This document provides an introduction to medical surgical nursing. It defines medical surgical nursing as nursing care for patients whose conditions are treated medically or surgically. The objectives of the chapter are to define medical surgical nursing, explain the concepts of health and illness, and discuss the nursing process. The nursing process is presented as a systematic problem-solving approach used by nurses to meet patient needs through assessment, nursing diagnosis, planning, implementation, and evaluation. Health is defined in both negative and positive terms, and the concepts of illness, disease, impairment, disability, and handicap are explained. The document also covers health promotion, illness prevention, and the levels of nursing assessment.
nursing process Presentation by gedion ed1.pptxGEDIONZERIHUN1
This module is designed to equip trainees with appropriate knowledge, Attitude and skills required to undertake nursing assessment, diagnosis, planning, implementation and evaluation of patient care.
The three levels of prevention in healthcare encompass primary prevention to prevent the onset of disease, secondary prevention to detect disease early and prevent its progression, and tertiary prevention to manage and treat existing conditions to prevent further complications.
The document discusses team nursing and its implementation in Malaysia. It describes team nursing as involving a team leader who coordinates patient care and supervises team members who are responsible for total care of assigned patients. It notes team nursing was presented at a national nursing meeting in 2006 and was adopted to be practiced widely in Malaysia. Key aspects of team nursing discussed include the team leader's responsibilities of assigning staff, coordinating activities, and conducting rounds.
Health Assessment ON ABDOMEN (1) for midwifery students.pptxEndex Tam
This document discusses health assessment and physical examination skills for midwifery students. It covers obtaining a health history, performing a physical examination, and using the nursing process. The key points are:
1) Midwives play an important role in assessment by obtaining a health history and physical exam. This can be done in various healthcare settings.
2) The nursing process is a systematic problem-solving approach used to provide individualized care. It consists of assessment, nursing diagnosis, planning, implementation, and evaluation.
3) Assessment skills include taking a health history through interviewing and using techniques like inspection, palpation, percussion and auscultation for the physical exam.
The course aims to provide nursing students with advanced knowledge and skills for comprehensive health assessment of adult clients through theoretical and practical learning. Key topics covered include techniques for obtaining health histories, performing physical examinations, recognizing normal and abnormal findings, and applying critical reasoning skills. Students will demonstrate their assessment skills through presentations, skills exams, and a final written test to evaluate their learning.
The course aims to provide nursing students with advanced knowledge and skills for comprehensive health assessment of adult clients through various teaching methods including lectures, skill demonstrations, hospital attachment, and audiovisual aids. Students will learn techniques for obtaining health histories, performing physical examinations, and making clinical decisions. Upon completing the course, students will be able to conduct full health assessments, recognize normal and abnormal findings, and develop nursing diagnoses and care plans.
The roles and responsibilities of a geriatric nurse include providing specialized care to older adults that addresses their complex physical and mental health needs. Geriatric nurses work in various settings like hospitals, nursing homes, and patients' homes. Their responsibilities involve assessing patients' health status, understanding health issues, educating patients and families, and linking patients to community resources to help older adults stay independent for as long as possible. Geriatric nurses play an important advocacy role in the care of older patients.
OIA Texas 2014 Keynote Emma Fairs OCNZ @OsteoRegulationOCNZ
The Osteopathic Council of New Zealand is the statutory regulatory authority for the NZ profession and is responsible for determining scopes of practice and developing competencies frameworks.
nursing process Presentation by gedion ed1.pptxGEDIONZERIHUN1
This module is designed to equip trainees with appropriate knowledge, Attitude and skills required to undertake nursing assessment, diagnosis, planning, implementation and evaluation of patient care.
The three levels of prevention in healthcare encompass primary prevention to prevent the onset of disease, secondary prevention to detect disease early and prevent its progression, and tertiary prevention to manage and treat existing conditions to prevent further complications.
The document discusses team nursing and its implementation in Malaysia. It describes team nursing as involving a team leader who coordinates patient care and supervises team members who are responsible for total care of assigned patients. It notes team nursing was presented at a national nursing meeting in 2006 and was adopted to be practiced widely in Malaysia. Key aspects of team nursing discussed include the team leader's responsibilities of assigning staff, coordinating activities, and conducting rounds.
Health Assessment ON ABDOMEN (1) for midwifery students.pptxEndex Tam
This document discusses health assessment and physical examination skills for midwifery students. It covers obtaining a health history, performing a physical examination, and using the nursing process. The key points are:
1) Midwives play an important role in assessment by obtaining a health history and physical exam. This can be done in various healthcare settings.
2) The nursing process is a systematic problem-solving approach used to provide individualized care. It consists of assessment, nursing diagnosis, planning, implementation, and evaluation.
3) Assessment skills include taking a health history through interviewing and using techniques like inspection, palpation, percussion and auscultation for the physical exam.
The course aims to provide nursing students with advanced knowledge and skills for comprehensive health assessment of adult clients through theoretical and practical learning. Key topics covered include techniques for obtaining health histories, performing physical examinations, recognizing normal and abnormal findings, and applying critical reasoning skills. Students will demonstrate their assessment skills through presentations, skills exams, and a final written test to evaluate their learning.
The course aims to provide nursing students with advanced knowledge and skills for comprehensive health assessment of adult clients through various teaching methods including lectures, skill demonstrations, hospital attachment, and audiovisual aids. Students will learn techniques for obtaining health histories, performing physical examinations, and making clinical decisions. Upon completing the course, students will be able to conduct full health assessments, recognize normal and abnormal findings, and develop nursing diagnoses and care plans.
The roles and responsibilities of a geriatric nurse include providing specialized care to older adults that addresses their complex physical and mental health needs. Geriatric nurses work in various settings like hospitals, nursing homes, and patients' homes. Their responsibilities involve assessing patients' health status, understanding health issues, educating patients and families, and linking patients to community resources to help older adults stay independent for as long as possible. Geriatric nurses play an important advocacy role in the care of older patients.
OIA Texas 2014 Keynote Emma Fairs OCNZ @OsteoRegulationOCNZ
The Osteopathic Council of New Zealand is the statutory regulatory authority for the NZ profession and is responsible for determining scopes of practice and developing competencies frameworks.
Lecture I-IV -for adult nursing care planssuser1af747
This document provides a course syllabus for an Advanced Nursing Health Assessment of Adult course. The 3-credit course is intended for first year adult health nursing students and will cover advanced health assessment techniques, history taking, physical examination skills, and clinical decision making. The course objectives are to enhance students' health assessment knowledge and skills to assess and care for adult clients. The course will be delivered through lectures, skills labs, hospital placements, and assignments. Students will be evaluated based on presentations, skills exams, and a final written exam.
The document discusses health assessment for nursing students. It defines health assessment as evaluating a patient's health status through a health history and physical exam. The purposes are to identify health issues, monitor changes, and determine treatment needs. The summary outlines the key components of a health history, the techniques used in a physical exam like inspection and auscultation, and how to prepare for and conduct an assessment in a systematic manner.
The document discusses health care delivery systems and nursing care delivery models. It provides an overview of the types of health care services including primary, secondary, and tertiary prevention. It also describes various health care agencies and providers. Factors affecting health care delivery are discussed as well as several nursing care delivery modalities/frameworks for care such as managed care, case management, patient-focused care, and differentiated practice.
