Health and Wellness Concepts in Nursing
Test and Grades
Test grades to be returned on Wednesday after the last individual exam.
Roll call procedure initiated; students should pass the roll call sheet.
Class Structure Following an Exam
Acknowledgment that post-exam lectures can be taxing for students.
Reminders:
Two PrepU quizzes due tonight.
Ensure mastery level set to three.
In-class assignments were given related to material learned.
Purpose: To alleviate pressure from learning formal material before the week’s exam.
Health and Wellness
Definition of Health
Health is defined as a state of complete mental and social well-being.
Not merely the absence of disease or infirmity but includes mental and social dimensions.
Measurement of Health
Public health is often assessed through morbidity and mortality rates:
Morbidity: Frequency of disease occurrence.
Mortality: Number of deaths resulting from a disease.
Individual Perceptions of Health
Each individual's definition of health is influenced by:
Personal values and beliefs.
Family, cultural, community, and societal influences.
Definition and Concept of Wellness
Wellness: An active state of being healthy, encompassing a lifestyle that promotes physical, mental, and emotional health.
Distinction between disease and illness:
Disease: Pathological changes in the structure/function of body/mind.
Illness: A person’s unique response to disease involving abnormal functional changes.
Health Care Approach
Holistic Health Care: Nursing philosophy addressing all dimensions of the whole person.
Acute Illness: Rapid onset and short duration (e.g., flu).
Chronic Illness: Longer-term illnesses with several characteristics:
Permanent changes caused by irreversible alterations in anatomy & physiology.
Requires special education for rehabilitation, long-term support.
Examples: Diabetes, rheumatoid arthritis.
Exacerbation and Remission in Chronic Illnesses
Remission: Periods when the disease is present but symptoms are absent.
Exacerbation: Periods with active symptom presentation when illness flares up.
Common Chronic Diseases
Examples include:
Heart disease, stroke, diabetes, obesity, arthritis.
Significant burden on healthcare systems; often disabling and costly.
Risk Factors for Chronic Illnesses
Modifiable risk factors include:
Tobacco use
Alcohol use
Lack of physical activity
Poor diet
Disparities in Health Care
Health Equity vs. Health Disparities
Health Equity: Attainment of the highest level of health for all people.
Health Disparity: Specific health differences linked to social, economic, or environmental disadvantages.
Social Determinants of Health
Conditions in the environment where people live, work, and play that affect health outcomes:
Economic stability, employment, income, food access, etc.
Example: Higher costs of healthy foods can lead lower-income individuals to choose unhealthy diets.
Vulnerable Populations
Populations facing health disparities include:
Racial and ethnic minorities
Individuals living in poverty
Women, children, older adults
Residents of rural and urban areas
Those with disabilities or special healthcare needs.
Human Needs and Health Dimensions
Basic Human Needs
Essential for emotional and physiological health and survival.
Unmet needs increase the risk of illness.
Human Dimensions Influencing Health
Physical: Genetic inheritance, age, race, sex.
Emotional: The impact of mental health on physical health.
Intellectual: Knowledge and cognitive abilities.
Environmental: Factors such as housing and pollution.
Social-Cultural: Economic level, lifestyle, family dynamics.
Spiritual: Religious beliefs affecting health and nutrition.
Risk Factors
Risk factors defined as anything that increases the individual's chance for illness or injury:
Modifiable: Lifestyle changes (e.g., diet, exercise).
Nonmodifiable: Genetic predispositions (e.g., family history of disease).
Health Promotion and Illness Prevention
Levels of Health Promotion
Primary Prevention: Focuses on preventing disease before it occurs.
Examples: Immunization clinics, family planning, health education.
Secondary Prevention: Aims for early detection and prompt treatment of existing disease.
Examples: Screening tests, regular health check-ups.
Tertiary Prevention: Reducing the impact of the disease after diagnosis.
Examples: Rehabilitation programs, patient education on disease management.
Health Belief Model
Describes health behaviors based on individual perceptions of threat from disease.
Key components: perceived susceptibility, seriousness of disease, and perceived benefits of actions (e.g., mask-wearing during COVID).
Agent-Host-Environment Model
Describes interactions between the agent (cause), host (patient), and environment that lead to disease.
Stages of Change Model
Describes the process of behavior change:
Precontemplation: No intention to change behavior.
Contemplation: Awareness of a problem but no commitment.
Preparation: Intending to take action.
Action: Active modification of behavior.
Maintenance: Sustaining the change; avoiding relapse.
Perioperative Nursing
Phases of Perioperative Care
Preoperative Phase: Begins with the decision for surgery until the patient is transferred to the OR.
Intraoperative Phase: From the transfer to the OR until the transfer to PACU.
Postoperative Phase: From admission to recovery until the last follow-up.
Types of Surgery
Elective Surgery: Planned procedures based on patient choice (e.g., tonsillectomies, cosmetic surgeries).
Urgent Surgery: Needs to be conducted within a short timeframe to preserve health (e.g., removal of tumors).
