Health Promotion

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Health Promotion

• Larry Santiago, MSN, RN

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Health Care Delivery and Nursing Practice

• Nursing is defined as the diagnosis and
  treatment of human responses to health and
  illness.

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Health Care Delivery and Nursing Practice 2

• Health is defined as a state of complete
  physical, mental, and social well-being.

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Health Care Delivery and Nursing Practice 3

• Wellness includes a conscious and deliberate
  approach to an advanced state of physical,
  psychological, and spiritual health.

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Maslows Hierarchy of Needs
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Roles of the Nurse

• Practitioner Role
• Leadership Role

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Roles of the Nurse 2

• Research Role

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Health Education

• Goal of patient education is to encourage people
  to adhere to therapeutic regimens

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Health Education 2

• Teaching techniques and methods enhance learning

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Health Education 3

• Learning readiness
• Learning environment

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Health Education 4

• People with disabilities
• Gerontologic considerations

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Health Promotion

• Health Promotion encourages people to achieve as
  high a level of wellness as possible

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Health Promotion 2

• Health Promotion principles include
  self-responsibility, nutrition,stress
• management
• and exercise

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Chronic Illness

• Larry Santiago, MSN, RN

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Chronic Conditions

• Medical conditions or health problems with
  associated symptoms or disabilities that require
  long-term management

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Chronic Conditions 2

• Occur in every age
• group
• Major and minor activity limitations
• Expensive

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Phases of Chronic Illness

• 1) Pretrajectory phase person is at risk for
  developing a chronic condition because of genetic
  factors or lifestyle
• behaviors that increase
• susceptibility to chronic
• illness

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Phases of Chronic Illness 2

• 2) Trajectory phase characterized by the onset
  of symptoms or disability associated with a
  chronic condition

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Phases of Chronic Illness 3

• 3) Stable phase indicates that symptoms and
  disability are being managed adequately

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Phases of Chronic Illness 4

• 4) Unstable phase characterized by exacerbation
  of illness symptoms, development of
  complications, or reactivation of an illness in
  remission

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Phases of Chronic Illness 5

• 5) Acute phase characterized by sudden onset of
  severe or unrelieved symptoms that require
  hospitalization

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Phases of Chronic Illness 6

• Crisis phase characterized by a critical or
  life-threatening situation that requires
  emergency treatment or care

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Phases of Chronic Illness 7

• Comeback phase recovery after an acute period
• Downward phase marks the worsening of a
  condition
• Dying phase characterized by the gradual or
  rapid decline despite efforts to halt the disorder

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Nursing Management

• Identify trajectory phase
• - assess the patient to determine the specific
  phase

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Nursing Management 2

• Establish goals should be a collaborative
  effort with the patient, family, and nurse
  working together

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Nursing Management 3

• 3) Establish a plan to achieve desired outcomes
• 4) Identify factors that facilitate or hinder
  attainment of goals

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Nursing Management 4

• 5) Implementing Interventions
• 6) Evaluating the
• Effectiveness of
• Interventions

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End-of-Life Care

• Larry Santiago, MSN, RN

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Death and Dying

• Technology has prolonged life

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Death and Dying 2

• Sociocultural Context

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End of Life Care

• Palliative Care

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End of Life Care 2

• Hospice Care

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Advance Directives

• Written documents that allow the individual of
  sound mind to document preferences regarding
  end-of-life care
• Most common types
• Living will
• Durable power of attorney for health care

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Health Care of the Older Adult

• Larry Santiago, MSN, RN

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Health Care of the Older Adult

• Gerontology is the study of the aging process

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Health Care of the Older Adult 2

• Demographics of Aging

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Health Care of the Older Adult 3

• Health Care Costs of Aging

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Health Care of the Older Adult 4

• Ageism is prejudice or discrimination against
  older adults

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Age Related Changes

• Physical

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Age Related Changes 2

• Psychosocial

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Age Related Changes 3

• Cognitive

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Age Related Changes 4

• Environmental

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Age Related Changes 5

• Pharmacologic

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Living Arrangements

• Own home
• Family home
• Continuing Care Retirement Communities
• Long term care

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Geriatric Syndromes

• Impaired Mobility
• Urinary Incontinence
• Immunodeficiency
• Depression
• Delirium
• Dementia

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Perspectives in Transcultural Nursing

• Larry Santiago, MSN,RN

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Culture

• Culture involves learned and transmitted
  knowledge about values, beliefs, rules of
  behavior, and lifestyle practices that guide
  groups in their thinking and actions

