Levels of Care
Prepared by: Genevieve D. Chavez, RN

Scope of Nursing
❖ Nurses provide care for three types of clients:
individuals, families, and communities.
❖ Nursing practice involves four areas: promoting
health and wellness, preventing illness, restoring
health, and care of the dying.

• Primary prevention focuses on
(a) health promotion
(b) protection against specific health problems (e.g., immunization
against hepatitis B).
• Secondary prevention focuses on
(a) early identification of health problems
(b) prompt intervention to alleviate health problems.
• Tertiary prevention focuses on restoration and rehabilitation, with
the goal of returning the individual to an optimal level of functioning.
Levels of Prevention

Promoting Health and
Wellness/ Health Promotion
❏ Nurses promote wellness in clients who are both healthy and ill.
⮚ healthy lifestyles, such as improving nutrition and physical fitness
⮚ preventing drug and alcohol misuse
⮚ restricting smoking
⮚ preventing accidents and injury in the home and workplace.

Health Promotion
❏ It is both the art and science of supporting people to male
lifestyle changes and create an environment conducive to health.
❑ It spans from the prevention of disease to empowering
individuals, to promoting environmental and policy change.
❑ Concepts of individuality, holism, homeostasis and human
needs.

❑ Concepts of Individuality
⮚ Each individual is a unique being who is different from
every other human being, with a different combination of
genetics, life experiences, and environmental
interactions.
⮚ In total care context- the nurse considers all the
principles and areas that apply when taking care of any
client.
⮚ In individualized care context- the nurse becomes
acquainted with the client as an individual.

❑ Concept of Holism
⮚ It emphasizes that nurses must keep the whole person in
mid and strive to understand how one area of concern
relates to the whole person.
⮚ The nurse must also consider the relationship of the
individual to the external environment and to others.

❑ Concept of Homeostasis
⮚ Was first introduced by Cannon, to describe relative
constancy of the internal processes of the body, such as
blood oxygen and carbon dioxide levels, blood pressure,
body temperature, blood glucose and FE balance.
⮚ It is the tendency of the body to maintain a state of
balance or equilibrium while continually changing.

❑ Concept of Homeostasis
⮚ Physiologic homeostasis
1. They are self-regulating
2. They are compensatory
3. They tend to be regulated by negative feedback systems.
4. They may require several feedback mechanisms to
correct only one physiologic imbalance.

❑ Concept of Homeostasis
⮚ Psychological homeostasis refers to emotional or
psychological balance or a state of mental well-being.
⮚ It is maintained by a variety of mechanisms.
⮚ Each individual has certain psychological needs, such as
the need for love, security, and self-esteem, which must
be met to maintain psychological homeostasis.

❑ Concept of
Human
Needs

Healthy
People
2020

Prevention of Illness/
Disease Prevention
• The goal of illness prevention programs is to maintain optimal
health by preventing disease.
• Nursing activities that prevent illness include immunizations,
prenatal and infant care, and prevention of sexually
transmitted infections.

Health Restoration/ Maintenance
Restoring health focuses on the ill client, and it extends from early
detection of disease through helping the client during the recovery
period. Nursing activities include the following:
• Providing direct care to the ill individual, such as administering
medications, baths, and specific procedures and treatments
• Performing diagnostic and assessment procedures, such as measuring
blood pressure and examining feces for occult blood.

Health Restoration/ Maintenance
• Consulting with other healthcare professionals about client
problems
• Teaching clients about recovery activities, such as exercises that will
accelerate recovery after a stroke
• Rehabilitating clients to their optimal functional level following
physical or mental illness, injury, or chemical addiction.

• It refers to health care practices that treat patients with the
intent of curing them, not just reducing their pain or stress. An
example is chemotherapy, which seeks to cure cancer patients.
• The issue of curative care comes up when a patient has a
terminal illness and is considering hospice care.
Curative

Rehabilitative
Rehabilitative care emphasizes the importance of assisting
clients to function adequately in the physical, mental, social,
economic, and vocational areas of their lives.