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FUNDAMENTALS OF NURSING
GOOD MORNING!!! - Sir Ritchel . . .` :
GOOD MORNING!!! - Sir Ritchel . . .`
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NURSING > the diagn!i! " h#$an re!%n!e! t act#al and %tential %r&le$!. -- A$erican N#r!e! A!!ciatin >
the act " #tili'ing the en(irn$ent " the %atient t a!!i!t hi$ in hi! rec(er). -- Flrence Nightingale > t a!!i!t the
indi(id#al !ic* r +ell. -- ,irginia -ender!n
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.$$n The$e!/ N#r!ing i! .aring. N#r!ing i! an Art. N#r!ing i! Science. N#r!ing i! .lient-.entered. N#r!ing i!
-li!tic. N#r!ing i! Ada%ti(e. N#r!ing i! cncerned +ith health 0r$tin1 -ealth Maintenance and -ealth
Re!tratin. N#r!ing i! a -el%ing 0r"e!!in.
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N#r!ing a! a 0r"e!!in. 0r"e!!in - calling that re2#ire! !%ecial *n+ledge1 !*ill and %re%aratin. 0ri$ar)
.haracteri!itic!/ 3. Ed#catin 4. Ther) 5. Ser(ice 6. A#tn$) 7. .de " Ethic!
INTRODUCTION TO NURSING :
INTRODU.TION TO NURSING 8RIEF -ISTOR9
I. INTRODUCTION TO NURSING :
I. INTRODU.TION TO NURSING 3. Int#iti(e N#r!ing :%ri$iti(e ti$e! t ; th cent#r)< a. N#r!ing in ancient
ci(ili'atin!= in!tincti(e n#r!ing date! &ac* e(en d#ring the %ri$iti(e tri&e!= N#r!ing +a! a "#nctin that &elnged t
+$en &eca#!e " their %lace in !ciet). &. 8elie"! a&#t the ca#!e " di!ea!e +ere e$&edded in !#%er!titin and
$agic c. Earlie!t recrding " healing +a! a 61>>> )ear-ld cla) ta&let attri&#ted t the S#$erian ci(ili'atin
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d. A! !cietie! e(l(ed1 n#r!ing &eca$e a "#nctin " "e$ale !la(e! +h cared "r in"ant children " +ealth) "a$ilie!
thr#gh +et n#r!ing and the %ractice " $id+i"er) r the %r(i!in " care t the $ther and in"ant d#ring &irthing= the
!la(e-n#r!e +a! de%endent n the $a!ter1 healer r %rie!t "r in!tr#ctin r directin in the care " her charge e.
La!ted thr#gh the .hri!tian era #t " "eeling " c$%a!!in "r ther!1 #t " de!ire t hel% and #t " +i!h t d
gd t ther! a! e$&died in the .hri!tian (al#e " ?l(e th) neigh&r a! th)!el".@
2. !!re"tice N#r$i"% &'th - 18th ce"t#r():
4. A%%rentice N#r!ing :; th - 3A th cent#r)< a. Al! called the %erid " ?n the B& training@ &. Men engaged in
N#r!ing d#ring the .r#!ade! thr#gh/ - Cnight! -!%italer! r Cnight! " Saint Dhn " Der#!ale$ - Te#tnic Cnight! -
Cnight! " Saint La'ar#! c. Thi! hi!trical %erid eEtend! "r$ the "#nding " religi#! n#r!ing rder! in the ; th
cent#r)1 thr#gh the .r#!ade! +hich &egan in the 33 th cent#r)1 t 3A5; +hen Thedre Fliedner rein!tit#ted the
Order " Deacnne!!e! and %ened a !$all h!%ital and training !chl in Cai!!er+erth 1 Ger$an) d. Flrence
Nightingale +a! the $!t "a$#! Cai!!er+eth %#%il= !he changed the !tat#! " n#r!ing t a re!%ecta&le cc#%atin
"r +$en
3. *+d#c,ti-". N#r$i"% :
5. ?Ed#catin@ N#r!ing a. 8egan in D#ne 3A;> +hen the Flrence Nightingale Schl " N#r!ing %ened at St.
Th$a! -!%ital in Lndn= thi! !chl had the "ir!t %rgra$ " "r$al ed#catin "r the n#r!e &. The 0hil!%h) "
the NightingaleF! S)!te$ +a! &a!ed n the "ll+ing/ - training " n#r!e! !h#ld &e cn!idered a! i$%rtant a! an)
ther "r$ " ed#catin and &e !#%%rted &) %#&lic "#nd!. - training !chl! "r n#r!e! !h#ld ha(e cl!e a""iliatin
+ith h!%ital! &#t retain "inancial and ad$ini!trati(e inde%endence "r$ the$. - %r"e!!inal n#r!e! !h#ld &e
re!%n!i&le "r the ed#catin " n#r!ing !t#dent! rather than %er!n! nt in(l(ed in n#r!ing - n#r!ing !t#dent!
