Primary Nursing Diagnosis

Altered tissue perfusion (cardiopulmonary, cerebral, peripheral, renal) related to arterial vasospasm and obstruction to flow OUTCOMES. Vital signs status Urinary elimination Fluid balance Neurological status Coagulation status Tissue perfusion Abdominal organs Fetal status Intrapartum INTERVENTIONS. Fluid monitoring Fluid electrolyte management Seizure precautions Medication administration Vital signs monitoring Fluid management Bedside laboratory testing Electronic fetal monitoring H PLANNING...

Info

SURGICAL Vein Ligation and Stripping Varicose veins (varicosities) are abnormally dilated tortuous veins. They occur most often in the lower extremities but can appear anywhere in the body. Primary varicosities are caused by incompetent valves in the superficial saphenous veins, whereas secondary varicosities are the result of impaired blood flow in the deep veins. Primary varicosities tend to occur in both legs, whereas secondary varicosities usually occur in only one leg. In a ladder-like...

Genetic Considerations

Breast cancer is a feature of several cancer syndromes including Cowden syndrome, Li-Fraumeni syndrome, Peutz-Jeghers syndrome, Bloom syndrome, Werner syndrome, ataxia-telangiectasia, and xeroderma pigmentosum, but these account for less than 1 of all breast cancers. More familiar to most people are the nonsyndromic breast cancer susceptibility genes, which account for 5 to 10 of breast cancer cases. The two most widely known genes are BRCA1 and BRCA2, both tumor suppressor genes. Lifetime risk...

Gender Ethnicracial And Life Span Considerations

Approximately one to two out of four patients with allergic purpura have GU symptoms such as dysuria and hematuria. Other symptoms include headaches fever peripheral edema and skin lesions accompanied by pruritus, paresthesia, and angioedema (swelling of the skin, mucous membranes, or organs). Other patients describe severe GI symptoms (spasm, colic, constipation, bloody vomitus, bloody stools) and joint pain. PHYSICAL EXAMINATION. Inspect the patient's skin for the typical skin...

DescriptionSurgical Major Chest Procedures

Rate remains approximately 41 , and the 5-year survival rate is 15 . Only 16 of lung cancers are found at an early, localized stage, when the 5-year survival rate is 49 . The survival rate for lung cancer has not improved over the last 10 years. There are two major types of lung cancer small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). Sometimes a lung cancer shows characteristics of both types and is labeled small cell large cell carcinoma. Both types have the capacity to...

Alcohol Withdrawal DRG cew 434

Description MEDICAL Alcohol or Drug Abuse or Dependence, Detoxification, or Other Symptoms Treated with CC ithdrawal is a pattern of physiological responses to the discontinuation of a drug. Although most central nervous system (CNS) depressants produce similar responses, alcohol is the only one in which withdrawal is life threatening, with a mortality rate of about 25 . Withdrawal symptoms should be anticipated with any patient who has been drinking the alcohol equivalent of a six-pack of beer...

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...

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...

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...

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...

Description Medical Cardiac Arrhythmias and

Cardiac rhythms that are generated from the area around the atrioventricular AV junction node are termed junctional dysrhythmias. For a variety of reasons, the area that surrounds the AV node may generate impulses and become the cardiac pacemaker. Impulses produced in the junction do not necessarily result in an atrial contraction that precedes the ventricular contraction. This lack of coordination leads to a loss of ventricular filling during the last part of diastole this loss of what is...

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...

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...

Causes

Graves' disease has an autoimmune derivation and is caused by circulating anti-TSH autoanti-bodies that displace TSH from the thyroid receptors and mimic TSH by activating the TSH receptor to release additional thyroid hormones. Graves' disease is also associated with Hashimoto's disease, a chronic inflammation of the thyroid gland that usually causes hypothyroidism but can also cause symptoms similar to those of Graves' disease. Thyrotoxicosis has several different pathophysiological causes,...