ASUHAN KEPERAWATAN

Bronchopneumonia

Etymology: Gk, bronchos + pneumon, lung

an acute inflammation of the lungs and bronchioles, characterized by chills, fever, high pulse and respiratory rates, bronchial breathing, cough with purulent bloody sputum, severe chest pain, and abdominal distension. The disease is usually a result of the spread of infection from the upper to the lower respiratory tract, most common caused by the bacterium Mycoplasma pneumoniae, Staphylococcus pyogenes, or Streptococcus pneumoniae. Atypical forms of bronchopneumo

Hypertension

Hypertension, also referred to as high blood pressure, HTN or HPN, is a medical condition in which the blood pressure is chronically elevated. In current usage, the word "hypertension" without a qualifier normally refers to systemic, arterial hypertension.

Persistent hypertension is one of the risk factors for strokes, heart attacks, heart failure and arterial aneurysm, and is a leading cause of chronic renal failure. Even moderate elevation of arterial blood pressure leads to shortened life expectancy.(Wikipedia)

Definition

Chronic kidney disease (CKD) is a worldwide public health problem and is now recognized as a common condition that is associated with an increased risk of cardiovascular disease and chronic renal failure (CRF).

The Kidney Disease Outcomes Quality Initiative (K/DOQI) of the National Kidney Foundation (NKF) defines chronic kidney disease as either kidney damage or a decreased kidney glomerular filtration rate (GFR) of less than 60 mL/min/1.73 m² for 3 or more months. Whatever the underlying etiology, the destruction of renal mass with irreversible sclerosis and loss of nephrons leads to a progressive decline in GFR. The different stages of chronic kidney disease form a continuum in time; prior to February 2002, no uniform classification of the stages of chronic kidney disease existed. At that time, K/DOQI published a classification of the stages of chronic kidney disease, as follows:

• Stage 1: Kidney damage with normal or increased GFR (>90 mL/min/1.73 m²)
• Stage 2: Mild reduction in GFR (60-89 mL/min/1.73 m²)
• Stage 3: Moderate reduction in GFR (30-59 mL/min/1.73 m²)
• Stage 4: Severe reduction in GFR (15-29 mL/min/1.73 m²)
• Stage 5: Kidney failure (GFR less than 15 mL/min/1.73 m² or dialysis)

Source : http://emedicine.medscape.com



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Definition

Congestive heart failure (CHF) is generally classified as systolic or diastolic heart failure and becomes progressively more common with increasing age.

Systolic heart failure: The pumping action of the heart is reduced or weakened. A common clinical measurement is the ejection fraction (EF). The ejection fraction is a calculation of how much blood is ejected out of the left ventricle (stroke volume), divided by the maximum volume remaining in the left ventricle at the end of diastole or relaxation phase. A normal ejection fraction is greater than 50%. Systolic heart failure has a decreased ejection fraction of less than 50%.

Diastolic heart failure: The heart can contract normally but is stiff, or less compliant, when it is relaxing and filling with blood. This impedes blood filling into the heart and produces backup into the lungs and CHF symptoms. Diastolic heart failure is more common in patients older than 75 years, especially in women with high blood pressure. In diastolic heart failure, the ejection fraction is normal.

Source : http://www.emedicinehealth.com
Image : http://www.downloadheart.us



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Definition

Endocarditis is an inflammation of the inner layer of the heart, the endocardium. It usually involves the heart valves (native or prosthetic valves). Other structures which may be involved include the interventricular septum, the chordae tendineae, the mural endocardium, or even on intracardiac devices.

Endocarditis is characterized by a prototypic lesion, the vegetation, which is a mass of platelets, fibrin, microcolonies of microorganisms, and scant inflammatory cells. In the subacute form of infective endocarditis, the vegetation may also include a center of granulomatous tissue, which may fibrose or calcify.

There are multiple ways to classify endocarditis. The simplest classification is based on etiology: either infective or non-infective, depending on whether a microorganism is the source of the inflammation. Regardless, diagnosis of endocarditis is based on the clinical features, investigations such as echocardiogram, as well as any blood cultures demonstrating the presence of endocarditis-causing microorganisms.

From Wikipedia, the free encyclopedia
Image : http://medicastore.com



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Anemia

Definition

Anemia is a medical condition in which the red blood cell count or hemoglobin is less than normal. The normal level of hemoglobin is generally different in males and females. For men, anemia is typically defined as hemoglobin level of less than 13.5 gram/100ml and in women as hemoglobin of less than 12.0 gram/100ml. These definitions may vary slightly depending on the source and the laboratory reference used.