!h#ld &e %r(ided +ith re!idence d#ring their training +hich ""er the$ %lea!ant1 c$"rta&le !#rr#nding! cl!e t
the h!%ital.
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c. US and .anada c%ied the Nightingale Schl! " England (er) cl!el) &#t the US training !chl! "ailed t
re$ain !e%arate "r$ the h!%ital! re!#lting in a "r$ " ed#catinal a&#!e " n#r!ing !t#dent! &) the h!%ital! d.
Gritten %h)!icianF! rder! riginated +ith Nightingale +h in!i!ted that n#r!e! acc$%an) the %h)!ician! n %atient
(i!it! e. 8elie(ed that health teaching +a! a critical re!%n!i&ilit) " the n#r!e i" natinal health +a! t i$%r(e ". The
la!t t+ decade! " the 3H th cent#r) i! al! called the ?a+a*ening " n#r!ing@
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g. In the earl) decade! " the 4> th cent#r)1 h!%ital! !tarted t !egregate %atient! accrding t their di!ea!e %rce!!
th#! the cnce%t " clinical n#r!e !%eciali!t ar!e h. 8et+een 3H35 and 3H5I1 a !tandardi'ed c#rric#l#$ "r Schl!
" N#r!ing +a! %re%ared &) the Natinal Leag#e "r N#r!ing Ed#catin
4. C-"te/!-r,r( N#r$i"% :
6. .nte$%rar) N#r!ing a. 8egan at the end " Grld Gar II= a!!ciated +ith !cienti"ic and technlgical
de(el%$ent! and !cial change! !ince 3H67 &. .hanging %attern! in N#r!ing ed#catin &) adding $re clinical
cntent c. 0r"e!!inali'atin " N#r!ing d. Gl&ali'atin/ &rderle!! n#r!ing
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The Earlie!t -!%ital!/ A. -!%ital Real de Manila :37II< - it +a! e!ta&li!hed $ainl) t care "r the S%ani!h CingF!
!ldier! &#t al! ad$itted S%ani!h ci(ilian!. - "#nded &) G(. Franci!c de Sande. 8. San La'ar -!%ital :37IA< -
&#ilt eEcl#!i(el) "r %atient! +ith le%r!). - "#nded &) 8rither D#an .le$ente. .. -!%ital de Indi :37A;< - !er(ice
+a! in general !#%%rted &) al$! and cntri&#tin! "r$ charita&le %er!n!.
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D. -!%ital de Ag#a! Santa! :37H>< - "#nded &) 8rther D. 8a#ti!ta " the Franci!can Order. E. San D#an De Di!
-!%ital :37H;< - "#nded &)8rtherhd " Mi!ericrdia and ad$ini!tered &) the -!%itallier! " San D#an de Di!.
Slide 1':
The 0r$inent %er!n!/ 3. D!e%hine 8rac*en - +i"e " D!e Ri'al. In!talled a "ield h!%ital in an e!tate h#!e "
TeBer!. 0r(ided n#r!ing care t the +#nded night and da). 4. R!a Se(illa De Al(er - cn(erted their h#!e int
2#arter! "r the Fili%in !ldier d#ring the 0hili%%ine-A$erican +ar that &r*e #t in 3AHH. 5. D Ja -ilaria de
Ag#inald -+i"e " A$eli Ag#inald= rgani'ed the Fili%in Red .r!! #nder the in!%iratin " A%linari Ma&ini.
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6. DJa Maria de Ag#inald - !ecnd +i"e " E$ili Ag#inald. 0r(ided n#r!ing care "r the Fili%in !ldier! d#ring
the Re(l#tin. 0re!ident " the Fili%in Red .r!! &ranch in 8atanga!. 7. Melchra A2#in :Tandang Sra< - n#r!e
the +#nded Fili%in !ldier! and ga(e the$ !helter and "d. ;. Trinidad Tec!n - ?Ina ng 8iac na 8at@1 !ta)ed in
the h!%ital at 8iac na 8at t care "r the +#nded !ldier!.
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-!%ital! and N#r!ing Schl!/ 3. Ilil Mi!!in -!%ital Schl " N#r!ing :Ilil .it)1 3H>;< > It +a! r#n &) the
8a%ti!t Freign Mi!!in Sciet) " A$erica. > Mi!! R!e Niclet K "ir!t !#%erintendent > Mi!! Flra Ern!t K an
A$erican n#r!e1 t* charge " the !chl in 3H64 4. St. 0a#lF! -!%ital Schl " N#r!ing :Manila1 3H>I< >The
h!%ital +a! e!ta&li!hed &) the Arch&i!h% " Manila1 The M!t Re(erend Dere$iah -art) 1 #nder the !#%er(i!in "
the Si!ter! " St. 0a#l de .hartre! .
