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Impaired swallowing is the abnormal functioning of the swallowing mechanism. The impairment is associated with deficits in the oral, esophageal or pharyngeal structure of the function. It prevents the sufferer from meets daily nutritional requirements by preventing proper eating and absorption. It is a difficult disorder and should be prevented. Impaired Swallowing Care Plan provides an updated assessment of the diagnosis to the patient with an impaired swallowing condition. For this reason, nursing care team may have a need to seek for impaired swallowing care plan writing help to design a neat and well structured impaired swallowing care plan for their patients.

Impaired Swallowing Care Plan Diagnosis

The signs and symptom that a care plan should anticipate include:

Oral: First stage

Chocking and coughing before swallowing
Drooling
Food pushing and falling from the mouth
Gagging before swallowing
Incomplete lip closure
Inability to clear the oral cavity
Insufficient chewing
Ineffective tongue action in forming bolus
Nasal reflux
Prolonged in inconsistencies in bolus

Pharyngeal (second stage)

Alteration in the head position
Chocking, coughing and delayed swallowing
Gagging sensation
Repetitive swallowing
Poor voice quality
Recurrent pulmonary infection

Esophageal: third stage

Swallowing difficulties
Acidic smell in breath
Heat burn
Bruxism
Hyperextension of the head
Nighttime coughing an awakening
Repetitive swallowing and complain of “stuck food.”
Voice limitation
Vomiting
Irritability around mealtime

In all phases, the swallow study is abnormal, and the patient may refuse to eat.

Impaired Swallowing Care Plan Desired Outcomes

A care plan by a practitioner caring for a patient with impaired swallowing should help to implement measures to improve swallowing ability and help the patient to achieve these outcomes:
Display ability to swallow safely as shown by the absence of choking, coughing or aspiration (drawing breath) when drinking or eating.
No status of foods in the oral cavity after feeding
Active ability to ingest food /fluid
Can discuss the appropriate actions to prevent choking or aspiration and emergency measures if chocking occurs.
Verbalizes best positioning when eating, safe environment and type of food that he or she can tolerate.

Impaired Swallowing Care Plan Nursing Assessment

Assessment is necessary for helping the caregiver to recognize the likely problems that could be the cause of impaired swallowing and handle any difficulty rat could emerge during care.

Asking the patient to swallow to assess his or her ability: Lets the caregiver determine ability of swallowing mechanism

Observe the occurrence of coughing or choking when eating and drinking: Signals a nurse about signs that indicate aspiration (drawing of breath).

Assess an ability to swallow small amounts of water: Ability to swallow liquid is a test for risk of aspiration

Check fluid or food backflow: Another signal about risk of aspiration

Determine and evaluate the readiness to eat: Helps to determine the physical and mental ability of a patient to attempt eating without the presence of aspiration.

Impaired Swallowing Care Plan Interventions

The care plan for impaired swallowing should contain therapeutic nursing interventions to help in managing the current condition and promote healing.

Position the patient in the proper position when eating: Correct positioning prevents aspiration.

Encourage eating small frequent meals with rests in between: These feeding steps prevent exhausting activities including feeding

Encourage self-feeding as possible: Promotes independence and motivates the patient to practice best swallowing techniques

The caregiver should place the food on the unaffected side when feeding a patient recovering from a stroke: Allows chewing on the unaffected side to prevent food from getting to the affected side a risking aspiration.

Prevent oral care before meals: Oral cleanliness helps to increase appetite.

Ensure their suction equipment at the bedside: Having suction equipment at the ready helps the nurse to drain saliva in case of drooling

Initiate alternative feeding when oral intake is impossible: Helps to maintain nutritional intake.

Oversee eating to the end: A nursed should oversee the feeding to ensure that the patient does not talk or get distracted while eating. It lets the entire concentration to be on feeding.

Arrange calorie count: Refer the patient to a dietician for calorie content in consideration to the patient's food preferences.

It offers guidelines on better food choices that have the correct caloric content: Consult a therapist or speech pathologist

Allow the patient to get quick intervention of swallowing and other accompanying impairment: It is good for the caregiver to praise a patient every time he or she follows directions and swallows successfully.

