Archive for December, 2009

IMPLEMENTATION AND EVALUATION IN NURSING CARE

The fourth step in the nursing process is implementation. Implementation involves the execution of the nursing plan of care derived during the planning phase. It consists of performing nursing activities that have been planned to meet the goals set with the client. Nurses may delegate some of the nursing interventions to other persons assigned to care for the client—for example, the licensed practical nurses and unlicensed assistive personnel.
Implementation involves many skills. The nurse must continue to assess the client’s condition before, during, and after the nursing intervention. Assessment prior to the intervention provides the nurse with baseline data. Assessment during and after the intervention allows the nurse to detect positive or negative responses the client may have to the intervention. If negative responses occur during the procedure, the nurse must take appropriate action. If positive responses occur, the nurse adds this information to the database for use in evaluating the efficacy of the intervention. The nurse must also possess psychomotor skills, interpersonal skills, and critical thinking skills to perform the nursing interventions that have been planned. The nurse uses psychomotor skills when performing procedures such as giving injections, changing dressings, and helping the client perform range-of-motion (ROM) exercises. Interpersonal skills are necessary as the nurse interacts with the client and the family to collect data, provide information in teaching sessions, and offer support in times of anxiety. Critical thinking skills enable the nurse to think through the situation, ask the appropriate questions, and make decisions about what needs to be done. The implementation step also involves reporting and documentation. Data to be recorded include the client condition prior to the intervention, the specific intervention performed, the client response to the intervention, and client outcomes. Read more…

ASUHAN KEPERAWATAN ANAK DENGAN DEMAM BERDARAH DENGUE

A. PENGERTIAN
DHF adalah suatu infeksi arbovirus akut yang masuk ke dalam tubuh melalui gigitan nyamuk spesies aides. Penyakit ini sering menyerang anak, remaja, dan dewasa yang ditandai dengan demam, nyeri otot dan sendi. Demam Berdarah Dengue sering disebut pula Dengue Haemoragic Fever ( DHF ).

B. PATOFISIOLOGI
Setelah virus dengue masuk ke dalam tubuh, pasien akan mengalami keluhan dan gejala karena viremia, seperti demam, sakit kepala, mual, nyeri otot, pegal seluruh badan, hiperemi ditenggorokan, timbulnya ruam dan kelainan yang mungkin muncul pada system retikuloendotelial seperti pembesaran kelenjar-kelenjar getah bening, hati dan limpa. Ruam pada DHF disebabkan karena kongesti pembuluh darah dibawah kulit.
Fenomena patofisiologi utama yang menentukan berat penyakit dan membedakan DF dan DHF ialah meningginya permeabilitas dinding kapiler karena pelepasan zat anafilaktosin, histamin dan serotonin serta aktivasi system kalikreain yang berakibat ekstravasasi cairan intravaskuler. Hal ini berakibat berkurangnya volume plama, terjadinya hipotensi, hemokonsentrasi, hipoproteinemia, efusi dan renjatan. Read more…

AGEISM—FACTS AND MYTHS OF AGING

When nursing students enter educational programs they are often asked with which populations they would like to work. Most students answer that they wish to work with children and babies. Some students respond that they would like to work in maternity. Very few (if any) students reply that they came to nursing school to work with older adults. In fact, the society that currently exists in the United States is extremely youth-oriented. This means that older adults are not always considered and respected for their unique needs and contributions to society. Beliefs about older adulthood in the United States are perpetuated by myths of aging. The following section reports on the top 10 myths of aging and discusses why they are untrue of today’s population of older adults. Read more…