Factors Influencing Health Status of The Elderly

Factors Influencing Health Status of The Elderly

Geriatric Nursing  

There are several factors that affect the mental health of the elderly. These factors shall be addressed wisely so that the elderly can enjoy their life happily. As for some of the factors facing the elderly are greatly affecting their mental health is as follows:

1. Decrease in Physical Condition

After someone entered the elderly, generally ranging seized their physical condition, which is pathological regression (multiple pathology), for example, reduced power, decreased energy, more wrinkled skin, the more teeth fall out, the more brittle bones, etc..

In general, the physical condition of a person who has entered a period of elderly decline exponentially. This all may cause interference or physical dysfunction, psychological and social, which in turn can lead to a state of dependence on others. In the lives of the elderly in order to maintain a healthy physical condition, it is necessary to align with the physical needs psychological and social conditions, so inevitably there must be efforts to reduce the activities of a physical memforsir. An elderly should be able to set a good way of life, such as eating, sleeping, rest and work in balance.



2. Decrease Function and Sexual Potency

Decrease function and sexual potency in the elderly is often associated with a variety of physical disorders such as:

1. Heart problems.
2. Metabolic disorders, eg, diabetes mellitus.
3. Vaginitis.
4. Recently completed operations: for example prostatectomy.
5. Malnutrition, due to imperfect digestion or appetite is very less.
6. The use of certain medications, such as antihypertensives, steroid group, tranquilier.
7. Psychological factors that accompany the elderly, among others:
   • Sense of taboo or embarrassment when maintaining sexual life of the elderly.
   • Attitudes families and communities that lack support and strengthened by tradition and culture.
   • Fatigue or boredom due to lack of variation in his life.
   • Spouse has died.
   • Sexual dysfunction due to hormonal changes or other mental health problems anxiety, depression, dementia, etc..

3. Changes in Psychosocial Aspects

In general, after entering the elderly then it decreased cognitive and psychomotor function. Cognitive function includes the process of learning, perception, comprehension, understanding, attention and others that cause reactions and behaviors of the elderly become increasingly slow. While psychomotor function (conative) covers matters relating to such will boost the movement, action, coordination, resulting in that the elderly become less nimble.
With the decrease in both functions, the elderly also experience changes in psychosocial aspects related to the state of kepabrikan elderly. Some of these changes can be differentiated based on 5 elderly personality types as follows:

1. Construction personality , usually this type is not a lot experienced turmoil , calm and steady until very old .
2. Independent personaliy , there is a tendency in this type of experience post power syndrome , especially if in the future be filled with the elderly are not activities that can provide autonomy on him .
3. Dependent personality , in this type usually greatly affected family life , family life always harmonious if the elderly are not volatile at times , but if the spouse dies, the spouse left behind will be miserable , especially if you do not get up from his position .
4. Hostility personality , in this type after entering the elderly are still not satisfied with his life , a lot of desire that is sometimes not in the carefully calculated , causing economic conditions to be messy .
5. Self Hate Personality , the elderly of this type generally looks miserable , because the behavior itself is difficult aided by others or themselves tend to be difficult .

Nursing Diagnosis and Interventions of Activity Intolerance in Elderly

Nursing Diagnosis and Interventions of Activity Intolerance in Elderly

Nursing Diagnosis and Interventions  

Assessment

1. Physical examination:

• Musculoskeletal: decreased tone, strength, muscle size and endurance; range of motion of joints and skeletal strength.
• Cardiovascular: the formation of thrombosis, thrombophlebitis signs include: erythema, edema, tenderness and signs of positive Humans.
• Respiration: atelectasis and pneumonia symptoms, early signs include an increase in temperature and heart rate.
• Integument: ischemia injury against the first tissue is inflammatory, early changes seen on the surface of the skin as an irregular area of erythema.
• Urinary function: physical signs such as urinating a little and often, lower abdominal distension and bladder limits that can be touched.
• Gastrointestinal: constipation and faecal going small, hard and dry.
• Environment: bathroom without handles, loose rugs, lighting is not adequate, a high ladder, slippery floor and toilet seat that lowers the client mobility.