Emergency Surgery: Must be performed immediately to save life or body function (e.g., tracheostomy for obstruction).
Anesthesia Types
General Anesthesia: Induces CNS depression, leads to unconsciousness.
Phases include induction (beginning), maintenance (during surgery), and emergence (waking up).
Moderate Sedation: Patient can respond to verbal commands but may not recall anything said.
Regional Anesthesia: Includes nerve blocks, epidurals, spinal anesthetics.
Local Anesthesia: Numbs a specific area; used for minor procedures.
Informed Consent
Informed consent requires effective communication and patient's voluntary agreement encompassing:
Description of procedure, risks & benefits, alternatives, and the right to refuse.
Role of the Nurse in Perioperative Care
Preoperative responsibilities include:
Obtaining consent, assessment of patient risk, ensuring preparation and education.
Intraoperative responsibilities include:
Supporting surgical team, maintaining safety, ensuring sterile practices.
Postoperative responsibilities include:
Regular monitoring and assessment for complications.
Common Postoperative Complications
Hemorrhage: Signs include restlessness, drop in blood pressure.
Shock: Requires immediate attention, positioning and monitoring vital signs crucial.
Deep Vein Thrombosis (DVT): Presents as swollen, painful legs; prevention through exercises and medications.
Pulmonary Embolism: Symptoms: dyspnea, chest pain; requires immediate intervention.
Atelectasis and Pneumonia: Assessing lung function is crucial, along with promoting deep breathing.
Wound Infection: Monitor vital signs and nutrition to aid healing; maintain aseptic techniques.
Patient Education
Importance of patient education on preoperative preparation and postoperative care.
Questions and Conclusion
Open floor for any additional questions on health disparities, wellness definitions, and the health belief models.
Reminder to study the definitions and levels of health promotion and prevention activities as they are key to nursing practice.
Chapter 3: Health, Wellness, Disease, and Illness, and Health Promotion
1. Describe concepts and models of health, wellness, disease, and illness.
Definition of Health: A state of complete mental and social well-being, not merely the absence of disease or infirmity.
Measurement of Health: Often assessed through morbidity (frequency of disease occurrence) and mortality (number of deaths resulting from a disease).
Individual Perceptions of Health: Each individual's definition of health is influenced by personal values and beliefs, and family, cultural, community, and societal influences.
Definition and Concept of Wellness: An active state of being healthy, encompassing a lifestyle that promotes physical, mental, and emotional health.
Distinction between Disease and Illness:
Disease: Pathological changes in the structure/function of body/mind.
Illness: A person’s unique response to disease involving abnormal functional changes.
Health Belief Model: Describes health behaviors based on individual perceptions of threat from disease. Key components: perceived susceptibility, seriousness of disease, and perceived benefits of actions (e.g., mask-wearing during COVID).
Agent-Host-Environment Model: Describes interactions between the agent (cause), host (patient), and environment that lead to disease.
2. Compare and contrast acute illness and chronic illness.
Acute Illness: Rapid onset and short duration (e.g., flu).
Chronic Illness: Longer-term illnesses with several characteristics:
Permanent changes caused by irreversible alterations in anatomy & physiology.
Requires special education for rehabilitation, long-term support.
Examples: Diabetes, rheumatoid arthritis.
Exacerbation and Remission in Chronic Illnesses:
Remission: Periods when the disease is present but symptoms are absent.
Exacerbation: Periods with active symptom presentation when illness flares up.
Common Chronic Diseases: Examples include heart disease, stroke, diabetes, obesity, arthritis. Significant burden on healthcare systems; often disabling and costly.
Risk Factors for Chronic Illnesses: Modifiable risk factors include tobacco use, alcohol use, lack of physical activity, poor diet.
3. Discuss the factors that play a role in health equity and health disparities including social determinants of health.
Health Equity: Attainment of the highest level of health for all people.
Health Disparity: Specific health differences linked to social, economic, or environmental disadvantages.
Social Determinants of Health: Conditions in the environment where people live, work, and play that affect health outcomes:
Economic stability, employment, income, food access, etc.
Example: Higher costs of healthy foods can lead lower-income individuals to choose unhealthy diets.
Vulnerable Populations: Populations facing health disparities include racial and ethnic minorities, individuals living in poverty, women, children, older adults, residents of rural and urban areas, those with disabilities or special healthcare needs.
4. Explain how the human dimensions, basic human needs, and self-concept influence health and illness.
Basic Human Needs: Essential for emotional and physiological health and survival. Unmet needs increase the risk of illness.
Human Dimensions Influencing Health:
Physical: Genetic inheritance, age, race, sex.
Emotional: The impact of mental health on physical health.
Intellectual: Knowledge and cognitive abilities.
Environmental: Factors such as housing and pollution.
Social-Cultural: Economic level, lifestyle, family dynamics.
Spiritual: Religious beliefs affecting health and nutrition.
Risk Factors: Anything that increases the individual's chance for illness or injury:
Modifiable: Lifestyle changes (e.g., diet, exercise).
