ASUHAN. KEPERAWATAN PADA LANSIA DENGAN DEMENSIA Oleh: 1. Sena Wahyu Purwanza 2. Endah Widayanti 3. Contoh masalah dimensia. Nutrisi/cairan: memori sekunder dari dimensia. 2. Resiko melakukan Memberikan rangsangan pada SSP khususnya fluid. Karena penyakit-penyakit yang menyebabkan demensia berkembang Tanda- tanda awal juga mungkin tergantung pada jenis demensianya dan bisa sangat.
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Number Visitor site meter statistics. Preparation of patient, nurse and environmental. Introduce yourself to the client, including name, job title or role, and explain what you will do. Verify the identity of the client. Explain the procedure and the reasons for such action, explained in a language that can be understood by the client. Wash hands before contact with new clients.
Ensure that clients are comfortable and that you had were dememsia good and have adequate lighting for the task. Provide privacy for the client, or the client’s position and closed as needed. Ditch patients at least 5 minutes before the measurement. And make sure patients feel relaxed and comfortable. Ask the patient to open the upper arms to be checked, so there is no pressure on the brachial artery. Positioning the patient can lie, half-sitting or cemensia comfortably with the volar forearm above.
Use cuffs that fit the size of the patient’s arm.
Fit a circular cuff on the arm at heart level checkpoints, with the bottom cuff cm above lamsia cubital fossa and which parts tapping rubber balloon just above the brachial artery. Sure the hoses are not bent or pinched cuff. Connect sphymomanometer cuff awkep mercury, upright position and the level of the mercury level of the heart.
Feel brachial arterial pulse in the cubital fossa and the radial artery with the index finger and middle finger to ensure no emphasis. Ensure eye examiner must be parallel to the surface of the mercury so that the proper reading of the measurement results.
Close control valve on the pump cuff.
Ensure proper entry into the stethoscope ear examiner, palpating the radial artery pulse. Pump the cuff until no palpable radial artery pulse again. Then pump again until mm hg not paxa, because it will cause pain to the patient, the pain will increase tension. Put the head of the stethoscope over the brachial artery.
Disconnect the control valve slowly so that the mercury drops with the speed of mm hg per second per second or 1 scale. Ensure high mercury when the first beats sound the lansix artery is the systolic pressure.
Ensure high mercury in the event of changes in the sound suddenly weakened throbbing latter diastolic pressure. Disconnect from ear examiner stethoscope and cuff from the patient’s arm. Clean earpieces and diaphragm stestokop with disinfectant. If the retry wait at least 30 seconds. Say thank you to clients. Immediately report the presence of abnormal findings.
Clean and return equipment that is used in place. Open PPE and wash hands. Document the results of the procedure. Clean the thermometer with clean water when stored in a disinfectant solution and then dry with a paper towel. Performed many times until the mercury is below C scale.
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Invite the client open reservoir mouth and place it under the tongue sublingual. Navigate to the corner of the mouth thermometer and encourage clients to shut his mouth tightly.
Demenxia thermomether for minutes. Read and record the results obtained. Put the reservoir right in the middle of the armpit, close the upper arm to the body and sleeves client down on the chest client.
Konsep Dan Respon Kematian Pada Lansia CNP IV
Allow the thermometer for demensai. Adjust the position of the client with sim position and reveal little blankets clients to stretch the buttocks buttocks clients to look sphinchter ani. In infants, the supine position and lift both legs. Insert the thermometer into the rectum reservoir 3. Allow to stand for minutes. Thermomether Remove and wipe with tissue paper towards the reservoir, so the water looks clear mercury. P reparation of patientnurse and the environment: Introduce yourself to the clientincluding namejob title or roleand explain what you will do.
Verify the identity of the client 3. Explain the procedure and the reasons for such action Prepare equipment 4. Wash hands before contact with a new clientwear PPE 5.
Provide privacy for the client,ansia the client’s position and closed as needed. When a new client activitywait minutes to check pulse. Arrange clients with supine sleeping position, or sit semifowler.
Put 3 fingers index, middle finger and ring finger just above the artery being examined radial or other. Use your index finger to press the artery while the middle and ring finger to assess the quality of rhythm and a pulse. Perform checks for one minute. Record for the measurement: Pulse frequency in a minute. Knowing the patient’s general kesdaan. Determine the paea and fragile nature of breathing askkep 1 minute 3.
Following the development of the disease 4. Do not tell the client that the nurse would calculate the frequency of respiratory Make sure the client sitting in a comfortable position better. Place your hands crossed to the patient’s chest. Observation movement of azkep chest wall during inspiration and exspirasi one respiration. Calculate the amount of respiration in a minute. Record the results obtained include: Chest wall motion abnormalities.