Sandra Hutto Faria

Limb loss: Alterations in body image

An estimated 10% of persons older than 70 years have peripheral vascular disease. Peripheral vascular disease includes venous and arterial medical conditions. Peripheral arterial disease (PAD) is a major concern in assessment of patients for loss of limb. With the ever increasing numbers of senior citizens in the United States today, a major public health concern is the management of chronic health problems. Many persons who have progressive PAD as a result of circulatory changes eventually are forced to have a limb amputated. This amputation triggers the realization of the loss of the limb, which directly influences body image. Therefore, management of the effect of limb loss on body image becomes a major nursing consideration in health promotion/health maintenance endeavors by health care professionals. This article explores the concepts of limb loss and body image. The relationship between PAD and limb loss is established. The conceptual link between limb loss and body image alteration is described, with emphasis on the importance of nursing interventions to manage body image alterations. Pathophysiologic conditions leading to PAD and limb loss are reviewed. Nursing implications for management of body image alterations with limb loss are summarized.

Through the eyes of a family caregiver part 2: Strategies to manage caregiver problems

With the ever-increasing number of U.S. senior citizens, maintaining the health of care-givers for the chronically ill has become a major public concern. About 20% of older Americans need help getting out of bed and bathing. Millions more need help with finances, meals, and transportation. Overwhelmingly, their families provide that help; only about 5% of elderly Americans live in nursing homes.

Caring for the patient with a gastrostomy/jejunostomy tube

A gastrostomy or jejunostomy (G or J) tube is useful for feeding malnourished patients and is preferred to prolonged use of total parenteral nutrition. Because enteral feeding has become commonplace in both the hospital and home setting, it is vital that health care workers instruct caregivers on the treatment of individuals with G tubes and/or J tubes. Many problems can be prevented when caregivers know how to care for the patient and troubleshoot potential concerns.

Assessment of peripheral arterial pulses.

For the home care provider, determination of adequate cardiac function is vital to the well-being of the patient at home. If the heart fails as a pump, the patients physical condition will deteriorate rapidly. This article will briefly review the normal blood vessel and blood flow principles and the principles guiding assessment of peripheral arterial pulses.

Assessment of vital signs in the child

Abstract An assessment of an individuals vital signs—temperature, pulse, respirations, and blood pressure (BP)—gives an overview of his or her general health. These measures, which indicate the effectiveness of circulatory, respiratory, and neural body functions, offer a quick and efficient way to monitor a childs condition, identify problems, and evaluate the response to interventions. Therefore, it is imperative that the home care provider accurately assess these values. This article will review key principles in assessing vital signs in the child.

Reflex sympathetic dystrophy syndrome: An update

RSDS is a complicated condition that requires early diagnosis and treatment for a favorable prognosis. The nurse should be alert to clinical signs in a patient with a traumatized area and report them to the physician as soon as possible. Management of the pain and establishment of trust will help promote successful physical therapy for the patient. The nurse should coordinate and manage the total care of the patient so that emotional and physical care can be at an optimum level for the patient and the patients family.

Assessment of immobility hazards

As home health care nurses, we see many patients who are bedridden or immobilized. Impaired physical mobility (immobility) is defined by the North American Nursing Diagnosis Association as a state in which the individual experiences or is at risk for experiencing limitation of physical movement. Altered physical mobility can be a result of prescribed bedrest, movement physically restricted by an external device (e.g., a cast), voluntarily restricted movement, or impaired or lost motor function.

Interpretation of arterial blood gases by nurses

Many clinical nurses find the concept of acid/base balance confusing. This article presents a step-by-step approach to arterial blood gas (ABG) analysis. In addition, the components of ABGs (pH, PCO2 and HCO3) are presented; metabolic and respiratory abnormalities (acidosis and alkalosis) are discussed in relation to cause and signs and symptoms; the concept of compensation is reviewed; the degrees of compensation are explained; the five steps of ABG analysis are outlined; and practice problems are provided and explained. By using this approach, the nurse can analyze the ABG values confidently and make a wise choice about appropriate nursing actions.

Assessment of infections in home care patients

Infections can occur in any individual fairly rapidly. If the patient is hospitalized, frequent assessment by the nurse usually leads to early detection and treatment. In the home, patients are assessed less frequently, and therefore infections may go undetected for longer periods. Thus it is important for home care providers to assess patients who may be at risk for infection during each visit. Knowing who is at risk for developing a specific infection is an essential element in the assessment process. Such knowledge helps determine both the frequency and depth of patient assessment and the time necessary for the home health care provider to perform this activity. Additionally, family caregivers need to be taught information about infections (i.e., what to assess, how to prevent) whenever possible.

Assessment of the patient in heart failure

Abstract Heart failure is the inability of the heart to act as a pump to supply the body with adequate circulating blood. If the heart suddenly becomes damaged in any way, its pumping ability decreases. Therefore the home care provider must be alert to the clues indicating heart failure so that early interventions can be initiated. This article briefly reviews the basic principles of cardiac function and the classifications of heart failure, basic assessment of the heart failure patient, and assessment for heart failure complications.