مرکز منطقه ای اطلاع رساني علوم و فناوري - NURSING CARE PLAN AND EVALUATION OF PATIENT WITH JUVENILE DERMATOMYOSITIS ACCORDING TO OREM’S SELF-CARE THEORY

Abstract :

This case report presents determination of a patient’s self care requirements and nursing care plan who was diagnosed with Juvenile Dermatomyositis and monitored in an intensive care unit according to Orem s Self-Care Theory. Juvenile Dermatomyositis is a chronic, inflammatory and autoimmune connective tissue disease with an unknown cause and it is often characterized with myasthenia and skin eruption. The final diagnosis is made with symetric, progressive and proximal myasthenia, an increase in the concentration of blood enzymes in serum, abnormal EMG findings, chronic inflammation in muscle biopsy and characteristic skin findings. Its pathophysiology still remains unknown yet it is commonly assumed that cellular and humoral immunity related components triggers the deterioration of veins and muscles. Despite being a rare disease, its findings caused our patient in this case to fail to fulfill self-care requirements and urged for an intensive care program. Developed by Orem, the Self-Care Theory is one of the most common theoretical approaches in nursing practices. Individuals may sometimes be deprived of self care abilities due to a lack of knowledge, skills or motivation. Consequently, nurses are expected to evaluate their potential to conduct curative self care activities and identify their self care limitations and disadvantages in terms of knowledge, skills and motivation. This care report investigates the self care requirements and the self care requirements of the case are determined by three basic factors: myasthenia, shortness of breath and skin deterioration. Considering such data at hand, a special nursing care and appropriate nursing initiatives were designed with the diagnoses of Ineffective Airway Clearance, Impaired Tissue Integrity, Impaired Physical Mobility, Deficient Fluid Volume, Nutrition: less than body requirements, Risk of Infection, Risk of Altered Oral mucous membrane, Communication: Impaired, Verbal, Interrupted Family Processes and Self-care Deficit.