cp of viral hepatits ( prelim )

8/19/2019 Cp of Viral Hepatits ( PRELIM )

1/34

LICEO DE CAGAYAN UNIVERSITY

COLLEGE OF NURSING

NCM104

In Partial Requirements of the course NCM104

Medical - Surgical Ward

Related Learning !"erience

A CASE STUDY ON

“Viral Hepatitis”

Su#mitted $o%

Mrs. Arlyn B. Celestil RN.MNClinical Instructor

Su#mitted #&%

R!se My O. C! "ler

'SN-NCM104

De#e$%er &' (01(

1


2/34

TABLE OF CONTENTS

PAGES

I. INTRODUCTION

A. OVERVIEW OF THE STUDY 1

B. SCOPE AND LIMITATIONS OF THE STUDY 2

C. OBJECTIVE OF THE STUDY

II. PROFILE OF THE PATIENT 3

III.DEVELOPMENTAL THEORY 4

IV. HEALTH HISTORY

a.Pers!a" Hea"#$ H%s#r& '

(.H%s#r& ) Prese!# I""!ess *

V. MEDICAL MANAGEMENT

a. Me+%,a" Or+ers -%#$

(. La(ra#r& Res/"#s 0

,. Dr/ S#/+&

VI. ANATOMY AND PHYSIOLOGY 13

VII. PATHOPHYSIOLOGY 14

VIII. NURSING ASSESSMENT

a. N/rs%! S&s#e Re%e- C$ar# 1'

IX. NURSING MANAGEMENT

(. I+ea" N/rs%! Ma!aee!# 25

,. A,#/a" N/rs%! Ma!aee!# 23

X. EVALUATION AND IMPLICATION 2*

XI. REFERRALS AND RECOMMENDATION(HEALTH TEACHINGS) 230

XII. PROGNOSIS 20

XIII.BIBLIOGRAPHY 2

(


3/34

I. INTRODUCTION

a. Overview ! "#e S"$%&

He6a#%#%s %s a ser%/s %!)"aa#%! ) #$e "%er7 /s/a""& +/e # a %r/s. I# ,a! a"s (e,a/se+ (& a! era,#%e %/!e s&s#e7 a!+ )r +r/s7 a",$"%s7 ,$e%,a"s7 a!+e!%r!e!#a" #8%!s. I! #$e U!%#e+ S#a#es7 %ra" $e6a#%#%s /s/a""& a66ears as #&6e A7 B7r C. T- #$er #&6es 99 D a!+ E 99 are rare %! #$e U.S.

T&6e A %s #$e s# ,! )r ) %ra" $e6a#%#%s. I# )#e! a))e,#s s,$" ae+ ,$%"+re!.T$e +%sease %s /s/a""& #ra!s%##e+ -$e! se!e %!es#s )e,a" a##er #$r/$,!#a%!a#e+ )+ r -a#er. Y/ ,a! a"s e# $e6a#%#%s A (& $a%! se8 -%#$ se!e-$ $as #$e %r/s. A 6ers! -$ $as $e6a#%#%s A ,a! (e ,!#a%/s (e)re #$e& ee!:!- #$e& $ae #$e +%sease. U!"%:e #$er )rs ) %ra" $e6a#%#%s7 #$e %r/s +es!; # s#a&

%! &/r (+& !,e &/ re,er. T$e (es# -a& # 6ree!# $e6a#%#%s A %s -%#$ a a,,%!e a!++ $&%e!e.

He6a#%#%s #&6es B a!+ C a))e,# 6e6"e ) a"" aes. Ms# 6e6"e -$ (e,e %!)e,#e+-%#$ $e6a#%#%s B e# r%+ ) #$e %r/s -%#$%! * !#$s. T$%s #&6e ) s$r# %!)e,#%! %s :!-!as a! s,arr%! ) #$e "%er? a!+ "%er ,a!,er. T$ere %s a a,,%!e # 6ree!# $e6a#%#%s B.

A!&!e -$ $as ,$r!%, $e6a#%#%s B %s a"s s/s,e6#%("e # %!)e,#%! -%#$ a!#$er s#ra%! ) %ra" $e6a#%#%s :!-! as $e6a#%#%s D >)rer"& ,a""e+ +e"#a %r/s?. He6a#%#%s D %r/s ,a!!"& %!)e,# ,e""s %) #$e $e6a#%#%s B %r/s >HBV? %s 6rese!#. Pe6"e -$ /se IV +r/s are a#rea#es# r%s:. Be%! %!)e,#e+ -%#$ (#$ $e6a#%#%s B a!+ D ra%ses #$e r%s: ) +ee"6%!,%rr$s%s r "%er ,a!,er.

He6a#%#%s C %s /s/a""& s6rea+ #$r/$ ,!#a,# -%#$ %!)e,#e+ ("+7 as -$e! IV +r/ /serss$are !ee+"es. I# ,a! (e e%#$er a,/#e >a s$r# #er %!)e,#%!? r (e,e ,$r!%, a!+ee! "%)e #$rea#e!%!. T$ere %s ! a,,%!e )r $e6a#%#%s C.

He6a#%#%s E %s rare %! #$e U!%#e+ S#a#es. I# %s s6rea+ #$r/$ %!es#%! )+ r -a#er,!#a%!a#e+ -%#$ )e,es. T$ere %s ! a,,%!e )r $e6a#%#%s E. T$e !"& -a& # 6ree!##$e +%sease %s # re+/,e #$e r%s: ) e86s/re # #$e %r/s.

)


4/34

'. Se a*% Li+i"a"i* ! "#e S"$%&

T$%s s#/+& %!,"/+es #$e ,""e,#%! ) %!)ra#%! s6e,%)%,a""& # #$e 6a#%e!#@s $ea"#$

,!+%#%! 6r%ar%"& # V%ra" He6a#%#%s. T$e s#/+& a"s %!,"/+es #$e assesse!# ) #$e

6$&s%"%,a"9e#%!a" s#a#/s7 a+e/a,& ) s/66r# s&s#es7 a!+ ,are %e! (& #$e)a%"& as -e"" as #$er $ea"#$ ,are 6r%+ers.

T$e s,6e ) #$%s s#/+& %!,"/+es

•Da#a ,""e,#e+ %a assesse!#7 %!#er%e-s -%#$ #$e 6a#%e!# a!+ )a%"& e(ers

a!+ ,"%!%,a" re,r+s.

• A,#/a" a!+ I+ea" 6r("es a!+ %#s a66r6r%a#e !/rs%! %!#ere!#%!s #$a# -/"+ (e

a66"%e+ #$r/$/# $%s s#a& %! #$e $s6%#a".

•Dee"6%! a 6"a! ) ,are #$a# -%"" re+/,e %+e!#%)%e+ 6re+%,ae!#s a!+

,6"%,a#%!s

•Cr+%!a#%! a!+ +e"ea#%! %!#ere!#%!s -%#$%! #$e 6"a! ) ,are # ass%s# 6a#%e!#

Mr.RTN # rea,$ a8%/ )/!,#%!a" $ea"#$.

•F/r#$er ea"/a#%! #$e e))e,#%e!ess ) !/rs%! %!#ere!#%!s #$a# $ae (ee!

a66"%e+ # 6a#%e!# Mr. RTN e!#%re ,/rse ) #$era6&.

T$e s#/+& %s "%%#e+ (& #$e )""-%! )a,#rs

T$e !/rs%! %!#ere!#%!s +!e # 6a#%e!# Mr.RTN are !"& "%%#e+ # /r

assesse!# )r 3 ,!se,/#%e +a#es Ne(er 217 2512 1535a. >assesse!# 1 s#

%s%#?7 Ne(er 227 2512 >2!+ %s%#?7 Ne(er 237 2512 >3 r+ %s%#?. I!)ra#%! a#$ere+

-as "%%#e+ !"& # #$e ,"%e!# a!+ #$e +a#a re)"e,#e+ ! #$e 6a#%e!#@s ,$ar# a!+ )r /r

6$&s%,a" assesse!#. T$ere -ere a"s "%%#a#%!s ! #$e %!#ere!#%!s -e -ere !"&

6er%##e+ # 6er)r7 #$e #%e a!+ +%s#a!,e a""##e+ )r /r %s%# !"&. N %!#er%e-s -ere

a+e -%#$ #$e 6re%/s 6$&s%,%a!s a##e!+%! # /r 6a#%e!#.

4


5/34

. O',e"ive ! "#e -"$%&

A# #$e e!+ 3 +a&9,are # #$e 6a#%e!#7 -e -%"" (e a("e # + #$e )""-%!

1. Assess a!+ !%#r #$e $ea"#$ s#a#/s a!+ %#a" s%!s ) & 6a#%e!#s.

2. I+e!#%)& a,#/a" a!+ 6#e!#%a" $ea"#$ 6r("es ) #$e 6a#%e!#.

3. P"a! )r #$e 6a#%e!#@s ,are

4. Per)r !/rs%! %!#ere!#%!s >e+%,a#%!s %!,"/+e+? e))e,#%e"& a!+

e))%,%e!#"&

'. Ea"/a#e 6a#%e!#@s res6!se a!+ rea,#%! a!+

*. I6ar# $ea"#$ #ea,$%!s # /r 6a#%e!#

*


6/34

II. PATIENTS PROFILE

Nae RTN

e!+er Ma"e

Ae 23 &ears "+

B%r#$+a#e Se6#e(er 357 15

P"a,e ) B%r#$ B/:%+!!

