List of Nursing Diagnosis

Nursing Diagnosis for Osteoarthritis : Disturbed Sleep Pattern related to pain

Outcomes :
Clients can meet the needs of rest or sleep.

Independent:

1. Determine the normal and usual sleep habits and the changes that occur.
2. Provide a comfortable bed.
3. Create a new bedtime routine that is included in the old patterns and new environment.
4. Instruct act of relaxation.
5. Increase comfort bedtime regimen, such as a warm bath and massage.
6. Use the bed fence as indicated : if possible lower the bed.
7. Avoid disturbing the client when the client is asleep, when possible, for example wake for drugs or therapy.

Collaboration :

1. Give medications as indicated.

Rationale :

1. Assessing the need for and identify appropriate interventions.
2. Improving the convenience of sleep and support the physiological / psychological.
3. When the new routines contain as many aspects of old habits, stress and anxiety -related can be reduced.
4. Help induce sleep.
5. Increase the relaxation effect.
6. Can feel the fear of falling due to changes in the size and height of the bed, place a fence to help change the position.
7. More uninterrupted sleep creates a feeling of fresh and patients may possibly not be able to go back to sleep if awakened.

1. May be given to help the patient sleep or rest.

Nursing Care Plan for Lower Back Pain (LBP)


Low Back Pain is chronic pain in the lumbar, usually caused by a recessive the vertebral muscles, herniation and regeneration of the nucleus pulposus, osteoarthritis of the lumbar sacral spine (Brunner, 1999).

Causes

• Changes in posture usually because primary and secondary trauma. Primary trauma such as : Trauma spontaneously, for example accidents. Secondary trauma such as : HNP, osteoporosis, spondylitis, spinal stenosis, spondylitis, osteoarthritis.
• Lumbosacral ligament instability and muscle weakness.
• Procedures degeneration in elderly patients.
• The use of heels that are too high.
• Obesity.
• Lifting weights the wrong way.
• Sprain.
• Prolonged exposure to vibration.
• Gait.
• Smoking.
• Sitting too long.
• Less exercise (by sport).
• Depression / stress.
• Sports (golp, tennis, soccer).

Risk Factors of Low Back Pain

Physiological risk factors.

• Age ( 20-50 years ).
• Lack of physical exercise.
• Less anatomical postures.
• Obesity.
• Severe scoliosis.
• HNP.
• Spondylitis.
• Spinal stenosis (narrowing of the spine).
• Osteoporosis.
• Smoking.

Environment risk factors .

• Sitting too long.
• Prolonged exposure to vibration.
• Sprains or twisted.
• Sports ( golf, tennis, gymnastic, and football).
• Vibration old.

Psychosocial risk factors.

• Inconvenience of work.
• Depression.
• Stress.

Clinical Manifestations

Changes in gait.

• Walking stiff.
• No bias play back.
• Lame.

Innervation

• When tested with a light and a touch of the pin, the patient felt a sensation on both limbs, but having a stronger sensation in areas that are not stimulated.
• Uncontrolled defecation and urination.

Pain.

• Acute and chronic back pain for more than two months.
• Pain when walking with the heel.
• Pain in the muscles.
• Lower back pain gets spread legs.
• Painful heat on the back of the thigh or calf.
• Severe pain in the feet increases.

Nursing Care Plan for Lower Back Pain

Nursing Diagnosis : Disturbed Sleep Pattern related to pain, discomfort

Defining characteristics :

• Patients appear to endure pain ( moaning, grinning )
• Patients express can not sleep because of pain .

Goal : sleep needs can be met.

Outcomes :

Sleep

• The amount of time to sleep enough.
• Normal sleep patterns.
• Enough quality sleep.
• Sleep on a regular basis.
• Not often awakened.
• Vital signs within normal limits.

Rest

• Adequate rest.
• The quality of a good rest.
• Enough physical rest.
• Enough psychic rest.

Anxiety control

• Adequate sleep.
• There is no physical manifestation.
• No behavioral manifestations.
• Seeking information to reduce anxiety.
• Using relaxation techniques to reduce anxiety.
• Interact socially.

Interventions for Lower Back Pain

Improved sleep / Sleep Enhancement

1. Assess patterns of sleep / activity patterns.
2. Encourage clients to sleep on a regular basis.
3. Explain the importance of adequate sleep during illness and treatment.
4. Monitor sleep patterns and note the physical, psychosocial disrupt sleep.
5. Discuss on the client and family about the technical improvement of sleep patterns.

Environmental management

1. Limit visitors.
2. Take care of the noisy environment.
3. No nursing action when clients sleep.

Anxiety Reduction

1. Explain all procedures including the feelings that may be experienced while undergoing the procedure.
2. Give the object that can provide a sense of security.
3. Speaking slowly and calmly.
4. Build a trusting relationship.
5. Listen attentively clients.
6. Create an atmosphere of mutual trust.
7. Encourage parents to express feelings, perceptions and anxiety verbally.
8. Provide equipment / entertaining activities to reduce tension.
9. Suggest to use relaxation techniques.
10. Provide a quiet environment.
11. Limit visitors.

Signs and Symptoms of Alzheimer's Disease

Mild Alzheimer's disease

As the disease progresses, memory loss worsens, and changes in other cognitive abilities are evident. Problems can include:
getting lost
trouble handling money and paying bills
repeating questions
taking longer to complete normal daily tasks
poor judgment
losing things or misplacing them in odd places
mood and personality changes

Moderate Alzheimer's disease

Symptoms may include:
increased memory loss and confusion, problems recognizing family and friends, inability to learn new things, difficulty carrying out tasks that involve multiple steps (such as getting dressed), problems coping with new situations, hallucinations, delusions, and paranoia, impulsive behavior

Severe Alzheimer's disease

Their symptoms often include:
inability to communicate, weight loss, seizures, skin infections, difficulty swallowing, groaning, moaning, or grunting, increased sleeping, lack of control of bowel and bladd


Nursing Diagnosis for Alzheimer's Disease: Disturbed Sleep Pattern related to changes in the sensory.
Nursing Care Plan for Alzheimer's Disease

Purpose:

Having given nursing care, the client is expected to change in sleep patterns can be resolved
the expected outcomes:
No changes in the behavior and appearance (agitated), Being able to create adequate sleep patterns with a decrease of the mind hovering (daydreaming), Being able to determine the cause of inadequate sleep.

Nursing Interventions:

1. Provide a comfortable environment for improving sleep (turn off the light, adequate ventilation, appropriate temperature. Avoiding noise)

2. Encourage exercise during the day and lower mental activity / physical in the afternoon.

3. Give the afternoon snack, warm milk, bath, and massage back.

4. Decrease the number of drinks the afternoon. Perform voiding before bed.

5. Encourage clients to listen to music.



1. Cortical inhibition in the reticular information will be reduced during sleep, improving automatic response, thereby increasing cardiovascular response to noise during sleep.

2. Physical activity and mental fatigue that can lead to long increase confusion, programmed activities without excessive stimulation increased sleep time.

3. Increase relaxation with drowsiness.

4. Reduce the need for up to urinate during the night.

5. Lowering the sensory stimulation by blocking other sounds from the environment around that will inhibit sleep.