Colonic conduit: This is a similar

NCP Upper Gastrointestinal / Esophageal Bleeding

Bleeding duodenal ulcer is the most frequent cause of massive upper gastrointestinal (GI) hemorrhage, but bleeding may also occur because of gastric ulcers, gastritis, and esophageal varices. Severe vomiting can precipitate gastric bleeding as a result of a tear in the mucosa at the gastroesophageal junction (Mallory-Weiss syndrome). Stress ulcers are often associated with severe burns, major

NCP Transplantation (Postoperative and Lifelong)

With current advances in technology and knowledge of immune responses at the molecular level, organ and tissue transplantation is becoming more commonplace. The most frequently transplanted organs are the kidney, liver, and heart. The major problem to be overcome is the immunologic response of the patient to donor tissues. The ability of the immune system to distinguish self from nonself is

NCP Total Nutritional Support : Parenteral / Enteral Feeding

Nutritional status is a key factor in patient’s overall immune function and a patient’s ability to mount a stress response. Underfeeding a patient may lead to increased nosocomial infections, poor wound healing, respiratory muscle dysfunction, and respiratory failure. Overfeeding patients, in contrast, may increase physiological stress and lead to problems such as hyperglycemia, fluid overload,

NCP Total Joint Replacement

Joint replacement is indicated for irreversibly damaged joints with loss of function and unremitting pain (e.g., degenerative and rheumatoid arthritis [RA]), selected fractures (e.g., hip/femoral neck), joint instability, and congenital hip disorders. The surgery can be performed on any joint except the spine. Hip and knee replacements are the most common procedures. The prosthesis may be