As healing progresses, it is necessary to weight the patient weekly to evaluate nutritional intake and encourage exercises that strengthen muscular strength of tongue or face.

It is also necessary to educate the patient and family on best caring practice and dietary requirements.

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Impaired physical mobility is a limitation of purposeful, independent movement of the body or body part. Impairment of physical mobility can be temporary, recurring or permanent. Aging is the most significant cause, but medical conditions such stroke of physical injuries that cause fractures can also hinder free movement.

Impaired Physical Mobility Care Plan Diagnosis

Various reasons may hinder the ability to move independently, but a caregiver should look for the defining signs and symptoms as the way of establishing whether a patient has impaired physical mobility.

The inability for purposeful movement within a physical environment. It includes bed mobility, ambulation, and transfers.
Failure to perform actions according to instruction
Limited range of motion

A patient with movement impairments will be reluctant to attempt any movements.

Impaired Physical Mobility Care Plan Goals and outcomes

A care plan should have goals to help the patient in recovering from impaired physical mobility or prevent deteriorating from current ability. After therapy intervention, a caregiver should help the patient to achieve some of the outcomes.

Regains ability to perform physical activity independently or within confines of a disease
Increased mobility
Ability to use increase movement with the use of adaptive devices
Becomes free from complications caused by immobility such as thrombophlebitis (blood clot in a vein), irregular, bowel patterns or labored breathing

Impaired Physical Mobility Care Plan Patient Assessment

Impaired physical mobility is a representation of complex health care problems that will require treatment by health care professionals in different specializations. However, nursing assessment is crucial to determine if it exists and identify underlying issues that could cause impaired physical mobility.

Check functional level of mobility

Functional mobility is on a scale of 1 ( walking at regular pace and ground level with one flight of stairs or more causing shortness of breath ) to 4 (Dyspnea and fatigue when at rest).

Understanding the particular level helps in adjusting the care plan to accommodate techniques that allow best management plan. You determine the patient's independent physical mobility on a 0-4 scale. 0 shows the person is independent and 4 are entirely dependent without participating in any activity.

Assess impediments to mobility

Identifying barriers to independent movement such as chronic arthritis, swollen/ painful joints help in designing an optimal treatment plan.

Assess strength to perform a range of motion on all joints.

Strength assessment provides helpful data on the extent of the physical problems and determining the right therapy. A test by a physiotherapist might be necessary.

Monitor nutritional needs to improve mobility

Good nutrition is a source of essential energy to participate in rehabilitative activities and exercises.

It is essential that a caregiver r determines if the cause of impaired physical mobility could be psychological. Some client is unable to move due to matters that emanate from their psychology state such as depression.

Impaired Physical Mobility Care Plan Intervention

After proving that the patient has impaired physical mobility, the caregiver must strive to implement the action part of the care plan. A nurse will not treat as a physician, but the rationale of the intervention is that it will help to restore mobility if possible. If it is impossible, a caregiver can still assist in preserving urgent motion.

Special care includes helping the patient to change positions, exercises, take nutritious diet and get a safe environment. A care plan for impaired physical mobility involves:

Implementing measures for maintenance of optimal mobility of joints and muscles during immobility through various actions.

Instructing and assisting clients to exercise the parts of the body they can move at least thrice a day unless there are other institutions by a physician
Help to perform activities and applying plan according to recommendation by occupational and physical therapists
Encourage participation in self-care if it is allowed
Assist the patient to use electrical stimulation devices as required to strength muscles
Perform actions that reduce contractures ( permanent shortening of joints or muscle due to prolonged immobility)
Help to determine and take adequate diet with the necessary nutrition to maintain muscle mass, strength, and tone.

Consult the right healthcare providers such as physicians or physiotherapists when there is a need or if the client’s mobility or range of motion is limited beyond expectation.

Marshall the support of family members by teaching and assisting them to assist the patient with a variety of movements. Encouragement from family and friends help to uplift the most of a patient.

A caregiver puts side rails and provides an overhead trapeze for the safety of a patient with mobility challenges.