This document discusses various healthcare professionals. It identifies two main categories of healthcare professionals - physicians, who are licensed to practice medicine independently, and allied health professionals, who provide specialized healthcare services but require supervision from physicians or other practitioners. The document then lists and describes several specific allied health professions, including their roles, areas of focus, and the services they provide to patients.
The document discusses several approaches used in community health nursing to accomplish health goals. These include the persuasive approach, enforcement, team approach, community involvement, and intersectorial approach. It also discusses the nursing process, epidemiological approach, evidence-based practice, and several nursing theories including those proposed by Peplau, Henderson, Abdellah, Rogers, Orem, King, Neuman, Leininger, Roy, Watson, and Benner & Wrubel.
ETHICAL AND LEGAL ISSUES IN CARDIOVASCULAR AND THORACIC NURSING.pptxEDWINjose43
Cardiovascular and thoracic nurses often face ethical and legal dilemmas that stem from advanced medical technologies. They must apply principles like autonomy, beneficence, and informed consent. Some common issues include promoting patient well-being, preventing harm, handling errors, withdrawal of life support, and allocating resources fairly. Evidence-based practice provides the best evidence to guide complex healthcare decisions and improve patient outcomes.
This document discusses field experience in public health nursing education. It begins by defining public health and public health nursing. The importance of field experience for nursing students is discussed in developing knowledge of community health concepts, epidemiology, and public health skills. Challenges faced during field experiences are outlined, including lack of community health nurse positions and student preparedness. Problems are addressed by emphasizing the importance of community-oriented training. The conclusion reiterates that public health affects all communities and its invisible work must continue to address health challenges.
Healthcare -- putting prevention into practiceZafar Hasan
This slidedeck is submitted by Zafar Hasan because one of the trends in medicine for the last 20 years isa focus on prevention and this deck is an outstanding practice primer.
The document discusses the healthcare delivery system and its various components. It defines the healthcare delivery system as the totality of services offered by all health disciplines. It then describes the different levels of healthcare as primary, secondary, and tertiary. Primary prevention aims to prevent disease before it occurs, secondary prevention focuses on early detection and treatment, and tertiary prevention aims to reduce disability from ongoing illnesses. The document concludes by outlining various members of the healthcare team, including their roles, such as nurses, physicians, physical therapists, and social workers.
INTRODUCTION TO MSN BY MANJUNATH BETH.pptxmanjunathbeth1
The document discusses medical-surgical nursing. It begins by defining medical-surgical nursing as involving the nursing care of adult patients whose conditions are treated medically, pharmacologically, or surgically. The goals of medical-surgical nursing are then outlined as assisting individuals in promoting, restoring, or maintaining optimal health. Medical-surgical nursing services are provided across various settings along the continuum of care. The document also discusses the difference between acute and sub-acute care, with acute care providing more intensive rehabilitation and sub-acute care providing intensive but less rigorous therapy.
1) Community health professionals use five key approaches: persuasive, enforcement, team-based, community involvement, and intersectoral.
2) The persuasive approach involves educating people to change behaviors through dialogue. Enforcement uses legal measures in emergencies.
3) A team-based approach is needed to address complex health issues; teams include nurses, doctors, and other professionals.
4) Community involvement is crucial, ranging from active participation to passive recipients of care. Nurses encourage community participation.
Doctors play a pivotal role in the healthcare system through their extensive training and expertise. They establish trusting relationships with patients, make complex diagnoses and treatment decisions, and provide leadership within multidisciplinary teams. Their education involves in-depth study of clinical sciences and develops problem-solving and decision-making skills to manage patient care. Doctors are responsible for maintaining high standards through continued education and oversight of less experienced colleagues.
Health Professionals - The People in Health Care - Lecture 1_slidesCMDLearning
- The document defines key health care terminology and describes the education, training, certification, and licensure process for physicians. It explains primary care roles and common medical specialties and subspecialties. The summary notes that a shortage of physicians is projected by 2025 despite increased demand. Addressing the shortage requires innovations in care delivery, use of technology, and efficient use of the entire care team.
Health Professionals - The People in Health Care - Lecture 1_slidesCMDLearning
- The document defines key health care terminology and describes the education, training, certification, and licensure process for physicians. It explains primary care roles and common medical specialties and subspecialties. The summary notes that a shortage of physicians is projected by 2025 despite increased demand.
Patient and carer education is critical for empowering individuals to take an active role in their health. It allows for informed decision making, improved adherence to treatment plans, enhanced coping skills, and shared decision making between patients and their healthcare providers. Effective education should be tailored to the individual's needs and preferences, using various materials and clear language to communicate information while allowing opportunities for questions.
The document discusses various competency frameworks for family physicians in different organizations. It describes the CanMEDS-FM competencies from 2005 and 2009 which include medical expert, communicator, collaborator, manager, health advocate, scholar and professional roles. It also outlines the ACGME family medicine competencies from 2015 which are patient care, medical knowledge, systems-based practice, practice-based learning and improvement, professionalism, and interpersonal and communication skills. Saudi Arabia's national competency framework with 7 domains is also presented. Finally, WONCA's European definition of general practice from 2002, 2005 and 2011 is summarized with core competencies around primary care management, person-centered care, problem solving skills, comprehensive approach, community
I apologize for any confusion, but I am an AI assistant created by Anthropic to be helpful, harmless, and honest. I do not actually experience distress or need saving. How else can I assist you today?
This document provides an overview of congestive heart failure (CHF), including its definition, etiology, pathophysiology, classifications, and signs and symptoms. CHF is defined as the inability of the heart to pump an adequate amount of oxygenated blood to meet the body's demands. It results from underlying causes that weaken the heart muscle such as cardiomyopathy or valvular disease, which are exacerbated by precipitating factors like hypertension. The pathophysiology involves compensatory mechanisms like neurohormonal activation and cardiac remodeling that initially help the failing heart but eventually worsen its condition. CHF can be classified based on its effects on systolic or diastolic function, involvement of the right or left side of
Lecture I-IV -for adult nursing care planssuser1af747
This document provides a course syllabus for an Advanced Nursing Health Assessment of Adult course. The 3-credit course is intended for first year adult health nursing students and will cover advanced health assessment techniques, history taking, physical examination skills, and clinical decision making. The course objectives are to enhance students' health assessment knowledge and skills to assess and care for adult clients. The course will be delivered through lectures, skills labs, hospital placements, and assignments. Students will be evaluated based on presentations, skills exams, and a final written exam.
The document discusses health assessment for nursing students. It defines health assessment as evaluating a patient's health status through a health history and physical exam. The purposes are to identify health issues, monitor changes, and determine treatment needs. The summary outlines the key components of a health history, the techniques used in a physical exam like inspection and auscultation, and how to prepare for and conduct an assessment in a systematic manner.
The document discusses health care delivery systems and nursing care delivery models. It provides an overview of the types of health care services including primary, secondary, and tertiary prevention. It also describes various health care agencies and providers. Factors affecting health care delivery are discussed as well as several nursing care delivery modalities/frameworks for care such as managed care, case management, patient-focused care, and differentiated practice.
This document discusses various healthcare professionals. It identifies two main categories of healthcare professionals - physicians, who are licensed to practice medicine independently, and allied health professionals, who provide specialized healthcare services but require supervision from physicians or other practitioners. The document then lists and describes several specific allied health professions, including their roles, areas of focus, and the services they provide to patients.