A++ress L/(a&a- Va"e!,%a B/:%+!!

S#a#/s S%!"e

Re"%%! Ra! Ca#$"%,

Na#%!a"%#& F%"%6%!

He%$# 'F#. '%!,$es Ta""

We%$# >6rese!#? '0 :

E+/,a#%!a" A##a%!e!# H%$ S,$" ra+/a#e

O,,/6a#%! CAFU

I!,e 27556$6$G!#$

C$%e) C6"a%!#s Ye""-%s$ S,"era

A+%##%! D%a!s%s V%ra" He6a#%#%s

A+%ss%! Da#e O,#(er 27 2512

A+%ss%! T%e 2556..

A##e!+%! P$&s%,%a! Dr. C&!#$%a M. W

Hs6%#a" Ca6 Ea!e"%s#a S#a#%! Hs6%#a"

1

+


7/34

III.DEVELOPMENTAL THEORY

2Eri/ Eri/-* P-&#-ia0 T#er&

• P-&#-ia0 C*!0i"1 I!#%a,& Vers/s Is"a#%! > 2592' &ears "+?

• Ma,r 2$e-"i*1 es#a("%s$e+ +/r%! #$e %+e!#%#&ers/s ,!)/s%! s#ae? %s esse!#%a" # (e%! a("e # )r %!#%a#e re"a#%!s$%6s. S#/+%es$ae +e!s#ra#e+ #$a# #$se -%#$ a 6r se!se ) se") #e!+ # $ae "ess ,%##e+re"a#%!s$%6s a!+ are re "%:e"& # s/))er e#%!a" %s"a#%!7 "!e"%!ess7 a!++e6ress%!.

Er%:s! (e"%ee+ %# -as %#a" #$a# 6e6"e +ee"6 ,"se7 ,%##e+ re"a#%!s$%6s -%#$#$er 6e6"e. S/,,ess "ea+s # s#r! re"a#%!s$%6s7 -$%"e )a%"/re res/"#s %! "!e"%!ess

a!+ %s"a#%!.

,

http://psychology.about.com/od/profilesofmajorthinkers/p/bio_erikson.htmhttp://psychology.about.com/od/theoriesofpersonality/a/psychosocial.htmhttp://psychology.about.com/od/theoriesofpersonality/a/psychosocial.htmhttp://psychology.about.com/od/theoriesofpersonality/a/psychosocial.htmhttp://psychology.about.com/od/theoriesofpersonality/a/psychosocial.htmhttp://psychology.about.com/od/profilesofmajorthinkers/p/bio_erikson.htm


8/34

IV. HEALTH HISTORY

a. H%s#r& ) Prese!# I""!ess

A ,ase ) a 23 &ear "+7 a"e7 Ra! Ca#$"%, )r L/(a&a- Va"e!,%a

B/:%+!! -as a+%##e+ # Ca6 Ea!e"%s#a S#a#%! Hs6%#a". Pr%r # a+%ss%! ,/$

-as !#e+ -%#$ ! a!+ )) )eer )""-e+ (& &e""-%s$ +%s,"ra#%! ) s,"era.

Pa#%e!# $a+ ! 6re%/s $s6%#a"%a#%! a!+ -as !# :!-! )r +%a(e#es7

$&6er#e!s%!7 as#$a7 a!+ $as ! :!-! )+ a!+ +r/ a""er&.

(. Pas# Me+%,a" H%s#r&

C"%e!# $as ! :!-! e+%,a" $%s#r& a!+ #$%s %s #$e )%rs# #%e #$a# $e -as (e%!

$s6%#a"%e+. He $as 6re%/s %""!esses s/,$ as )eer7 ,/$ a!+ ,"+s (/# !"&

a!ae+ a# $e a!+ ! ,!s/"#a#%! -as +!e a!+ ! e+%,a#%! -ere#a:e!.

V. MEDICAL MANAGEMENT

a. Me+%,a" Or+ers

Da#e a!+ #%e D,#r@s r+er O,#(er 272512

1'25H

Per a+%# # %s"a#%!

TPR eer& s$%)# A##a,$ CBC7 Ur%!a"&s%s7 )e,a"&s%s7 a!+ HBs

AEsse!#%a"e #a( TIDP"ease re)er a,,r+%!"&

Ne(er 147 2512

15'5H

Fr a!#% HAV 1

UTK ) HBTNe(er 1*7 2512

51*H

Fr re)erre+ # +e!#a" +e6ar#e!#

535H Fr a!#% HAV 1 !,e -%#$ !e&Fr s,$e+/"%! ) UTK ) HBT !,e -%#$

!e&

(. La(ra#r& Res/"#s

COMPLETE BLOOD COUNT


9/34

O"'er 3453673

Te-" Re-$0"- Re!ere*e

WBC 7555 >'75559157555?3

He"(%! 13.' >14910?

Hea#,r%# 4'.0 >459'4?

Ne/#r6$%" 44 >'595?

L&6$,e 4' >2595?

Es%!6$%" 50 >5295*?

HB-A8

O"'er 345 3673

HBsA N!9rea,#%e

S&6$%"%s!!e

URINALYSIS

O"'er 345 3673

C"r Dar: Ye""-

Tra!s6are!,& ,"ear

S/ar !!e

A"(/%! !!e

s6e,%)%, ra%#& 1.52'

WBC 5.2 G$6)

FECALYSIS

O"'er 345 3673

C0r1 Brw* RBC1 NONE

C#ara"er1 S!" 9BC1 NONE

Para-i"e-1 *

,. Dr/ S#/+&

7.

Na+e ! Dr$81 A8%,%""%!

.


10/34

Da"e r%ere% Ne(er 1*7 2512

C0a--i!ia"i* A!#%9%!)e,#%e +r/

D-e:!re;$e*& '55 ,a6 TID )r 3+a&s

Me#a*i-+ ! A"i* A! a%!6e!%,%""%! #$a# 6ree!#s (a,#er%a" ,e""9-a"" s&!#$es%s

+/r%! re6"%,a#%! ,"a/a"a!%, a,%+ %!,reases a8%,%""%! e))e,#%e!ess (&

Sei!i I*%ia"i* Fr re,/rre!# r 6ers%s#e!# a,/#e #%#%s e+%a7 "-er res6%ra#r&

%!)e,#%!7 s%!/s%#%s7 s:%! a!+ s:%! s#r/,#/re a!+ /r%!ar& #ra,# %!)e,#%!

C*"rai*%ia"i* C!#ra%!+%,a#e+ %! 6a#%e!#s $&6erse!s%#%%#& # +r/ r #$er 6e!%,%""%!

a!+ %! #$se -%#$ $%s#r& ) a8%,%""%! re"a#e+ ,$"es#a#%, a/!+%,e r $e6a#%,

+&s)/!,#%!

Si%e E!!e"- CNS A%#a#%!7 a!8%e#& 7 %!s!%a

I Na/sea a!+ %#%! 7 as#r%#%s

N$r-i*8 Ma*a8e+e*"1

Use ,a/#%/s"& %! 6a#%e!# s -%#$ #$er +r/ a""er%es (e,a/se ) 6ss%("e ,rss9

se!s%#%%#& O(#a%! s6e,%e! )r ,/"#/re a!+ se!s%#%%#& #es# (e)re %%! )%rs# +se

%e +r/ a#"eas# 1$r (e)re (a,#er%a" s#a#%, a!#%(%#%,

S$/"+ (e #a:e! -%#$ ea"s

3.

Na+e ! Dr$8 Esse!#%a"e )r#e

Da"e r%ere% O,#(er 27 2512

C0a--i!ia"i* He6a#%, 6r#e,#r

D-e:!re;$e*& 1 #a( TID

Me#a*i-+ ! A"i* N/r%s$ #$e "%er

Sei!i I*%ia"i* T #rea# #8%, a!+ e#a("%, "%er +%sease

C*"rai*%ia"i* C!#ra%!+%,a#e+ # 6a#%e!#s $&6erse!s%#%%#& # #$%s +r/

Si%e e!!e"- Hea+a,$e7 !a/sea 7 %#%!7 ,!s#%6a#%!

N$r-i*8 Ma*a8e+e*"

S$/"+ (e #a:e! -%#$ ea"s

F""- #$e 12 r%$#s ) 6a#%e!#


11/34

Me#a*i-+ ! a"i* A!#ra!%"%, a,%+ +er%a#%e %!$%(%#s 6rs#a"a!+%! s&!#$es%s a!+

a))e,#s 6"a#e"e# )/!,#%!

Sei!i i*%ia"i* Re"%e) 6a%! %!,"/+%! /s,/"ar7 r$e/a#%,7 $ea+a,$e a!+ %ra%!e

C*"rai*%ia"i* C!#ra%!+%,a#e+ # 6a#%e!#s $&6erse!s%#%%#& # +r/ I

%!)"aa#%! r /",era#%!

Si%e e!!e"- CNS +r-s%!ess7 %!s!%a 7 +%%!ess

I seere +%arr$ea7 /",era#%! 7 ("ee+%!

S:%! /r#%,ar%a 7 ras$

CV 6a"6%#a#%!

