Nursing Care Plan for Unilateral Arm Lymphoedema- myassignmenthelp

Question: Discuss about theNursing Care Plan for Unilateral Arm Lymphoedema. Answer: Intervention: Laboratory analysis of the urine sample for the evaluation of the presence of bacterial culture, red blood cells and white blood cells. Rationale: The gold standard for the detection of the urinary tract infection (UTI) is via urine culture via using midstream urine. It helps in the estimation of bacteriuria or the concentration of the bacterial population in the urine. 10^5 colony forming unit (CFU) is considered as the threshold, the CFU higher than the threshold signifies UTI (Foxman, 2014). However, the threshold might change depending on the bacterial strain residing in the urine culture. Betty White is suspected to be suffering from UTI because her urine has offensive odour. Normal urine is clear with a mild straw-yellow colour. The odour of the urine may vary from person to person but does not have a strong smell. The presence of bacteria in the urine (as in case of UTI) can alter the urine odour making it pungent or offensive (Foxman, 2014). Other symptoms which indicated UTI are a) Type 2 Diabetes: Type 2 Diabetes increases the chance of UTI. Diabetes hampers normal circulation of blood as a result the WBC, the principal immune cells fail to travel to all portion of the body, leading to bacterial colonization in the urine (UTI). Moreover, during diabetes, the emptying of the bladder urine gets hampered as a result urine stays in the bladder for long promoting bacterial proliferation (Foxman, 2014). b) Breast Cancer: Chemotherapy for breast cancer treatment causes drying out of the vaginal tissue and reduces bodys ability to combat against infection generating susceptibility for UT. Moreover, UTI is common in older women (Mody Juthani-Mehta, 2014) Lymphoedema occurs due to swelling of the lymph nodes that blocks the normal functioning of the lymphatic system. Out of the five women who have been suffering from breast cancer develops lymphoedema (DiSipio, Rye, Newman Hayes, 2013). Bratty White has a clinical history of breast cancer and hence she has developed lymphoedema in her right arm. Here the obstruction of the lymphatic system might have occurred due to the consequence of tumor, radiation therapy, chemotherapy or surgery of the breast cancer (Brahmi Ziani, 2016). Intervention Rationale Periodic encourage Betty to void urinary bladder after every 2 to 3 hours while accessing patients pattern of urination This will prevent accumulation of urine in the bladder and thus reducing the number of bacterial colonization (Oman et al., 2012) Encourage Betty to consume 3-4 litres of water per day (if tolerated) It will help to increase the fluid balance in the body, help in proper renal flow via diluting the concentration of urine (Oman et al., 2012) Maintain acidic environment inside the bladder via administration of medicines like vitamin C or ascorbic acid Acidic environment will prevent the growth f bacteria (Oman et al., 2012) Nursing Care Plan: 1 Nursing diagnosis Urinary Tract Infection Nursing goal Restoration of the normal bladder function and resolution of the urinary infection Interventions Rational Proper access of the urine colour, concentration, odour and urine clarity Helps in the identification of the chronicity of the disease Performance of the appropriate laboratory test Helps in the identification of the bacterial strain colonizing inside the urinary tract (Oman et al., 2012) Nursing Care Plan: 2 Nursing diagnosis High blood pressure (BP) (145/90) Nursing goal To reduce the high blood pressure of Betty White and provide her relief from hypertension Interventions Rational Proper monitoring and recording of the BP in both the arm and things after an interval of 5 mins while the patient is at rest Comparison of the BP level helps to get a clear view of the nature of vascular impairment or the scope of the underlying problem Taking notes of the peripheral pulses Helps in the detection of the level of vaso-constriction followed by proper diagnosis of the disease condition and care (Benetos et al., 2015) References Benetos, A., Labat, C., Rossignol, P., Fay, R., Rolland, Y., Valbusa, F., ... 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Nurse-directed interventions to reduce catheter-associated urinary tract infections.American journal of infection control,40(6), 548-553.