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NURSING CARE PLAN FOR DIABETIC GANGRENE

Gangrene is a serious and potentially life-threatening condition that arises when a considerable mass of body tissue dies (necrosis). This may occur after an injury or infection, or in people suffering from any chronic health problem affecting blood circulation. The primary cause of gangrene is reduced blood supply to the affected tissues, which results in cell death. Diabetes and long-term smoking increase the risk of suffering from gangrene.

There are different types of gangrene with different symptoms, such as dry gangrene, wet gangrene, gas gangrene, internal gangrene and necrotising fasciitis. Treatment options include debridement (or, in severe cases, amputation) of the affected body parts, antibiotics, vascular surgery, maggot therapy or hyperbaric oxygen therapy.


Nursing Care Plan for Diabetic Gangrene

Nursing diagnosis that appear in diabetic foot gangrene patients are as follows:

Impaired tissue perfusion related to the weakening / decreased blood flow to the area of ​​gangrene due to obstruction of blood vessels.

Objective:

• Maintain peripheral circulation remain normal.

Results Criteria:

• Palpable peripheral pulses were strong and regular
• The color of the skin around the wound is pale / cyanotic
• The skin around the wound felt warm.
• Edema does not occur and injuries from getting worse.
• Improved sensory and motor

Nursing Interventions for Diabetic Gangrene

• Teach the patient to mobilize
  Rational: the mobilization improves blood circulation.
• Teach about the factors that can increase blood flow:
  Elevate the legs slightly lower than the heart (elevation position at rest), avoid tight bandage, avoid using a pillow, behind the knees and so on.
  Rational: to increase blood flow through so that does not happen edema.
• Teach about the modification of risk factors such as:
  Avoid high-cholesterol diet, relaxation techniques, stop smoking, and drug use vasoconstriction.
  Rationale: High cholesterol can accelerate the occurrence of atherosclerosis, smoking can cause vasoconstriction of blood vessels, relaxation to reduce the effects of stress.
• Cooperation with other health team in the provision of vasodilators, regular blood sugar checks and oxygen therapy (HBO).
  Rational: vasodilator administration will increase the dilation of blood vessels so that tissue perfusion can be improved, while the regular blood sugar checks can be up to date and state of the patient, to improve the oxygenation of the HBO ulcer / gangrene.

NURSING CARE PLAN FOR NON-HODGKIN'S LYMPHOMA

Non-Hodgkin's lymphoma

Non-Hodgkin's lymphoma is cancer of the lymphoid tissue, which includes the lymph nodes, spleen, and other organs of the immune system.

Causes

White blood cells called lymphocytes are found in lymph tissues. They help prevent infections. Most lymphomas start in a type of white blood cells called B lymphocytes, or B cells.
For most patients, the cause of this cancer is unknown. However, lymphomas may develop in people with weakened immune systems. For example, the risk of lymphoma increases after an organ transplant or in people with HIV infection.

There are many different types of non-Hodgkin's lymphoma. It is classified according to how fast the cancer spreads.

• The cancer may be low grade (slow growing), intermediate grade, or high grade (fast growing). Burkitt's tumor is an example of a high-grade lymphoma. Follicular lymphoma is a low-grade lymphoma
• The cancer is further sub-classified by how the cells look under the microscope, for example, if there are certain proteins or genetic markers present.

According to the American Cancer Society, a person has a 1 in 50 chance of developing non-Hodgkin's lymphoma. Most of the time, this cancer affects adults. However, children can get some forms of lymphoma. High-risk groups include those who have received an organ transplant or who have a weakened immune system.
This type of cancer is slightly more common in men than in women.

Signs and symptoms of NHL include the following:

• Swollen, painless lymph nodes in the neck, armpits, or groin
• Unexplained weight loss
• Fever
• Night sweats
• Coughing, trouble breathing, or chest pain
• Weakness and tiredness that don't go away (fatigue)
• Abdominal pain or swelling, or a feeling of fullness in the abdomen
• Itching of the skin

Treatment
Treatment depends on:

• The type of lymphoma
• The stage of the cancer when you are first diagnosed
• Your age and overall health
• Symptoms, including weight loss, fever, and night sweats
• Radiation therapy may be used for disease that is confined to one body area.