N$r-i*8 i*"erve*"i*

D%s,!#%!/e +r/ 6r6#"& %) +%arr$ea7 +ar: s#"s7 e6%s#a8%s7 ras$ ,,/r a!+ +

!# /se aa%! N#%)& 6$&s%,%a! %) 6ers%s#e!# I +%s,)r#7 sre #$ra# ,,/r

VI. ANATOMY AND PHYSIOLOGY

11


12/34

H$+a* A*a"+&

T$e 0iver 7 hepar 7 %s a %#a" ra! 6rese!# %! er#e(ra#es a!+ se #$er a!%a"s. I# $as a

-%+e ra!e ) )/!,#%!s7 %!,"/+%!+e#8%)%,a#%!7 6r#e%! s&!#$es%s7 a!+ 6r+/,#%! )(%,$e%,a"s !e,essar& )r +%es#%!. T$e "%er %s !e,essar& )r s/r%a" #$ere %s

,/rre!#"& ! -a& # ,6e!sa#e )r #$e a(se!,e ) "%er )/!,#%! %! #$e "! #er7a"#$/$ !e- "%er +%a"&s%s #e,$!%/es ,a! (e /se+ %! #$e s$r# #er.

T$%s ra! 6"a&s a ar r"e %! e#a("%s a!+ $as a !/(er ) )/!,#%!s %! #$e (+&7%!,"/+%! "&,e! s#rae7 +e,6s%#%! ) re+ ("+ ,e""s7 6"asa

6r#e%! s&!#$es%s7 $r!e 6r+/,#%!7 a!+ +e#8%)%,a#%!. I# "%es (e"- #$e +%a6$ra %!#$e a(+%!a"96e"%, re%! ) #$e a(+e!. I# 6r+/,es (%"e7 a! a":a"%!e ,6/!+

-$%,$ a%+s %! +%es#%! %a #$e e/"s%)%,a#%! ) "%6%+s. T$e "%er;s $%$"&s6e,%a"%e+ #%ss/es re/"a#e a -%+e ar%e#& ) $%$9"/e (%,$e%,a" rea,#%!s7

%!,"/+%! #$e s&!#$es%s a!+ (rea:+-! ) sa"" a!+ ,6"e8 "e,/"es7 a!& ) -$%,$are !e,essar& )r !ra" %#a" )/!,#%!s. 2

T$e "%er %s a "are7 ea#& ra! #$a# s%#s ! #$e r%$# s%+e ) #$e (e""&. We%$%! a(/# 3

6/!+s7 #$e "%er %s re++%s$9(r-! %! ,"r a!+ )ee"s r/((er& # #$e #/,$. Nra""& &/

,a!;# )ee" #$e "%er7 (e,a/se %#;s 6r#e,#e+ (& #$e r%( ,ae.

T$e "%er $as #- "are se,#%!s7 ,a""e+ #$e r%$# a!+ #$e "e)# "(es. T$e a""("a++er s%#s

/!+er #$e "%er7 a"! -%#$ 6ar#s ) #$e 6a!,reas a!+ %!#es#%!es. T$e "%er a!+ #$ese

ra!s -r: #e#$er # +%es#7 a(sr(7 a!+ 6r,ess )+.

T$e "%er;s a%! ( %s # )%"#er #$e ("+ ,%! )r #$e +%es#%e #ra,#7 (e)re 6ass%!

%# # #$e res# ) #$e (+&. T$e "%er a"s +e#8%)%es ,$e%,a"s a!+ e#a("%es +r/s. As %#

+es s7 #$e "%er se,re#es (%"e #$a# e!+s /6 (a,: %! #$e %!#es#%!es. T$e "%er a"s a:es

6r#e%!s %6r#a!# )r ("+ ,"##%! a!+ #$er )/!,#%!s.

Liver Conditions

• He6a#%#%s I!)"aa#%! ) #$e "%er7 /s/a""& ,a/se+ (& %r/ses "%:e $e6a#%#%s A7 B7a!+ C. He6a#%#%s ,a! $ae !!9%!)e,#%/s ,a/ses #7 %!,"/+%! $ea& +r%!:%!7+r/s7 a""er%, rea,#%!s7 r (es%#&.

1(

http://en.wikipedia.org/wiki/Vital_organhttp://en.wikipedia.org/wiki/Vertebratehttp://en.wikipedia.org/wiki/Detoxificationhttp://en.wikipedia.org/wiki/Protein_synthesishttp://en.wikipedia.org/wiki/Digestionhttp://en.wikipedia.org/wiki/Liver_dialysishttp://en.wikipedia.org/wiki/Organ_(anatomy)http://en.wikipedia.org/wiki/Metabolismhttp://en.wikipedia.org/wiki/Metabolismhttp://en.wikipedia.org/wiki/Glycogenhttp://en.wikipedia.org/wiki/Plasma_proteinhttp://en.wikipedia.org/wiki/Plasma_proteinhttp://en.wikipedia.org/wiki/Hormonehttp://en.wikipedia.org/wiki/Hormonehttp://en.wikipedia.org/wiki/Bilehttp://en.wikipedia.org/wiki/Digestionhttp://en.wikipedia.org/wiki/Emulsificationhttp://en.wikipedia.org/wiki/Lipidshttp://en.wikipedia.org/wiki/Biological_tissuehttp://en.wikipedia.org/wiki/Liver#cite_note-2http://www.webmd.com/hepatitis/default.htmhttp://en.wikipedia.org/wiki/Vital_organhttp://en.wikipedia.org/wiki/Vertebratehttp://en.wikipedia.org/wiki/Detoxificationhttp://en.wikipedia.org/wiki/Protein_synthesishttp://en.wikipedia.org/wiki/Digestionhttp://en.wikipedia.org/wiki/Liver_dialysishttp://en.wikipedia.org/wiki/Organ_(anatomy)http://en.wikipedia.org/wiki/Metabolismhttp://en.wikipedia.org/wiki/Glycogenhttp://en.wikipedia.org/wiki/Plasma_proteinhttp://en.wikipedia.org/wiki/Plasma_proteinhttp://en.wikipedia.org/wiki/Hormonehttp://en.wikipedia.org/wiki/Bilehttp://en.wikipedia.org/wiki/Digestionhttp://en.wikipedia.org/wiki/Emulsificationhttp://en.wikipedia.org/wiki/Lipidshttp://en.wikipedia.org/wiki/Biological_tissuehttp://en.wikipedia.org/wiki/Liver#cite_note-2http://www.webmd.com/hepatitis/default.htm


13/34

• C%rr$s%s L!9#er +aae # #$e "%er )r a!& ,a/se ,a! "ea+ # 6era!e!#s,arr%!7 ,a""e+ ,%rr$s%s. T$e "%er #$e! (e,es /!a("e # )/!,#%! -e"".

• L%er ,a!,er T$e s# ,! #&6e ) "%er ,a!,er7 $e6a#,e""/"ar ,ar,%!a7a"s# a"-a&s ,,/rs a)#er ,%rr$s%s %s 6rese!#.

• L%er )a%"/re L%er )a%"/re $as a!& ,a/ses %!,"/+%! %!)e,#%!7 e!e#%, +%seases7a!+ e8,ess%e a",$".

• As,%#es As ,%rr$s%s res/"#s7 #$e "%er "ea:s )"/%+ >as,%#es? %!# #$e (e""&7 -$%,$(e,es +%s#e!+e+ a!+ $ea&.

• a""s#!es I) a a""s#!e (e,es s#/,: %! #$e (%"e +/,# +ra%!%! #$e "%er7$e6a#%#%s a!+ (%"e +/,# %!)e,#%! >,$"a!%#%s? ,a! res/"#.

• He,$ra#s%s He,$ra#s%s a""-s %r! # +e6s%# %! #$e "%er7

+aa%! %#. T$e %r! a"s +e6s%#s #$r/$/# #$e (+&7 ,a/s%! /"#%6"e #$er$ea"#$ 6r("es.

• Pr%ar& s,"ers%! ,$"a!%#%s A rare +%sease -%#$ /!:!-! ,a/ses7 6r%ar&s,"ers%! ,$"a!%#%s ,a/ses %!)"aa#%! a!+ s,arr%! %! #$e (%"e +/,#s %! #$e"%er.

• Pr%ar& (%"%ar& ,%rr$s%s I! #$%s rare +%sr+er7 a! /!,"ear 6r,ess s"-"& +es#r&s#$e (%"e +/,#s %! #$e "%er. Pera!e!# "%er s,arr%! >,%rr$s%s? ee!#/a""&+ee"6s.

A!a#&

T$e "%er %s a re++%s$ (r-! ra! -%#$ )/r "(es ) /!e/a" s%e a!+ s$a6e. A $/a!

