Non- Pharmacological Therapies for Constipation

Non- Pharmacological Therapies for Constipation

Constipation  

Constipation is a condition in which a person's bowel movement difficulty with normal daily pattern. At each state of constipation, causes of constipation should be correctly identified in order to determine the therapeutic approach. Causes of constipation can be as diverse as a low fiber diet or due to the consumption of drugs hypothyroidism.

Constipation is generally regarded as the usual health problems, experienced by many people, and generally they do the treatment themselves. Problems many people experience constipation problems are usually associated with a low fiber diet. Constipation is also often wrongly understood by the general public. Society generally considers that a bowel movement every day is important for health. And assume that the bowel is not routine every day will contribute to the accumulation of toxins and lead to somatic complaints varied. This misunderstanding resulted in the use of laxatives are less rational society.

To assess the condition of constipation, required an assessment of the following variables:

1. Frequency of bowel movements. Someone would otherwise be constipated if bowel frequency magnitude less than 3 times a week in women and 5 times per week in men.
2. The size and consistency of stools. A person with constipation requires 25% more time than usual for the number of defecation and fecal or fewer.
3. Symptoms as the sensation of defecation incomplete.

The following are some factors or conditions can cause constipation:

1. Diseases of the gastrointestinal tract; irritable bowel syndrome, diverticulitis, gastrointestinal disease above the anal and rectal disease, hemorrhoids, tumors, hernia, intestinal volvulus, syphilis, tuberculosis, worm infections, limphogranuloma, hirscprung's Disease
2. Metabolic and endocrine disorders; diabetes mellitus with neuropathy, hypothyroidism, pheochromocytoma, hypercalcemia, enteric glucagon excess.
3. Pregnancy; Emphasis intestinal motility, increased fluid absorption from the large intestine, decreased physical activity, dietary changes, lack of fluid intake, low fiber diet, the use of iron salts.
4. Neurogenic; central nervous system disease, brain trauma, spinal injuries kordata, central nervous system tumors, cerebrovascular accident, Parkinson's disease
5. Psychogenic; Psychogenic to ignore / postpone the urge to defecate, psychiatric disease.
6. Use of certain drugs

Signs and Symptoms

1. Signs and symptoms that need to be considered in knowing whether a person is constipated or not:
2. Keep in mind the condition whether the patient complained of a lack of volume conditions stool during bowel movements, stomach feeling full, pain during bowel movements.
3. Signs and symptoms such as hard stools, small or dry. Abdominal discomfort, pain, cramps, nausea and vomiting, headache, and fatigue.

Non- Pharmacological Therapies for Constipation

High Fiber Diet
Nonpharmacologic therapy is first-line therapy in the treatment of constipation by making dietary modifications to increase the amount of fiber consumed. Fibers that are part of the vegetable that is not digested in the intestines will increase stool bulk, liquid stool retention, and increase stool transit in the gut. With fiber therapy is the increased frequency of bowel movements and decrease pressure on the colon and rectum.

Patients are advised to consume at least 10 grams per day of crude fiber. Fruit, vegetables and cereals are examples of food rich in fiber. Raw bran contains about 40% fiber. In addition there are also medicinal product which is the mass of fiber-forming agents such as hydrophilic colloids psylium, methylcellulose or polikarbofil which can produce effects similar to those of high-fiber foods are available in the preparation of tablets, powders or capsules.

Surgery
In some constipated patients required surgery. This is because the presence of colonic malignancy or gastrointestinal tract obstruction that required bowel resection. Besides surgery is also necessary in cases of constipation caused by pheokromositoma.

Biofeedback
Most of the patients of constipation due to pelvic floor dysfunction benefit from the electromyogram biofeedback therapy.

Nursing Care Plan for Acute Tonsillitis

Nursing Care Plan for Acute Tonsillitis

Nursing Care Plan  

Tonsillitis is an inflammation of the tonsils. according to the stage, tonsillitis is divided into three stages, namely:

1. Acute tonsillitis
2. Membranous tonsillitis
3. Chronic tonsillitis

Acute Tonsillitis
Acute definition is an inflammation of the tonsils and sudden in onset.

