Dharline Abbygale G.

Agullana BSN III-B LEPROSY Nursing Diagnosis Social Isolation related to presence of skil lesions all over the body as manifested by refusal to interact ith others! insecurity in public! dull affect! ithdra n! no eye contact ith a verbali"ation of #dik kayat ti makalangen-langen ta mabainak kadetoy sakit ko!pagarup dan tu pay akarak suda# Nursing Inference $ycobacterium leprae! the causative agent of leprosy! primarily a affects the superficial peripheral nerves hich is manifested e%ternally as skin lesions. &he patient have skin lesions all over the body thus he can no longer hide it. Because of the stigma that leprosy is a humiliating disease and easily transmittable! the patient refuse to interact ith others thus e%periencing social isolation. Nursing Goal After '-( hours of nursing interventions! the client ill be able to increased sense of selforth as manifested by illingness to engaged in pharmacologic measures to manage the disease! understand that leprosy is not highly contagious and people ith leprosy has also a normal life ith a verbali"ation of #Ammok itan nga haan unay makaakar ti leprosy nangruna nu agagas nak isu nga agtumarak tay agas ko kanayunen tapnu malaingan nakun ken maprebentarak nga makaakar nak.# Nursing Interventions 1. Establish therapeutic nurse client relationship -promotes trust allo ing client to feel free to communicate his problems !. Provi"e accurate infro#ation about lepros$ to the client -to increase the level of kno ledge and at the same time correct misconceptions about the disease %. E"ucate the client about the i#portance of ta&ing the prescribe" #e"ications -to increase adherence to the medications thus managing the disease and problem '. Encourage the client to avoi" snee(ing or coughing in front of people or in the public to prevent transmitting the disease ). Provi"e positive reinforce#ent *hen client loses hope to encourage continuation of efforts Nursing Evaluation

After ( hours of nursing interventions! the client as able to increased sense of selforth as manifested by illingness to engaged in pharmacologic measures to manage the disease! understand that leprosy is not highly contagious and people ith leprosy has also a normal life ith a verbali"ation of #Ammok itan nga haan unay makaakar ti leprosy nangruna nu agagas nak isu nga agtumarak tay agas ko kanayunen tapnu malaingan nakun ken maprebentarak nga makaakar nak.# DENG+E ,E-ER Nursing Diagnosis )isk for bleeding related to altered clotting factor secondary to Dengue Nursing Inference Since the client as bitten by an infected mos*uito! the virus has rapidly dissemianated in the blood causing several mechanisms that leads to the occurence of altered clotting factor. &hese includes the suppresion of the bone marro by the dengue virus and its possible binding to human platelets in presence of virus specific antibody and immune mediated clearance of platelets. It may also bedue to the spontaneous aggregation of platelets to vascular endothelial cell pre-infected by virus inducing aggregation! lysis and platelet destruction. All of hich decreases the clotting factor of the infected person thus the patient is prone or risk for bleeding Nursing Goal After +, minutes to ' hour of rendering nursing interventions the client ill be able to demonstrate behaviors that reduce the risk for bleeding as manifested by laboratory results ithin normal range! increased fulid intake and avoidance of in-ury hich may precipitate bleeding. Nursing Interventions 1. .ssess an" #onitor vital signs of the patient -to serve as a baseline data and an increase in pulse ith decreased blood pressure can indicate loss of circulating blood volume !. .ssess for signs an" s$#pto#s of GI blee"ing /*hich #a$ be #aniste" through "ar& stools or bloo"$ vo#itus0 the GI tract is the most usual souce of bleeding because of its mucosal fragility %. Note changes in sensoriu# -changes such changes in mentation and level of consiousness. this may indicate decreased cerebral perfusion due to hypovolemia '. .voi" rectal te#perature -rectal and esophageal vessels are most vulnerable to ruptue ). Encourage the use of soft tooth brush to avoid mucosal bleeding

1. Instruct the client to avoi" straining for stool an" forceful nose blo*ing -this may cause mucosal bleeding 2. Encourage the client to avoi" eating "ar& colore" foo"s -the feces may turn dark/black and this may be mistaken as internal bleeding 3. Instruct the client to increase flui" inta&e to maintain hydration of the client 4. Encourage the client to rest #ore -to recover from the pains and aches brought by disease and at the same time conserve energy Nursing Evaluation After ' hour of rendering nursing interventions the client as able to demonstrate behaviors that reduce the risk for bleeding as manifested by laboratory results ithin normal range! increased fulid intake and avoidance of in-ury hich may precipitate bleeding.