"%er !ra""& -e%$s 1.441.** : >3.23. "(?7 a!+ %s a s)#7 6%!:%s$9(r-!7 #r%a!/"arra!. I# %s (#$ #$e "ares# %!#er!a" ra! >#$e s:%! (e%! #$e "ares# ra! era""? a!+

#$e "ares# "a!+ %! #$e $/a! (+&. I# %s ",a#e+ %! #$e r%$# /66er /a+ra!# )#$e a(+%!a" ,a%#&7 res#%! /s# (e"- #$e +%a6$ra. T$e "%er "%es # #$e r%$# ) #$e

s#a,$ a!+ er"%es #$e a""("a++er . I# %s ,!!e,#e+ # #- "are ("+ esse"s7 !e,a""e+ #$e $e6a#%, ar#er& a!+ !e ,a""e+ #$e 6r#a" e%!. T$e $e6a#%, ar#er& ,arr%es ("+

)r #$e ar#a7 -$ereas #$e 6r#a" e%! ,arr%es ("+ ,!#a%!%! +%es#e+ !/#r%e!#s )r#$e e!#%re as#r%!#es#%!a" #ra,#a!+ a"s )r #$e s6"ee! a!+ 6a!,reas. T$ese ("+esse"s s/(+%%+e %!# ,a6%""ar%es7 -$%,$ #$e! "ea+ # a "(/"e. Ea,$ "(/"e %s a+e /6 ) %""%!s ) $e6a#%, ,e""s -$%,$ are #$e (as%, e#a("%, ,e""s. L(/"es are #$e )/!,#%!a"

/!%#s ) #$e "%er.

Ce00 "&e-

T- ar #&6es ) ,e""s 66/"a#e #$e "%er "(es :ara# 6are!,$&a" a!+ !!9

6are!,$&a" ,e""s. 05= ) #$e "%er "/e %s ,,/6%e+ (& 6are!,$&a" ,e""s ,!"&re)erre+ # as$e6a#,es. N!96are!,$&a" ,e""s ,!s#%#/#e 45= ) #$e ##a" !/(er )

"%er ,e""s (/# !"& *.'= ) %#s "/e. S%!/s%+a" e!+#$e"%a" ,e""s7 /6))er ,e""s a!+$e6a#%, s#e""a#e ,e""s are se ) #$e !!96are!,$&a" ,e""s #$a# "%!e #$e $e6a#%,s%!/s%+.

1)

http://www.webmd.com/digestive-disorders/cirrhosis-liverhttp://www.webmd.com/cancer/understanding-liver-cancer-basic-informationhttp://www.webmd.com/digestive-disorders/digestive-diseases-liver-failurehttp://www.webmd.com/digestive-disorders/ascites-medrefhttp://www.webmd.com/digestive-disorders/gallstoneshttp://www.webmd.com/digestive-disorders/inherited-liver-diseaseshttp://www.webmd.com/digestive-disorders/cholangitis-primary-sclerosinghttp://www.webmd.com/digestive-disorders/tc/primary-biliary-cirrhosis-pbc-topic-overviewhttp://en.wikipedia.org/wiki/Lobe_(anatomy)http://en.wikipedia.org/wiki/Skinhttp://en.wikipedia.org/wiki/Glandhttp://en.wikipedia.org/wiki/Right_upper_quadranthttp://en.wikipedia.org/wiki/Abdominal_cavityhttp://en.wikipedia.org/wiki/Thoracic_diaphragmhttp://en.wikipedia.org/wiki/Gallbladderhttp://en.wikipedia.org/wiki/Blood_vesselhttp://en.wikipedia.org/wiki/Portal_veinhttp://en.wikipedia.org/wiki/Hepatic_arteryhttp://en.wikipedia.org/wiki/Gastrointestinal_tracthttp://en.wikipedia.org/wiki/Spleenhttp://en.wikipedia.org/wiki/Pancreashttp://en.wikipedia.org/wiki/Lobules_of_liverhttp://en.wikipedia.org/wiki/Hepatocyteshttp://en.wikipedia.org/wiki/Kupffer_cellshttp://www.webmd.com/digestive-disorders/cirrhosis-liverhttp://www.webmd.com/cancer/understanding-liver-cancer-basic-informationhttp://www.webmd.com/digestive-disorders/digestive-diseases-liver-failurehttp://www.webmd.com/digestive-disorders/ascites-medrefhttp://www.webmd.com/digestive-disorders/gallstoneshttp://www.webmd.com/digestive-disorders/inherited-liver-diseaseshttp://www.webmd.com/digestive-disorders/cholangitis-primary-sclerosinghttp://www.webmd.com/digestive-disorders/tc/primary-biliary-cirrhosis-pbc-topic-overviewhttp://en.wikipedia.org/wiki/Lobe_(anatomy)http://en.wikipedia.org/wiki/Skinhttp://en.wikipedia.org/wiki/Glandhttp://en.wikipedia.org/wiki/Right_upper_quadranthttp://en.wikipedia.org/wiki/Abdominal_cavityhttp://en.wikipedia.org/wiki/Thoracic_diaphragmhttp://en.wikipedia.org/wiki/Gallbladderhttp://en.wikipedia.org/wiki/Blood_vesselhttp://en.wikipedia.org/wiki/Portal_veinhttp://en.wikipedia.org/wiki/Hepatic_arteryhttp://en.wikipedia.org/wiki/Gastrointestinal_tracthttp://en.wikipedia.org/wiki/Spleenhttp://en.wikipedia.org/wiki/Pancreashttp://en.wikipedia.org/wiki/Lobules_of_liverhttp://en.wikipedia.org/wiki/Hepatocyteshttp://en.wikipedia.org/wiki/Kupffer_cells


14/34

B0% !0w

T$e "%er e#s a +/a" ("+ s/66"& )r #$e $e6a#%, 6r#a" e%! a!+ $e6a#%, ar#er%es.S/66"&%! a66r8%a#e"& '= ) #$e "%er;s ("+ s/66"&7 #$e $e6a#%, 6r#a" e%!,arr%es e!/s ("+ +ra%!e+ )r #$e s6"ee!7 as#r%!#es#%!a" #ra,#7 a!+ %#s ass,%a#e+

ra!s. T$e $e6a#%, ar#er%es s/66"& ar#er%a" ("+ # #$e "%er7 a,,/!#%! )r #$erea%!+er ) %#s ("+ )"-. O8&e! %s 6r%+e+ )r (#$ s/r,es a66r8%a#e"& $a") ) #$e "%er;s 8&e! +ea!+ %s e# (& #$e $e6a#%, 6r#a" e%!7 a!+ $a") %s e# (& #$e

$e6a#%, ar#er%esB"+ )"-s #$r/$ #$e "%er s%!/s%+s a!+ e6#%es %!# #$e ,e!#ra" e%! ) ea,$ "(/"e.

T$e ,e!#ra" e%!s ,a"es,e %!# $e6a#%, e%!s7 -$%,$ "eae #$e "%er.

T$e #er biliary tree %s +er%e+ )r #$e ar(rea" (ra!,$es ) #$e (%"e +/,#s.

T$e (%"e 6r+/,e+ %! #$e "%er %s ,""e,#e+ %! (%"e ,a!a"%,/"%7 -$%,$ ere # )r (%"e+/,#s. W%#$%! #$e "%er7 #$ese +/,#s are ,a""e+ intrahepatic >-%#$%! #$e "%er? (%"e +/,#s7

a!+ !,e #$e& e8%# #$e "%er #$e& are ,!s%+ere+ extrahepatic >/#s%+e #$e "%er?. T$e%!#ra$e6a#%, +/,#s ee!#/a""& +ra%! %!# #$e r%$# a!+ "e)# $e6a#%, +/,#s7 -$%,$ ere #

)r #$e ,! $e6a#%, +/,#. T$e ,&s#%, +/,# )r #$e a""("a++er %!s -%#$#$e ,! $e6a#%, +/,# # )r #$e ,! (%"e +/,#.

B%"e e%#$er +ra%!s +%re,#"& %!# #$e +/+e!/ %a #$e ,! (%"e +/,#7 r (e #e6rar%"&s#re+ %! #$e a""("a++er %a #$e ,&s#%, +/,#. T$e ,! (%"e +/,# a!+ #$e 6a!,rea#%,

+/,# e!#er #$e se,!+ 6ar# ) #$e +/+e!/ #e#$er a# #$e a6/""a ) Va#er .

S$r!ae a*a"+&

Peritoneal ligaments

A6ar# )r a 6a#,$ -$ere %# ,!!e,#s # #$e +%a6$ra >#$e s9,a""e+


15/34

Ea,$ ) #$e "(es %s a+e /6 ) "(/"es a e%! es )r #$e ,e!#re7 -$%,$ #$e! %!s ##$e $e6a#%, e%! # ,arr& ("+ /# )r #$e "%er.

O! #$e s/r)a,e ) #$e "(/"es7 #$ere are +/,#s7 e%!s a!+ ar#er%es #$a# ,arr& )"/%+s # a!+)r #$e.

F$*"i*a0 a*a"+&

T$e ,e!#ra" area -$ere #$e ,! (%"e +/,#7 $e6a#%, 6r#a" e%!7 a!+ $e6a#%, ar#er&6r6er e!#er %s #$e $%"/ r


16/34

VII. PATHOPHYSIOLOGYDia8*-i-1 V%ra" He6a#%#%s

De!i*i"i* %s a %ra" %!)e,#%! ) #$e "%er ass,%a#e+ -%#$ (ra+ s6e,#r/ ) ,"%!%,a"

a!%)es#a#%!s )r as&6#a#%, %!)e,#%! #$r/$ %,#er%, $e6a#%#%s # $e6a#%, !e,rs%s

Pre+%s6s%! )a,#rs Pre,%6%#a#%! )a,#rs

E!%r!e!# Ae>42 &ears "+?

H&%e!e e!+er>a"e?

S#ress S:%!

