Health promotion and disease prevention

Test 2 - sem 2

Health

A state of complete physical, mental, and social well- being and not merely the absence of disease of infirmary (WHO)

Wellness

A positive state of health of individual, family, or community. Multidimensional and constantly changing

Disease

A medical term referring to the pathological changes in the structure or function of the body or mind

Illness

Response of the person to the disease

Modifiable variables

Smoking

Nutrition

Health education

Sexual practices

Exercise

Non-modifiable variables

Gender

Age

Developmental level

Genetic traits

Social determinants of Health

Education access and quality

Health care and quality

Neighborhood and built environment

Social and community context

Economic stability

Those effected my social determinants of health

Poverty, elderly, women, children, minorities, ect…

Physical factor affecting health

Genetics, biological sex, developmental level

Emotional factors affecting health

Stress, anxiety

Sociocultural affecting health

Economics level, culture, beliefs

Spiritual affecting health

Beliefs affecting healthcare

Environmental affecting health

Housing, sanitation, pollution

Intellectual affecting health

Education, cognitive abilities

Primary health promotion

Promoting health and preventing the development of disease processed or injury

Immunization clinics

Lead abatement

Family planning

Education!!!

Safety

Health risk assessment

Secondary health promotion

Focus is on screening for early detection

Assess children for normal growth and development

Nutrition screening

Regular medical, dental, and vision exams

B/P

Cholesterol

Skin cancer screenings

Colonoscopy

Breast self exam

Testicular self-exam

Tertiary health promotion

Begins after and illness is diagnosed. Goal is return to maximum functioning

Education!!

Support groups

Monitoring responses to treatment

Oral health

Good oral health improves ability to speak, smile, smell, taste, touch, chew, & swallow

Oral disease causes pain and disability

Preventive oral care:

• Brushing and flossing 2x day

• Preventive dental treatment

• Water fluoridation

• Avoid surgery foods/beverages

Toddlers: just starting to brush teeth

Adolescents: cavities, losing teeth, braces

Adults: wisdom teeth

Elderly: dentures

Physical fitness

Maintain healthy weight

Reduce risks of health disease, stroke, & cancer

Maintain bone & joint health

Improves mood

Majority of adults and teens do no get recommended amount of physical activity

May be primary prevent (to prevent disease) or tertiary (cardiac rehab after MI)

Sleep and rest

Sleep disorders associated with increased risk of

• Heart disease

• HTN

• Obesity

• Diabetes

• Accidents, decreased productivity

Adequate sleep is necessary to

• Fight infection

• Support metabolism of sugar to prevent diabetes

• Improve performance in school or work

Sleep schedule, can’t give sleeping meds to elderly

Nurse’s role in promoting health

Genetics

Cognition

Education level

Race and ethnicity

Culture

Age and biological sex

Lifestyle

Family

Community

Environment

Socio-economic status

Access across the lifespan for the individual and family

Passive immunity

Antibodies of one person are passed to another

Lasts few weeks or months

Placenta, colostrum, or injection

Passive natural: antibodies are passed from mother to fetus/newborn

Passive artificial: antibodies in the form of immune globulins are administered (ex. after an animal or snake bite)

Active immunity

When a person’s one immune system generates a response

Lasts for years or lifetime

Active natural: the body produces antibodies in response to a pathogen that enters the body naturally

Active artificial: develops when a vaccine is given and the body produces antibodies

Classification of vaccines

Live attenuated

• Modified living organisms that are weakened

• DOES NOT produce complications of the illness

• Create an immune response, don’t get you sick

Inactivated (killed)

• Whole, dead, organism

Toxoid

• Used a toxin (harmful product) made by the germ

Conjugate

Recombinat

Messenger RNA

Viral vector

Vaccines (bolded= live)

Hepatitis (Hep B)

Diphtheria, tetanus, and pertussis (DTaP) and TdaP (>7 years and pregnancy)

Rotavirus (RV)

Varicella (kids) and Zoster (Shingles)(adults)

Measles, mumps, and rubella (MMR)

Pneumococcal (kids and adults) (PCV13)

Human papillomavirus (HPV)

Hepatitis A (Hep A)

Polio (IPV)

Influenza (intranasal) (kids and adults)

• Egg allergy?

Haemophilus influenza type B (hib)

Meningococcal (MCV4, MPSV4, MenACWY, MenB)

Vaccine mnemonic

Birth → Hep B

2 months:

Runny (Rotavirus)

Drippy (DTaP)

Hacky (Hib)

People are (PCV13)

Infectious (IPV) to

Babies (Hep B

4 months → RDHPI

6 months → RDHPI, Hep B, Influenza

12-15 months → MMR (Autism?)

