Applying Standardized Practice in Nursing Process

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Table of Contents

Scenario
NANDA
Nursing Outcomes Classification
NIC
The data, information, knowledge, and wisdom utilized
Conclusion
References

The American Nurses Association has come up with a standardized nursing language. Standardized language boosts the knowledge of nursing process, offers reliability in practicum, advances critical thinking skills, and enhances communication (Huether & McCance, 2012). Nursing language comprises of NANDA, NIC, and NOC elements. The article below focuses on NANDA, NIC, and NOC elements of a patient with motility disorder.

Scenario

A 42-year-old woman has been admitted to a hospital after presenting a nine-month history of gastrointestinal pain. The patient reports that she does not exhibit clear triggers of pain episodes. As such, her episodes occur daily and at any time. The pain lasts for up to three hours. In the past, the patient has tried antacids and painkillers in a bid to ease her pain. Notably, the drugs were not effective because the pain keeps recurring. Currently, the patient has been hospitalized after exhibiting abdominal distention, recurrent obstructions, abdominal pain, severe constipation, and recurrent vomiting. According to the patient’s health records, she has been to different health centers in the last nine months for this pain. The patient is worried about her situation because her mother exhibited the same pain, which went away after treatment. Therefore, she wants a physician to undertake a thorough diagnosis and treatment to ease her pain.

NANDA

NANDA refers to a medical assessment about a patient reaction to real and possible health complications or life processes. Based on the illustrations indicated in the scenario, the following NANDA elements were obtained.

Motility disorder is an abnormality of the gastrointestinal mechanism. With this disorder, the GI tract loses its control over muscular activities in the intestines. Endogenous and exogenous factors cause intestinal motility disorder. Listed below are the defining characteristics:

Persistent dribbling of soft stool, fecal odor
Incapability to delay defecation
Rectal urgency
Self-report of incapability to feel rectal fullness or the presence of stool in the bowel
Fecal staining of underclothing
Rectal fullness but reports incapability to eject formed stool
Inattention need to defecate
Incapability to be aware of the urge to defecate

The risk factors identified are listed below:

Alteration in fecal consistency
Irregular motility (metabolic complaints, inflammatory bowel illness, communicable ailment, drug induced motility disorders, food xenophobia)
Weaknesses in rectal vault function
Sphincter dysfunction
Neurological syndromes affecting gastrointestinal motility

Nursing Outcomes Classification

NOC refers to the taxonomy of nurse sensitive results. While coming up with appropriate NOC outcomes three labels were identified. The labels were mobility disorder, bowel elimination, and bowel continence. The client outcomes were also identified. The outcomes were associated with the risk for the contamination. Listed below are the patient’s outcomes.

Steady, complete removal of fecal matters from the rectal vault
Defecated soft-formed feces
Reduced or nonappearance of bowel incontinence occurrences
Unbroken skin in the perianal
Exhibited the capability to detach, contract, and ease pelvic muscles in the occurrence of incontinence linked to sphincter incompetence. Similarly, the patient exhibited a rise in pelvic muscle strength in the occurrence of incontinence linked to sphincter ineptitude.

NIC

NIC refers to an inclusive, homogenous language relating managements that nurses undertake in all situations and in all spheres. Diagnosis and treatment of motility disorders require careful observation. While coming up with appropriate NIC interventions, two labels were identified. The labels were Optimized PPI therapy and endoscopy test. The patient’s history was the basis for the examination. However, the influx of genetic factors was not overruled. Thus, the PH of the esophagus was assessed. As such, the patient’s genetic pathways influenced the secretion of inflammatory substances. Thus, pH inspection was undertaken using the manometer and a tube test to examine gastrointestinal disorders.

From the assessment, it was noted that the patient was suffering from a motility disorder. Abnormal changes were noted in the lining of the patient’s gastric mucosa. As such, acid secretion had digested the linings of the gastric mucosa. The breakdown of gastric mucosa had caused intestinal disorders in the patient.

To treat her, nurses combined several drugs to decrease the level of acidity in her intestinal tract. The drugs include dH₂ blockers, antacids, proton pump inhibitors, and prostaglandins. Similarly, the patient was treated using the optimized PPI therapy. Endoscopy test decreased the level of acidity.

The data, information, knowledge, and wisdom utilized

While coming up with the above elements, the physicians considered the patients’ medical and family history. The patient’s genetic factors influence the stimulation and secretion of gastrin. Knowledge of the genetic factors that influence the pathophysiology of gastric acid secretions was very helpful in treating the patient mentioned in the case study. There was a substantial proof that linked the hereditary affinity of the client and her ability to develop motility disorder. The proof relied on epidemiologic and family investigations. However, it should be noted that a number of questions remain unanswered on how genes play a role in the development of the disease (Huether & McCance, 2012). There may be a prearranged genetic tendency to build up different phenotypes of a motility disorder. A number of the genetic tendencies to build up motility disorder rely on factors such as hiatus hernia. Chromosomal determinant exhibits a huge number of exclusive relations for the reason that there are multiple factors drawn in the pathogenesis of the disorder.

Studies have suggested that genetic factors influence the pathophysiology of gastroesophageal reflux disease (Drossman, 2006). The results showed that genes alter the secretion and production of gastric acid. Several pathways influence the inflammatory factors. The pathways include DNA, carcinogen detoxification, and visceral hypersensitivity. Acid reflux stimulates esophageal mucosa. As a result, genetic stimulation may cause neural dysfunction and heartburn.

Gastric glands control the changes that occur during acid stimulation and secretion (Gasiorowska & Fass, 2009). Hormonal stimulus controlled by smell, taste, and sight of food activates gastric secretion. On the other hand, digestive enzyme digests food compounds using gastric acid secretions. The balance between the acid gastric secretions and the mucosa gland controls the digestive system. However, a change in the intestinal balance affects the gastric mucosa. As a result, the acid secretion digests the lining of the gastric mucosa. The breakdown of gastric mucosa causes intestinal disorders. The esophagus digests the gastric mucosa in patients.

Conclusion

In conclusion, it should be noted that the motility disorder is an abnormality of the gastrointestinal mechanism. With this disorder, the GI tract loses its control over muscular activities in the intestines. Endogenous and exogenous factors cause intestinal motility disorders. The manifestation of motility disorders includes abdominal distention, recurrent obstruction, abdominal pain, peptic ulcer, constipation, and gastritis. To treat the disease, nurses combined several drugs to decrease the level of acidity in the patient’s intestinal tract.

References

Drossman, D. (2006). The Functional Gastrointestinal Disorders And The Rome III Process. Gastroenterology, 130(5), 1377-1390.

Gasiorowska, A., & Fass, R. (2009). Gastroesophageal Reflux Disease (GERD) and Irritable Bowel Syndrome (IBS)—Is It One Disease or an Overlap of Two Disorders?. National Center for Biotechnology Information Journal, 10(1), 1-6.

Huether, S. E., & McCance, K. L. (2012). Understanding pathophysiology (5th ed.). St. Louis, Mo.: Mosby/Elsevier.

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