2. Assessing the skeletal body: The deformity and alignment. Abnormal bone growth due to bone tumors. Shortening of limb, amputation and body parts that are not in anatomical alignment. Abnormal angulation of the long bones or movement at a point other than the joints usually indicate the presence of fractures.

3. Assessing the spine:

• Scoliosis (curvature of the lateral deviation of the spine)
• Kyphosis (curvature of the spine increase the chest)
• Lordosis (quack, the curvature of the lumbar spine over)

4. Assessing joint system: Broad movement was evaluated both active and passive, deformity, stability, and the lumps, the joint stiffness.

5. Assessing muscle system: The ability to change the position, muscle strength and coordination, and the size of each muscle. Limb circumference to mementau or atropfi edema, muscle pain.

6. Assessing how patients walk: The irregular movements are not considered normal. If one limb shorter than the other. A variety of neurological conditions associated with abnormal gait (eg walking spastic hemiparesis way - stroke, patients go step by step - lower motor neuron disease, patients walked vibrate - Parkinson's disease).

7. Assessing the skin and the peripheral circulation: palpation of the skin can indicate a temperature hotter or colder than others and the edema. Peripheral circulation was evaluated by assessing peripheral pulses, color, temperature and capillary refill time.

8 . Assessment of functional status :

• Baths : Told independent when in client activity just need help to scrub or clean up a certain portion of the body member , said the dependent if the client requires assistance to more than one body part .
• Dress : Independent if unable to take his own clothes in a closet or drawer .
• To the toilet : Independent when the elderly can not afford to own a toilet , getting out of the toilet and hem itself . Dependent when it need a bed pan or pot .
• Transferring : Independent themselves when able to climb down from a bed or wheelchair . Dependent if always require assistance for activities above or unable to perform one or more activities of transferring .
• Continence : Independent shitting themselves when able ( urinary and defecation ) . When dependent on one or both of micturition or sefekasi require enema or catheter .
• Eating : Independent if it is able to bribe their own food , take away from the plate .

Nursing Diagnosis and Interventions of Activity Intolerance in Elderly

Nursing Diagnosis : Impaired Physical Mobility related to depression

Goal : Depression can be resolved and activities to do.

Outcomes:

Clients can perform daily activities , and depression disappeared .

Intervention :

1. The prevention of osteoporosis , either through medical intervention , nutrition , as well as lifestyle adjustments .
2. The prevention of falls in accordance with the results of the assessment of the environmental factors as well as risk factors does surgery on the risk of environmental factors .
3. Maintenance of strength and resilience of the musculoskeletal system , which includes daily exercise conditioning program both isometric and isotonic muscle contraction , strengthening and aerobic activity , nutrition and protein anabolism to increase bone formation and attitude of commitment to exercise .
4. Maintaining the flexibility of the joints involved in range of motion exercises , proper positioning and activities of daily living .
5. Maintenance of normal ventilation and hyperinflation include mobilization and eliminate secretions .
6. Maintenance of adequate circulation include supporting measures to maintain vascular tone , compression stockings to put external pressure on the limbs and adequate fluid intake to prevent dehydration effect on blood volume .
7. Maintenance of urinary and bowel function were normal relies on nutritional support and environmental structure and routines to facilitate elimination .

7 Minimum Standards of Antenatal Care

7 Minimum Standards of Antenatal Care

Obstetrical Nursing  

Antenatal Care (ANC) is a prenatal care provided by a midwife or doctor to the mother during pregnancy to optimize mental and physical health of pregnant women, so as to face childbirth, childbirth preparation, breastfeeding, and the return of normal reproductive health (Manuaba, 1998) .

Antenatal antenatal examination is done to check on the mother and fetus at regular intervals, followed by efforts to correct the deviations found (Antenatal Care Guidelines on Basic Service Level, 2004: 1).

7 Minimum Standards Antenatal Care

According to Saifuddin (2002) Antenatal care covers a lot of things, but in the application of the minimum standards of known operations consist of:

1. Measure weight
During pregnancy is between 0.3-0.5 kg per week. When gestational age was associated with weight gain during early pregnancy ± 1 kg, then the second and third trimester, respectively increases of 5 kg. At the end of pregnancy weight gain total is 9-12 kg. If there is excessive weight gain should be considered towards the risk as swelling, multiple pregnancy, hydramnios, and a great kid.