Chemotherapy is the main type of treatment. Most often,multiple different drugs are used in combination together.

Another drug, called rituximab (Rituxan), is often used to treat B-cell non-Hodgkin's lymphoma.

Radioimmunotherapy may be used in some cases. This involves linking a radioactive substance to an antibody that targets the cancerous cells and injecting the substance into the body.

People with lymphoma that returns after treatment or does not respond to treatment may receive high-dose chemotherapy followed by an autologous bone marrow transplant (using stem cells from yourself).

Additional treatments depend on other symptoms. They may include:

• Transfusion of blood products, such as platelets or red blood cells
• Antibiotics to fight infection, especially if a fever occurs

Nursing Care Plan for Non-Hodgkin's Lymphoma

Priority Nursing

• Providing physical and psychological support for diagnostic tests and treatment programs.
• Preventing complications
• Eliminate pain
• Provides information about the disease / prognosis and treatment needs

Purpose

• Complications prevented / decreased
• Receive real situation.
• Pain relief / control
• The disease process / prognosis, possible complications and treatment programs understand.

Nursing Diagnosis Nursing Care Plan for Non-Hodgkin's Lymphoma 

• Ineffective Breathing Pattern
• Ineffective Airway Clearance

Risk factors include
Tracheobronchial obstruction, mediastinal node enlargement or edema and airway path (Hodgkin's and non-Hodgkin's), superior vena cava syndrome (non-Hodgkin's)

Possible evidenced by
(not applicable, the existence of signs and symptoms make the actual diagnosis)

Expected Result / Patient Evaluation Criteria will
Maintaining Normal Breathing Pattern / Effective Free Dyspnea, cyanosis or Signs Other Respiratory distress

NURSING CARE PLAN FOR CONGESTIVE HEART FAILURE

Heart failure (HF) often called congestive heart failure (CHF) is generally defined as the inability of the heart to supply sufficient blood flow to meet the needs of the body. Heart failure can cause a number of symptoms including shortness of breath, leg swelling, and exercise intolerance. The condition is diagnosed with echocardiography and blood tests. Treatment commonly consists of lifestyle measures (such as smoking cessation, light exercise including breathing protocols, decreased salt intake and other dietary changes) and medications, and sometimes devices or even surgery.

Common causes of heart failure include myocardial infarction and other forms of ischemic heart disease, hypertension, valvular heart disease, and cardiomyopathy. The term "heart failure" is sometimes incorrectly used to describe other cardiac-related illnesses, such as myocardial infarction (heart attack) or cardiac arrest, which can cause heart failure but are not equivalent to heart failure.

The symptoms of congestive heart failure vary among individuals according to the particular organ systems involved and depending on the degree to which the rest of the body has "compensated" for the heart muscle weakness.

• An early symptom of congestive heart failure is fatigue. While fatigue is a sensitive indicator of possible underlying congestive heart failure, it is obviously a nonspecific symptom that may be caused by many other conditions. The person's ability to exercise may also diminish. Patients may not even sense this decrease and they may subconsciously reduce their activities to accommodate this limitation.
• As the body becomes overloaded with fluid from congestive heart failure, swelling (edema) of the ankles and legs or abdomen may be noticed. This can be referred to as "right sided heart failure" as failure of the right sided heart chambers to pump venous blood to the lungs to acquire oxygen results in buildup of this fluid in gravity-dependent areas such as in the legs. The most common cause of this is longstanding failure of the left heart, which may lead to secondary failure of the right heart. Right-sided heart failure can also be caused by severe lung disease (referred to as "cor pulmonale"), or by intrinsic disease of the right heart muscle (less common)
• In addition, fluid may accumulate in the lungs, thereby causing shortness of breath, particularly during exercise and when lying flat. In some instances, patients are awakened at night, gasping for air.
• Some may be unable to sleep unless sitting upright.
• The extra fluid in the body may cause increased urination, particularly at night.
• Accumulation of fluid in the liver and intestines may cause nausea, abdominal pain, and decreased appetite.