Etiology

1. Group A Beta-Hemolytic Streptococcal.
2. Pneumococcus.
3. Staphylococcus.
4. Haemophilus influenzae.

Pathophysiology

1. Inflammation of the tonsils caused by a virus.
2. Resulted in the formation of exudate.
3. Cellulitis tonsils and surrounding areas.
4. Peritonsilar abscess formation.
5. Tissue necrosis.

Symptoms

1. Sore throat and dysphagia.
2. Patients do not want to eat or drink.
3. Malaise.
4. Fever.
5. Breath odor.
6. Otitis media is one of the originators.

Management

1. Bed rest.
2. Provision of adequate fluids and light diet.
3. Giving medications (analgesics and antibiotics).
4. If there is no progress then the alternative actions that can be done is surgery.

Preparation operations may be undertaken

1. Laboratory tests (hemoglobin, leukocytes, bleeding time).
2. Give an explanation to the client, treatment and care after surgery.
3. Fasting 6-8 hours before surgery.
4. Give antibiotics as prophylaxis.
5. Give premedication ½ hours before surgery.

Assessment

1. Medical history factors associated with the occurrence of tonsillitis supporters , as well as bio - psycho - socio - spiritual.

2. Circulatory
Palpitations, headache during position changes, decreased blood pressure, bradycardia, body felt cold, pale extremities appear.

3. Elimination
Changes in the pattern of elimination ( urinary incontinence ), abdominal distension, bowel sounds disappearance.

4. Activity / rest
There is a decrease in activity due to body weakness, loss of sensation or parese / plegia , tiredness, difficulty in recuperating from muscle cramps or spasms and pain. The reduced level of consciousness, decreased muscle strength, general body weakness.

5. Nutrition and fluids
Anorexia, nausea and vomiting due to increased ICP ( intracranial pressure ), impaired swallowing, and loss of sensation on the tongue.

6. Nervous system
Dizziness / syncope, headache, decreased visual field wider / blurred vision, decreased touch sensation, especially in the area of ​​the face and extremities. Comatose mental status, weakness in the extremities, muscle paralise face, aphasia, dilated pupils, decreased hearing.

7. Comfort
Tense facial expressions, headache, restlessness.

8. Breathing
Shortened breath, inability to breathe, apnea, apnea onset period in breathing patterns.

9. Security
Fluctuations of temperature in the room.

10. Psychological
Denial, disbelief, anguish, fear, anxiety.

12 Nursing Diagnosis for Mitral Stenosis

12 Nursing Diagnosis for Mitral Stenosis

Nursing Diagnosis and Interventions  

Nursing Care Plan for Mitral Stenosis

Mitral stenosis is a narrowing of the mitral valve in the heart. This restricts the flow of blood through the valve. Back pressure which builds up behind the narrowed valve can cause various problems and symptoms. The more severe the narrowing, the more serious the problems.

Mitral stenosis (MS) is characterized by obstruction to left ventricular inflow at the level of mitral valve due to structural abnormality of the mitral valve apparatus. The most common cause of mitral stenosis is rheumatic fever.

Symptoms can include:

• Shortness of breath. This tends to occur on exercise at first, but occurs at rest if the stenosis becomes worse. This symptom is due to the congestion of blood and fluid in the lungs.
• Fainting, dizziness or tiredness. If the amount of blood getting through to the ventricle is reduced, the output of blood from the left ventricle to the body is then reduced.
• Chest pains (angina). This may develop if there is a reduced blood flow to the coronary arteries (the arteries that take blood to the heart muscle).
• Chest infections. These are common.
• Coughing up blood-stained sputum. This may occur due to the congestion of blood and fluid in the lungs.

If rheumatic fever is the cause then, typically, symptoms start between the ages of 20 and 50. (That is, 10-20 years after having have had an episode of rheumatic fever as a child.)