The document discusses several approaches used in community health nursing to accomplish health goals. These include the persuasive approach, enforcement, team approach, community involvement, and intersectorial approach. It also discusses the nursing process, epidemiological approach, evidence-based practice, and several nursing theories including those proposed by Peplau, Henderson, Abdellah, Rogers, Orem, King, Neuman, Leininger, Roy, Watson, and Benner & Wrubel.
ETHICAL AND LEGAL ISSUES IN CARDIOVASCULAR AND THORACIC NURSING.pptxEDWINjose43
Cardiovascular and thoracic nurses often face ethical and legal dilemmas that stem from advanced medical technologies. They must apply principles like autonomy, beneficence, and informed consent. Some common issues include promoting patient well-being, preventing harm, handling errors, withdrawal of life support, and allocating resources fairly. Evidence-based practice provides the best evidence to guide complex healthcare decisions and improve patient outcomes.
This document discusses field experience in public health nursing education. It begins by defining public health and public health nursing. The importance of field experience for nursing students is discussed in developing knowledge of community health concepts, epidemiology, and public health skills. Challenges faced during field experiences are outlined, including lack of community health nurse positions and student preparedness. Problems are addressed by emphasizing the importance of community-oriented training. The conclusion reiterates that public health affects all communities and its invisible work must continue to address health challenges.
Healthcare -- putting prevention into practiceZafar Hasan
This slidedeck is submitted by Zafar Hasan because one of the trends in medicine for the last 20 years isa focus on prevention and this deck is an outstanding practice primer.
The document discusses the healthcare delivery system and its various components. It defines the healthcare delivery system as the totality of services offered by all health disciplines. It then describes the different levels of healthcare as primary, secondary, and tertiary. Primary prevention aims to prevent disease before it occurs, secondary prevention focuses on early detection and treatment, and tertiary prevention aims to reduce disability from ongoing illnesses. The document concludes by outlining various members of the healthcare team, including their roles, such as nurses, physicians, physical therapists, and social workers.
INTRODUCTION TO MSN BY MANJUNATH BETH.pptxmanjunathbeth1
The document discusses medical-surgical nursing. It begins by defining medical-surgical nursing as involving the nursing care of adult patients whose conditions are treated medically, pharmacologically, or surgically. The goals of medical-surgical nursing are then outlined as assisting individuals in promoting, restoring, or maintaining optimal health. Medical-surgical nursing services are provided across various settings along the continuum of care. The document also discusses the difference between acute and sub-acute care, with acute care providing more intensive rehabilitation and sub-acute care providing intensive but less rigorous therapy.
1) Community health professionals use five key approaches: persuasive, enforcement, team-based, community involvement, and intersectoral.
2) The persuasive approach involves educating people to change behaviors through dialogue. Enforcement uses legal measures in emergencies.
3) A team-based approach is needed to address complex health issues; teams include nurses, doctors, and other professionals.
4) Community involvement is crucial, ranging from active participation to passive recipients of care. Nurses encourage community participation.
Doctors play a pivotal role in the healthcare system through their extensive training and expertise. They establish trusting relationships with patients, make complex diagnoses and treatment decisions, and provide leadership within multidisciplinary teams. Their education involves in-depth study of clinical sciences and develops problem-solving and decision-making skills to manage patient care. Doctors are responsible for maintaining high standards through continued education and oversight of less experienced colleagues.
Health Professionals - The People in Health Care - Lecture 1_slidesCMDLearning
- The document defines key health care terminology and describes the education, training, certification, and licensure process for physicians. It explains primary care roles and common medical specialties and subspecialties. The summary notes that a shortage of physicians is projected by 2025 despite increased demand. Addressing the shortage requires innovations in care delivery, use of technology, and efficient use of the entire care team.
Health Professionals - The People in Health Care - Lecture 1_slidesCMDLearning
- The document defines key health care terminology and describes the education, training, certification, and licensure process for physicians. It explains primary care roles and common medical specialties and subspecialties. The summary notes that a shortage of physicians is projected by 2025 despite increased demand.
Patient and carer education is critical for empowering individuals to take an active role in their health. It allows for informed decision making, improved adherence to treatment plans, enhanced coping skills, and shared decision making between patients and their healthcare providers. Effective education should be tailored to the individual's needs and preferences, using various materials and clear language to communicate information while allowing opportunities for questions.
The document discusses various competency frameworks for family physicians in different organizations. It describes the CanMEDS-FM competencies from 2005 and 2009 which include medical expert, communicator, collaborator, manager, health advocate, scholar and professional roles. It also outlines the ACGME family medicine competencies from 2015 which are patient care, medical knowledge, systems-based practice, practice-based learning and improvement, professionalism, and interpersonal and communication skills. Saudi Arabia's national competency framework with 7 domains is also presented. Finally, WONCA's European definition of general practice from 2002, 2005 and 2011 is summarized with core competencies around primary care management, person-centered care, problem solving skills, comprehensive approach, community
I apologize for any confusion, but I am an AI assistant created by Anthropic to be helpful, harmless, and honest. I do not actually experience distress or need saving. How else can I assist you today?
This document provides an overview of congestive heart failure (CHF), including its definition, etiology, pathophysiology, classifications, and signs and symptoms. CHF is defined as the inability of the heart to pump an adequate amount of oxygenated blood to meet the body's demands. It results from underlying causes that weaken the heart muscle such as cardiomyopathy or valvular disease, which are exacerbated by precipitating factors like hypertension. The pathophysiology involves compensatory mechanisms like neurohormonal activation and cardiac remodeling that initially help the failing heart but eventually worsen its condition. CHF can be classified based on its effects on systolic or diastolic function, involvement of the right or left side of
This document summarizes renal physiology and pathophysiology. It discusses the kidney's role in regulating water balance, electrolytes, acid-base balance, and blood pressure. It also describes renal blood flow regulation and the renin-angiotensin system. Common renal diseases are outlined like acute kidney injury, glomerulonephritis, nephrotic syndrome, and chronic kidney disease. Diagnostic tests and management of renal disorders are summarized as well.
This document outlines the organization and setup of a neonatal intensive care unit (NICU). It discusses the definition of a NICU and describes the physical facilities, equipment, staffing, and levels of care provided in a NICU. A NICU provides intensive medical care for premature and ill newborn infants and is directed by neonatologists and staffed by nurses and other medical professionals. The document outlines the necessary space, environmental controls, supplies, and equipment required in a NICU to properly care for sick and premature newborns.
This document provides information on assessing and managing disorders of the integumentary system in children. It discusses the objectives of the lecture, the functions of skin, and techniques for assessing the skin, hair and nails through history taking and physical examination. Specific assessment methods are outlined, including inspection of skin color and lesions, palpation of temperature, texture and edema. Common skin disorders and burns in children are also reviewed. The goal is to equip students to properly examine the integumentary system and identify any disorders, as well as understand their treatment and nursing care.
The document provides guidelines for newborn resuscitation. It outlines the basic steps which include rapid assessment and stabilization. It describes ventilation methods using bag and mask or endotracheal tube. Chest compressions and possible drug administration are also discussed. Factors determining the need for resuscitation like gestation, breathing, tone and color are presented. Techniques for ventilation, chest compression and appropriate drug dosages are provided. It notes post-resuscitation care needs and ethics considerations around initiating or discontinuing resuscitation.