2. Measure blood pressure
During pregnancy, high blood pressure when more than 140/90 mmHg. When blood pressure increases, ie 30 mmHg systolic or more and or diastolic 15 mm Hg or more. These abnormalities may progress to preeclampsia and eclampsia if not handled properly.

3. Measure the height of fundus of uterus

Normal fundus height is as follows:
12 weeks: 1-2 fingers above the symphysis.
16 weeks: halfway between the symphysis-center.
20 weeks: 3 fingers under center.
24 weeks: tall center.
28 weeks: 3 fingers above the center.
32 weeks: mid-center - processus xiphoideus.
36 weeks: three fingers below the processus xiphoideus.
40 weeks: midway between the processus xiphoideus - center (Mochtar, 1998)

4. TT immunization
Giving TT, will lead to a protective effect when given at least twice with a minimum interval of 4 weeks. Except if the mother had previously received TT twice in the last pregnancy or at the time of the TT pretty bride was given only once.

5. Provision of iron tablets
Basically giving iron tablets initially treated with a single daily tablet as soon as possible after the nausea passes.

6. Tests for sexually transmitted diseases.
During pregnancy, mothers should be tested for sexually transmitted diseases such as HIV / AIDS, Gonorrhoe, syphilis. That is because very influential on the fetus. If found disease - sexually transmitted diseases should be addressed.

7. Counseling
Preparation refers to higher health care, need to be prepared because the maternal and infant mortality due to delay in reaching health facilities.

Headaches During Pregnancy - Prevention and Pain Management

Headaches During Pregnancy - Prevention and Pain Management

Pain Management  

Headaches experienced during the first trimester due to the rapidly changing hormone levels, resulting in increased blood volume in the body. In addition, feelings of stress which is often plagued pregnant women is also one of the triggers of these symptoms. There are several types of headaches that can occur during pregnancy. One of them is feeling like a squeezing pain on both sides of the head or the back of the neck.

Many women who experience tension headaches during pregnancy and this may become more severe during the first trimester. This type of headache is usually caused by lack of sleep and depression during pregnancy. However, the increased levels of the hormone can also be one cause.

Mothers who are pregnant should not take carelessly known cure for fear of affecting the fetus in the womb. Most of headache medications may have harmful effects or unknown impact on infant development.


Prevention

For that to know a few things that can prevent the occurrence of headaches during pregnancy :

1. Avoiding triggers, various things are known can be a trigger like eating late, certain smells or foods consumed.
2. Physical activity in your daily routine, such as walking every day or doing light aerobic exercise.
3. Perform relaxation exercises, soothing activities such as yoga, deep breathing and visualization can help keep headaches.
4. Eat small meals but more frequently, so they can keep blood sugar levels stable and prevent headaches. If you do not eat for 2-3 hours, a quick snack consumption, such as biscuits. This will immediately raise blood sugar levels.
5. Consume enough fluids to keep the body well hydrated. Immediately drink water or juice.
6. Maintain a regular sleep schedule, due to fatigue and lack of sleep can contribute to headaches during pregnancy, and be sure to go to bed and wake up at the same time even on weekends.
7. Maintain good posture, due to poor posture or muscle tension can cause headaches, especially the weight gain to support the pregnancy.
8. First of all, sit down first. This method helps reduce the pain (because blood flow to the head so much smoother), also prevents falling pregnant women.
9. If it will change the position of the body, do it slowly. For example, if you stand up from a lying position, try to sit down, then stand slowly.

But if the inevitable headaches and attacking pregnant women , then do the following steps :

1. Do the rest by lying in a dark room or dim , quiet atmosphere and eyes closed .
2. Using warm compresses to the eyes , face and temples or forehead , or could also try a cold compress on the back of the neck .
3. Ask someone to do massage on the shoulders and neck to relieve tension , or massaging the temples also can help . Actually , headache disorders are not severe .

But , if the second trimester headaches for the first time ( both with impaired vision or not , abdominal pain , skyrocketing weight gain , and swelling of the face or hands ) , soon to consult a midwife or a doctor . Could be , blood pressure and urine should be examined in the laboratory to see the possibility of developing pre - eclampsia or pregnancy poisoning . This is also the reason for the importance of antenatal care on a regular basis .