Viber In community health nursing, the family will be the considered as a client aside from individual clients in the family.
Posted by JefFrey Lopez on Saturday, March 12, Assessment Before surgery, the nurse must evaluate the neurovascular and functional status of the extremity through history and physical assessment.
If the patient has experienced a traumatic amputation, the nurse assesses the function and condition of the residual limb. The nurse also assesses Family nursing care plan circulatory status and function of the unaffected extremity. If infection or gangrene develops, the patient may have associated enlarged lymph nodes, fever, and purulent drainage A culture is taken to determine the appropriate antibiotic therapy.
For wound healing, a balanced diet with adequate protein and vitamins is essential. Any concurrent health problems eg, dehydration, anemia, cardiac insufficiency, chronic respiratory problems, diabetes mellitus need to be identified and treated so that the patient is in the best possible condition to withstand the trauma of surgery.
The use of corticosteroids, anticoagulants, vasoconstrictors, or vasodilators may influence management and wound healing. Grief response to a permanent alteration in body image is normal.
An adequate support system and professional counseling can help the patient cope in the aftermath of amputation surgery. Pain may be incisional or may be caused by inflammation, infection, pressure on a bony prominence, or hematoma.
The pain may be an expression of grief and alteration of body image. It occurs more frequently may in above-knee amputations. The patient describes pain or unusual sensations, such as numbness, tingling, or muscle cramps, as well as a feeling that the extremity is present, crushed, cramped or twisted in an abnormal position.
When a patient describes phantom pains or sensations, the nurse acknowledges these feelings and helps the patient modify these perceptions. The nurse who has established a trusting relationship with the patient is better able to communicate acceptance of the patient who has experienced an amputation.
The nurse assists the patient to regain the previous level of independent functioning. The patient who is accepted as a whole person is more readily able to resume responsibility for self-care; self-concept improves, and body-image changes are accepted. Even with highly motivated patients, this process may take months.
Abduction, external rotation, and flexion of the lower extremity are avoided. The foot of the bed is raised to elevate the residual limb. They participate, as appropriate, in skin care and residual limb care and in the management of the prosthesis The patient receives ongoing instructions and practice sessions in learning how to transfer and how to use mobility aids and other assistive devices safely.
Continuing Care in the Home and Community After the patient has achieved physiologic homeostasis and has demonstrated achievement of major health care goals, rehabilitation continues either in a rehabilitation facility or at home Continued support and supervision by the home care nurse are essential.
An overnight or weekend experience at home may be tried to identify problems that were not identified on the assessment visit.
Physical therapy and occupational therapy may continue in the home or on an outpatient basis. Transportation to continuing health care appointments must be arranged. The social service department of the hospital or the community agency managing continued health care may be of great assistance in securing personal assistance and transportation services.
Periodic preventive health assessments are necessary. Frequently, an elderly spouse is unable to provide the assistance required, and additional help at home is needed. Modifications in the plan of care are made on the basis of such findings. Often, the patient and family find involvement in an amputee support group to be of value; here, they are able to share problems, solutions, and resources.
Talking with those who have successfully dealt with a similar problem may help the patient develop a satisfactory solution. Because patients and their family members and health care providers tend to focus on the most obvious needs and issues, the nurse reminds the patient and family about the importance of continuing health promotion and screening practices, such as regular physical examinations and diagnostic screening tests.
Those patients who have not been involved in these practices in the past are instructed in their importance and are referred to appropriate health care providers.
Evaluation Expected patient outcomes may include: Experiences absence of pain a. Uses measures to increase comfort 2. Experiences absence of phantom limb pain a.
Reports diminished phantom sensations b. Uses distraction techniques c. Performs stump desensitization massage 3.
Achieves wound healing a. Controls residual limb edema b. Achieves healed, nontender, nonadherent scar c. Demonstrates residual limb care 4.As a critical care nurse my role is to monitor, maintain, plan, implement, and evaluate for my patient.
My role has made me confident in many areas, including critical thinking, making specific judgment, organization, and prioritizing based on the patient's needs. OUTCOME: Caregiver-Patient Relationship Major Interventions Suggested Interventions Optional Interventions; Caregiver Support; Conflict Mediation; Emotional Support; Family Integrity Promotion.
Presented by Group #3 Family Nursing Care Plan (Part 2) Garbage Disposal and Sanitation: Waste baskets are present in the house where trash is placed into. Nursing care plan for Hypertension, Nursing care plan for Diabetes Mellitus, Nursing care plan Myocardial Infarction (MI), Nursing care plan Tuberculosis (TB), Nursing Management for Hypovolemic Shock, Nursing Management for Fracture, Nursing Management of the Patient with Sepsis, etc.
Presented by Group #3 Family Nursing Care Plan (Part 3) •Ignorance of community resources for health care:The low receptiveness of our help is perhaps due to the fact that the mother only thought that we were there to conduct interviews.
THE NURSING CARE PLAN The family care plan – Family care plan is the blueprint of the care that the nurse designs to systematically minimize or eliminate the identified health and family nursing problems through explicitly formulated outcomes of care (goals and objectives) and deliberately chosen of interventions, resources and evaluation.