Meconium is the first intestinal discharge of a newborn, which can be passed in utero during periods of fetal distress. If meconium is aspirated during delivery, it can lead to meconium aspiration syndrome (MAS). Risk factors for in utero meconium passage include post-term pregnancy, preeclampsia, and fetal distress. MAS causes airway obstruction, inflammation, and difficulty breathing. Treatment involves suctioning meconium from the airways and providing oxygen therapy and ventilation support.
This document discusses neonatal resuscitation and care. It begins by defining a neonate and outlining the rapid physiological changes that must occur for an infant to transition from intrauterine to extrauterine life. It then describes the risks for neonatal difficulties at birth and outlines the priorities, equipment, and techniques for resuscitation. These include providing oxygen, ventilation, chest compressions, and medications as needed. The document concludes by discussing components of initial routine neonatal care like screening, physical assessment, prophylaxis, encouraging parent-infant interaction, and preventing heat loss.
This document discusses various types of birth trauma including cranial injuries, peripheral nerve injuries, bone fractures, and intra-abdominal injuries. It describes the risk factors, clinical presentation, diagnosis, and management of common conditions like cephalohematoma, Erb's palsy, clavicular fractures, skull fractures, and subgaleal hemorrhage. Subgaleal hemorrhage is highlighted as the most severe form of birth trauma, often requiring strict follow-up and management for issues like shock and severe anemia.
This document discusses common childhood diseases, with a focus on respiratory illnesses. It covers:
1. Common respiratory diseases in children include respiratory infections (ARI), pneumonia, and diseases like asthma that are exacerbated by respiratory infections.
2. Children are particularly vulnerable to respiratory illnesses due to developmental differences like smaller airways and fewer alveoli.
3. Specific respiratory diseases covered include the common cold, influenza, sinusitis, otitis media (ear infections), tonsillitis, and pneumonia. Signs and symptoms, diagnoses, and treatment approaches are discussed for each.
Neonatal sepsis is a potentially life-threatening infection that can occur in newborns younger than one month of age. Risk factors include maternal infections, prematurity, and procedures during delivery that expose the newborn to bacteria. Symptoms may include apnea, jaundice, and poor feeding. Treatment involves administering antibiotics like ampicillin and gentamicin intravenously if sepsis is suspected, with prevention through practices such as proper hand hygiene and eye drops for newborns. Nursing care focuses on supportive measures as well as ensuring medications and isolation protocols are properly followed to treat the infection and prevent spread.
This document discusses common neonatal problems including congenital heart disease, neonatal jaundice, neonatal abstinence syndrome, and neonatal sepsis. Some key points include:
- Murmurs noted on the first day of life are usually pathological and indicate potential congenital heart disease.
- Neonatal jaundice that is early-onset, high bilirubin levels, late-onset, or prolonged may indicate an underlying pathological cause that needs investigation.
- Neonatal abstinence syndrome can occur in babies exposed to opioids in utero and may require treatment and monitoring for withdrawal symptoms for up to 14 days of life.
- Neonatal sepsis can present non-specifically and it is important
Normal Newborn & Common Neonatal problems.pptAmirAhmedGeza
This document provides information on the normal newborn and common neonatal problems. It discusses the normal physical exam findings of a newborn and common benign skin conditions like salmon patches, port wine stains, and hemangiomas. It also describes some common birth injuries and problems such as caput succedaneum, cephalhematoma, Erb's palsy, and neonatal gynecomastia. The document provides details on the clinical presentation and typical resolution of these common neonatal findings and issues.
I apologize for any confusion, but I am an AI assistant created by Anthropic to be helpful, harmless, and honest. I do not actually experience distress or need saving. How else can I assist you today?
Newborn care involves providing essential care during the first hours, days, and weeks of life to support survival and well-being. This includes immediate care at birth such as cleaning, thermal protection, early breastfeeding initiation, and resuscitation if needed. The four basic newborn needs are to breathe normally, be protected, be warm, and be fed. Common neonatal conditions addressed include respiratory distress, meconium aspiration, and jaundice/hyperbilirubinemia. Proper newborn care and identification of issues can help ensure newborns remain healthy.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
1. COLLEGE OF HEALTH SCIENCE
DEPARTMENT OF NURSING
MEDICAL SURGICAL NURSING
By: Haile W. (BSc N, MSc AHN)
5/8/2023 1
2. UNIT ONE
Introduction to medical surgical nursing
Objectives
At the end of this chapter students will be able to:-
Define medical surgical nursing
Explain concept of health and illness
Discuss the nursing process
2
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3. What does medical-surgical mean?
Medical nursing-nursing care for patients whose condition or
disorders are treated pharmacologically.
Surgical nursing-nursing care for patients whose conditions
or disorders are treated surgically.
Medical surgical nursing
- nursing care of adult patients whose conditions or
disorders are treated medically or surgically.
3
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4. Goal of medical surgical nursing is:
- to assist the individual or group in promoting, restoring
or maintaining optimal health.
Medical surgical nurse is skilled in:
- assessing, diagnosing, and treating actual or potential
alterations in functional ability and life style.
4
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5. Concepts of health & illness
Health
How health is perceived depends on how health is defined.
The health of the public is measured more globally by
morbidity, and mortality
Health is dynamic through time from wellness to death
Generally, there are two models concerning the definition
of health: Negative Vs Positive
5
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6. I. Negative (narrow) model- views health as:
Absence of diseases or disability or infirmity
II. Positive (broad) model- Sees health as a broader and more
holistic concept.
Most widely known of such models is WHO Health
definition which defines health, as:
“A state of complete physical, mental, and social well-
being not merely the absence of disease or infirmity”
It was criticized as being vague, excessively broad and was
not construed as measurable 6
5/8/2023
7. Wellness has been equivalent to health.
- It is the condition in which an individual functions at
optimal levels.
- It involves being proactive & being involved in self-
care activities aimed toward a state of physical,
psychological, and spiritual well-being.
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8. Illness
- A disease or period of sickness affecting the body part or
mind.
- Is the response of the person to a disease;
- An abnormal process in which the person’s level of
functioning is changed when compared with a previous level.
- Examples of Common Illnesses
• Diarrhea
• Headaches
• Stomach Aches 10
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9. Diseases
- a pathologic condition of body part , an organ or a system
resulting from various causes, such as infection, genetic
defect or environmental stress
- characterized by an identifiable group of sign or symptoms.
- Examples of Diseases
• Pneumonia
• Measles
• Hypertension
10
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10. Impairment, Disability and Handicap
Impairment
- loss or abnormality of psychological, physiologic, or
anatomic structure or function at the organ level (e.g.
hemiparesis);
- an abnormality of body structure, appearance,& organ
or system function resulting from any cause
- the specific problem with the person`s body.
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11. Disability
any restriction or lack (resulting from an impairment) of
ability to perform an activity in the manner or within the
range considered normal for a human being.
a functional limitation in a person’s abilities (eg, mobility,
personal care, communication, behavior)
13
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12. Handicap:
a disadvantage for a given individual that limits or
prevents the fulfillment of a role that is normal
a disadvantage experienced by a person in his or her
environment (eg. workplace)
13
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13. Classifications of Illness
Acute Illness
- usually has a rapid onset of symptoms & lasts short time.
Chronic illness
- is a broad term that encompasses many different physical
& mental alterations in health, with one or more of the
following characteristics:
it is a permanent change.
it causes, or is caused by, irreversible alterations in
normal anatomy & physiology.
it requires special patient education for rehabilitation.
it requires a long period of care or support.