A",$" a(/se

1+

Ne,rs%s a!+

%!)"aa#%! )

$e6a#%, ,e""s

De,rease L%er

)/!,#%!

C%r,/"a#%! %/!e

,6"e8es s&s#e

a,#%a#%!

I6a%re+ (%"%r/(%!

e#a("%s a!+

(s#r/,#%! # (%"e


17/34

NURSING SYSTEM REVIE9 CHART

Na+e1 RTN Da"e1Ne(er 217 2512

Vi"a0 Si8*-1

Te+1.


18/34

VI. NURSING SYSTEM REVIE9 CHART

Nae RTN Da#e Ne(er 217 2512

V%#a" s%!s

P/"se 0*(6 Te6 3*.3QC We%$# '0:

INSTRUCTIONS1 P"a,e a! >8? %! #$e area ) a(!ra"%#&. Wr%#e ,e!# ! #$e s6a,e.I!+%,a#e+ #$e ",a#%! ) #$e 6r("e %! #$e )%/re /s%! >8?.

EENT1 %6a%re+ %s%! ("%!+ 6a%! re++e!e+ +ra%!ae /s 8 $ar+ ) $ear%! +ea) #$ra# )r a(!ra"%#& ! 6r("e

RESPIRATION1 as&e#r%, #a,$&6!ea (arre" ,$es# a6!ea ra"es ,/$ (ra+&6!ea s$a""- r$!,$ s6/#/ +%%!%s$e+ +&s6!ea r#$6!ea "a(re+ -$ee%! 6a%! ,&a!#%, assess res6. ra#e7 r$$7 +e6#$7 6a##er!8 (rea#$ s/!+7 ,)r# r ! 6r("e

GASTROINTESTINAL TRACT

(ese 8 +%s#e!#%! ass +&s6$a%a r%%+"& 6a%! assess a(+e!7 (-e" $a(%#s7 s-a""-%!8 (-e" s/!+s7 ,)r# ! 6r("e

GENITO@URINARY AND GYNE 6a%! /r%!e ,"r a%!a" ("ee+%! $ea#/r%a +%s,$are !,#/r%a

1


19/34

assess /r%!e )re.7 ,"r7 +r7 ,)r# &!9("ee+%! +%s,$are ! 6r("e

NEURO 6ara"&s%s s#/6r/s /!s#ea+& se%/res

"e#$ar#%, ,a#se er#% #rers ,!)/se+ %s%! r%6 assess #r )/!,#%!7 se!sa#%!7 LOC7 s#re!#$7 r%67 a"#7 ,r+%!a#%!7 s6ee,$7 ! 6r("e

MUSCULOSELETAL a66"%a!,e s#%))!ess %#,$%! 6e#e,$%ae $# +ra%!ae 6rs#$es%s s-e""%! "es%! 8 6r #/rr 8 ," +e)r%#&

NURSING ASSESSMENT II

SUBECTIVE OBECTIVECOMMUNICATION18 Hear%! "ss

V%s/a" ,$a!es De!%e+

"asses "a!/ae

,!#ra,# "e!ses $ear%! a%+e R LP/6%" s%e 394 s6ee,$+%))%,/"#%esRea,#%! 6/6%"s e/a""& r/!+e+ rea,#%! #"%

$#s a,,+a#%!.

OXYGENATION +&s6!ea8 s:%! $%s#r&

A6r%" 2511

,/$ s6/#/ +e!%e+

Res6. 8 re/"ar %rre/"ar Des,r%(e res6%ra#r& ra#e %s -%#$ %! !ra"ra!e a!+ "%%#.

R r%$# "/! s&e#r%, # #$e "e)# "/!L "e)# "/! s&e#r%, # #$e r%$# "/!

CIRCULATION1

8 ,$es# 6a%! "e 6a%!8 !/(!ess )

E8#ree#%es +e!%e+

Hear# r$$ 8 re/"ar %re/"ar A!:"e e+ea !!eCar#%+ ra+%a" +rsa" 6e+%s )era"R 0* L 0* Ce!#s a"" 6/"se are 6a"6a("e.

NUTRIRION1D%e# D%e# as T"era#e+8 N VC$ara,#er%s#%, re,e!# ,$a!e %!

We%$#7 a66e#%#e

+e!#/res 8 !!e

F/"" 6ar#%a" -%#$ 6a#%e!#

U66er 8

1.

Comments%2 dili

3a&o 3o 3adungogusaha&2 aser#alied #& the"atient

Comments% 5 6ala

man noon 3o

galisod og ginha6a

5 as er#alied #&

the "atient7

Comments%

5gasa3it a3ong

dughan usaha& og

ga"aminhod "ud

a3o tuhod usaha&2

as er#alied #&

Comments%2o3a&

raman a3o

"ag3aon di man

noon 3o galisod

3ung mag3aon2

as er#alied #&

the "atient


20/34

s-a""-%! D%))%,/"#&8 +e!%e+

L-er 8

ELIMINATION1

Us/a" (-e" 6a##er! /r%!e)re/e!,& #%es a +a& ,!s#%6a#%! /re!,& Ree+%esPa6a&a7 (a!a!a +&s/r%aNe(er 217 2512 $ea#/r%a Da#e ) "as# BM %!,!#%!e!,e 6"&/r%a +%arr$ea )"& %! 6"a,e C$ara,#er +e!%e+

Ce!#s B-e" s/!+s

Nra,#%e A(+%!a"D%s#e!#%! Prese!# &es 8! Ur%!e > ,"r7,!s%s#e!,& O+r?+ar: &e""- 7)/" .+r %) )"e& (a

,a#$e#er %s I! 6"a,e

MGT. OF HEALTH ILLNESS18 A",$" +e!%e+> a/!#7 )re/e!,&? '559*55" 3#%es a +a& SBE "as# Pa6 Sear !# a66"%,a("eLMP !# a66"%,a("e TE !!e

Br%e)"& +es,r%(e #$e 6a#%e!#@s a(%"%#& # )""-#rea#e!#s > +%e#7 e+s7 e#,.? )r ,$r!%,$ea"#$ 6r("es.> %) 6rese!#?

T$e 6a#%e!# %s a("e # )""- #$e e+%,a#%!s6res,r%(e+ (& #$e 6$&s%,%a!.

SIN INTEGRITY1

8 +r& ,e!#s-a"a 7a!6+ : %#,$%! a6a!a#" sa : 6a!%# #$er er(a"%e+ (& #$e 6#. +e!%e+

8 +r& ,"+ 6a"e )"/s$e+ 8 -ar %s# ,&a!#%,ras$es7 /",ers7 +e,/(%#%s> +es,r%(e s%e7",ar#%!7 +ra%!ae? T$ere %s !ras$es7ras$es7 +e,/(%#%s #$a# are (sere7

ACTIVITY: SAFETY1 ,!/"s%! +%%!ess "%%#e+ #%!

O) %!s a(/"a#e (a#$e se") #$er 8 +e!%e+

LOC a!+ r%e!#a#%! 6a#%e!# %s ,!s,%/s# #%e 7 6ers! a!+ 6"a,e a%# -a":er ,are #$er s#ea+& /!s#ea+&

Se!sr& a!+ #r "sses %! )a,e re8#re%#%esN se!sr& a!+ #r "sses %! )a,e a!+e8#ree#%es ROM "%%#a#%!s $e $as !6r("erear+%! ROM.

COMFORT: SLEEP: A9AE18 6a%!> ",a#%!? )re/e!,&Ree+%es

!,#/r%a

8 s"ee6 +%))%,/"#%es +e!%e+

)a,%a" r%a,es /ar+%! #$er s%!s ) 6a%! T$ere %s ! s%! ) 6a%! (sere

8 s%+e ra%" re"ease )r s%!e+ >*5 &ears?

(0

'o6el "atternis normal and

#o6el sound

is normoactie

6hen

auscultated

Comments% 5o3a&

raman a3ong

"anliho3 8 a3o mannoon maliho3 a3o

la6as2 as er#alied

#& the "atient

Comments% 9ili

3a&o s&a 3a

tarong og tulog

tungod sa i&ang

sige:g 3ali#anga2

as er#alied #&


21/34

COPING1O,,/6a#%! CAFUMe(ers ) $/se$"+s Ms# s/66r#%e 6ers! $%s (r#$er

O(sere+ !!9 er(a" (e$a%rN !!9(e$a%r (sere.Pers! > 6$!e !/(er? 52*01*4'

IX. IDEAL NURSING MANAGEMENT1.

C/es N/rs%!

+%a!s%

s

O(e,#%es I!#ere!#%!

s

Ra#%!a"e Ea"/a#%!

S/(e,#%e

a:a-a"a

/sa$a& a:!

:/s as

er(a"%e+ (&

#$e 6a#%e!#

O(e,#%e9 La,: )

e!er&9 De,reas

e

6er)ra

!,e9 I!,rease

6$&s%,a",6"a%!

s

Fa#%/e

r#

+e,reas

e

e#a("%

,

e!er&6r+/,#%

!

A# #$e e!+ )

1$r 6a#%e!# -%""

(e a("e #

• Re6r#

%6re

+ se!se

)e!er&

• Per)r

ADLs

a!+

6ar#%,%6

a#e %!

+es%re+

a,#%%#%e

s a#

"ee" )

a(%"%#&

1. Pr

#e (e+

res# +/r%!