Nursing Assessment for Congestive Heart Failure

a. Identity

b. Food or liquid
Symptoms:

• Loss of appetite
• Nausea and vomiting
• Swelling of the extremities
• Diit high salt or fat, sugar and caffeine

c. Elimination
Symptoms:

• Decreased urination, dark urine
• Urination at night
• Diarrhea or constipation

d. Activity / rest
Symptoms:

• Fatigue or tiredness constantly throughout the day
• Insomnia
• Chest pain with activity

e. Circulation
Symptoms:

• History of hypertension
• Cardiac surgery
• Anemia
• Endocarditis

f. Ego integrity
Symptoms:

• Anxiety, worry and fear
• Stress-related illnesses

g. Comfort
Symptoms:

• Chest pain, acute or chronic angina
• Muscle pain

h. Respiratory
Symptoms:

• Dyspnea on exertion, while sitting or sleeping with multiple pillows

i. Social interaction
Symptoms:

• Decreased participation in usual social activities

j. Security
Symptoms:

• Changes in mental function
• Loss of strength or muscle tone
• skin blisters

Nursing Diagnosis for Congestive Heart Failure

Decreased cardiac output related to

• Changes in myocardial contractility or inotropic changes.
• Changes in frequency, rhythm, cardiac conduction.
• Structural changes. (eg, valve abnormalities, ventricular aneurysm)

Activity intolerance related to

• Weakness, fatigue.
• Changes in vital signs, presence of dysritmia.
• Dyspnea.
• Pale.
• Sweating.

Excess fluid volume related to

• The decline in glomerular filtration rate (decrease in cardiac output) or increased production of ADH and sodium and water retention.

Risk for impaired skin integrity related to

• Bed rest.
• Edema, decreased tissue perfusion.

NURSING CARE PLAN FOR CATARACT

A cataract is a clouding of the lens in your eye. It affects your vision. Cataracts are very common in older people. By age 80, more than half of all people in the United States either have a cataract or have had cataract surgery.

Common symptoms are

• Blurry vision
• Colors that seem faded
• Glare
• Not being able to see well at night
• Double vision
• Frequent prescription changes in your eye wear

Cataracts usually develop slowly. New glasses, brighter lighting, anti-glare sunglasses or magnifying lenses can help at first. Surgery is also an option. It involves removing the cloudy lens and replacing it with an artificial lens. Wearing sunglasses and a hat with a brim to block ultraviolet sunlight may help to delay cataracts.

NIH: National Eye Institute

Cataract Symptoms

Having cataracts is often compared to looking through a foggy windshield of a car or through the dirty lens of a camera. Cataracts may cause a variety of complaints and visual changes, including blurred vision, difficulty with glare (often with bright sun or automobile headlights while driving at night), dulled color vision, increased nearsightedness accompanied by frequent changes in eyeglass prescription, and occasionally double vision in one eye. Some people notice a phenomenon called "second sight" in which one's reading vision improves as a result of their increased nearsightedness from swelling of the cataract. A change in glasses may help initially once vision begins to change from cataracts; however, as cataracts continue to progress and opacify, vision becomes cloudy and stronger glasses or contact lenses will no longer improve sight.

Cataracts are usually gradual and usually not painful or associated with any eye redness or other symptoms unless they become extremely advanced. Rapid and/or painful changes in vision are suspicious for other eye diseases and should be evaluated by an eye-care professional.