12 Nursing Diagnosis for Mitral Stenosis

1. Ineffective individual coping
related to :

• Situational crisis;
• Inadequate support systems;
• Ineffective coping methods.

2. Deficient Knowledge (learning needs)
related to :

• Lack of knowledge;
• Misinterpretation of information;
• Cognitive limitations;
• Deny the diagnosis.

3. Risk for Fluid Volume Excess
related to :

• The displacement of the pressure on the congestive pulmonary vein;
• Decrease in perfusion organ (kidney);
• Increased retention of sodium / water;
• Increased hydrostatic pressure, or decreased plasma protein (absorbs liquid in the interstitial area / tissue).

4. Risk for Impaired gas exchange
related to :

• Alveolar - capillary membrane changes (displacement of fluid into the interstitial area / alveoli).

5. Ineffective breathing pattern
related to:
decreased lung expansion.

6. Anxiety
related to:

• Threat of loss / death;
• Situational crisis;
• Threats to self-concept (self-image).

7. Ineffective Tissue perfusion
related to:

• Decrease in peripheral blood circulation;
• Cessation of arterial-venous flow;
• Decrease in activity.

8. Decreased cardiac output
related to:

• Obstruction of blood flow from the left atrium into the left ventricle,
• Presence of ventricular tachycardia,
• Shortening of the diastolic phase.

9. Imbalanced Nutrition: less than body requirements
related to:

• Shortness of breath.

10. Impaired Urinary Elimination
related to:

• Decreased glomerular perfusion;
• Decrease in cardiac output.

11. Risk for Fluid Volume Deficit
related to:

• Decrease in cardiac output;
• Decline in glomerular filtration.

12. Activity intolerance
related to:

• Decreased cardiac output,
• Congestive pulmunal.

Fluid and Electrolyte Imbalance - Nursing Care Plan for Vomiting

Fluid and Electrolyte Imbalance - Nursing Care Plan for Vomiting

Vomiting  

Nursing Care Plan for Vomiting - Nursing Diagnosis : Fluid and Electrolyte Imbalance : less than body requirements.

Vomiting is a symptom, not a disease. Symptoms of this form of discharge of the contents of the stomach and intestines through the mouth, with a force. Vomiting is the body's protective reflex, because it can protect against toxins accidentally ingested. In addition, an attempt vomiting removing toxins from the body and can reduce the pressure caused by the blockage or enlargement of the organ that puts pressure on the digestive tract. Generally vomiting consists of three phases, namely nausea (feeling sick), retching (initial maneuver to vomit) and regurgitation (evisceration stomach / intestine into the mouth).

Vomiting occurs through a mechanism that is very complex. The occurrence of vomiting is controlled by the vomiting center in the central nervous system (brain) us. Vomiting occurs when there are certain conditions that stimulate the vomiting center. Stimulation of the vomiting center and then proceed to the diaphragm (the partition between the chest and abdomen) and stomach muscles, resulting in decreased diaphragm and constricting (shrinking) the muscles of the stomach. That in turn resulted in increased pressure in the abdomen especially in the stomach and cause the release of stomach contents through the mouth. Some conditions that can stimulate the vomiting center in which various gastrointestinal disorders in both infections (including gastroenteritis) and non-infectious (such as obstruction of the digestive tract), toxins (poisons) in the digestive tract, balance disorders, and metabolic disorders.

Nursing Care Plan for Vomiting : Fluid and Electrolyte Imbalance : less than body requirements related to excessive fluid output.

Goal: fluid and electrolyte deficits resolved

Outcomes:

• There are no signs of dehydration,
• mucosa of the mouth and lips moist,
• fluid balance.

Intervention:

• Observation of vital signs.
• Observation for signs of dehydration.
• Measure the input and output of fluid (fluid balance).
• Provide and encourage the family to drink a lot more than 2000 - 2500 cc per day.
• Collaboration with physicians in fluid therapy, electrolyte laboratory examination.
• Collaboration with a team of nutrition in low-sodium fluids.