#8%,

s#a#e.Pr%+

e a /%#e

e!%r!e!#

2.Re,

e!+

,$a!%! )

6s%#%!

)re/e!#"&

3.D

1.Pr#e

s res# a!+

re"a8a#%!.

Aa%"a("e

e!er& %s

/se+ )r

$ea"%!2.Pr#e

s 6#%a"

res6%ra#r&

)/!,#%!

a!+

%!%%es

6ress/re

# re+/,e

r%s: )

#%ss/e

(rea:+-

A# #$e e!+ )

1$r 6a#%e!#

-as (e a("e

#

• Re6r#

%6re

+ se!se)

e!er&• Per)r

ADLs

a!+

6ar#%,%6

a#e %!

+es%re+

a,#%%#%e

s a#

"ee" )

a(%"%#&

(1


22/34

!e,essar&

#as: /%,:"&

a!+ a# !e

#%e as

#"era#e+4.I!,rease

a,#%%#& as

#"era#e+7

+e!s#ra#

e

a,#%eG6ass%

e ROMe8er,%se

'.E!,/ra

e /se )

s#ress

a!aee

!#

#e,$!%/e

!

3.A""-s

)r

e8#e!+e+

6er%+ )

/!%!#err/6#

e+ res#

4.Pr"!

e+ (e+

res# ,a!

(e

+e(%"%#a#%!

. T$%s ,a!

(e ))se#

(& "%%#e+

a,#%%#&

a"#er!a#%!

-%#$

6er%+s'.Pr#e

s

re"a8a#%!

a!+

,!seres

e!er&

2.

C/es N/rs%!

+%a!s

%s

O(e,#%es I!#ere!#%!s Ra#%!a"e Ea"/a#%!

S/(e,#

%e

-a"a

!a+a$

/ !a

a:a

%!9a!%

!-"e

+e

+e)%,%#

re"a#e+

#

,!+%#%

!7

A# #$e e!+ )

1$r !/rs%!

%!#ere!#%!

6a#%e!# -%"" (e

a("e #

• Ver(a"%

I*%ee*%e*"1

Assess

6a#%e!#@sa(%"%#& #

"ear!.

Lear!%

!

+e6e!+s !

e#%

!a"

a!+

6$&s%,

A# #$e e!+ )

1$r !/rs%!

%!#ere!#%!

6a#%e!# -as

a("e #

• Ver(a"%

((


23/34

: -a"a

6/+ :

:a(a"

sa

a!a&

!a:

(/$a#

! as

er(a"%

e+ (&

#$e

6a#%e!#

#rea#e

!# a!+

6ree!#%

!

e

/!+ers#a

!+%! )

+%sease

6r,essG

6r!s%

s a!+

6ree!#%

!

• I!%#%a#e

(e$a%r

"%)es#&"e,$a!es

#

%6re

e!era

-e""

(e%!

a!+

re+/,e

r%s: )

$%s

,!+%#%

!

E!,/ra

e+

6a#%e!# #

er(a"%e

+,!,er!s

.

E6$as%

e #$e%6r#a!

,e )

a%!#a%!%

! $%$

6r#e%!

a!+

,ar($&+

ra#es7

a!+a+e/a#

e )"/%+

%!#a:e.

E86"a%!

e+%,a#%

!

+saea!+

)re/e!,

& )

a+%!%s#r

a#%!.

a"

rea+%!

ess

a!+ %s

a,$%e

e+ as

a!

%!+%%+

/a"

6a,e.

Pr%+

es

66r#

/!%#& #

,rre,#

%s,!

,e6#%!

sG

a""e%a#

e

a!8%e#&

.

Mee#%!

e#a(

"%,

!ee+s

$e"6s

%!%%

e

)a#%/e

a!+6r#

e

re,e

r&.

E!$a!

,es,6er

a#%!

-%#$

#$e

#$era6

e

/!+ers#a

!+%! )

+%sease

6r,essG

6r!s%

s a!+

6ree!#%

!

• I!%#%a#e

(e$a%r

"%)es#&"e,$a!es

#

%6re

e!era

-e""

(e%!

a!+

re+/,e

r%s: )

$%s

,!+%#%

!

()


24/34

E!,/ra

e+ #

a(s#a%!%!

)r

s:%!

e/#%,

re%e

!. A"#$/

$s:%!

+es

!#

s#%/"a

#e

re,/rre

!,e )

TB7 %#

+es

%!,reas

e #$e

"%:e"%$

+ )

res6%ra

#r&+&s)/!

,#%!

3.

C/es N/rs%!

+%a!s%

s

O(e,#%es I!#ere!#%!s Ra#%!a"e Ea"/a#%!

S/(e,#

%e

s/:a+

!a9

a+%#

:

!%/(s

a:!

#%(a!

as

er(a"%

I(a"a!

,e+

N/#r%#%!

re"a#e+

#

A!re8%

a > Lss

)

A66e#%#e

A# #$e e!+ )

0$rs !/rs%!

%!#ere!#%!

6a#%e!# -%"" (e

a("e #

+e!s#ra#e

6rress%e

-e%$# a%!

#-ar+ a"

-%#$

!ra"%a#%!

I!+e6e!+e!#

• As,er#a%!

6a#%e!#@s

/s/a"

+%e#ar&

6a##er!.

• E!,/ra

e+ a!+

6r%+e

)re/e!#

res#

6er%+s.

• He"6)/"

%!

%+e!#%)&%!

s6e,%)%,

!ee+s

a!+ a&

%6re

+%e#ar&%!#a:e.

• He"6s

,!sere

e!er&

es6e,%a""

& -$e!

A# #$e e!+ )

0$rs !/rs%!

%!#ere!#%!

6a#%e!# -%"" (e

a("e #

+e!s#ra#e

6rress%e

-e%$# a%!

#-ar+ a"

-%#$

!ra"%a#%!

(4


25/34

e+ (&

#$e

6a#%e!#

) $%s ea#%!

6a##er! a!+

-%"" %!%#%a#e

(e$a%rsG"%)e

s#&"e

,$a!es #

rea%! a!+

a%!#a%!

a66r6r%a#e

-e%$#

• Pr%+e

ra" ,are

• E!,/ra

e+ sa""

)re/e!#

)ee+%!s

• A+%!%s#e

r

e+%,a#%

!s as

%!+%,a#e+• A!#%e%#%,

s7

e#,"6r

a%+e

>ra"a!?7

#r%e#$(

e!a%+e

>#%a!?

a!#a,%+s7

B

,6"e8

e#a("%

,

re/%re

e!# are

%!,rease

+ (&

)eer.• T

%6re

+ ra"

#as#e

• Ma8%%

es

!/#r%e!#%!#a:e

-%#$/#

/!+/e

)a#%/eGe

!er&

e86e!+%#

/re )r

ea#%!

"are

ea"s7a!+

re+/,es

as#r%,

%rr%#a#%!.

• %e!

$r (e)re

ea"s7

a&

re+/,e

!a/sea

a!+

%!,rease

)+

#"era!,

e

) $%s ea#%!

6a##er! a!+

-%"" %!%#%a#e

(e$a%rsG"%)e

s#&"e

,$a!es #

rea%! a!+

a%!#a%!

a66r6r%a#e

-e%$#

(*


26/34

A"$a0 N$r-i*8 Ma*a8e+e*"

1.

S a:a-a"a /sa$a& a:! :/s /sa$a& as er(a"%e+ (&

#$e 6a#%e!#

O O(e,#%e

9 La,: ) e!er&9 De,rease 6er)ra!,e

I!,rease 6$&s%,a" ,6"a%!s A Fa#%/e rG# +e,rease e#a("%, e!er& 6r+/,#%!

S$r# #er

(+


27/34

P A# #$e e!+ ) 1$r 6a#%e!# -%"" (e a("e #

• Re6r# %6re+ se!se ) e!er&

• Per)r ADLs a!+ 6ar#%,%6a#e %! +es%re+ a,#%%#%es

a# "ee" ) a(%"%#&

I

1.Pr#e (e+ res# +/r%! #8%, s#a#e. Pr%+e a /%#e

e!%r!e!#

2.Re,e!+ ,$a!%! ) 6s%#%! )re/e!#"&

3.D !e,essar& #as: /%,:"& a!+ a# !e #%e as #"era#e+

4.I!,rease a,#%%#& as #"era#e+7 +e!s#ra#e

a,#%eG6ass%e ROM e8er,%se'.E!,/rae /se ) s#ress a!aee!# #e,$!%/e

E A# #$e e!+ ) 1$r 6a#%e!# -as (e a("e #

• Re6r# %6re+ se!se ) e!er&

Per)r ADLs a!+ 6ar#%,%6a#e %! +es%re+ a,#%%#%es a# "ee"

) a(%"%#&

2.

S :a& a! : /:a! 6er /sa$a& -a"a :& a!a as

er(a"%e+ (& #$e 6a#%e!#

O 9 We%$# "ss > )r *0:s +-! # *2:s?9 Fa#%/e9 Pr /s,"e #!e9 La,: %! %!#eres# %! )+9 A"#ere+ #as#e se!sa#%!

A I(a"a!,e+ !/#r%#%! rG# a!re8%a > "ss ) a66e#%#e ?

