HyperglycemiaDRG CategoT 463

Mean LOS 4.5 days Description MEDICAL Signs and Symptoms with CC I I yperglycemia exists when the blood glucose level is greater than 110 mg dL. Normal blood glucose levels can be maintained between 70 and 110 mg dL when there is an adequate balance between insulin supply and demand. In acutely ill individuals, hyperglycemia is usually not diagnosed until a random test of serum glucose level shows an increase above the 150 to 200 mg dL range. Glucose is the most important carbohydrate in body...

Primary Nursing Diagnosis

Risk for infection related to urinary stasis and instrumentation OUTCOMES. Knowledge Infection control Risk control Risk detection Nutritional status Tissue integrity Skin and mucous membranes Treatment behavior Illness or injury INTERVENTIONS. Infection control Tube care Urinary Infection protection Surveillance Nutritional management Medication management Teaching Disease process U PLANNING AND IMPLEMENTATION Collaborative Temporary urinary drainage may be achieved by a nephrostomy or...

Acidbase Disorder Common Causes

Metabolic acidosis Decreased acid excretion chronic renal disease results in decreased acid excretion and is the most common cause of chronic metabolic acidosis Excessive acid production oxygen tissue deprivation with shock and cardiopulmonary arrest, vigorous exercise (transient), prolonged periods of fever, ketoacidosis in insulin-dependent diabetics, alcoholic ketoacidosis, and ingestion of drugs and chemicals (methanol, ethylene glycol, aspirin) Underproduction of bicarbonate pancreatitis...

Description Medical Coagulation Disorders

I diopathic thrombocytopenia purpura (ITP) is an acquired hemorrhagic disorder that is characterized by an increased destruction of platelets because of antiplatelet antibodies. The antibodies attach to the platelets, reduce their life span, and lead to a platelet count below 100,000 mm3 but occasionally as low as 5000 mm3. ITP can be divided into two categories acute and chronic. Acute ITP is generally a self-limiting childhood disorder, whereas chronic ITP predominantly affects adults and is...

Surgical Liver Transplant

Cirrhosis is a chronic liver disease that is characterized by destruction of the functional liver cells, which leads to cellular death. Cirrhosis along with other chronic liver diseases result in up to 35,000 deaths each year in the United States and is the ninth leading cause of death. In cirrhosis, the damaged liver cells regenerate as fibrotic areas instead of functional cells, causing alterations in liver structure, function, blood circulation, and lymph damage. The major cellular changes...

BOX 1 Bleeding Esophageal Varices

Esophageal varices (fragile, distended, and thin-walled veins in the esophagus) occur in patients with liver failure because of portal hypertension. Obstructed blood circulates to low-resistance alternate vessels around the portal circulation in the liver, which is a high-pressure system. One of these routes is through the esophageal veins, which become distended with blood, irritated from pressure, and susceptible to rupture. Treatment of esophageal varices includes Surgery Procedures include...

Causes

The causes of GERD are not well understood. Many patients with GERD have normal resting LES pressure and produce normal amounts of gastric acid. Possible explanations for GERD include delays in gastric emptying, changes in LES control with aging, and obesity. Environmental and physical factors that lower tone and contractility of the LES include diet (fatty foods, peppermint, alcohol, caffeine, chocolate) and drugs (nicotine, beta-adrenergic blockers, nitrates, theophylline, anticholinergic...

Migraine Headache DRG CategT 025

Mean LOS 3.3 days Description MEDICAL Seizure and Headache Age > 17 without CC M igraine headache is a primary headache syndrome that is an episodic vascular disorder with or without a common aura. Approximately 23 million people have migraine headaches in the United States. A migraine headache is a prototype of a vascular headache, which involves vasodilation and localized inflammation. Ultimately, arteries are sensitized to pain. Cerebral blood flow is diminished before the onset of the...

Anorexia Nervosa DRG Categr 428

Mean LOS 5.7 days Description MEDICAL Disorders of Personality and Impulse Control Anorexia nervosa is an eating disorder of complex and life-threatening proportions. It is an illness of starvation that is brought on by a severe disturbance of body image and a morbid fear of obesity. One in 250 adolescents are affected, and tragically, about 5 of those affected die. Anorexia nervosa is characterized by a person's refusal to maintain a minimally normal body weight for her or his height and age....

