Comprehensive Health Assessment (Final Cha)

8/13/2019 Comprehensive Health Assessment (Final Cha)

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Comprehensive HEALTH ASSESSMENT11 PATTERN GORDON

IN structured !"

#ictor Mu$%tu%A&'(()NIM (11(''(('

INSTIT*TE O+ HEALTH SCIENCE ,INA-AN

.A/ARTA

,%c0 round,urns %nd in2uries re$%ted to him or her is sti$$ the $e%din c%use o3 de%th %nddis% i$it! in the *nited St%tes utm%& C$inic%$ insi hts o3 urn c%re re3ers to the 3$uid%nd e$ectro$!te ph!sio$o !4 sur ic%$ in3ections4 nutrition%$ m%inten%nce4 monitorin0%rdiopu$mon%r4 %nd 5ound c%re4 5hich none c%n e %ddressed %s sep%r%teconditions 5ithout underst%ndin the dise%se process %s % 5ho$e& C%re centers

shou$d e e6uipped urns 5ith e6uipment th%t c%n provide support services 3or the$on .%n0% p%tients 5ith urns th%t %re sm%$$er %nd do not re6uire hospit%$i7%tion&In the *nited St%tes % out ' mi$$ion peop$e su33er urns e%ch !e%r4 8((4((( peop$e5ere tre%ted in emer enc! rooms4 5hi$e 9: ((( p%tients need tre%tment in hospit%$%dmissions due to urns& More th%n '(4((( p%tients h%ve ver! severe urns so th%tre6uire tre%tment %t % speci%$i7ed urns c%re center& T5e$ve thous%nd peop$e 5i$$die 3rom urn in2uries&

The $%r est roup 5ith urns c%ses 5ere chi$dren under the % e o3 ; !e%rs< even the


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u$0 o3 $ess th%n ' !e%rs o$d& The second is the pe%0 incidence o3 urns due to 5or04ie %t the % e o3 '8=>8 !e%rs& Despite the num er o3 e$der$! p%tients 5ith urns 6uitesm%$$4 ut these roups o3ten re6uire speci%$ tre%tment in the 3%ci$it! urns&Accordin to current rese%rch4 the surviv%$ in 5hich p%tients c%n return to the st%te

e3ore the in2ur! in e$der$! p%tients4 h%s improved more r%pid$! th%n the ener%$

popu$%tion o3 other urns& The incidence o3 urns p%rticu$%r$! in men4 ec%use o3the domin%nce o3 m%$e 5or0ers in he%v! industr! %nd the $ives o3 men %re %t hi herris0&,urn in2uries o3ten invo$ve the socio=economic roups 5ho %re $ess 3ortun%te&Perm%0%i%n he%ters th%t c%n open dipind%=Pind%4 e$ectric%$ s!stem %nd the 5%rminth%t is not true4 cro5ded $ivin conditions4 %nd the % sence o3 smo0e pendeter0sitoo$s4 %re the c%uses o3 urns&Centr%$ tre%tment center ne%r pu $ic housin or in %re%s ne%r the oi$ industr! more$i0e$! to receive in2uries 3rom urns& -hi$e the center = in the midd$e o3 the cit!center c%re more $ister in2ur!& E$ectric%$ in2ur! c%n occur due to occup%tion%$ or%ccident%$ cont%ct 5ith hi h ten %n %n 3$o5 3rom the su 5%!& C%ses o3 3ires %nd