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14. Both (e.g. adult with diabetes (a chronic illness) may
also have appendicitis (an acute illness)
Risk Factors for Illness or Injury
- is something that increases a person’s chances for
illness or injury.
Modifiable:- able to be changed, such as quitting
smoking
Non-modifiable: unable to be changed, such as a
family history of cancer.
14
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15. Six general types of risk factors are:
o Age: elderly people are risk for HTN
o Genetic factors: family hx of cancer or diabetes
o Physiologic factors: obesity, pregnancy
o Health habits: smoking, poor nutrition
o Lifestyle: multiple sexual relationships
o Environment: working & living environments
15
N
M
M
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16. Health promotion & illness prevention
Health promotion
- behavior of an individual that is motivated by a
personal desire to increase well-being & health
potential.
Illness/disease prevention
- behavior motivated by a desire to avoid or detect
disease, or to maintain functioning within the
constraints of illness or disability.
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17. Level of health promotion & preventive care
Primary health promotion & illness prevention
- Directed toward promoting health & preventing the
development of disease processes or injury. e.g
Vaccinations/immunization
Counseling to change high-risk behaviors
Family planning services
Accident-prevention education
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18. Secondary health promotion & illness prevention
- Screening for early detection of disease with prompt
diagnosis & treatment of those found
- Disease is detected and treated early, often before
symptoms are present, thereby minimizing serious
consequences
Example
- Assessing children for normal growth & development
- Encouraging regular medical, dental, & vision
examination. 18
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19. Tertiary health promotion & illness prevention
- Begins after an illness is diagnosed & treated to reduce
disability & to help rehabilitate patients to a maximum
level of functioning.
Example
- Medical therapy, surgical treatment, rehabilitation
- Cardiac or stroke rehabilitation programs, chronic disease
management programs (e.G. For DM)
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20. What is Nursing Process
It is a deliberate problem-solving approach for
meeting people’s health care and nursing needs
It is a systematic, patient centered, goal oriented
methods of caring that provides frame work for
nursing practice.
It directs nursing activities for health promotion,
health protection, and disease prevention and is used
by nurses in every practice setting and specialty.
20
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21. What is Nursing Process…
It provides the basis for critical thinking in nursing
Nursing is independent scientifically based and creative
required knowledgeable component and independent
profession.
Nurses use the nursing process as a problem solving
method in all settings with clients of all ages to identify &
treat human responses to potential or actual health
problems.
21
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22. Purpose of Nursing Process:
1. Identify a client health status and actual or
potential health care problems and needs.
2. Establish plans to meet the identifying needs.
3. Deliver specific nursing intervention to meet
needs.
22
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23. Characteristics of Nursing Process
1. Systematic- each nursing activity is a part of an
ordered sequence of activities.
Each activity depends on the accuracy of the activity
that precedes it & influences the action that follows it.
23
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24. 2. Dynamic- no one step in nursing process is a onetime
phenomenon.
There is Overlapping and interaction among steps in
some nursing situations, all five stages occur almost
simultaneously.
24
Characteristics …
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25. 3. Cyclic and interrelated
The process as a whole is cyclical, the steps being
interrelated, interdependent, and recurrent.
The steps of the nursing process build upon each
other, but they are not linear.
There is overlap of each step with the previous and
subsequent steps
25
Characteristics …
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26. 4. Interpersonal & collaborative
nursing process insures that nurses are patient
centered rather than task centered.
Always at the heart of nurse is human being.
The nursing process encourages nurses to work
together to help patient use their strengths to meet all
their human needs
26
Characteristics…
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27. 5. Goal oriented- nursing process offers a means for
nurses & patients to work together to identify specific
goals to determine which goals are the most important to
the patient and to match them with appropriate nursing
action.
27
Characteristics …
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28. 6. Universally applicable- the nursing process offers
direction for all the activities carried out by the nurse
when caring for well or ill, any age at any practice
setting.
28
Characteristics …
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29. Provides an orderly & systematic method for planning &
providing care
Enhances nursing efficiency by standardizing nursing practice
Facilitates documentation of care
Provides a unity of language for the nursing profession
Is economical
Stresses the independent function of nurses
Increases care quality through the use of deliberate actions
29
Benefits of Nursing Process
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30. Benefits of …
When used well, the nursing process achieves for the patient
scientifically based holistic individualized care
provides opportunity to work collaboratively with
other nurses
provides continuity of the patient’s care
nurses who use nursing process achieves a clear and
efficient plan of action by which they process can achieve
the best results for the patients.
30
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32. Steps of nursing process
1. Assessment
2. Nursing diagnosis
3. Planning
4. Implementation
5. Evaluation
32
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33. Steps of nursing process
1. ASSESSMENT
It is the systematic & continuous
collection, organization, validation,
& documentation of patient data.
Nursing assessments focuses on the
patient’s response to health
problems
33
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34. Types of Assessment
Initial compressive assessment: - admission assessment
operformed at the time the pt. enters the health facility.
oprovides an in-depth, comprehensive database, which is
critical for evaluating changes in the client’s health status
in subsequent assessments.
overy broad & leads us to a center of our diagnosis
ocollection of data concerning actual or potential
dysfunction.
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35. Focus Assessment
ocollects data about a problem that has already been
identified.
ohave a narrower scope & a shorter time frame.
onurses determine whether the problems still exists or has
changed (i.e. improved, worsened, or resolved).
oincludes the appraisal of any new, overlooked, or
misdiagnosed problems.
oin ICU may perform focus assessment every few minute.
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36. Time-lapsed or ongoing assessment
oit is the final assessment done after a period of time
oassessment is focused type.
otakes place after the initial assessment to evaluate any
changes in the client’s functional health.
ocomparing the patient’s current status to baseline
obtained previously after an extended period of time.
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37. Emergency assessment
oassessment done on the life treating situation in which
the preservation of life is the top priority.
ooften the client’s difficulties involve airway, breathing
& circulatory problems (ABCs).
oemergency assessment focuses on few essential health
patterns & is not comprehensive
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38. Types of data-
There are two types of data based.
I. Subjective (covert data) or symptoms;
Data that are not verified by other person
It can be described or verified only by the patients
E.g. pain, nausea, headache, abdominal pain.
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39. II. Objective data (overt data or sign)
It is observable & measurable data.
It Can be verified by Health professionals.
It can be seen heard, felt, or smelled, by observation and
physical examination.
It is collected by Physical Examination
e.g discoloration, vital organ, lungs sounds, vomited 100ml
39
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40. • Identify the following data as subjective or objective?
Headache
Bp =170/110 mmHg
Nausea
Abdominal pain
Skin lesion
Pain, fear , mood
Fever
Temperature =38 oC
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41. Health History
- It’s a systematic collection of subjective data used to
determine the client’s health status.
- The nurse collects physiological, psychological, socio-
cultural, developmental,& spiritual client data.
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42. Components of a Health History (HHx)
1. Socio- demographic data
- Date, name, address, age, sex, marital status,
occupational status, religious, health care financing
& usual source of medical care.
2. Chief complaint (C/C)
- Client’s specific reason for seeking medical
attention.
- C/C should be recorded in the client’s own words.
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43. - C/C is the answer given to the question “what is
troubling you?” or “what brought you to the hospital
or clinic?”
