The bifocal model of clinical activity, represents the situations that influence, people, groups and communities, as well as the classification of these responses, from a nursing perspective.

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Nurse Professional activities Medical Guide Online

These situations are organized into five broad categories:
Pathophysiological
Related to treatment
Personal
Environmental
Related to maturational stages

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Please note that the scope of clinical nursing, is at the level of patient response, and not to the level of the situation.

The Bifocal Model describes the two aspects of the clinical
core of nursing clinic:
Nursing Diagnoses
Collaborative problems

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Clinical Nurse Specialist Medical Guide Online

A Nursing Diagnosis: is a clinical judgment regarding the responses of a person, family or communities to actual or potential health problems.

The diagnosis inf / ca is the foundation on which to choose nursing interventions aimed at achieving the results, of which the nurse is responsible.

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(NANDA 1990) North American Nursing Diagnosis Association.
The Collaborative Problem: are certain complications that nurses monitor to identify the occurrence or a modification.

The nurse takes independent decisions for both collaborative problems, and for nursing diagnosis.

The main difference is that in the Diagnosis is nursing prescribing definitive treatment to achieve the result, while in COLLABORATIVE PROBLEMS, prescription treatments for the final result is that by nursing medicine.

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Head Nurse Medical Guide Online

The Nursing Interventions are treatments or actions, that benefit to a patient showing a problem, reducing it or eliminating it and promoting a more healthy.

Collaborative problems
Bronchial Asthma:
Hypoxemia, acute respiratory failure, production of mucus and thick secretions.
High risk of breathing pattern ineffective.
Anxiety related to tachypnea.
Sense of helplessness related to loss of control.
In collecting data to focus on what triggered the event.
What drugs are predominantly prescribed.
Monitor acid-base imbalances.

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COPD:
Hypoxemia, right heart failure.
Liberation ineffective airway related to excessive secretions.
Anxiety related to breathlessness and fear of suffocation.
Disturbance of sleep pattern.
Monitor to indicate failure of acid-base balance, Blood Gas.
The 'EGA helps to assess gas exchange in the lung.

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Hypertension:
Vascular insufficiency.
Monitor to detect evidence of tissue ischemia.
Hypertension can cause hypertrophy of vascular smooth muscle
Damage to retinal blood vessels
Cerebral arteriosclerosis and progressive ischemia
Kidney problems in general and nephrons

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Nurse Curriculum Medical Guide Online

Pneumonia:
respiratory failure, septic shock, paralytic ileus.
High risk of alteration of the mucosa of the oral cavity.
Activity intolerance related to insufficient oxygenation.
Liberation ineffective airway.
Monitor: fever of 39 ° C or higher, chills, tachycardia.
(High fever increases the metabolic demand and oxygen consumption)

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Deep Venous Thrombosis:
Pulmonary embolism, chronic lower limb edema, stasis ulcers.
Pain related to circulatory compromise.
High risk for impaired skin integrity.
High risk of colon constipation, related to immobility.
High risk for impaired respiratory function, related to immobility.

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