Causes

Any process that can disrupt the normal life span of a red blood cell may cause anemia. Normal life span of a red blood cell is typically around 120 days. Red blood cells are made in the bone marrow.

Anemia is caused essentially through two basic pathways. Anemia is either caused :

1. by a decrease in production of red blood cell or hemoglobin, or
2. by a loss or destruction of blood.

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Osteoarthritis

Osteoarthritis is a deterioration of the moving parts of the joints. In the hand, osteoarthritis most often affects the small joints of the fingers and the joint at the base of the thumb - the basal joint. This is sometimes referred to a degenerative arthritis or degenerative joint disease. Osteoarthritis is primarily treated by medical doctors, and may require treatment by an arthritis specialist. Medical resources on arthritic conditions are available through the American College of Rheumatology.


Causes

• The exact reason for developing osteoarthritis is not known.


• It is thought to be due to deterioration of the smooth layer of cartilage which covers the ends of the bones. The small joints of the fingers are prone to breakdown of this layer, which seems to self-destruct in some people early in life.


• It tends to run in families, and is probably a genetic condition in many people.


• Degenerative joint disease can also occur after injury, but the typical pattern of osteoarthritis is that the small joints of the fingers are affected, but the other joints of the hand are not.


• Osteoarthritis is different from other forms of arthritis, such as rheumatoid arthritis, gouty arthritis, psoriatic arthritis and others.

Source : http://www.eatonhand.com



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Appendicitis means inflammation of the appendix. It is thought that appendicitis begins when the opening from the appendix into the cecum becomes blocked. The blockage may be due to a build-up of thick mucus within the appendix or to stool that enters the appendix from the cecum. The mucus or stool hardens, becomes rock-like, and blocks the opening. This rock is called a fecalith (literally, a rock of stool). At other times, the lymphatic tissue in the appendix may swell and block the appendix. After the blockage occurs, bacteria which normally are found within the appendix begin to invade (infect) the wall of the appendix. The body responds to the invasion by mounting an attack on the bacteria, an attack called inflammation. An alternative theory for the cause of appendicitis is an initial rupture of the appendix followed by spread of bacteria outside the appendix.. The cause of such a rupture is unclear, but it may relate to changes that occur in the lymphatic tissue, for example, inflammation, that line the wall of the appendix.)

If the inflammation and infection spread through the wall of the appendix, the appendix can rupture. After rupture, infection can spread throughout the abdomen; however, it usually is confined to a small area surrounding the appendix (forming a peri-appendiceal abscess).

Sometimes, the body is successful in containing ("healing") the appendicitis without surgical treatment if the infection and accompanying inflammation do not spread throughout the abdomen. The inflammation, pain and symptoms may disappear. This is particularly true in elderly patients and when antibiotics are used. The patients then may come to the doctor long after the episode of appendicitis with a lump or a mass in the right lower abdomen that is due to the scarring that occurs during healing. This lump might raise the suspicion of cancer.
Source : http://www.medicinenet.com



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Typhoid

Typhoid is a severe, contagious and life-threatening disease. It is caused by contaminated food, drinks and water by bacteria called S.typhi, which may result in fever with severe complications.

Typhoid fever is transmitted in several ways. The bacteria are disseminated by typhoid patients and carriers in large quantities through stools and vomit. The bacteria then find their way to food, drinks and water through house-flies and other insects. These contaminated food or drinks, when consumed, causes typhoid fever.

Raw vegetables grown on sewage-irrigated fields also act as a source of infection.
The bacteria can survive in soil and water for several months. They grow rapidly in milk and milk-products.

Typhoid carriers can harbor the bacteria for many years, posing a potential danger to healthy individuals. Unhygienic conditions in our surroundings are mainly responsible for the widespread infection.
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cephalalgia

In medicine a headache or cephalalgia is a symptom of a number of different conditions of the head and sometimes neck. Some of the causes are benign while others are medical emergencies. It ranks among the most common pain complaints.

There are a number of different classification systems for headaches. The most well-recognized is that of the International Headache Society. Wikipedia
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Gastroenteritis

Gastroenteritis is the irritation and inflammation of the digestive tract. This condition may cause abdominal pain, vomiting and diarrhea. Severe cases of gastroenteritis can result in dehydration. In such cases, fluid replacement is the primary factor in treatment. All ages and both sexes may be affected yet the most severe symptoms are experienced by infants and those individuals over sixty years old. The use of certain drugs such as aspirin, antibiotics or cortisone drugs may increase risk for this condition.

Food poisoning, stress, excessive alcohol or tobacco use, viral infections, food allergies, improper diet, certain drugs, food consumed in foreign countries and intestinal parasites are all possible causes for this condition.