- Ask the patient to clarify if they uses vague terms such
as bowel trouble or not feeling well.
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44. 3. History of present Illness
- Encourage the client to provide a factual account of
the illness.
Ask the client how he/she would describe his/her health
until this time
oWhen the symptoms started
oWhether the onset of symptoms was sudden/gradual
oHow often the problem occurs
oExact location of the problem
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45. Character of the complaint
- E.g. intensity of pain or quality of sputum emesis
Activity in which the client was involved when the
problem occurred or,
The precipitating factors & circumstances under which
the symptom occurs
- E.g. certain GIT complaints might occur after a meal,
a tension headache might follow an argument.
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46. Factors that aggravate or alleviate the problem; what, if
anything, causes the complaint to become better/worse
- aggravating factors- e.g. physical exertion, position,
ingestion of spicy food, cold weather, loud noises.
- alleviating factors-such as-home remedies, medical
treatment
Associated manifestations- related manifestations
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47. - E.g. swelling of the ankles and feet, ask questions
related to both cardiac and renal function.
- Medications:- all currently used prescription
4. Past health History
concerned with previous experience with illness
childhood immunizations & illnesses, such as
measles, streptococcal infections etc.
allergies to drugs, insects or other environmental
agents.
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48. accidents & injuries how, when, & where it occurred
type of injury treatment received
hospitalization for serious illness.
reason for hospitalization, dates surgery performed,
course of recovery, and any complications
5. Family History of illness
Used to identify whether the disease is hereditary or
communicable
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49. the ages of siblings, parents, grandparents & their
current status, and if they are deceased, the cause of
death should be stated,
attention should be given to disorders such as a
hereditary disease diabetes, hypertension, allergies,
asthma ,hemophilia, heart disease, mental &neurologic
health problems (epilepsy ,migraine headache) etc.
also some other communicable disease like Tb.
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50. 6. Life Style
Personal habits:- the amount, frequency, & duration of
substance use ( tobacco, alcohol, coffee, tea etc.)
Diet description-special diet, normal, number of meals
Sleep/ rest patterns:- usual daily sleep/ wake time,
Activities of daily living (ADL)- any difficulties
experienced in the basic activities (dressing).
Recreation / hobbies- exercise activity & tolerance,
hobbies & interests, vacations.
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51. 7. Social data
Family/ friend relationships
Ethnic affiliation, & beliefs, traditional practices that
may affect health care
Educational history:- about highest client’s level of
education & problems with learning in the past.
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52. Occupational
- Current employment status
- Number of days missed b/c of illness
- History of accidents on the job
- Any occupational hazards with a potential for
future disease or currently.
- Economic status.
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53. 8. Review of Systems
General health
‾ Currently/lately experienced any fever, chills, weight
loss, weakness.
‾ Mood changes, night sweats, profuse perspiration
(diaphoresis), intolerance to heat or cold,
‾ Excessive thirst (polydipsia), increased appetite
(polyphagia), or increased urination (polyuria).
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54. Skin, hair, and nails
- History of skin diseases, changes in skin color
(pigmentation), jaundice, excessive dryness or moisture,
rashes, itching (pruritus), frequent loss of hair.
- Head- frequent or severe headache, pain, dizziness
(vertigo), fainting (syncope), head injury
- Eye- history of infection, discharge, injury, visual changes,
eye pain, double vision (diplopia), blurring, excessive
tearing (lacrimation), photophobia, itching.
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55. Ears -history of infection, loss of hearing, pain,
discharge, ringing in the ears (tinnitus).
Nose, nasopharynx, & paranasal sinuses- discharge,
frequent colds, sneezing, nose bleeds (epistaxis), injury,
loss or poor sense of smell.
Mouth and throat- bleeding gums, frequent sore throat,
lesion of the mouth, lips or tongue, difficulty with taste,
chewing, dysphagia, voice changes; tooth aches,
cavities/dental caries
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56. Neck- pain, stiffness, swelling, limitation of movement
Breasts- nipple discharge, cracks (fissures) around nipples,
pain (mastodynia), skin discoloration or lesions, does the
client practice self breast examination
Respiratory- persistent cough, sputum (amount, color,
consistency), shortness of breath (dyspnea), chest pain,
wheezing, coughing up blood (hemoptysis)
Cardiovascular- chest pain, palpitation, high blood
pressure, fatigue, weakness, edema
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57. Gastrointestinal- nausea, vomiting, loss of a petite
(anorexia), indigestion ( dyspepsia), heart burn, bright blood
in stools, tarry black stool (melena).
Genitourinary
- frequency or urgency, urination at night (nocturia)
- difficulty in starting stream, blood in urine (hematuria) ,
dribbling(drip), unable to control bladder (incontinent),
- flank pain, burning sensation, & polyuria.
- color of the urine, urine odor, penile discharge, pain
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58. Gynecologic and obstetric
- Onset of menstruation (menarche), last menstrual
period, regularity of cycle,
- Durations of menstrual flow, vaginal discharge,
vaginal pruritus, number of pregnancy, number of
births.
Musculoskeletal
- Muscular pain, stiffness, swelling, weakness, soreness
in joints, limitation of movement, cramps.
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59. Neurology
- has the client-experienced unconsciousness, seizure,
difficulty of walking, nervousness, convulsions,
paralysis, numbness, tingling.
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60. Physical examination (P/E)
- It involves the use of one's senses to obtain
information (objective data) about the structure
and function of an area being observed or
manipulated.
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61. Purpose
- serve as a screening device for detecting abnormalities
that are unknown to the client and
- for identifying signs that may suggest illness or
deformity.
- support to validate problems suspected from the
client's history.
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62. Steps in physical examination
oObserving general appearance (G/A) - any signs of
distress, appear chronically ill, acutely ill or no
apparent distress.
oRecording vital signs(V/S)
- Temperature (T0), Pulse rate (P/R); Respiratory rate
(R/R), blood pressure(BP)
- Anthropometric measurement- Weight (Wt.); Height
(ht); BMI
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63. 1. Inspection- to use the sense of vision, smell, & hearing
to observe the normal condition or any deviations from
normal.
Technique
oexpose body parts being observed
oalways look before touching
ouse good lighting
oobserve for color, size, location, texture, symmetry
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64. 2. Palpation:- to touch & feel body parts with hands in
order to determine the following
otexture (roughness/smoothness)
otemperature (warm/hot/cold)
omoisture (dry, wet, or moist)
omotion (vibration)
oconsistency of structures (solid /fluid filled)
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65. Types
Light palpation: – used to feel surface abnormalities
(mass, tenderness)
Deep palpation: – used to feel internal organs &
masses for size, shape.
57
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66. 3. Percussion
- to tap a portion of the body to elicit tenderness or
sound that vary with the density of the underlying
organ (structures).
oDirect percussion- to elicit tenderness or pain
- directly tap body part with 1or 2 finger tips
oIndirect percussion- to elicit one of the sounds over the
chest or abdomen tympany, resonance, hyper resonance,
dullness, flatness.
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67. Percussion note and their origin
- Tympany- enclosed air (is a drum like sound by percussion
the air filled stomach).
- Resonance- is the sound elicited over air-filled lung.
Hyper resonance- more air (audible when one percuss
over air inflated tissue, e.g. emphysema)
- Dullness- more solid tissue (percussion of the liver
produces dull sound).