urns 3rom smo0in seems dip%$por0%n $ess th%n it shou$d& H%mpis ste%m urns0ern% entire$! on the peop$e 5ho 5or0ed on the production %nd distri ution o3ste%m& ?Sc5%rt7 Se!mour4 '(((@&Prior to hospit%$,urnin process shou$d e stopped %s soon %s possi $e4 3or e %mp$e doen %ne tin uish the 3ire4 di$ute %nd 5%sh the chemic%$s th%t destro!4 or remove thevictim 3rom cont%ct 5ith e$ectric current c%uses& -hether or not to use therespir%tor depends on the ener%$ condition %nd respir%tor! st%tus o3 victims& I3 thep%tient is urned in % c$osed room4 m%0 h%ve predicted the e istence o3 c%r onmono ide poisonin in cert%in de rees4 %nd h%ve iven 1((B o ! en usin % m%s0th%t 3its& I3 the victim is the e ch%n e o3 respir%tor! 3%i$ure4 then %n endotr%che%$tu e %nd % venti$%tor c%n e mounted& ,urns need to e covered 5ith % c$e%n c$othor %u7e %nd% e4 to prevent 3urther cont%min%tion o3 the 5ound sur3%ce4 %ndreduce p%in in cert%in re ions o3 D%er% thic0ness urns& The ne t victim 5%scovered 5ith % c$e%n $%n0et to prevent $oss o3 od! he%t %nd reduces the ris0 o3h!pothermi%&In Indonesi% the incidence o3 urns is hi h enou h4 more th%n '8( peop$e per!e%rs died 3rom urns& Due to the num er o3 chi$dren %nd the e$der$! is hi h inIndonesi% %nd the po5er$essness o3 chi$dren %nd the e$der$! to prevent 3ire4 then4the % e o3 the chi$dren %nd the e$der$! %ccounted 3or the hi hest de%th r%te 3rom

urns th%t occurred in Indonesi%& ?Http" 555&$u0% %0%r&net&htm@

,erd%rs%r0%n description % ove %uthors %re interested in discussin the c%se inIndonesi% di0er%n%0%n urns urns the incidence is sti$$ hi h& Se$%i%n it4 th%t thepeop$e o3 Indonesi% %re sti$$ not %5%re o3 proper h%nd$in to cope 5ith severe urns&

Then the incidence o3 urns is sti$$ 6uite hi h in the chi$d s % e %nd the e$der$! inIndonesi%


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C$ient n%med Mr&& S4 88 !e%rs4 m%$e d%tin to ,udi Merc! Hospit%$ emer enc! roomon the ;th o3 .une '(1' %nd %dmitted on the 9th 3$oor 5est %t (9"(( pm c%rried !o33icers 3rom the 5or0p$%ce o3 emp$o!ees 5ith prim%r! comp$%ints o3 urns& On%rriv%$ %t the hospit%$ per3ormed the %ssessment o3 the urn is 5hen the c$ient %nd

the c$ient 5or0 men!e$up0%n his h%nd in the h!droch$oric %cid& A out % hour $%terthe c$ient 3e$t his h%nd on 3ire %nd turned into % 3orm o3 s0in ch%pped& C$ientsdirect$! re3erred to the hospit%$ one hour %3ter the urn& Di% nosis is % urn medi%c$ient 1)B on the %nte r%chii in the %rm ! h%nd& C$ients do not h%ve % histor! o3h!pertension %nd di% etes me$$itus4 or chronic dise%se& Leve$ o3 c$ient %5%renesscompos mentis4 ,, h%s not decre%sed since the i$$ness& TT# c$ients" ,P 19( 1((mmH 4 N )( mnt4 stron 4 RR '; mnt4 S >; C& C$ients %re iven dru s such%s R%nitidine In2ection I#4 0etoro$%c ' 14 Ce3tri% one I# In2ection %nd in3usionAserin mounted 8((cc ) %t '( drops per minute& L% or%tor! tests on .une ;4 '(1'resu$t" Leu0oc!tes" 1>&) thous%nd uL4 hemo $o in 1(&: dL4 hem%tocrit" 'FB4p$%te$ets" '88 thous%nd uL4 A$ umin '&; dL& Time o3 %ssessment4 the c$ient$oo0s rim%ced %nd $oo0ed %5%! the p%in& In the d%! = the d%! the c$ient re6uires%ssist%nce 3rom his 5i3e %nd peno$on %n& +or p%tterns o3 he%$th 3unctions4 the c$ients%id since the p%in o3 urns& Go to the hospit%$ since the c$ient does not h%ve the

urn pen %n %n dru s&On .une 1)4 '(1' C$ient4 Tn& S studied 5ith the 3o$$o5in resu$ts"A& P%tterns o3 perception o3 he%$th = he%$th c%reAssessed %t the time the c$ient s%!s 3re6uent consumption o3 3oods such %s chic0ennood$e st%$$s4 %nd me%t %$$s4 %nd the c$ient underst%nd th%t the i$$ness need to ehospit%$i7ed so m%n! times in the he%$in process& He%$th! sense o3 perception !the c$ient is hospit%$i7ed %nd % speed! recover! so he cou$d o %c0 to 5or0 % %in&M%suh c$ients to the hospit%$ 3or urns su33ered in the de tr% %nd $e3t in the %nte