Gastroenteritis caused by viral infection or bacteria is easily passed from one person to another. Care should always be taken to wash the hands often, especially when preparing food and after bowel movements. Hand washing after bowel movements is important since the organism that causes this condition lives in the digestive tract.(Wikipedia)
Source : http://download-my-ebook.blogspot.com



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Hyperemesis Gravidarum

Nausea and vomiting in pregnancy is extremely common. Hyperemesis gravidarum (HEG) is the most severe form of nausea and vomiting in pregnancy. A continuous spectrum of the severity of nausea and vomiting ranges from the nausea and vomiting that occurs in most pregnancies to the severe disorder of hyperemesis gravidarum.

Normal nausea and vomiting may be an evolutionary protective mechanism—it may protect the pregnant woman and her embryo from harmful substances in food, such as pathogenic microorganisms in meat products and toxins in plants, with the effect being maximal during embryogenesis (the most vulnerable period of pregnancy). This is supported by studies showing that women who had nausea and vomiting were less likely to have miscarriages and stillbirth.

Hyperemesis gravidarum is characterized by persistent nausea and vomiting associated with ketosis and weight loss (>5% of prepregnancy weight). Hyperemesis gravidarum may cause volume depletion, electrolytes and acid-base imbalances, nutritional deficiencies, and even death. Severe hyperemesis requiring hospital admission occurs in 0.3-2% of pregnancies.
Source : http://emedicine.medscape.com


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Mania

Mania (from Greek μανία from μαίνομαι - mainomai, "to rage, to be furious") is a state of abnormally elevated or irritable mood, arousal, and/ or energy levels, which is a criterion for certain psychiatric diagnoses.

There are several possible causes for mania outside of mood disorders, including drug abuse and brain tumors, but it is most often associated with bipolar disorder, where episodes of mania alternate with episodes of major depression. These cycles may relate to diurnal rhythms and environmental stressors. Mania varies in intensity, from mild mania (known as hypomania) to full-blown psychotic features including hallucinations and delusions. Naturally, since mania and hypomania have also been associated with creativity and artistic talent, it is not always a foregone conclusion that the clearly manic bipolar person will feel it is necessary to choose immediate medical assistance and/or quarantine; such people will often either be unaware that they have "gone manic" severely enough to be committed or to commit themselves, or will not care because they enjoy how it feels. Manic individuals can often be mistaken for being on drugs or other mind-altering substances.
Source : http://en.wikipedia.org



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Stroke

Definition

Stroke is the clinical manifestation of cerebral function disorders, both focal and overall (global), which is very quick, lasting more than 24 hours, or end in death, without finding the cause other than vascular disorders.

A stroke is an interruption of the blood supply to any part of the brain. A stroke is sometimes called a "brain attack."
http://www.nlm.nih.gov


Etiologi

Penyebab-penyebabnya antara lain :

1. Trombosis (bekuan cairan di dalam pembuluh darah otak).
2. Embolisme cerebral (bekuan darah atau material lain).
3. Iskemia (Penurunan aliran darah ke area otak).
   (Smeltzer C. Suzanne, 2002).

Symptoms

The symptoms of stroke depend on what part of the brain is damaged. In some cases, a person may not even be aware that he or she has had a stroke.

Symptoms usually develop suddenly and without warning, or they may occur on and off for the first day or two. Symptoms are usually most severe when the stroke first happens, but they may slowly get worse.

A headache may occur, especially if the stroke is caused by bleeding in the brain. The headache:

* Starts suddenly and may be severe
* Occurs when lying flat
* Wakes you up from sleep
* Gets worse when you change positions or when you bend, strain, or cough

Other symptoms depend on the severity of the stroke and what part of the brain is affected. Symptoms may include:

* Muscle weakness in the face, arm, or leg (usually just one side)
* Numbness or tingling on one side of the body
* Trouble speaking or understanding others who are speaking
* Problems with eyesight, including decreased vision, double vision, or total loss of vision
* Sensation changes that affect touch and the ability to feel pain, pressure, different temperatures, or other stimuli
* Changes in hearing
* Change in alertness (including sleepiness, unconsciousness, and coma)
* Personality, mood, or emotional changes
* Confusion or loss of memory
* Difficulty swallowing
* Changes in taste
* Difficulty writing or reading
* Loss of coordination
* Loss of balance
* Clumsiness
* Trouble walking
* Dizziness or abnormal sensation of movement (vertigo)
* Lack of control over the bladder or bowels
http://www.nlm.nih.gov


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Vertigo

Definition

Vertigo is the feeling that you or your environment is moving or spinning. It differs from dizziness in that vertigo describes an illusion of movement. When you feel as if you yourself are moving, it's called subjective vertigo, and the perception that your surroundings are moving is called objective vertigo.