Cataract Exams and Tests

To detect a cataract, the eye-care provider examines your lens. A comprehensive eye examination usually includes the following:

• Visual acuity test: An eye chart test is used to measure your reading and distance vision.
• Refraction: Your eye doctor should determine if glasses would improve your vision.
• Glare testing: Vision may be significantly altered in certain lighting conditions and normal in others; in these circumstances, your doctor may check your glare symptoms with a variety of different potential lighting sources.
• Potential acuity testing: This helps the ophthalmologist get an idea of what your vision would be like after removal of the cataract. Think of this as the eye's vision potential if the cataract was not present.
• Contrast sensitivity testing: This checks for your ability to differentiate different shades of gray, which is often this limited by cataracts.
• Tonometry: a standard test to measure fluid pressure inside the eye (Increased pressure may be a sign of glaucoma.)
• Pupil dilation: The pupil is enlarged with eye drops so that the ophthalmologist can further examine the lens and retina. This is important to determine if there are other conditions which may ultimately limit your vision besides cataracts.

Source : http://www.emedicinehealth.com/cataracts/page6_em.htm#Exams and Tests

Nursing Care Plan for Cataract

Data Analysis

1. Objective data: patient's eye's lens appears cloudy. Both pupils appear to look gray.

Subjective data: patients complaining blurred vision / dim and decreased visual acuity and glare, the patient is difficult to see at night.

Changes in sensory reception or sense organ of vision status.

Impaired sensory perception (visual)

2. Objective data: patient looks anxious.

Subjective data: the patient says with a nervous illness.

Changes in health status.

Anxiety

3. Objective data: -

Subjective data: patient revealed not know much about the illness.

Not familiar with information sources

Lack of knowledge.

4. Objective data: patients seem to lack confidence

Subjective data: the patient says embarrassed by the disease

Impaired self-image

Low self esteem

Nursing Diagnosis for Cataract

1. Impaired sensory perception (visual) related to Changes in sensory reception or sense organ of vision status.

2. Anxiety related to changes in health status.

3. Lack of knowledge related to Not familiar with the sources of information.

4. Low self esteem, related to, Impaired self-image

NURSING CARE PLAN FOR THYROID CANCER

Thyroid cancer is a disease in which malignant (cancer) cells form in the tissues of the thyroid gland.

The thyroid is a gland at the base of the throat near the trachea (windpipe). It is shaped like a butterfly, with a right lobe and a left lobe. The isthmus, a thin piece of tissue, connects the two lobes. A healthy thyroid is a little larger than a quarter. It usually cannot be felt through the skin. The thyroid uses iodine, a mineral found in some foods and in iodized salt, to help make several hormones. Thyroid hormones do the following:

• Control heart rate, body temperature, and how quickly food is changed into energy (metabolism).
• Control the amount of calcium in the blood.

There are four main types of thyroid cancer:

• Papillary thyroid cancer: The most common type of thyroid cancer.
• Follicular thyroid cancer. Hürthle cell carcinoma is a form of follicular thyroid cancer and is treated the same way.
• Medullary thyroid cancer.
• Anaplastic thyroid cancer.

Possible signs of thyroid cancer include a swelling or lump in the neck.

Thyroid cancer may not cause early symptoms. It is sometimes found during a routine physical exam. Symptoms may occur as the tumor gets bigger. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur:

• A lump in the neck.
• Trouble breathing.
• Trouble swallowing.
• Hoarseness

How To Search Files On Filestube

Finding a file hosted on a particular filehosting site like rapidshare,mediafire,megaupload,depositfiles or any other filehosting site can be difficult job.But now it is possible to find almost anything on any of these filehosting sites.All you need to do is just enter the name of the file,movie,game,software and press enter and most probably you will get the file.Moreover you will also have the option to find the file on a particular filehosting like mediafire or rapidshare or whichever you prefer.

I would like to keep this tutorial very short and we will be finding winrar on mediafire in this tutorial.

Here is the tutorial on How To Search Files On Any Filesharing Server

1. Goto filestube.com                   

Enter the name of the file you want(In this case winrar)

Click on More in the left side.

 Select mediafire.Now you will get all files on mediafire.

Click on the link that is most appropriate

 Now click on download to go to the mediafire server for downloading.