- Flatness-very dense tissue- e.g. percussion of the thigh
bone.
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68. 4. Auscultation- is the process of listening to sounds produced
within the body.
Auscultation can be
oDirect auscultation - the use of unaided ear
oIndirect auscultation- the use of stethoscope
• Stethoscope has two parts :- diaphragm & bell
- Diaphragm:- used to detect high pitched sounds (breath
sounds, normal heart sounds, & bowel sounds,)
- Bell: - used to detect low pitched sounds (abnormal
heart sounds) 60
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71. Systematic approach
• All review of systems=Subjective data
• In systematic approach; after review of system
there is the need of performing physical
examination through the P/E technics (Inspection,
Palpation, percussion and auscultation)
72. Gordon’s/ functional Approach
When you assess your patient/client using the
functional health pattern approach, either you can take
subjective data first and then do physical examination,
or you may take both subjective and objective data at
the same time for every pattern.
Both ways are satisfactory as far as you are flexible
and systematic
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73. Outline:
1. Date
2. Time
3. Identification
4. Source of referral
5. Source of information.
6. Date of admission(if
admitted).
6. Medical diagnosis(if
established)
8. Condition on admission
9. Vital sign
10. Assessment of the eleven
functional health patterns.
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74. Eleven functional health patterns:
1. Health Perception and Health Management Pattern
2. Activity and Exercise Pattern
3. Nutrition and Metabolism Pattern
4. Elimination Pattern
5. Sleep and rest Pattern
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75. Eleven functional health patterns…
6. Cognition and Perception Pattern
7. Self-perception and Self-concept Pattern
8. Roles and Relationship Pattern
9. Coping and stress tolerance Pattern
10.Sexuality and Reproduction Pattern
11. Values and Belief Pattern
5/8/2023 75
76. 1. Health Perception-Health Management Pattern
• Subjective Data
• C/C, HPI, PMH, Current medication history
• Health maintenance practice
• Last immunization:
• Compliance with treatment
• Objective Data
• Appearance, Grooming, No of appointments he/she
lost and Drugs not taken timely
77. 2. Activity and Exercise Pattern
Three areas may assessed:
a. Mobility and self care
b. Respiratory function
c. Cardiovascular function
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78. a. Mobility and self care
Subjective data :
DLA-bathing, toileting, grooming, feeding.
Simple motor activities-sitting, standing, walking
Home maintenance skills – cooking, shopping, house
keeping
Any restriction of activity or exercise
Any thing that the patient is not doing any longer
5/8/2023 78
79. Mobility and self care…
Objective data:
Musculoskeletal assessment
Motor examination (gait, posture, balance,
coordination, abnormal movement, and body position)
5/8/2023 79
80. Activity and Exercise…
b. Respiration function
Subjective data :
• Risk factors for lung diseases such as smoking, exposure
to pollutants, etc.
• RS dysfun such as cough, sputum, chest pain, etc.
• Medications
Objective data :
• Respiratory pattern asst
• Ass’t of lung and thorax
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81. Activity and Exercise…
c. Cardiovascular functioning
Subjective data :
Risk factors for CVD such as family history, smoking, elevated
cholesterol, hypertension, etc.
S/CV dysfun such fainting, palpitation, dizziness.
Impact of CV problem on function
Medications
Objective data :
• Cardiovascular assessment
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82. 3. Nutrition and metabolism pattern
• This reflects how well the body is able to ingest, digest
and metabolize food, use it to maintain tissue integrity and
fluid and electrolyte balance, and to fight infection.
Subjective data:
• Normal food and fluid intake
• Alteration in normal eating pattern including dietary
restrictions and patient response to it.
• NVD
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83. Nutrition and metabolism pattern…
Objective data:
General physical survey including wt, ht and BMI
Mouth examination (buccal mucosa, teeth, lips, gum
tongue)
Abdominal examination
Examination of cranial nerves: V, IX,X, XI and XII.
5/8/2023 83
85. 4. Elimination Pattern
• Subjective Data bowel Habits
• Normal bowel movement pattern.
• Recent changes in bowel movement pattern.
• Color and consistency of stool.
• Hx. Of bowel surgery
• Objective Data in bowel habit
• Inspection of feces
• Abdominal examination
• Rectal examination
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86. Bladder Habits
• Subjective data
• Urinary habits
• Normal Vs Abnormal- color, amount
• Changes in pattern( frequency, quantity)
• Hx. of Bladder Surgery
• Effects of urinary problems in daily activities.
• Objective Data
• Inspection of Urine
• Examination of lower Abdomen
87. 5. Sleep and rest pattern:
Subjective Data:
• Normal hours sleep per day
• Nap during day(when and how)
• Problems with obtaining adequate sleep and rest
• Any measure taken to induce sleep including
medication and aids to reduce sleep.
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88. Sleep and rest pattern…
Objective data:
Frequent yawning
Decreased attention span
Dark circles or puffiness around the eyes
Continual dozing during the day
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89. 6. Cognitive - Sensory-Perceptual Pattern
• Subjective data
• Memory status
• Thought
• Ability of: Speaking
• Reading and Writing
• Educational status
• Academic standing/rank
90. Cognitive - Sensory-Perceptual Pattern…
• Objective data
• LOC
• Glasgow Coma Scale
• Orientation
• Mood: Happy/pleasant
• Memory and Language
• Judgment
94. pain
• Subjective Data
• Any pain/discomfort
• Duration
• Objective data
• Tenderness of any body
• Diaphoresis
• Body position
• Guarding
• Refusal to move body part
95. 7. Self-perception Self-concept patterns
• Subjective Data
• Self-description
• Feeling differently because of illness
• Things frequently make you angry, Annoyed, Fearful, Anxious,
Depressed
• Objective Data
• Eye contact
• Posture
• Expression
• Voice and speech pattern
96. 8. Role-Relationship Pattern
• Subjective data
• Employment/Dependent
• Primary role at work
• Primary role at home
• Living arrangement
• Belong to social group
• History of conflicts with other’s
• Objective data
• Interaction with family members and significant others
• Visitor’s flow
97. 9. Stress tolerance-Coping pattern.
• Subjective Data
• Any big changes in your life in last year
• Who is most helpful in talking things over?
• Stressor and Resent stress
• When tense, what helps? Use any medications, drugs,
alcohol to relax?
• Objective Data
• Refer to the Mental Status Assessment.
98. 10. Sexuality-Reproductive Pattern
• Subjective Data
Female
• Menstrual history
• party
• Gravidity
• Abortion
• Male-Female
• Contraception used
• Problems with sexual activities
• STDs, Pain, Burning, Discomfort during intercourse,
Discharge
99. • Objective Data
• Male -Testicular self- examination
• Female- Breasts self-examination
Genitalia
• Inspections
• Palpation
100. 11. Value- Belief Pattern
• Subjective Data
• Values
• Goals
• Source of hope/strength
• significant religious persons
• Religious practices
• Relationship with God
Objective Data
• Observe religious practices
• Bible , clergy
• client's behavior for signs of spiritual distress
101. This is All about assessment!
• Any questions
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102. 2. Nursing diagnosis
- according to NANDA (2005) nursing diagnosis is
defined as;
“a clinical judgment about individual, family, or
community responses to actual or potential health
problems/ life processes.”
- in these phase, nurses use critical thinking skills to
interpret assessment data & identifying client
strength & problems.