P

L! #er A# #$e e!+ ) 0$rs ) !/rs%! %!#ere!#%!s7

6a#%e!# -%"" %!%#%a#e (e$a%rs r "%)es#&"e ,$a!es # rea%!

a!+ a%!#a%! a66r6r%a#e -e%$#

S$r# #er A# #$e e!+ ) 1$r ) !/rs%! %!#ere!#%!s7

6a#%e!# -%"" (e a("e # +e!s#ra#e 6rress%e -e%$#

a%! a!+ !ra"%e $%s ea#%! 6a##er!.

9 E!,/rae sa"" )re/e!# )ee+%!s

(,


28/34

I 9 Pr%+e ra" ,are9 E!,/rae a!+ 6r%+e res# 6er%+9 E!,/rae # ea# )+s r%,$ %! 6r#e%! a!+

,ar($&+ra#es9 A+%!%s#er e+%,a#%!s )r )+ s/66"ee!#

E L! #er A# #$e e!+ ) 0$rs ) !/rs%! %!#ere!#%!s7

6a#%e!# -as a("e # %!%#%a#e (e$a%rs r "%)es#&"e ,$a!es

# rea%! a!+ a%!#a%! a66r6r%a#e -e%$#

S$r# #er A# #$e e!+ ) 1$r ) !/rs%! %!#ere!#%!s7

6a#%e!# -as a("e # +e!s#ra#e 6rress%e -e%$# a%!

a!+ !ra"%e $%s ea#%! 6a##er!.

3.

S a6a!a#" a:/! 6aa!%# /sa$a& as er(a"%e+ (& #$e

6a#%e!#.

O +r& s:%! 6r s:%! #/rr %#,$%!ess

A R%s: )r %6a%re+ s:%!G #%ss/e %!#er%#&

P

L! #er a# #$e e!+ ) 0 $rs !/rs%! %!#ere!#%!s

6a#%e!# -%"" (e a("e # +%s6"a& %!#a,# s:%!G#%ss/es7 )ree )

e8,r%a#%!.

S$r# #er a# #$e e!+ ) 1 $r !/rs%! %!#ere!#%!s 6a#%e!#

-%"" (e a("e # re6r# a(se!,e r +e,rease ) 6r/r%#/sG

s,ra#,$%!

1. O(sere s:%! )r areas ) re+!ess7 (rea:+-!.

(


29/34

I 2. A%+ /se ) a":a"%!e sa6.3. ee6 )%!er!a%"s ,/# s$r#. Pr%+e s)# ,##!

"%!e!s.4. Pr%+e +%ers%!a" a,#%%#%es.'. A+%!%s#er e+%,a#%!s as %!+%,a#e+ a!#%$%s#a%!e7

+%6$e!$&+ra%!e >Be!a+r&"?7 aa#a+%!e >6#%%!e?E L! #er a# #$e e!+ ) 0 $rs !/rs%! %!#ere!#%!s

6a#%e!# -%"" (e a("e # +%s6"a& %!#a,# s:%!G#%ss/es7 )ree )

e8,r%a#%!.

S$r# #er a# #$e e!+ ) 1 $r !/rs%! %!#ere!#%!s 6a#%e!#

-%"" (e a("e # re6r# a(se!,e r +e,rease ) 6r/r%#/sG

s,ra#,$%!.

X. EVALUATION AND IMPLICATION

W%#$%! #$e s6a! ) 2 +a&s ) re!+er%! ,are # RTN7 I -as a("e # %+e!#%)&

6#e!#%a" 6r("es a!+ s6e,%)%, !/rs%! %!#ere!#%!s -ere 6r%+e+. W%#$ #$e $e"6 )

$ea"#$ #ea,$%!s a!+ #$er %!#ere!#%!s7 Pa#%e!# RTN -as a("e # "ear! $- #

re,!%e s%!s a!+ s&6#s a!+ #$er r%s: )a,#rs ) $%s ,!+%#%!. M& 6a#%e!# -as

a("e # er(a"%e+ #$e %6r#a!,e ) %%! e+%,a#%!s. He $a+ a"s re,!%e+ #$e

%6r#a!,e ) ,6"%a!,e # #rea#e!# re%e! %! r+er # a!ae $%s ,!+%#%!

XI. REFERRALS a*% RECOMMENDATION

O/r )/r#$er I!6a#%e!# ,are %!,"/+es !%#r%! ) ,$a!es %! %#a" s%!s7 assesse!# )

e))e,#%e!ess ) #rea#e!# re%e!7 re%!)r,ee!# ) +%e#ar& a+%,e7 a!+ #$e a+%,e

rear+%! #$e %6r#a!,e ) a+e/a#e (e+ res#.

O/r )/r#$er /#6a#%e!# ,are %!,"/+es %!s#r/,#%!s ) Mr. RTN $%s +%e#ar&

+%)%,a#%!7 ,6"%a!,e -%#$ #rea#e!# re%e! a!+ $%s 6ar#%,%6a#%! #$r/$ re6r#%!) a+erse e))e,#s ) e+%,a#%!s # $%s 6$&s%,%a!7 Dr.C&!#$%a W. T$e 6a#%e!# -as a"s

%!s#r/,#e+ # $ae a re/"ar ,$e,:9/6 a# Ca6 Ea!e"%s#a S#a#%! $s6%#a" %! r+er #

!%#r $%s ,/rre!# ,!+%#%!.

(.


30/34

HEALTH TEACHINGS

Nae ) 6a#%e!# RTN

Me+%,a#%!s

I!s#r/,#e+ ,"%e!# a(/# #$e %!+%,a#%!s a!+ e,$a!%ss ) a,#%!s ) ea,$ +r/

#$a# #$e +,#r r+ere+ s #$a# -%#$/# $es%#a#%! #$e& -%"" rea""& ,6"& a"" #$e

e+%,a#%!s %e! -%#$ #$e. A+$ere!,e # #$e e+%,a#%! 6r#es %6ree!# ) ,!+%#%!.

E8er,%se

E!,/rae+ )re/e!# ,$a!es ) 6s%#%! a,,r+%! # $%s ,)r# "%:e s%##%! !

(e+ %) $%s (+& ,a! #"era#e a!+ (& #/r!%! # s%+es # 6ree!# 6!e/!%a a!+

(e+sres. A%+ er s#re!//s a,#%%#%es

E!,/rae+ 6ass%e ra!e ) #%! # 6r#e 6r6er ,%r,/"a#%! a!+ 6ree!#

/s,"e a#r6$&G,6"%,a#%! (r/$# (& %(%"%#&. I!s#r/,#e+ a"s #$e ,"%e!# a# $e # (a"a!,e $%s +a%"& a,#%%#%es es6e,%a""& -$e!

+%s,$are+. E!,/rae+ 6a#%e!# # + +ee6 (rea#$%! e8er,%sesG Re"a8a#%! Te,$!%/e

Trea#e!#

A+%se+GE6$as%e+ #$e %6r#a!,e # a+$ere # #rea#e!# re%e!. T$a# %s #

)a,%"%#a#e )as#er %6ree!# ) 6rese!# ,!+%#%! a!+ 6ree!# ,6"%,a#%!. Be+ res# %s %6r#a!# # 6ree!# er )a#%a(%"%#& #$e! a(/"a#e -%#$ %! #"era("e

"%%#s A+%se+ # # #$e%r $ea"#$ ,e!#er )r ,$e,: /6 !%#r%!. T$%s s$/"+ (e +!e

!,e %! #$e -ee:. I!,rease+ )"/%+ %!#a:e /6 # *90 "asses a +a&

O/#6a#%e!# >CHEC9UP?

I!s#r/,#e+ #$e ,"%e!# # ,e (a,: !e -ee: a)#er +%s,$are+ )r )/r#$er )""-9/6

a!+ ea"/a#%! ) #$e ,"%e!#@s $ea"#$ ,!+%#%!. T$%s %s er& %6r#a!# s #$a# #$e

$ea"#$ ,!+%#%! ) #$e ,"%e!# -%"" (e ea"/a#e+ %) #$ere %s (e##er %6ree!#. T$e

6$&s%,%a! s$/"+ see a!+ e8a%!e #$e 6$&s%,a" a66eara!,e ) #$e ,"%e!#.

D%e#

I!,rease+ %!#a:e ) 6r#e%! (e,a/se #$%s %s %6r#a!# )r s:%! %!#er%#&.

I!,rease+ %!#a:e ) )r/%#s a!+ ee#a("es (e,a/se #$%s ,a! 6r%+e %#a%!s a!+

%!era"s )r !/#r%#%!.

)0


31/34

E!,/rae # ea# )+s r%,$ %! %!, s/,$ as es7 (ee)7 !/#s7 sar+%!es7 a!+ )+s

#$a# are r%,$ %! V%# (* s/,$ as (a!a!as a!+ a,a+s

T$e 6a#%e!# #$ers %s a+%se+ # ,e(a,: ! #$e s,$e+/"e+ +a#e ) %s%# -%#$ #$e

6$&s%,%a! #e#$er -%#$ #$e re)erra" )r %e! +/r%! #%e ) +%s,$are+ ! #$e e8a,##%eG+a#e a!+ 6"a,e s6e,%)%e+ )r !%#r%!Gre,$e,:%! ) $%s ,!+%#%!. E!,/rae

6a#%e!# # ea# re )r/%#s a!+ ee#a("es as -e"" # $ae r%,$ %! )%(er # 6ree!#

,!s#%6a#%!. A!+ "as#"& e!,/rae+ #$e 6a#%e!## $ae re/"ar %s%# # #$e $ea"#$ ,e!#er

r ,"%!%, a!+ a%+ se")9e+%,a#%! r #a:%! e+%,a#%!s /# ) -$a# %s (e%! 6res,r%(e+.

