Nurse Advocate: Case Study with NCP

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Showing posts with label Case Study with NCP. Show all posts
Showing posts with label Case Study with NCP. Show all posts

Tuesday, March 23, 2010

Case Study with NCP: Pregnancy Induced Hypertension

Pregnancy Induced Hypertension (PIH) is a condition in which vasospasms occur during pregnancy in both small and large arteries. Signs of hypertension, proteinuria, and edema develop. It is unique to pregnancy and occurs in 5% to 7% of pregnancies in the united states. Despite years of research, the cause of the disorder is still unknown. Originally it was called toxemia because researchers pictured a toxin of some kind being produced by a women in response to foreign protein of the growing fetus, the toxin leading to the topical symptoms. No such toxins have ever been identified.




UPDATE Case Study with NCP: Placenta Previa

The placenta is implanted in the lower uterine segment near or over the internal cervical os. The degree to which the internal cervical os is covered by the placenta has been used to classify four types of placenta previa; total, partial, marginal and low–lying. In total previa the internal os is entirely covered by the placenta. Partial placenta previa implies incomplete coverage of the internal os. Marginal placenta previa indicates that only an edge of the placenta extends to the margin of the internal os. And the last is the low – lying placenta has been used when the placenta is implanted in the lower uterine segment but not reach the os. The more descriptive classification that includes placenta previa is in the third trimester.




Wednesday, January 20, 2010

Case Study with NCP: Appendicitis

Inflammation of the vermiform appendix, with Assessments, Pathophysiology, Diagnostic Evaluations, and Surgical and Nursing Interventions.(www.nursingcrib.com)




Monday, January 18, 2010

Case Study with NCP: Placenta Previa

Explanation of Placenta Previa with its predisposing factors, types and its corresponding Nursing Interventions.(www.nursingcrib.com)




Sunday, January 17, 2010

Case Study with NCP: Peptic Ulcer Disease

An article featuring Peptic Ulcer Disease, its classification, types of PUD, with Assessment in Differentiating Gastric Ulcer from Duodenal Ulcer, Diagnostic Evaluations, and Pharmacologic, Surgical & Nursing Interventions. (www.nursingcrib.com)



Wednesday, May 20, 2009

Case Study with NCP: Postpartum Hemorrhage

Postpartum hemorrhage is defined as a loss of blood in the postpartum period of more than 500 mL. The average, spontaneous vaginal birth will typically have a 500 mL blood loss. In cesarean births the average blood loss rises to 800-1000 mL. There is a greater risk of hemorrhage in the first 24 hours after the birth, called primary postpartum hemorrhage. A secondary hemorrhage occurs after the first 24 hours of birth. In the majority of cases the cause of hemorrhage is uterine atony, meaning that the uterus is not contracting enough to control the bleeding at the placental site. Other reasons for a hemorrhage would include retained placental fragments (possibly including a placenta accreta), trauma of some form, like a cervical laceration, uterine inversion or even uterine rupture, and clotting disorders.

Common Signs and Symptoms:
  • uncontrolled bleeding
  • decreased blood pressure
  • increased heart rate
  • decrease in the red blood cell count (hematocrit)
  • swelling and pain in tissues in the vaginal and perineal area
Conditions that may increase the risk for postpartum hemorrhage include the following:
  • placental abruption - the early detachment of the placenta from the uterus.
  • placenta previa - the placenta covers or is near the cervical opening.
  • overdistended uterus - excessive enlargement of the uterus due to too much amniotic fluid or a large baby, especially with birthweight over 4,000 grams (8.8 pounds).
  • multiple pregnancy - more than one placenta and overdistention of the uterus.
  • pregnancy-induced hypertension (PIH) - high blood pressure of pregnancy.
  • having many previous births
  • prolonged labor
  • infection
  • obesity
  • medications to induce labor
  • medications to stop contractions (for preterm labor)
  • use of forceps or vacuum-assisted delivery
  • general anesthesia
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Case Study with NCP: Colorectal Cancer

Colorectal cancer is a disease in which normal cells in the lining of the colon or rectum begin to change, start to grow uncontrollably, and no longer die. These changes usually take years to develop; however, in some cases of hereditary disease, changes can occur within months to years. Both genetic and environmental factors can cause the changes. Initially, the cell growth appears as a benign (noncancerous) polyp that can, over time, become a cancerous tumor. If not treated or removed, a polyp can become a potentially life-threatening cancer. Recognizing and removing precancerous polyps before they become cancer can prevent colorectal cancer.



Predisposing Factors:
  • Age above 40 years old
  • Diet
  • Low in Fiber
  • High in fat, protein and refined carbohydrates
  • Obesity
  • History of chronic constipation
  • History of IBD, familial polyposis or colon polyps
  • Family history of colon cancer
Most Common Site:

Rectosigmoid area (70%)
Signs and Symptoms:
  • Ascending (Right) Colon Cancer
  • Occult blood in stool
  • Anemia
  • Anorexia and weight loss
  • Abdominal pain above umbilicus
  • Palpable mass
  • Distal Colon/Rectal Cancer
  • Rectal bleeding
  • Changed in bowel habits
  • Constipation or Diarrhea
  • Pencil or ribbon - shaped stool
  • Tenesmus
  • Sensation of incomplete bowel emptying
Dukes’s Classification of Colorectal Cancer
Stage A: Confined bowel mucosa, 80-90% 5-year survival rate
Stage B: Invading muscle wall
Stage C: Lymph node involvement
Stage D: Metastases or locally unresectable tumor, less than 5% 5-year survival rate
Guidelines for early detection of Colorectal Cancer
  • Digital rectal examination yearly after age 40
  • Occult blod test yearly after age 50
  • Proctosigmoidoscopy every 5 years after age 50, following 2 negative results of yearly examination
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