r%chii %re% o3 1)B4 5ith % p%in sc%$e o3 : ?1=8@4 sti33 3in ers4 di77iness4 %nd di33icu$t!s$eepin & The c$ient does not consume the previous one in the consumption o3ci %rettes per d%!& The c$ient does not h%nd$e the urn 5ith dru s such %s me oointment e3ore oin to the hospit%$& E33orts to %ddress outside o3 the hospit%$ 1hour e3ore ein tre%ted to % hospit%$ emer enc! room ,udhi Asih&,%sed on the %ssessment o3 the resu$ts o t%ined th%t the perception o3 nursindi% noses in p%tterns o3 he%$th = he%$th c%re in the p%ttern o3 Gordon is % $%c0 o30no5$ed e re$%ted to the $%c0 o3 in3orm%tion % out the h%nd$in o3 h!droch$oric%cid& This di% nosis 5%s 3ound ec%use the c$ient h%s % perception o3 $ess men %n%i

h%nd$in h!droch$oric %cid is supposed to do 5ith person%$ protective e6uipment& In%ddition4 c$ients %re not in3ormed % out the ris0s %nd 5%!s to h%nd$e h!droch$oric%cid& Then4 the c$ient is 5ron perceptions % out the h!droch$oric %cid4 shou$d h%ve0no5n th%t these su st%nces c%n e $i3e thre%tenin i3 men!e$up0%n ! h%nd ormen!etuh& -here %n individu%$ is e pected to e men!eusu%i itse$3 5ith thech%n es = ch%n es in intern%$ %nd e tern%$ environment%$ ch%n es to m%int%in0eseh%t%n!% ?Potter Perr!4 '((8@&


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'& The p%ttern o3 Nutrition = Met% o$ic,e3ore the i$$ c$ients to e%t three me%$s % d%! %nd e%tin p%tterns 5ere $itt$ech%n ed ut the c$ient4 the c$ient e pects to smo0e& M%0%n%n!% c$ients never $imit%nd no histor! o3 3ood %$$er !& C$ients %$so h%d no trou $e 5ith s5%$$o5in orche5in so$id 3oods& C$ient s 5ei ht e3ore the i$$ness %round 9( 0 %nd 191cm

tin % od!& +re6uenc! o3 e%tin three me%$s % d%!4 decre%sed %ppetite c$ient4 thec$ient does not spend % portion o3 the c$ient m%0%n%n!% %nd 5ei ht decre%sed to ;)0 3rom the d%te (;=(;='(1'& C$ients must e ri ed m%0%n%n!%&,%sed on the %ssessment resu$ts o t%ined th%t the nursin di% noses in nutrition%$p%tterns in the p%ttern o3 Gordon is % ch%n e in nutrition $ess th%n od!re6uirement re$%ted to %n in%de6u%te int%0e& Nursin di% noses 5ere 3ound due todecre%sed %ppetite c$ient %nd the c$ient c%n not e independent 3or men!endo0%nm%0%n%n!% o5n& This is ec%use due to % distur %nce in the di estive process

ec%use o3 the p%in 3%ctor& P%in c%n c%use % decre%se in %ppetite ec%use o3 theincre%sed stress %risin 3rom the p%in o3 urns&?Sme$t7er4 '(('@& E$imin%tion p%tternC$ients urin%te >=: times per d%! e3ore the i$$ness4 c$e%r !e$$o5 co$or o3 urine %ndthe c$ient does not e perience p%in 5hi$e urin%tin & C$ients s%! i%s 5%s consumin% ott$e o3 miner%$ 5%ter ?;((m$@ per d%!& C$ients do not use c%thether& C$ients donot h%ve comp$%ints durin o5e$ movements& -hi$e in the hospit%$ c$ients urin%te'=> times per d%!4 c$e%r !e$$o5 co$ored4 do not use c%thether4 %nd no comp$%ints o3