XII. PROGNOSIS

T$e a##e!+%! 6$&s%,%a!7 as -e"" as #$se -$ ae ,are a!+ s#/+%e+ #$e ,ase )

Mr.RTN ,ae /6 -%#$ + 6r!s%s (as%! )r #$e a)ree!#%!e+ %!+%,a#rs7 a!+

/s#%)%e+ as )""-s

A. !-"e+e ) #$e +%sease ,!+%#%!

T$e +%a!s%s )r #$%s ,r%#er%! %s 6r (e,a/se $e@s + !# )/""& /!+ers#a!+ #$e

%6r#a!,e ) ,6"%a!,eGa+$er%! # #rea#e!# re%e! a"#$/$ $e $as a 6s%#%e

a##%#/+e (/# s#%"" "a,: ) )%!a!,%a" as6e,# -as rea""& a! %6a,# ! $%

B. Aa%"a(%"%#& ) e+%,a#%!s a!+ ,6"%a!,e

N# +7 (e,a/se se#%e $e ,a! #a:e #$se e+%,a#%! !ee+e+ (/# as /,$

as #$e& -a!#e+ # s#%"" #$ere -/"+ (e a #%es #$a# #$e& +!@# $ae s/))%,%e!# )/!+s )r

#rea#e!# re%e! ,6"%a!,e.

C. A##%#/+e a!+ -%""%!!ess # #a:e #$e e+%,a#%!s a!+ )""- #rea#e!# re%e!

+ 6r!s%s (e,a/se $e -as a("e # #a:e $%s e+%,a#%!s ! #%e a!+

)""-e+ #$e #rea#e!# re%e! )r a!aee!# ) $%s ,!+%#%! -%#$ a 6s%#%e a##%#/+e

)r ,6"%a!,e a!+ ,6era#%! a"#$/$ #$ere -/"+ (e a #%e #$a# $e ,a!@# +e!& #$a#

$e %sse+ se +sae +/e # )%!a!,%a" as6e,#

XIV.Bi'0i8ra#&

)1


32/34

D/es7 M.E.e#.a".7 >2552?.. Nurse’s pocket guide: diagnosis, interventions &

rationales. >0#$ E+%#%!?.P$%"a+e"6$%a F.A. Da%s C6a!&.

D/es7 M.E.e#.a".7 >2552?.. Nursing care plan: guidelines for individualizing

patient care >*#$ E+%#%!? P$%"a+e"6$%a

F..A. Da%s C6a!&./"a!+%,:7 M. e#.a".7Nursing care plan. (3rd dition!

I!a#a%,%/s7 D.D. Wr:a!7 M.L. >255*?. "edical#surgical nursing: critical

thinking for collaborative care. >'#$ E+%#%!?. S#. L/%s7 M%ss/r% E"se%er Sa/!+ers.

%er7 B. e#.a".7 >2554?. $unda%entals of nursing: concepts, process & practice.

>#$ E+%#%!?. P$%"%66%!es Pears! E+/,a#%! S/#$ As%a PTE L#+.

Se"#er7 S.C. Bare7 B.. >2554?.extbook of %edical#surgical nursing >15#$

E+%#%!7 V"/e 2?. P$%"a+e"6$%a L%66%!,## W%""%as a!+ W%":%!s. 66 ''39'30.

S6ra##7 .R. W+s7 A.L. >14?. Nurse’s drug reference. USA De"ar

P/("%s$ers I!,r6ra#e+.

U"r%,$ Ca!a"e. >255'?. Nursing care planning guides. >*#$ E+%#%!?.

9e'0i8ra#&1

---.!/rs%!,r%(s.,

---."e.,

---.-%:e6e+%a.,

---.e+%6"/s.,

---.!/rses"a(.,

)(

http://www.nursingcribs.com/http://www.google.com/http://www.wikepedia.com/http://www.mediplus.com/http://www.nursingcribs.com/http://www.google.com/http://www.wikepedia.com/http://www.mediplus.com/


33/34

OURNAL READING

HBV $r*a0 ReviewMar# 75 36775 V0 5 * <by 'hristine ". ukka

Early Hepatitis B Screening and Treatment Saves Lives and Health Care Dollars

Ear"& +%a!s%s a!+ #rea#e!# ) $e6a#%#%s B ,/#s $ea"#$ ,are ,s#s a!+ +e,reases +ea#$

ra#es a! 6a#%e!#s %!)e,#e+ -%#$ #$e $e6a#%#%s B %r/s >HBV?7 a,,r+%! # a s#/+& (&

Ne- Yr: S,$" ) Me+%,%!e a!+ U!%ers%#& ) Pe!!s&"a!%a S,$" ) Me+%,%!e

resear,$ers.

C/rre!#"&7 47555 U.S. res%+e!#s +%e )r HBV %!)e,#%! ea,$ &ear a!+ #$e +%re,# a!+

%!+%re,# ,s# ) $e6a#%#%s B %s es#%a#e+ a# X1 (%""%! a!!/a""&. W$%"e #rea#e!# /%+e"%!es

e8%s#7 a!& %!)e,#e+ -%#$ HBV are !# +%a!se+ r #rea#e+ /!#%" #$e%r %!)e,#%! $asa+a!,e+7 res/"#%! %! ,%rr$s%s7 ,a!,er7 a!+ "%er )a%"/re. Fe-er #$a! 35= ) #$e

es#%a#e+ 2 %""%! 6e6"e -$ $ae $e6a#%#%s B %! #$e U.S. :!- #$e& are %!)e,#e+.

T$e resear,$ers ,!s#r/,#e+ a +e" #$a# ,6are+ #$e )%!a!,%a" a!+ s,%a" ,s#s )

#rea#%! 6a#%e!#s ear"& %! #$e%r %!)e,#%! aa%!s# a r/6 #$a# re,e%e+ "a#e ,are7 -$e!

,%rr$s%s a!+ "%er ,a!,er re/%re ,s#"& e+%,a" ,are a!+ #ra!s6"a!#s.

T$e& r/6e+ 6a#%e!#s (& #$e%r %ra" "a+ a!+ ae7 -$%,$ )#e! #ra!s"a#es %!# +%))ere!#

+%sease s#aes. I! ear"& ,are s,e!ar%s7 6e6"e re,e%e+ a!#%%ra" +r/s a!+ -ere

)re/e!#"& !%#re+ ear"& %! #$e%r %!)e,#%!7 -$%,$ :e6# #$e%r %ra" "a+s "-7 res/"#%! %!re /a"%#&9a+/s#e+ "%)e9&ears.

T$e resear,$ers )/!+ #$a# 6r%+%! ear"& ,are a%+s re ,s#"&7 +-!9s#rea $ea"#$

6r("es s/,$ as s/rer& )r ,a!,er r "%er #ra!s6"a!#s T$e 6r6r#%! ) 6a#%e!#s

-%#$ res"e+ %!)e,#%!s r "- %ra" "a+s -as '2.'= %! #$e "a#e ,are s,e!ar%7 a!+ 05=

))


34/34

%! #$e ear"& ,are s,e!ar% a)#er /s# )%e &ears ) #rea#e!# r "a,: ) #rea#e!#7 #$e&

-r#e %! #$e Fe(. 37 2511 %ss/e ) #$e /r!a" )ealth *ffairs.

T$e 6er,e!#ae ) 6a#%e!#s )a,%! ,%rr$s%s a!+ "%er ,a!,er7 -$%,$ re/%re+ #ra!s6"a!#s7

)e"" )r 1.2= a)#er #$ree &ears ) "a#e #rea#e!#7 # 5.= a)#er 25 &ears ) ear"& ,are.

Oer 25 &ears7 #$e !/(er ) !e- "%er ,a!,er ,ases -as '2 6er 1557555 ,$r!%,a""&

%!)e,#e+ 6e6"e %! #$e "a#e ,are s,e!ar%7 ,6are+ # /s# 14 6er 15557555 %! #$e ear"&

,are +e".

Pr%+%! ear"& ,are a"s +raa#%,a""& re+/,e+ +ea#$ ra#es. Dea#$s a)#er )%e &ears )

"a#e ,are 6er 1557555 6a#%e!#s -ere 2754 ,6are+ # 17*20 re,e%%! ear"& ,are. A)#er

25 &ears7 #$e +ea#$ ra#e -as 25735 6er 1557555 a! "a#e ,are 6a#%e!#s ,6are+ #

117*5* a! #$se re,e%%! ear"& ,are.

W$%"e %6"ee!#a#%! ) ,/rre!# s,ree!%! a!+ #rea#e!# /%+e"%!es -/"+ (e re,s#"& %! #$e s$r#9#er7 %# -/"+ sae "%es a!+ re+/,e ,s#s %! #$e "! r/! +/e #

re+/,e+ "%er +aae a!+ !ee+ )r ,s#"& s/rer& a!+ "%er #ra!s6"a!#s.

cp of viral hepatits ( prelim )

Documents