The Impaired Oral Mucous Membrane Care Plan Writing Help Online is about a lining on the inside of the mouth consisting of an oral epithelium and lamina propria an underlying connectivity tissue. The impaired oral mucous membrane is a disruption of the soft tissue of oral cavity and or lips. Nursing Writing Services offers the best Impaired Oral Mucous Membrane Care Plan Writing Help Online

Irritations are indicators of the impairment when the oral mucous or oral mucosa has systematic conditions. Other numerous symptoms also appear when the oral mucosa has problems. Most of the impairments are viral and treatable.

Many factors contribute to the occurrence of infection oral mucous membrane including aging, lack of self-care, use chemicals such as tobacco or alcohol and medical conditions like cleft lip, dehydration or impaired salivation.

Impaired Oral Mucous Membrane Care Plan Diagnosis

When a nursing comes across a patient complaining of irritation on the oral mucosa, it essential to examine and inquire if these symptoms that indicate the existence of impairment are existing:

Bleeding
Discolored tongue
Edema
Enlarged tonsils beyond normal
Dry mouth
Discomfort, pain , lesions or ulcers on the mouth
Bad , diminished or absence of taste
Speech difficulty
Bluish or red masses

Impaired Oral Mucous Membrane Care Plan Goals and Outcomes

The caregiver should aim to help the client in achieving a healthy oral cavity indicated by the following:

Intact and moist oral mucous membranes without debris and ulceration
Eliminate discomfort and inflammation on oral mucosa
Patient demonstrates a measure to regain and maintain healthy mucous membranes
Absence of lesions
Patient swallows without any discomfort
Reports of diminished pain and oral dryness

Impaired Oral Mucous Membrane Care Plan Patient Assessment

A care plan for oral mucous membrane should include a comprehensive assessment to determine the extent of infection by doing the following:

Inspect the oral cavity daily to check for bleeding, edema, lesions or dryness: Oral inspection helps to reveal signs, symptoms, trauma and drug side effects and refer the case to appropriate physician
Assess mechanical agents like chemical agents such as tobacco or ill-fitting dentures: The presence of these conditions increases or causes trauma to the oral mucous membranes.
Determine and monitor the nutritional and fluid status and establish if it is adequate: Malnutrition and dehydration increase possibility of impaired oral mucous membranes.
Establish if the patient has indicators of infections that could cause impairment of oral mucosa even if it needs the involvement of a physician: Herpes, candidiasis, gram-positive and negative bacterial infections are some of the ways that severe mucositis manifests itself.

Early evaluation of these manifestations allows for early and accurate treatment.

Impaired Oral Mucous Membrane Care Plan Interventions

These therapeutic nursing interventions help to reduce the effect and heal impaired oral mucous membrane.

Plan a thorough mouth care regimen after every meal and 4 hours while awake: Mouth care prevent formation of bacteria and oral plaques

Increase rinsing with a recommended solution between brushings and once at night if there are signs of mild stomatitis: Solutions help to promote comfort and reduce further damage.

Provide topics or systemic analgesics on prescription: Analgesics relieve pain and provide comfort

Use tap water or a normal saline for oral care: Commercial mouthwashes contain hydrogen peroxide that injures oral mucosa or alcohol as it causes drying of oral mucous membranes. Lemon sycerin swabs decrease oral moisture, salivary amylaise and erodes tooth enamel.

Mouth lubrication and moisturizing: Lubricating prevents dryness on the lips prevent drying and cracking. Maintaining moisture by frequent sips of water promptes cleansing effect of saliva and avert mucosal drying which causes fissures, lesions, and erosions

Encourage moth and teeth brushing with a soft toothbrush after meals and flossing at least one in a day: Brushing reduces plaque and controls periodontal diseases. If brushing or flossing cause much pain, you should stop it.

Urge the patient to take a vitamin and protein-rich diet: A balanced diet helps to promote healing. Encourage taking of lukewarm soft foods that do not require hard chewing and drinks with a straw.

When patients heal, a caregiver should teach them to implement and an appropriate oral hygiene plan which is significant to oral health. Education should include teaching patients to inspect oral cavities to monitor sign and symptoms of the impaired oral mucous membrane for implementation of early treatment.

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Impaired Gas Exchange Care Plan Writing Services is mainly about a deficit or excess of oxygenation or elimination of carbon dioxide at the alveolar-capillary membrane. Both situations can cause hypoxemia and hypercapnia.Nursing Writing Services offers the best Impaired Gas Exchange Care Plan writing services online.