Symptoms

Vertigo implies that there is a sensation of motion either of the person or the environment. This should not be confused with symptoms of lightheadedness or fainting.

• If true vertigo exists, there is a sensation of disorientation or motion. In addition, the patient may also have any or all of these symptoms :
  • Nausea or vomiting
  • Sweating
  • Abnormal eye movements
  
  
• The duration of symptoms can be from minutes to hours, and symptoms can be constant or episodic. The onset may be due to a movement or change in position. It is important to tell the doctor about any recent head trauma or whiplash injury as well as any new medications the patient is taking.


• The patient may have hearing loss and a ringing sensation in the ears.


• The patient might have visual disturbances, weakness, difficulty speaking, decreased level of consciousness, and difficulty walking.

Source : http://www.emedicinehealth.com


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Decreased Consciousness

Definition

Decrease in consciousness is a state where the patient is not conscious in the sense of not awake / not awake fully so as not to provide a normal response to stimuli.
Awareness simply be said as a state where a person knows / knew about himself and his environment.
(Padmosantjojo, 2000)


Causes

Many conditions can cause decreased consciousness, including :

• Alcohol or drug intoxication
• Arrhythmia
• Central nervous system diseases
• Decreased oxygen (hypoxia)
• Diabetic coma
• Electrolyte imbalance
• Exposure to heavy metals or hydrocarbons
• Extreme fatigue or sleep deprivation
• Ketoacidosis
• Head trauma
• Heart failure
• Hypoglycemia
• Infection
• Low blood pressure (hypotension)
• Metabolic problems
• Seizures such as those related to epilepsy
• Shock
• Stroke

Source : http://www.clarian.org


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Caesarean section

Definition

A caesarean section (c-section) is a surgical procedure in which a baby is born through an incision (cut) made in the mother’s abdominal wall and the wall of the uterus (womb). Your baby may need to be born by caesarean section if there are serious problems that prevent the baby being born by a normal vaginal birth.

A normal vaginal birth is the safest way for your baby to be born if both you and your baby are healthy during pregnancy and labour. If you do need a caesarean operation, your doctor should explain to you why it is necessary.


When you might need to have a caesarean birth

Some of the problems that may mean your baby needs to be born by caesarean section include:

• Your baby is presenting bottom or feet first (breech) or is lying sideways (transverse) and is not able to be turned by the doctor.
• You are having more than one baby at this birth.
• Your baby’s head does not sink down or ‘fit’ through your pelvis during labour.
• Your baby shows serious signs of distress – your doctor or midwife will look carefully for any signs of distress during labour.
• Your cervix (opening to the womb) is blocked by the placenta – this is known as placenta praevia.
• The umbilical cord, which provides important nutrients and oxygenated blood to your baby, has prolapsed (fallen down) through the cervix and into the vagina when your waters have broken.
• Your labour does not progress as expected – for example, your contractions are not strong enough and your cervix opens too slowly or not at all.
• You have a serious health problem such as high blood pressure.

Source : http://www.betterhealth.vic.gov.au

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Preeclampsia is a pregnancy condition in which high blood pressure and protein in the urine develop after the 20th week (late 2nd or 3rd trimester) of pregnancy.
Causes

The exact cause of preeclampsia is not known. Possible causes include :

• Autoimmune disorders
• Blood vessel problems
• Diet
• Genes

Preeclampsia occurs in a small percentage of pregnancies. Risk factors include :

• First pregnancy
• Multiple pregnancy (twins or more)
• Obesity
• Older than age 35
• Past history of diabetes, high blood pressure, or kidney disease.

Source : http://www.nlm.nih.gov

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Antenatal Care

What are antenatal classes?

Antenatal classes help you to prepare physically and emotionally for the birth of your baby. At the classes you can ask questions and explore the different ways in which you can give birth.

If you are a working mother you are entitled to paid time off to attend antenatal classes. Antenatal care is the key to healthy mothers and babies and it’s very important you attend your appointments.

When do I start having antenatal care?

After confirmation of your pregnancy your doctor will make arrangements for your antenatal care. Most women have their first and longest antenatal check- up between weeks 8 and 12 of pregnancy. The earlier you start attending antenatal check-ups the better. You should then attend antenatal check-ups once a month until 28 weeks, then twice a month until you are 36 weeks pregnant. During the last 4 weeks of your pregnancy you should go every week.

Source : http://www.homehealth-uk.com

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