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Culture 2

• Subcultures and minorities

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Transcultural Nursing

• Focus on cultural care values, beliefs, and
• practices of
• individuals from a
• particular culture
• (Giger Davidhizar,
• 1999)

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Transcultural Nursing 2

• Acculturation - process by which members of a
  cultural group adapt or learn how to take on the
  behaviors of another group

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Transcultural Nursing 3

• Cultural blindness inability of a person to
  recognize his/her own values, beliefs, and
  practices and those of others because of strong
  ethnocentric tendencies

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Transcultural Nursing 5

• Cultural imposition tendency to impose ones
  cultural beliefs, values, and patterns of
  behavior on a person/persons from a different
  culture

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Transcultural Nursing 6

• Cultural taboos those activities governed by
  rules of behavior that are avoided, forbidden, or
  prohibited by a particular cultural group

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Culturally Competent Nursing Care

• Cross-Cultural Communication

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Culturally Competent Nursing Care

• Culturally Mediated Characteristics
• - Space and Distance

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Culturally Competent Nursing Care 2

• Eye Contact

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Culturally Competent Nursing Care 3

• Time

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Culturally Competent Nursing Care 4

• Touch

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Culturally Competent Nursing Care 5

• Communication

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Culturally Competent Nursing Care

• Diet

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Acid-Base Disturbances

• Larry Santiago, MSN, RN

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Acid-Base Disturbances

• Identification of the specific acid-base
  imbalance is important in identifying the
  underlying cause of the disorder and in
  determining appropriate treatment

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Kidneys

• Regulate the bicarbonate level in the ECF
• In respiratory acidosis and most metabolic
  acidosis, kidneys excrete hydrogen and conserve
  bicarbonate to help restore balance
• In respiratory and metabolic alkalosis, kidneys
  retain hydrogren and
• excrete bicarb

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Lungs

• Adjusts ventilation in response to the amount of
  CO2 in the blood
• In metabolic acidosis, respirations increase,
  causing greater elimination of CO2
• In metabolic alkalosis,
• respiratory rate decreases,
• causing CO2 to be retained

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Metabolic Acidosis

• Clinical disturbance characterized by low pH, and
  low bicarbonate (HCO3) concentration
• Low pH Low HCO3

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Causes of Metabolic Acidosis

• Results from direct loss of bicarbonate
• Diarrhea
• Diuretics
• Early renal insufficiency
• TPN without bicarbonate

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Clinical Manifestations of Metabolic Acidosis

• Headache
• Confusion
• Drowsiness
• Increased respiratory rate and depth
• Nausea and vomiting
• Increased BP
• Cold, clammy skin

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Metabolic Alkalosis

• Clinical disturbance characterized by a high pH
  and a high bicarbonate
• high pH high
  HCO3

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Causes of Metabolic Alkalosis

• Vomiting or gastric suction
• Pyloric stenosis
• Hypokalemia
• Hyperaldosteronism
• Cushings syndrome
• Causes decreased Calcium

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Clinical Manifestations of Metabolic Alkalosis

• Related to hypocalcemia
• Tingling of the fingers and toes
• Dizziness
• Hypertonic muscles
• Depressed respirations
• Atrial tachycardia

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Respiratory Acidosis

• Clinical disorder in which the pH is less than
  7.35 and the PaCO2 is greater than 42 mmHg
• Always due to the inadequate excretion of CO2
  with inadequate ventilation, resulting in
  elevated CO2 levels
• low pH high PaCO2

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Causes of Respiratory Acidosis

• Pulmonary edema
• Aspiration of a foreign object
• Atelectasis
• Pneumothorax
• Sedative overdose
• Sleep apnea
• Severe pneumonia

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Clinical Manifestations of Respiratory Acidosis

• Increased pulse and respiratory rate
• Increased BP
• Mental cloudiness
• Feeling of fullness in the head
• Cerebrovascular vasodilation

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Respiratory Alkalosis

• Arterial pH is greater than 7.45 and the PaCO2 is
  less than 38 mm Hg
• high pH
  low PaCO2

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Causes of Respiratory Alkalosis

• Always due to hyperventilation
• Excessive blowing off of CO2
• Extreme anxiety
• Hypoxemia
• Gram negative bacteremia
• Inappropriate ventilator settings

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Clinical Manifestations of Respiratory Alkalosis

• Lightheadedness
• Inability to concentrate
• Tinnitus
• Loss of consciousness
• Tachycardia
• Ventricular/atrial
• dysrhythmias

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Normal values

• pH 7.35-7.45
• PaCO2 35-45
• HCO3 22-26

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