%c0 p%in or % sense o3 distension prost%ten!% section& C$ients do not h%ve % senseo3 inhi ition i3 it is to de3ec%te& C$ients o5e$ sounds 1) per minute& P%$p%tion o3the entire % domen 6u%ndr%n c$ient does not 3ee$ p%in or distention o3 the $iver&+$uid %$%nce I#+D %serin 8((m$ )2%m 5ith '( drops per minute r%te& C%$cu$%tionst%rts 3rom the d%te o3 .une 1) %round )"(( c$oc0 in shi3ts unti$ .une 1F4 '(1'&Int%0e drin0 ?;(( m$ ': hours@4 in3usion o3 '((( m$ ': hours4 %nd output ?1;)( cc

': hours4 I-L ;)( cc ': hours4 met% o$ic >:(cc ': hours@4 so the %$%nce o3 3$uidint%0e %nd output is& Input" '((( ;(( J '&;(( cc hr Output" '9((4 the rem%inin%mount 3rom ';(( to '9(( J =1(( cc ': hours& ,%sed on d%t% o t%ined 3rom the%ssessment o3 the c%se Tn&S th%t nursin di% nosis on the p%ttern o3 e$imin%tion inthe p%ttern o3 Gordon 5%s not 3ound&>& Activit! p%tterns o3 e ercise,e3ore the i$$ c$ients 5ho erhun %n %ctivities 5ith 5or0 th%t is drivin the vehic$e&

C$ients h%ve never h%d comp$%ints o3 urns durin the 5or0 so 3%r& C$ients %re % $eto drive % vehic$e th%t 5%s c%rr!in 3or ) hours per d%!& C$ient does not h%ve %3%mi$! histor! o3 dise%ses such %s he%rt dise%se4 stro0e4 di% $etes me$$itus orh!pertension& Durin the c$ient s hospit%$ c$ients % $i ht %ctivit! such %s 5%$0in tothe %throom& C$ients %ssisted ! his 5i3e in the conduct o3 %$$ %ctivities& C$ients 3ee$he$p$ess i3 the c$ient h%s to ho$d her h%nd& So i3 the c$ient 5%nts to retrieve theo 2ect the c$ient 5%s he$ped ! his 5i3e& Not %tt%ched o ! en %nd vit%$ si ns" $oodpressure 1:( )( mmH 4 respir%tor! '' menit4 temper%ture >; C %nd ); pu$se


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min&,%sed on d%t% o t%ined 3rom the %ssessment th%t the %ctivit! p%ttern o3 nursindi% noses = Gordon is %n e ercise in p%ttern o3 %ctivit! into$er%nce re$%ted to the$imited r%n e o3 motion %t %n %re% hospit%$& Nursin di% noses 5ere 3ound ec%usethe c$ient is %ssisted ! % 3%mi$! %ctivit!& Me%n5hi$e4 the %ctivit! is %n %ctivit! th%t

per3orms % musc$e movement to incre%se the po5er o3 se$3=m%de independent$!&:& The p%ttern o3 Rest = S$eep,e3ore the s$eep p%tterns o3 sic0 c$ients %round 9 hours per d%! %nd ec%use the$ien is o3ten used durin the d%! to s$eep % out >( minutes& C$ient h%s % princip$eth%t he 5%s % driver 5ho %$so need time 3or her to drive isitir%h%t ood& Ho5ever45hi$e in the hospit%$ c$ients to s$eep %t ni ht % out 8=; hours durin the d%! %ndc$ients %re sometimes i%sed to s$eep& Comp$%ints ! c$ients men ur%n n!% hourso3 s$eep ec%use o3 p%in in the %rm ! h%nd& C$ients $oo0ed $eth%r ic durin the d%!4c$ients seemed to ev%por%te durin the d%!&,%sed on d%t% o t%ined 3rom the resu$ts o3 th%t %ssessment on nursin di% nosisistrir%h%t p%ttern = the p%ttern o3 s$eep disruption in s$eep p%tterns Gordon is%ssoci%ted 5ith di33icu$t! s$eepin & C$ient s s$eep p%tterns distur ed ! ni ht %nd !d%! resu$tin in decre%sed 6u%$it! o3 s$eep& In s%!in ! Dr& Mc/h%n 3rom .ohnHop0ins *niversit! Schoo$ o3 Medicine4 the %du$t tot%$ s$eep time th%t is re6uired is9=) hours& ?Gu! Mc/h%nn4 '(1(@8& P%ttern o3 Co nitive = Perceptu%$Norm%$ soundin speech s!stem c$ients4 %nd c$ients %re % $e to respond to norm%$6uestions& C$ients use the Indonesi%n $%n u% e %nd stron $! inter%ctin 5ith thecooper%tive& Memh%mi c$ient t%$0s %nd the topic ein discussed& Norm%$ %uditor!3unction the c$ient4 the c$ient does not h%ve % he%rin $oss or he%rin %id use&C$ients norm%$ visu%$ 3unction %nd no e!e dise%ses such %s con2unctivitis4 the c$ientdoes not use % $%ss e!e %nd % norm%$ response to Ch%!%& C$ient s s0in temper%ture3e$t 5%rm %nd $oo0ed no s0in disorders %round %d%n!% e cept 3or the t5o %rms5ith % ro%d h%nd urns 1)B& C$ient s $eve$ o3 consciousness is compos mentis4 theG$%s o5 com% sc%$e E!es :4 #er %$ 84 %nd ; tot%$ motor 18 %nd the c$ient does note perience con3usion in time4 p$%ce %nd n%me& ,%sed on d%t% o t%ined 3rom the%ssessment o3 di% nosis peer%5%t%n c%rr! on co nitive perceptu%$ p%ttern 5%s not3ound on the c$ient&;& P%ttern o3 Se$3 Perception = Se$3=conceptC$ient perceptions o3 urns su33ered is 3ee$in s%d %nd po5er$ess c$ient pro $em he3%ced 5%s not % $e to return to 5or0 immedi%te$! %nd per3orm d%i$! %ctivities