Gas exchange takes place by diffusion between alveoli and pulmonary. Oxygen and carbon dioxide diffusion occur passively according to their normal concentration differences that should be maintained by air flow (ventilation) of alveoli and blood flow(perfusion) of pulmonary capillaries.

A balance exists between the two, but these individual conditions might cause an alteration hence the impaired gas exchange.

Altered oxygen, oxygen supply, alveolar-capillary membrane and blood flow are other contributing factors.
Exposure to cold, smoke or allergens and sleeping on the stomach for infants can cause impaired gas exchange.

Impaired Gas Exchange Care Plan Diagnosis

A care plan should anticipate the existing factors that help to diagnose the existence of impaired gas exchange.

The following signs and symptoms show the presence of impaired gas exchange:

Abnormal breathing rate, rhythm, and depth
Nasal flaring
Hypoxemia
Cyanosis in neonates decreases carbon dioxide
Confusion
Elevated blood pressure and heart rate
A headache after waking up
Restlessness
Somnolence and visual disturbances

Impaired Gas Exchange Care Plan Goals and Outcomes

A caregiver should have goals to achieve for the benefit of a patient after care giving. At the end of care session, a nurse should have seen some of these outcomes on the patient:

Maintenance of optimal gas exchange of in unlabored respiration at 12-20 per minute.
Maintenance of clear lung fluids free of any respiratory distress symptoms.
Understanding of the oxygen and other essential therapeutic interventions
Participation in oxygenation optimizing and other management regimens within the level of condition and capability

Impaired Gas Exchange Care Plan Nursing Assessment

Despite the need for other diagnostic tests, a caregiver should begin by looking for clues about the status of the respiratory system and individual responses. These assessments help to determine if there are signs of impaired gas exchange.

Assessment of respiratory rate, effort, and depth: Shallow or rapid breathing patterns and hypoventilation will affect gas exchange.
Monitor mental and behavioral status: Behaviors such as restlessness, confusion, and agitation are pointers to impaired gas exchange.
Crackling breathing sound and limited chest excursion: Collapse of alveoli will increase perfusion without ventilation thereby causing hypoxemia.
Check for interactions in heart rate and B: These conditions and respiratory rate increase when there are underlying conditions such as hypercapnia or hypoxia that put the patient at risk of impaired gas exchange.
Observe the color of nail beds, oral mucous membranes and tongue for cyanosis(bluish discoloration appearance.
Central cyanosis or oral mucosa or tongue indicates serious hypoxia( deficiency of oxygen reaching the body tissues) that require immediate medical attention.Peripheral cyanosis can be severe or not but still needs a medical check.
Determine the patient's nutritional status: Obesity restricts movement of the diaphragm and excessive weight in chest wall thus causing labored breathing. Malnutrition reduces respiratory mass and also strength.
Assess the ability to count and hydration status: Retained secretions can weaken gas exchange while insufficient hydration reduces the ability by patients to clear secretions if they have COPD and pneumonia. Over hydration impairs fair exchange especially for patients with heart failure.

Impaired Gas Exchange Care Plan Interventions

Control concentration of oxygen in COPD patients

Oxygen concentration increases the urge to breathe in making the patient retain carbon monoxide chronically

Administer humidified oxygen through the most appropriate device

Using a breathing device helps to overcome hypoventilation during oxygen therapy for a patient with chronic lung diseases that may need the more hypoxic drive.

Teach slow breathing techniques

A caregiver should use an incentive spirometer according to an instruction to teach deep breathing techniques to the patient. It helps to increase oxygenation.

Perform suction when necessary

Suction helps to clear the secretions if a patient is unable to clear the airway.

Help the patient to sleep in the proper position

There are various sleeping positions for patients with impaired gas exchange due to multiple causes. For instance, a caregiver should position a patient with the head of the bed in an elevated position at 45 degrees to allow lung expansion, increase thoracic capacity and prevent crowding of abdominal contents. Patients with lung conditions such as abscess and hemorrhage should lie with affected lung down to avert drainage on the working lung. It is essential to turn a patient after every two hours.

Caregivers should inform that their patient at the hospital or home stay in an irritant-free environment.

