HEALTH PROMOTION
T O TA L C L I E N T C A R E
Holistic Approach
Unique
Potential for growth
Focal point is the person
Mutual Cooperation
Patient should be an active participant of care.
One of our major roles in health promotion is to reinforce safe health practices
MA S L OW ’ S H I E R A R C H Y O F N E E D S
Lowest level need- Physiological Needs
Safety and Security
Love and Belonging
Self-Esteem
Self-Actualization
World Health Organization (Who) defines health as a state of complete physical, mental, and
social wellbeing and not merely the absence of disease. It is a state of harmony and balance.
One of our main objectives in health care is to help the individual obtain their optimum level of
health.
S E L YE ’ S G E N E R A L A D A P TA TI O N S Y N D R O ME
Canadian physician that theorized that the body uses hormonal responses to return the body to
homeostasis no matter the stressor and that stress played a role in all disease processes
Alarm Stage
fight or flight stage sympathetic nervous system activated
Stage of Resistance
Body resists the stress
Stage of Exhaustion
Body either returns to state of homeostasis or body dies
C O M MO N P A TI E N T S TR E S S O R S
Having to wear an ill-fitting gown that opens down the back
Sharing a room with a stranger
Being dependent on others for toileting or bathing
Sleeping in a different bed with a different pillow
Eating meals at different times than usual
Being awakened at odd hours and many times
Too many or too few visitors
Worrying about medical costs, home bills, family needs
Being uncertain of the diagnosis and what will happen
Not understanding medical terms
Having to deal with many health care workers who are strangers
Not being able to obtain desired foods, drinks, or objects
Being left on a stretcher in a hall without sufficient warm covers
Having to wait for tests to be done or for the doctor to come
Being stuck with a needle repeatedly for laboratory specimens or intravenous therapy
Having other health care workers bare in during toileting or cleansing
Having different personnel providing care each day
T R E N D S TH A T A F F E C T H E A L T H C A R E
Focus on prevention
Changes in population
Government involvement
Medicare- funding issues
DRGs
PPS
Medicaid
Technological and scientific advances
Managed health care
HMO’s and PPO’s
Uninsured
Prescription Medications costs
H E A L T H C A R E D E L I V E R Y S Y S TE MS
Primary Care- first contact in a given episode of illness
Acute Care- services that treat the acute phase of illness or disability
Long-term- services that provide symptomatic treatment and rehabilitative services for
patients of all ages
Hospitals can be for profit or not for profit
CCRC- continued care retirement community
Extended Care Facilities- Assisted Living, Rest Home, Residential Care
Health Department
Office, Clinics
Home Health
L E V E L S O F P R E V E N TI O N
Primary- prevention of avoids or delays occurrence of a specific disease or disorder
Secondary- following guidelines for screening for diseases that are easily treated if found early
or for detecting the return of disease
Tertiary- rehabilitation measures after the disease or disorder has stabilized
THE HEALTH CARE TEAM
Nurse
Doctor
Clergy
Dietician Patient PT
MSW
RT
Psy. Case
Mgr
Health-Increased Susceptibility-pre-disease state-subclinical disease-clinical disease-chronic
disease-permanent disability
ORGANIZATION OF NURSING CARE DELIVERY
Functional Nursing- task oriented
Team Nursing- RN team leader with others under them
Primary Nursing- each nurse has group of patients and responsible for from admissions
to discharge
Ancillary Personnel- unlicensed personnel
HEALTH-ILLNESS
Disease- any condition in which the physiologic or psychological functions of the body
deviate significantly from that regarded as “normal”
Stages of Illness
1. Transition- onset of vague symptoms
2. Acceptance- time at which denial of illness stops, patient assumes sick role,
people with terminal and chronic illnesses stay in the acceptance phase
3. Convalescent stage- begin to recover and regain health
Chronic Illnesses- go through stages of remission and exacerbation
MICROORGANISMS
Bacteria
Characterized by:
Shape
Cocci- round
Bacilli- rod shaped
Spirilla- corkscrew
Ricketsia- characteristics of virus and bacteria
Need for oxygen
Aerobic
Anaerobic
Motility
Gram stain positive or negative
Can be resistant to antibiotics
Viruses- protein around a nucleic acid core. Metabolic processes of the cells that they
enter replicate the virus. Do not live long outside the body. Usually self-limiting except
for rabies and AIDS. Antibiotics do not affect a virus.
Fungi- belong to the plant kingdom. Most common cause of illness in humans. Usually
not systemic.
Protozoa- single cell animals. Some found in GI tract. Amoebic Dysentary, Vaginal
Trichinosis, Malaria
P H Y S I O L O G I C D E F E N S E ME C H A N I S MS
Intact skin and mucous membranes
Acid medium of skin and antibacterial enzymes
Bacteriostatic substances secreted by mucous mmembranes
Lacrimal fluid
High acid content of stomach
Vaginal secretions
Cilia
Reflex acts (gag reflex, sneezing, eye blink)
Reitculoendothelial system
White blood cells
Neutrophils
Basophils- allergies
Eosinophils- allergic reaction and foreign proteins
Spleen
Liver
I N F L A M MA T I O N
Redness
Heat
Swelling
Pain
Limitation of movement
I N F E C TI O N
Endogenous- microorganism already in body but becomes overgrown- yeast infection
Exogenous- pathogens gain entry to the body
Endotoxins- present in cell walls of gram negative rods or cocci and they produce poison
Exotoxins- toxins produced by the bacteria and released (botulism)
Primary- acute infection that appears runs its course and resolves
Secondary- complication of a primary infection
Local- confined to a single area
Generalized- all over the body
Focal- spreads from one part of the body to another
Latent- bacteria present but not active
Specific- caused by one type of organism
Mixed- caused by more than one type of organism
I N TE R V E N TI O N S F O R I N F L A M MA TI O N / I N F E C T I O N
Rest
Elevation
Heat/Cold
Analgesia
Incision and Drainage
Keep I&O records
Antibiotics
Antimicrobials
I MMU N I T Y
Natural Immunity is acquired at birth
Acquired is by immunization or by having the disease
Passive- immunoglobulins or breast feeding
Humoral
Antibodies- react to specific antigens
Immunoglobulins
Cellular
T lymphocytes
Helper cells
Suppressor cells
Killer cells
P S Y C H O L O G I C A L D E F E N S E ME C H A N I S MS
Compensation-attempts to make up for real or imagined feelings of inadequacy
Napolean Syndrome
Conversion- emotional conflicts that can’t be dealt with are expressed by physical means
Get physically ill before a test
Denial- avoids painful reality by denying it exists
Displacement- pent up emotions are redirected toward a person or object other than the
primary source of emotions
Identification- unconsciously enhances self esteem by patterning after another person
Projection- protects self from being aware of ones own feelings by attributing them to
others
Rationalization- justifies inconsistent or undesirable behavior
Regression- returns to an earlier less mature level of adaptation
Reaction-formation- reverses unacceptable true feelings in exactly the opposite direction
Repression- blocking a wish or desire from conscious expression
Sublimation- unconscious or unacceptable desires are channeled into socially
acceptable activities
Undoing- symbolic acts out in reverse something that was done or thought that was
unacceptable in an attempt to erase the act of guilt
E MO TI O N A L E F F E C T S O F I L L N E S S / D I S E A S E
Regression
Fear
Insecurity
Anxiousness
Depression
Resentment
Confusion