HEALTHY LIVING

NURSING DIAGNOSIS

1. Alteration in nutritional status related to anorexia,nausea and vomiting.
2. Impaired skin integrity related to pruritis.
3. Activity intolerance related to fatigue and generalized malaize.
4. Abdominal pain related to tender, enlarged liver.
5. Fever related to body's defense reaction to invading organism.
6. Potential spread of infection.

Expected patient outcome and Nursing Intervention

1.Alteration in nutritional status related to anorexia, nausea and vomiting.

Expected patient outcome

a. Maintains adequate nutritional intake, avoids alcohol during ilness, maintains weight and identifies features of balanced diet.

b. Report decrease in anorexia , nausea and vomitting.

Nursing interventions

a. Provide balanced meals consistent with patient's food preferences.

b. Provide pleasant environment for meals.

c. Encourage the patient to eat in sitting positition to decrease abdominal tenderness and feeling of fullness.

d. Proovide frequent small meals if severe anorexia .

e. Instruct the patient about the importance of a balance diet and the need to avoid alcohol during illness.

2. Impaired skin integrity related to pruritis

Expected patient outcome.

Demonstrates improved skin integrity-intake skin with no evidence of excoriation for infection, decrease scrathing, no prurutis.

Nursing intervention.

a. Use starch or baking soda baths, soothing lotions such as calamine.

b. Administer cholestyramin (questran) to promote fecal excretion of bile salts to decrease itching .

c. Administer antihistamines, transquilizers, and sedatives if prescribed.

d. Assist the patient to divent the patien in reducing the strong tendency to scrach his skin :

• encourage activities to divent the patient attention
• keep nails trimmed and clean
• Avoid excessive top bleeding
• Give sooting massage, particular at night in prepering the patient for sleep, since this is a time when he is specially likely to scrach.
• Provide the client with gloves to use at night if the patient scratches during sleep.

3. Activity Intolerance related to fatigue and generalized malaise.

Expected patient outcome

Exhibits increased ability to carry out desired activities and allow sufficient periods for rest and relaxation.

Nursing Intervention

a. Encourage the patient to limit activity when fatigue

b. Assist the patient in planning periods of rest and activity when symptoms begin to subside.

c. Encourage gradual resumption of activities and mild excercise during recovery.

4. Abdominal pain related to tender, enlarged liver.

Expected patient outcome

Report a decrease or absence of abdominal pain and tenderness;restrict activities if pain occurs;participates in planned activities when free of pain; take prescribed analgesic if necessary.

Nursing Intervention

a. Asses and record presence or absence of abdominal pain or tenderness, hepatomegally and splenomegally.

b. Encourage the patient to maintain bedrest or restrict activities if abdominal pain or tenderness is present.

c. Administer analgesic as prescribed.

d. Notify the physian of sudden occuraence or increase in pain or tenderness.

5. Fever related to body's defense reaction to invading organism.

Expected patient outcome

Shows signs of recovering from fever, temperature begins decline, sense well-being returns.

Nursing Intervention

a. Reducing the fever when indicated(it's often impotant to wach temperature curve)

• Administer antipiretic drug as docter order
• Employ cool sponges cautiously as indicated

b. Measure and record body temperature, pulse and respiratory rates frequently.

c. Ensure the adequate hydration in the even excessive fluid loss through vomiting, diarhea or excessive sweating:

• Encourage liberal fluid intake.
• Prefpare for administration of IV Fluid as required.

6. Potential spead of infection

Expected patient outcome

Protect self and others from spread of infection adheres to anyisolation and hygiene measure that are implemented, reminds personne and visitors to wash hand when entering and leaving roo.

Nursing Interventions

a.Wash hand immediatly after contact with each patient and after every contact with that maybe contaminated and potentialy infectious-wash hand even if sterile gloves are used, wear gloves for direct exposure to blood, drainage or secretions (gloves are disposable)

b. Handle needles and syrings with extreme care because it is ussually not known which patient blood is contaminated

• Places used needles in labelled, puncture-resistance container, don not bend or break by hand.
• Blood spills should be cleaned up promptly with a solution of 5,25% sodium hypochloride sodium diluted 1:10 with water

c. Control dissemination of infections droplets

• Encourage the patient to cover nose and mouth when coughing or sneezing.
• Wrap contaminated tissues and articles in paper before disposal.