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Imbalanced Nutrition: More than Body Requirements Care Plan

Imbalanced nutrition becomes "more than body requirements" when the intake of nutrients exceeds the metabolic needs. It takes root when a person food intake is more than what the body uses to generate energy,hence need for imbalanced nutrition care plan to control the problem.If the condition persists, it can cause obesity, sleep disorders, type 2 Diabetes mellitus, infertility in women, and aggravated musculoskeletal problems. It also shortens life expectancy. Caregivers should have an efficient imbalanced nutrition care plan for patient suffering from imbalanced nutrition due to excess food intake. Nursing Writing Services is a top-ranked writing company and has the most qualified writers in the provision of an imbalanced nutrition care plan writing services.

More than Body Requirements Care Plan Diagnosis

Overweight, obesity and eventual imbalanced nutrition are a sedentary lifestyle, genetics, dysfunctional eating or medical conditions such as diabetes are some of the common cause of imbalanced diet.

The signs and symptoms below show that the intake of nutrients exceeds the metabolic needs.

Excessive intake of food in relation to the body's energy needs
Poor dietary habits and dysfunctional eating patterns like eating while engaging in other activities
Metabolic disorders
Using food as a mechanism to cope with emotional factors such as stress
Excess body weight by over 20% over ideal height and frame
Eating a large amount of food at the end of the day
Eating as a response other internal and external cues other than hunger such as anxiety or social factors
Triceps skin fold that is greater than normal size by over 15mm for men and 25 mm in women.

More than Body Requirements Care Plan Goals and Outcomes

A caregiver who deals with imbalanced nutrition due to consuming more food than the body requirements should have a care plan that helps a patient to attain these diet and healthy living goals.

Loose excess weight in a reasonable period. One to two pounds is a good starting point
Engages in relevant energy spending activities on a daily basis
Determine pertinent factors causing weight gain
Make dietary modifications to meet energy requirements
Gain control over current eating habits to attain a long term weight control by moderation and balance
Help the client to know about scientific sources that help in evaluating any need for nutritional supplements.

Imbalanced Nutrition Care Plan Assessment

Get the patient's history to determine if a patient only requires diet therapy or has other underlying illnesses that could be a contributor to excessive weight gain that may also require treatment.

Evaluate a patient psychological status

Psychological factors could be contributing to the excessive consummation of nutrients that body requirements. It is important to identify if a person is going through issues that cause disturbed emotions, thoughts and body image. A caregiver can help the person to resolve these issues to assist in long-term maintenance of healthy weight.

Assess the patient's knowledge on a nutrition diet and daily intake

It is wise to know if the patient knows what makes up a healthy diet. A person could be taking the wrong digest for his or her energy needs due to ignorance. Part of the help to such persons is to offer them information about the right diet for them.

Assessing the amount of food a dietary complement over 24 hours helps a nurse to determine if the patient has knowledge or ability to find the moat health diet. After that, a nurse knows the right information to offer the patient and follows up to ensure that the patient maintains consumption of a healthy diet.

More than Body Requirements Care Plan Interventions

A caregiver helps the patient to achieve the following:

Set and maintain healthy eating habits. A caregiver should help the client to prepare a meals diary comprising of daily food intake of healthy low-calorie foods and adequate amount of water to prevent overeating at frequent intervals. Other healthy eating habits that caregiver should help to a patient to achieve to:
Eat at the dining table only when hungry or time on the eating diary
Avoid idleness as it causes an urge to eat
Enhance exercising. Exercise increases energy expenditure to burn most of the food and maintenance of a lean body mass. A long-term exercise program is essential for weight reduction. A caregiver should help the patient to identify the best exercises and prepare a diary.
Introduce stress reduction methods. It is important for a caregiver to teach a stressed patient about the best way to overcome the cause and avoid overeating as a solace.

A caregiver should weight the patient at least two times a week and the same conditions to determine if there is any progress in cutting excess weight.

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imbalanced nutrition care plan writing services

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Imbalanced nutrition care plan writing services is a serious task as it is about coming up with care plans to solve imbalance nutrition-related problems, this means that our writers take a lot of seriousness in doing research to come up with reliable care plan information. Order with us to get the best online imbalanced nutrition care plan writing services.NurseDepo

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