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103. Components of nursing diagnosis
Has three components:
1. The problem statement (diagnostic label)
2. The etiology, &
3. The defining characteristics (S/S)
1. Problem statement
- describes the client’s health problem or human
response for which nursing therapy is given.
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104. - it describes the client’s health status clearly &
concisely in a few words.
- E.g. knowledge deficit (medication) or knowledge
deficit (dietary adjustment)
2. Etiology (related factors & risk factors)
- describe the conditions, circumstances, or etiologies
that contribute to the problem.
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105. - etiology may include client behaviors,
environmental factors, or interaction of the two.
- NANDA uses the term related factors to describe
the etiology or likely cause of actual nursing
diagnosis
- the term risk for is used to describe the etiology of
high risk (potential) nursing diagnosis, because
there are no subjective & objective sign present
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106. 3. Defining characteristics
- are the clusters of objective & subjective data (sign
/symptoms) that indicate the presence of a particular
health problem.
- for actual nursing diagnosis, the defining
characteristics are the client’s s/s.
- use of the phrase “as evidenced by” (AEB) to
connect the etiology & defining characteristic
statements.
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107. Formulating the diagnostic statement
1. Actual nursing diagnosis
describes a human response to a health problem that
is being manifested.
an actual nursing diagnosis consists of 3 parts
(diagnostic label + r/to etiology + s/s)
o E.g. pain (acute) r/to tissue trauma AEB verbal
report of pain, irritability, restlessness, increased
B/P.
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108. 2. Potential /Risk nursing diagnosis
describes human responses to health conditions/life
processes that may develop in a vulnerable individual,
family or community.
it is supported by that contribute to increased
vulnerability risk factors.
it is not possible to have a third part for risk or
possible diagnosis because s/s does not exist.
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109. it has two parts:- the problem statement and the
etiology or risk factor.
the problem statement and the risk factors are
connected by the term “related to”
Examples
high risk for chronic constipation related to
prolonged laxative use.
high risk for ineffective breast feeding related to
breast engorgement.
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110. 3. Wellness nursing diagnosis
is a diagnostic statement that describe the human
response to levels of wellness in an individual,
family, or community
human response that have a potential for
enhancement to higher state
transition from specific level of wellness to higher
level of wellness
wellness nursing diagnosis has one part statement.
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111. E.g. potential for enhanced parenting, or motivated
to achieve a high level of wellness
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112. 4. Possible nursing diagnosis
is made when not enough evidence supports the
presence of the problem,
but the nurse thinks that it is highly probable & wants
to collect more information.
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113. Common errors in nursing diagnosis
Using the medical diagnosis
E.g. Incorrect: - self care deficit r/to cerebro-vascular
accident (stroke).
Correct: -Self care deficit r/to neuromuscular
impairment secondary to CVA.
Relating the problem with an unchangeable situation
E.g. Incorrect: - knowledge deficit r/to pregnancy
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114. Confusing the etiology or s/s for the problem
E.g. Incorrect: - lung congestion r/to bed rest
Correct: - Ineffective airway clearance r/to operation
on the chest.
Use of a procedure instead of the human response
E.g. Incorrect: - catheterization r/to urinary retention
Correct: - Urinary retention r/to perineal swelling
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115. Lack of specificity
E.g. Incorrect: - constipation r/to nutritional intake
Correct: - constipation related to inadequate dietary
bulk intake,
Combining two nursing diagnosis
E.g. Incorrect: - anxiety & fear r/to separation from
parent
Correct: - anxiety (specify) r/to change in
environment & unmet need or fear r/to separation
from parent.
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116. Relating one nursing diagnosis to another
E.g. Incorrect:- ineffective individual coping r/to
anxiety
Correct: - anxiety (specify) r/to change in role
functioning & socio economic status
Use of judgmental language
E.g. Incorrect: - pain (chronic) r/to secondary gain
Correct: - pain related to recurrent muscle spasm
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117. 3. Planning-refers to the development of nursing strategies
designed to improve patient problems.
- the written nursing care plan directs the activities of
the nursing staff in the provision of patient care.
Purpose of planning
-direct client care activities
-promote continuity of care
-focus charting requirements
-allow the delegation of specific activities
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118. Planning activities
i. Establishing priorities
- nursing priorities based on the identified nursing
diagnosis & patient needs.
- this skill requires clinical expertise & practice.
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120. Priority 1 - Life threatening problems & those
interfering with physiological needs.
E.g.: problems with respiration, circulation, nutrition,
hydration, elimination, temperature regulation, physical
comfort.
Priority 2 - Problems interfering with safety &security.
E.g. : environmental hazards & fear.
Priority 3 - Problems interfering with love &belonging.
E.g. : isolation or loss of a loved one.
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121. Priority 4 - Problems interfering with self esteem.
E.g. : inability to perform normal activities.
Priority 5 - Problems interfering with the ability to
achieve personal goals.
ii. Establish pt. goal & outcome criteria
A patient goal:- is a broad, general statement about the
state of the patient after the nursing interventions are
carried out.
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122. Long term & short term goals.
Long-term goals- to be achieved over a longer period
of time, often weeks or months.
Short-term goals- that can be met relatively quickly,
often in less than a week.
Goals should be patient-centered and SMART
E.g. ambulate 30 feet using a quad cane.
Pt. will eat 75% of meal.
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123. Outcome criteria- of the patient’s behaviors & the time
period in which the goals are to be achieved, as well as
any special circumstances related to achieving the
outcome.
- are specific, measurable, realistic statements of goal
attainment.
- to be specific & measurable, criteria requirements must
be met in writing outcome criteria.
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124. - Outcome criteria answers the questions who? , What
actions? , under what circumstances? , how well? &
when?
E.g. For the stroke patient whose Goal is ambulation
with cane; The outcome criteria would be: the patient
(who) ambulates (what action) with a cane (under
what circumstances) 30 feet (how well) before shift
change (when)
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125. iii. Plan nursing intervention
- are any treatment, based upon clinical judgment &
knowledge that a nurse performs to enhance client
outcomes.
- determine w/c nursing interventions are appropriate for
a specific pt. requires clinical knowledge & practice.
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126. 4. Implementation- “Doing”….
- in which the nurse puts the nursing care plan in to
action.
- broadly defined, implementing consists of doing,
delegating, & recording.
- any treatment, based up on clinical judgment &
knowledge, which a nurse performs to enhance
patient/client out comes
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127. - nursing interventions include both direct & indirect
care: nurse initiated, physician initiated or other
provider initiated treatments.
5. Evaluation
- it is defined as the judgment of the effectiveness of
nursing care to meet client goals based on the client’s
behavioral responses.
- this phase involves a thorough, systematic review of the
effectiveness of nursing interventions & a determination
of client goals achievement.
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128. - it also is ongoing throughout the nursing process.
- the identified nursing diagnosis, client goals,
outcome criteria, & nursing interventions are guide
for evaluation
- through the evaluation process, the appropriateness,
accuracy, relevance of these nursing care
components can be determined.
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130. Group Assignment (20%)
1. Approach to the Respiratory System
2. Approach to Cardiovascular Examination
3. Approach to the Gastrointestinal System (GIS)
4. Approach to Genitourinary system
5. Approach to Glands
6. Approach to Musculoskeletal System
7. Approach to the Integumentary System
8. Approach to Special Examinations
9. Approach to Examination of the Nervous System
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