independent$!& The ver! thou ht o3 the current c$ient is %n ious to return to 5or0&E pect%tions o3 the c$ient %3ter the urn tre%tment is to e % $e to recover 6uic0$!0em% $i 5or0 immedi%te$!& ,%sed on the resu$ts o3 the %ssessment o3 the d%t%o t%ined th%t the p%ttern o3 se$3=perception o3 nursin di% nosis = Gordon s se$3=concept in % p%ttern not 3ound&9& The ro$e o3 p%tternC$ient s ro$e %s % 3%ther in the 3%mi$! %nd %s % se%rch 3or the necessities o3 $i3e in the3%mi$!& Home$ess c$ients $ived in .%0%rt% 5ith his 5i3e %nd chi$dren& C$ient


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re$%tionship 5ith the 3%mi$! ver! 5e$$ %s 5e$$ %s tet%n %n!%& In hu un %0communic%tion 5ith others %s 5e$$ %s medic%$ st%33 o33icers c$ient does not %ppe%rto h%ve pro $ems& Durin the hospit%$ %ccomp%nied ! his 5i3e s c$ients& And c$ients%re ver! cooper%tive 5ith medic%$ st%33 %nd su mit %nd $isten to %$$ su estions on %

ood urn& ,%sed on the resu$ts o3 the %ssessment o3 the d%t% o t%ined th%t the

p%ttern o3 nursin di% noses in Gordon s ro$e in the p%ttern o3 no pro $ems 5ere3ound&)& The p%ttern o3 Se u%$it! = ReproductiveIn the p%ttern o3 c$ient se u%$it! never do it 5ith someone other th%n his 5i3e&/ontr%cepti3 $i0e condom us% e is not used& C$ients re%$i7e th%t venere%$ dise%sec%n e o t%ined ec%use o3 i$$icit se & On the c$ient does not h%ve erecti$e pro $ems%nd impotence did not e perience %n! distur %nce& C$ients h%ve never e perienceds5e$$in in the enit%$ %re%& ,%sed on d%t% o t%ined 3rom the resu$ts o3 th%t%ssessment on nursin di% nosis se0su$it%s p%ttern = the p%ttern o3 reproduction inGordon 5%s not 3ound&F& Copin p%tterns = Stress To$er%nceAssessed %t the time the c$ient thin0s it is $i0e to recover 3rom urns su33ered inorder to return to 5or0& Copin mech%nism % %inst stress on the c$ient is t%$0in ortr!in to $oo0 us! t%s0& C$ient $oo0s s$i ht$! 5orried $oo0 %nd 5ithst%nd the p%ine perienced& Menun0u0%n c$ient does not seem emotion%$ %t the time o3%ssessment& At the c$ient s medic%$ st%33 to respond cooper%tive$! %nd to see % oode!e cont%ct 5ith men un0%n po$ite $%n u% e& ,%sed on the %ssessment resu$tso t%ined 3rom the nursin di% nosis on stress copin p%tterns in the p%ttern o3Gordon 5%s not 3ound1(& The p%ttern o3 Con3idenceIs$%m %nd re$i ious c$ients o3ten %ttend +rid%! pr%!ers %nd 0e% %%m%n %round hisresidence& Re$i ious %ctivit! is c%rried c$ient is pr%!ers& Durin hospit%$ c$ients donot %ttend +rid%! pr%!ers 0e% %%m ec%use his urns& C$ients do not pr%! %t thep$%ce %nd the c$ients sti$$ h%ve the con3idence th%t God c%n he%$ %$$ dise%ses& ,%sedon d%t% o t%ined 3rom the %ssessment o3 nursin di% nosis in % p%ttern th%t vote o3con3idence in Gordon p%ttern 5%s not 3ound&,%sed on the description % ove so I $$ 2ust t%0e the three priorities 3or the nursindi% nosis nursin %ction on Mr&& S& Prioriti7%tion is %ccordin to M%s$o5 0e uht%n iso3 ph!sio$o ic%$4 s%3et! %nd com3ort4 $ov% $e %nd $oved4 %ppreci%ted %nd v%$ued4%0tu$is%si themse$ves& In %ddition4 the %uthors chose the di% nosis o3 the mostthre%tenin to the $i3e th%t did not thre%ten the $ives o3 c$ients&

Three nursin di% nosis is"A& Ch%n es in nutrition $ess th%n od! re6uirements erhun %n 5ith %n in%de6u%teint%0e&Action t%0en is to e %mine the si n = % si n o3 % 5ei ht $oss c$ient s premises %renot e periencin the dr%stic 5ei ht $oss& C$ients %re encour% ed to stop theconsumption o3 ci %rettes in order to improve the c$ient so desires& So th%t thec$ient is %$so % $e to spend % portion m%0%n%n!% 3u$$& The %uthor %$so recommendsemp$o!ers to contro$ the p%in 5ith deep re%thin techni6ues so th%t c$ients %re


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% $e to e%t % %in i3 !ou do not e perience e cessive p%in&Activit! into$er%nce re$%ted to urns&Action t%0en is to e %mine the c$ient urns %nd %ssess ho5 the c$ient c%n move the3in er = % 3in er to move the c$ient $oo0s sti33 3in ers& C$ients %re encour% ed to tr!s$o5$! sh%0in his 3in ers % %n c$ient c%n prevent contr%ctures or sti33ness&

Assessin the c$ient s % i$it! to r%sp& Ho5ever4 the %uthors sti$$ recommend % c$ientto tr! to prevent more sti33ness in his h%nd&L%c0 o3 0no5$ed e re$%ted to $%c0 o3 in3orm%tion % out he%$th&Action t%0en is to provide in3orm%tion % out the he%$th o3 the urn4 5ith 2ut % c$ientto use person%$ protective e6uipment i3 % c$ient 3%cin chemic%$s& -ith the resu$tsseem to underst%nd the c$ient %nd 3%mi$! % out the need 3or person%$ protectivee6uipment to prevent cont%ct o3 h%rm3u$ chemic%$s& E p$%in ho5 the h%nd$er 5ithde ridement o3 urns %nd the c$ient c%n memh%mi import%nce h%nd$ers urns 5ithtoo$s %nd ho5 = the ri ht 5%!& Ho5ever4 the %uthors sti$$ recommend % c$ient toper3orm the movement o3 the r%dius o3 the c$ient th%t the c$ient is 3ree 3rom the ris0o3 contr%ctures& And the c$ient must underst%nd the 5%!s th%t urns 5ounds c%nhe%$ 3%ster&