Gastroesophageal Reflux Disease GERD

DRG Category Mean LOS Description DRG Category Mean LOS Description MEDICAL Esophagitis, Gastroenteritis, and Miscellaneous Digestive Disorders Age > 17 without CC 155 SURGICAL Stomach, Esophageal, and Duodendal Procedures Age > 17 without CC Gastroesophageal reflux disease (GERD) is a syndrome that is caused by esophageal reflux, or the backward flow of gastroesophageal contents into the esophagus. Approximately 7 of the U.S. population has symptoms of heartburn each day. GERD occurs...

Nephrotic Syndrome

Patients may report no illness before the onset of symptoms others have a history of systemic multisystem disease, such as lupus erythematosus, diabetes mellitus, amyloidosis, or multiple myeloma or have a history of an insect sting or venomous animal bite. Symptoms usually appear insidiously and may include lethargy, depression, and weight gain. The patient may describe gastrointestinal (GI) symptoms of nausea, anorexia, and diarrhea. Initially, patients report periorbital edema in...

Gallbladder and Biliary Duct Biliary System Cancer

DRG Category 197 Mean LOS 8.1 days Description SURGICAL Cholecystectomy except by Laparoscope without C.D.E. with CC Description SURGICAL Cholecystectomy with Gallbladder cancer and biliary duct cancer are relatively rare and account for fewer than 1 of all cancers. In 2005, over 3200 cases will be diagnosed and almost 2000 people will die of this cancer. Gallbladder cancer occurs five times more often in Native Americans than in whites and is more common in white females than in African...

DRG Category 182 Mean LOS 43 days Description Medical Esophagitis

Gastrointestinal and Miscellaneous Digestive Disorders, Age > 17 without CC I rritable bowel syndrome (IBS), sometimes called spastic colon, is the most common digestive disorder in the United States. with a prevalence as high as 10 to 20 in the population. It is a poorly understood syndrome of diarrhea, constipation, flatus, and abdominal pain that causes a great deal of stress and embarrassment to its victims. People often suffer with it for years before seeking medical attention. Although...

Cholecystitis and Cholelithiasis

DRG Category 493 Mean LOS 4.3 days Description SURGICAL Laparoscopic Cholecystectomy without C.D.E. with CC DRG Category 195 Mean LOS 9.7 days Description SURGICAL Cholecystectomy with C.D.E. with CC Cholecystitis is an inflammation of the gallbladder wall it may be either acute or chronic. It is almost always associated with cholelithiasis, or gallstones, which lodge in the gallbladder, cystic duct, or common bile duct. Silent gallstones are so common that most of the American public may have...

Assessment

Ask about the last menstrual period to determine the estimated date of delivery and the gestational age of the fetus. Inquire about any past history of vaginal infections or STIs. Question the patient as to the presence of any perineal pain, burning, malaise, or chills. Ask the patient if she is feeling contractions or if she has noted any leakage of the amniotic fluid. If the amniotic sac has ruptured, determine the time it occurred, the color of the fluid, and if the patient noted...

Gender Ethnicracial And Life Span Considerations

Osteoporosis is the twelfth leading cause of death in the United States and accounts for more than 6 billion in health-related costs each year. More than 1.5 million fractures per year occur in persons over age 45. The incidence in women is five times greater than in men, and approximately 50 of all women over age 65 have symptomatic osteoporosis. Whites and Asian Americans have a higher prevalence of osteoporosis than other groups. Two types of primary osteoporosis have been identified....

Discharge And Home Healthcare Guidelines

Patient teaching is individualized, but for most patients it includes information about each of the following. WOUND MANAGEMENT. This includes infection control, basic cleanliness, and wound management. SCAR MANAGEMENT. Functional abilities, including using pressure garments, exercises, and activities of daily living, must be assessed and taught. NUTRITION. Nutritional guidelines are provided that maintain continued healing and respond to the metabolic demands that frequently last for some time...

Primary Postoperative Nursing Diagnosis

Risk for infection related to the surgical incision OUTCOMES. Immune status Knowledge Infection control Risk control Risk detection Tissue integrity Skin Nutritional status INTERVENTIONS. Infection control Infection protection Medication prescribing Surveillance Wound care Nutritional management Fluid electrolyte management U PLANNING AND IMPLEMENTATION Collaborative SURGICAL. An appendectomy surgical removal of the appendix is the preferred method of management for acute appendicitis if the...