• PCV13

• Varicella

• IPV

• Hep A

• DTap

• Influenza (yearly)

4-6 years old:

Disney (DTaP)

Is (IPV)

My (MMR)

Favorite (Flu vaccine/Influenza)

Vacation (Varicella)

Vaccines

HPV (Human papillomavirus) - 2 or 3 dose series

• Cervical and oral cancers

Influenza vaccine annually - 6 months and older

Pneumococcal - adults 65 and older

Meningococcal - risk for people in colleges, prisons

Shingles zoster - recommended for adults >50 years (2 doses)

Tetanus booster - recommended booster every 10 years

COVID-19 - not recommended for children <6 months

Barriers

Misconceptions

• Parental concerns

• What constitutes a contraindication

• Political view

Multiple providers

Cost

Multiple injections

Postponing-delay in accurate timing

Vaccine administration for infant

Before + During:

Smiling with eye contact

Soothing touch

Favorite toy/blanket

Stay calm

Breastfeeding

After:

Cuddle

Caress

Hold

Soothing speech

Vaccine administration for toddlers

Before + During:

Smiling with eye contact

Soothing touch

Favorite toy/blanket

Stay calm

Reassure

DO NOT THREATEN

Puppets

Posters

Stories

After:

Give praise

Hugs

Surprises

Reassurance

Soothing speech

Vaccine administration for older child

Before + during:

Be honest with the child

Use familial support

Avoid scary stores or threats

Deep breaths

Stories

Room distractions

After:

Praise

Hugs

Love

Nurse role

Provide vaccine education and obtain consent (VIS)

Administer vaccine in proper location depending on age, medication, body habitus

Minimize discomfort-distract, topical anesthetic, oral sucrose, non-nutritive sucking

Follow storage and reconstitution directions

Documentation

Contraindications to vaccines:

• Anaphylaxis

• Moderate/sever illness with or without fever percussion

• Febrile illness

• Live virus to severely immunocompromised, pregnant

Complementary and alternative therapies

Complementary and alternative medicine (CAM)

Complementary Health Approaches (CHA)

Holistic nursing-healing the whole person

Helps with stress management

Improve quality of life

Individuals want greater control over their health

More medical schools offering course

Insurers

Alternate therapies

Relaxation

• Decrease BP, reduced pain, enhance sleep, reduce muscle tension

• Hypnosis, biofeedback

Meditation

• Manta meditation, mindfulness meditation

Guided imagery

• Promotes relaxation

Yoga

• Physical movements with breathing

Qi Gong & Tai Chi

• Posture, breathing, and visualization

Aromatherapy

• Essesital oils

• Affects the amygdala

• Antibacterial, anti fungal and antiviral

Massage

Healing touch

• “Realign energy”

• Does not actually physically manipulate patient

• ex. reiki therapy

Dance therapy

Pet therapy

Acupuncture

• Need a license

• Used for pain and nausea

Chiropractic care

• Primary on manipulation of the spine

• Four years of schooling

Complementary approaches for pain

Mind: body practice that are movement based

Natural products

Mind body: meditation, guided imagery, relaxation

Energy healing: manipulating electrical energy

Physical manipulation: massage, chiropractic, osteopathy

Lifestyle changes: sleep, positive work environment, healthy relationships, exercise

Aleo vera

Use:

Topically to treat sunburns, psoriasis and minor wounds

Orally to treat constipation

Adverse effect:

A liquid extract has a strong laxative effect

Interactions:

None

Nursing considerations:

Generally safe when used to treat skin disorder

Can cause minor skin irritation

Can cause stomach irritation when taken orally

Black Cohosh

Use:

Reduces premenstrual syndrome and symptoms of menopause

Adverse effect:

Occasional GI upset

Interactions:

May potentiate the effects of CNS depressants and blood pressure medications

Nursing considerations:

Question use of CNS depressants and blood pressure medications

Monitor BP

Echinacea

Use:

Appears to shorten symptoms and intensity a cold or the flu

Stimulated the immune system

Decreased inflammation

Adverse effect:

Mild GI upset

Allergic reaction with patients allergic to ragweed

Interactions:

With prolonged use can decreased positive effects of medication for tuberculosis, HIV, or cancer

Nursing considerations:

Question patients who have TB, HIV, can cancer

Lupus and rheumatoid arthritis about concurrent use

Feverfew

Use:

Decreased frequency and severity of migraine headache

Adverse effect:

GI upset

Post feverfew symptoms: agitation, tiredness, inability to sleep, headache, joint pain,

Allergic reaction

Interactions:

May cause increased risk for bleeding

Nursing considerations:

Question patient about use of NSAID’s, heparin, and warfarin

Discontinue use 2 weeks prior to surgery

Garlic

Use:

Blocks LDL cholesterol and raises HDL

Surpasses platelet aggregation

Acts as a vasodilator

Adverse effect:

GI upset

Interactions:

May increase bleeding risk

May increase hypoglycemia effects of diabetes medications

Decreases levels of specific HIV medication-saquinavir

Nursing considerations:

Question patients about the us of NSAID’s, heparin, and warfarin

If patient on anti-platelet, anticoagulant, or saquinavir medication to contact their MD

Ginger root

Use:

Relieves nausea and vertigo

Increase intestinal motility, gastric mucous production

Decrease GI spasm

Anti-inflammatory effect

Suppress platelet aggregation

Can decrease pain and stiffness of RA

Adverse effect:

Caution during pregnancy - can cause uterine spasm

Potential CNS and cardiac problems with large doses

Interactions:

Interactions with medication that interfere with coagulation NSAID’s, heparin, and warfarin

Nursing considerations:

Question patiens about use of NSAID’s helprin and warfarin

Monitor for hypoglycemia if taking insulin or other medication for diabetes

Ginkgo Biloba

Use:

Promotes vasodilation decreased leg pain in occlusive arterial disorders

Decrease platelet aggregation

Decrease bronchospasm

Increase blood flow to the brain - dementia, Alzheimer’s disease

Adverse effect:

GI upset

Headache

Lightheadedness

Give with caution for patients at risk for seizures

Interactions:

May interact with medications that lower the seizure threshold such as antihistamines, antidepressant, and antipsychotics

Can interfere with coagulation

May increase risk for bleeding

Nursing considerations:

Question history of antidepressant use (Tofranil) may cause a decrease in the patients seizure threshold

Question about the use of NSAID’s, heparin, and warfarin use

Glucosamine

Use:

Stimulates cells to make cartilage and synovial fluid (not proven)

Believed to suppress inflammation of joints and cartilage degeneration

Treats osteoarthritis of the knee, hip, and waist

Adverse effect:

GI upset

Caution shellfish allergy

Interactions:

Use caution if taking antiplatelet of anticoagulant medications

Nursing considerations:

Question patient about NSAID’s, heparin, and warfarin

Kava Kava

Use:

Relieves anxiety, stress, and restlessness and helps insomnia

Adverse effect:

Chronic use may cause dry skin and jaundice

Large does may cause liver damage and failure

Interactions:

Can cause sedation when taken concurrently with CNS depressants

Nursing considerations:

Question use of CNS depressant, including alcohol use, pre-exisiting liver condition

Ma Huang

Use:

Stimulates CNS, suppress appetite, used for weigh loss

Constricts arterioles - increase HR and BP

Bronchodilator - treatment of colds, flu, allergies

Adverse effect:

Contains ephedrine it stimulates cardiovascular system

Can cause hypertension, MI, tachycardia, stroke

May cause euphoria or in high doses psychosis

Interactions:

CNS stimulants to increase their effects

May cause HTN when taken with MAOI

Decreases effectiveness of antihypertensive medications

Nursing considerations:

Question patient about CNS stimulants or antihypertensive medications

Monitor BP, HR, and rhythm

St. John Wort

Use:

Affects serotonin producing antidepressant effects

Relieve pain or inflammation

Topically for infection

Adverse effect:

Dry mouth

Lightheadedness

Constipation

GI upset

Skin rash when exposed to sunlight

Interactions:

May cause serotonin syndrome when combined with other antidepressants, amphetamines, or cocaine

Decreases effectiveness of oral contraceptives, cyclosporine, warfarin, digoxin, calcium channel blockers, steroid, HIV, protease inhibitors, and some chemotherapy drugs

Nursing considerations:

Question patient if taking St. Johns Wort with any of the listed medications

Educate patient about sun exposure

Saw Palmetto

Use:

Decreases prostate symptoms of hyperplasia

Adverse effect:

GI upset

May decrease prostate specific antigen (PSA)

Interactions:

Additive effects with finasteride (Proscar)

Can interact with antiplatelet and anticoagulants

Nursing considerations:

Ask male patients about use prior to PSA test

Ask about aspirin, heparin, and warfarin use

Valerian

Use:

Increase gamma-aminobutyric acid (GABA) to prevent insomnia

Similar to a benzodiazepine

Reduces anxiety related restlessness

Adverse effect:

Drowsiness

Lightheadedness

Depression

Risk for dependence

Patients with mental health disorders should use caution

Avoid during pregnancy

Interactions:

May potentiate effects of CNS presents

Nursing considerations:

Warn patients about possible drowsiness

Do not operate heavy machinery until effect is known

Nursing implications for herbal supplements

Assess patients use of herbal supplements or other complementary therapies

• Be aware of interactions between prescribed medication & herbal supplements

• In general, herbal supplements need to be stopped 4-14 days before surgery. Follow provider’s orders for this

Ask “is it effective for you”

Find and use a reputable source

Nurse role for herbal supplements

Assess client need for alternate or complementary therapy

Help clients focus on their breathing

Provide quiet surroundings

Support guided imagery

Assess what complementary therapies would be compatible with clients' conditions and goals

• Identify benefits and complications, safety of therapy

Assess for sensitivities to odors

Education related to herbs and supplements interacting with medications

Evaluate outcomes and client response

Client education

Smoking cessation

Healthy nutrition

Weight loss

Exercise

Limit sun exposure

High risk behaviors

Hospitalized client

HABIT

How can me promote rest/sleep in the hospital

• Cluster care

• Eye mask

• Ear plugs

Early activity/ambulation prevents complications in the hospitalized patient

Taking care of ourselves