The medic%tion ther%p! the c$ient is o t%ined ! 0etoro$%c 18 m m$ ' 1 I#in2ection& Indic%tions" 0etoro$%c is indic%ted 3or short=term m%n% ement o3 %cutemoder%te to severe p%in %3ter sur ic%$ procedures& Contr%indic%tions" P%tients 5hoprevious$! h%ve h%d %n %$$er ! to this dru 4 ec%use there is the possi i$it! o3 cross=sensitivit!4 cere rov%scu$%r dise%se is suspected %nd th%t s 3or sure& Side e33ects"H!persensitivit! re%ctions4 3ever4 2oint p%in4 musc$e p%in& Ce3tri% one 1 r%m I#in2ection ' 1& Indic%tions" Lo5er respir%tor! tr%ct in3ections4 s0in4 urin%r! tr%ct& Sidee33ects" di%rrhe%4 n%use%4 vomitin 4 stom%titis4 $ossitis4 derm%titis4 pruritus4urtic%ri%4 edem%4 er!them% mu$ti3orm%4 %nd %n%ph!$%ctic re%ctions&Contr%indic%tions" H!persensitivit! to Ce3tri% one or other ceph%$osporins&R%nitidine '8 m m$ ' 1 I# in2ection& Indic%tions" r%nitidine used 3or the tre%tmento3 %cute %stric %nd duoden%$ u$cers4 re3$u esoph% itis4 %stric %cid h!persecretionp%tho$o ic%$ circumst%nces such %s Ko$$in er=E$$ison s!ndrome4 postoper%tiveh!persecretion& Side e33ects" di77iness4 dro5siness4 insomni%4 verti o4 constip%tion4di%rrhe%4 n%use%4 vomitin 4 %nd throm oc!topeni%& Contr%ct Indic%tions" P%tients5ho %re h!persensitive to r%nitidine& ?Http" 555&he ph%rm2%!%&com@*nder these conditions4 the ro$e o3 promotive4 preventive4 cur%tive4 %ndreh% i$it%tive ro$es th%t %re necessit%ted to c%re 3or p%tients& The p%tient m%! e

iven promotive he%$th educ%tion % out urns& Preventive %spect is % $e to %ddressthe prevention o3 the occurrence o3 urns due to the chemic%$s ! usin protectivee6uipment in %ccord%nce 5ith the procedure& O3 the cur%tive %spect4 %dvoc%tin onthe c$ient to h%nd$e the urn 5ith % dru = dru s th%t %re %v%i$% $e to speed up thehe%$in process& And reh% i$iti%ti3 the c$ient i3 the c$ient cou$d recover proper$!contro$ h%nd$e to the hospit%$ 3or his urns his h%nd in the second %rm o3 thecontr%ctures %nd m%int%in&O3 e p$%n%tion h%s een iven to rese%rch th%t uses p%ttern disumpu$0%n Gordon


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c%n e %pp$ied in deve$opin tre%tments to c$ients& The d%t% o t%ined 3rom Gordonp%tterns c%n he$p the c$ient to determine the di% nosis nursin di% nosis %ndnursin %ction se$ection th%t is ri ht 3or the c$ient s he%$th& In urns c%used !h!droch$oric %cid4 the c$ient is % victim o3 % tot%$$! $%c0 o3 0no5$ed e in men$indun ihim& So4 %s 3or the %dvice to e conve!ed ! the %uthors is 3or the nursin st%33 %re

e pected to %pp$! the Gordon p%ttern %ssessment& The %uthor hopes th%t c%ses $i0eMr&& S c%n e in minim%$is0%n ! Gordon %ssessment p%ttern& And 3or p%tients 5ithsevere urns %nd %re e pected to m%int%in the s%3et! 0eseh%t%n!% itse$3 3romenvironment%$ %nd chemic%$ su st%nces th%t c%n thre%ten hum%n $i3e&

Re3erences"http" 555&he ph%rm2%!%&comGu! Mc/h%nn4 M&D& And M%ri$!n A$ ert4 Ph&D& /eep !our r%in !oun 4 '(1(4 Ne5

or0" Medi% Pressindo4 p 91http" 555&$u0% %0%r&netPotter P& A& Anne Perr!& P ?'((:@4 +und%ment%$s o3 Nursin " Concepts4 Process %ndPr%ctice Issue :4 #o$ume 1& Ne5 or0" EGCSch5%rt74 Se!mour I& O3 '(((& Essence o3 the princip$es o3 sur er!& Ne5 or0" EGC&Sme$t7er4 SC %nd ,%re4 ,G& Te t oo0 o3 Medic%$ Sur er!& Issue )4 #o$ume '& Ne5

or0" EGC& '(('

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Comprehensive Health Assessment (Final Cha)