Nonmodifiable: Genetic predispositions (e.g., family history of disease).
Note: The provided notes do not explicitly detail how 'self-concept' influences health and illness.
5. Summarize the role of the nurse in promoting health, preventing illness, and addressing disparities in health care.
Nurses play a key role in health promotion and illness prevention through:
Utilizing models like the Health Belief Model to understand and influence patient behaviors.
Educating patients on managing chronic illnesses and modifiable risk factors (e.g., diet, exercise).
Addressing health disparities by understanding social determinants of health and advocating for vulnerable populations.
Promoting preventive activities across primary, secondary, and tertiary levels of care.
Providing patient education on preoperative preparation and postoperative care to prevent complications.
6. Explain the levels of preventive care.
Primary Prevention: Focuses on preventing disease before it occurs.
Examples: Immunization clinics, family planning, health education.
Secondary Prevention: Aims for early detection and prompt treatment of existing disease.
Examples: Screening tests, regular health check-ups.
Tertiary Prevention: Reducing the impact of the disease after diagnosis.
Examples: Rehabilitation programs, patient education on disease management.
7. Define diversity, inclusion, equity.
Health Equity: Attainment of the highest level of health for all people.
Note: The provided notes do not explicitly define 'diversity' or 'inclusion'.
Chapter 31: Perioperative Nursing
1. Describe the surgical experience, including perioperative phases, classifications of surgery, types of anesthesia, informed consent.
Phases of Perioperative Care:
Preoperative Phase: Begins with the decision for surgery until the patient is transferred to the OR.
Intraoperative Phase: From the transfer to the OR until the transfer to PACU (Post-Anesthesia Care Unit).
Postoperative Phase: From admission to recovery until the last follow-up.
Types of Surgery (Classifications):
Elective Surgery: Planned procedures based on patient choice (e.g., tonsillectomies, cosmetic surgeries).
Urgent Surgery: Needs to be conducted within a short timeframe to preserve health (e.g., removal of tumors).
Emergency Surgery: Must be performed immediately to save life or body function (e.g., tracheostomy for obstruction).
Anesthesia Types:
General Anesthesia: Induces CNS depression, leads to unconsciousness. Phases include induction (beginning), maintenance (during surgery), and emergence (waking up).
Moderate Sedation: Patient can respond to verbal commands but may not recall anything said.
Regional Anesthesia: Includes nerve blocks, epidurals, spinal anesthetics.
Local Anesthesia: Numbs a specific area; used for minor procedures.
Informed Consent: Requires effective communication and patient's voluntary agreement encompassing description of procedure, risks & benefits, alternatives, and the right to refuse.
Note: The provided notes do not explicitly detail 'advance directives' or 'outpatient/same-day surgery'.
2. Conduct a preoperative nursing history and physical assessment to identify patient strengths as well as factors that increase risks for surgical and postoperative complications.
Preoperative Assessment: A key responsibility of the nurse in the preoperative phase. This includes:
Obtaining consent.
Assessment of patient risk (identifying factors increasing surgical and postoperative complications).
Ensuring preparation and education.
3. Identify assessments and interventions specific to the prevention of complications in the immediate and early postoperative phases.
Role of the Nurse in Postoperative Care: Regular monitoring and assessment for complications.
Common Postoperative Complications and Interventions:
Hemorrhage: Signs include restlessness, drop in blood pressure. Re quires immediate attention.
Shock: Requires immediate attention, positioning, and monitoring vital signs.
Deep Vein Thrombosis (DVT): Presents as swollen, painful legs; prevention through exercises and medications.
Pulmonary Embolism: Symptoms: dyspnea, chest pain; requires immediate intervention.
Atelectasis and Pneumonia: Assessing lung function is crucial, along with promoting deep breathing.
Wound Infection: Monitor vital signs and nutrition to aid healing; maintain aseptic techniques.
4. Prepare a patient for surgery.
Patient Preparation for Surgery: A primary preoperative responsibility for the nurse, including:
Obtaining informed consent (ensuring patient understanding).
Thorough assessment of patient risk and strengths.
Ensuring all necessary preparations are completed (e.g., NPO status, skin preparation).
Comprehensive patient education on preoperative expectations and postoperative care.
5. Use the nursing process to develop an individualized plan of care for the surgical patient during each phase of the perioperative period.
Nurse's Role in Perioperative Care by Phase (supporting the nursing process):
Preoperative Responsibilities: Focus on assessment (patient risk, strengths), diagnosis, and planning (obtaining consent, ensuring preparation and education) to develop the initial individualized plan.
Intraoperative Responsibilities: Involve implementation (supporting surgical team, maintaining safety, ensuring sterile practices) according to the plan.
Postoperative Responsibilities: Center on evaluation (regular monitoring and assessment for complications) and ongoing implementation/revision of the plan (patient education on disease management, active participation in rehabilitation programs).
Patient Education: Emphasizes its importance across all phases for an individualized plan of care, empowering the patient in their recovery.