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5. 0hili%%ine General -!%ital Schl " N#r!ing :Manila1 3H>I< > In 3H>I1 +ith the !#%%rt " the G(. Gen. Fr&e!
and the Directr " -ealth and a$ng ther!1 %ened cla!!e! in n#r!ing #nder the a#!%ice! " the 8#rea# "
Ed#catin. > Ana!tacia Girn-T#%a! 1 +a! the "ir!t Fili%in t cc#%) the %!itin " .hie" N#r!e and S#%erintendent
in the 0hili%%ine!.
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6. St. L#*eF! -!%ital Schl " N#r!ing :L#e'n .it)1 3H>I< > The -!%ital i! an E%i!c%alian In!tit#tin. It &egan a!
a !$all di!%en!ar) in 3H>5. In 3H>I1 the !chl %ened +ith 5 Fili%in girl! ad$itted. > Mr!. ,itiliana 8eltran +a! the
"ir!t Fili%in Directr " the !chl. 7. Mar) Dhn!tn -!%ital and Schl " N#r!ing :Manila1 3H>I< > It !tarted a! a
!$all di!%en!ar) n .alle .er(ante!. > It +a! called 8ethan) Di!%en!ar) and +a! "#nded &) the Methdi!t Mi!!in.
> Mi!! Li&rada Da(elera +a! the "ir!t Fili%in Directr " the !chl.
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The Fir!t .llege! " N#r!ing in the 0hili%%ine!/ Uni(er!it) " Sant T$a!1 .llege " N#r!ing > 3H6; > Sr Taciana
Trinane! K Fir!t Directre!! Manila .entral Uni(er!it)1 .llege " N#r!ing > 3H6A > .n!#el Gi$en K Fir!t 0rinci%al
Uni(er!it) " the 0hili%%ine!1 .llege " N#r!ing > 3H6A > M!. D#lita SteB K Fir!t Dean
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Sciali'atin "r 0r"e!!inal N#r!ing 0ractice
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3. Sciali'atin - %rce!! &) +hich a %er!n learn! the +a)! " a gr#% r !ciet) in rder t &ec$e a "#nctining
%artici%ant 8ennerF! :3HA6< "i(e le(el! " %r"icienc) a! the n#r!e ac2#ire! SCA and (al#e! " n#r!ing 7 STAGES/
Stage 3/ N(ice - $a) &e !t#dent r n#r!e entering a clinical !etting +here that %er!n ha! n eE%erience Stage 4/
Ad(anced &eginner - de$n!trate! $arginall) acce%ted %er"r$ance
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Stage 5/ .$%etent - n#r!e ha! &een n the B& in the !a$e !it#atin "r 4 t 5 )ear!= de$n!trate! rgani'atinal
a&ilit) &#t lac*! the !%eed and "leEi&ilit) " the %r"icient n#r!e Stage 6/ 0r"icient - %ercei(e! a !it#atin a! a +hle
rather than B#!t it! indi(id#al a!%ect!= n#r!e "c#!e! n lng-ter$ gal! and i! riented t+ard $anaging the n#r!ing
care " the client rather than %er"r$ing !%eci"ic ta!*! Stage 7/ EE%ert - n lnger relie! n r#le1 g#ideline! r $aEi$!
t cnnect an #nder!tanding " the !it#atin t an a%%r%riate actin= ha(e highl) de(el%ed %erce%t#al ac#it) r
recgnitinal a&ilit)1 and their %er"r$ance i! "l#id1 "leEi&le and highl) %r"icient
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Rle! " the 0r"e!!inal N#r!e
Slide 2':
3. .are %r(iderM0arent S#rrgate - %ri$aril) cncerned +ith the client! need!. NNN Recgni'e the %atientF! $!t
i$$ediate need!. 4. .$$#nicatrM-el%er - c$$#nicate! +ith the client1 !#%%rt %er!n! and clleag#e!.
NNNE!ta&li!h tr#!t. 5. Teacher - %r(ide! health teaching t e""ect &eha(ir change +hich "c#!e! n ac2#iring ne+
*n+ledge r technical !*ill!. NNN A!!e!! clientF! learning need!M A!!e!! clientF! readine!! t learn.
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6. .#n!elr - %rce!! " hel%ing a client t recgni'e and c%e +ith !tre!!"#l %!)chlgical r !cial %r&le$!1 t
de(el% i$%r(ed inter%er!nal relatin!hi%! and t %r$te %er!nal gr+th. NNN Render acti(e li!teningM D nt gi(e
ad(ice. 7. .lient ad(cate - ad(cate! "r client right!. ;. .hange agent - initiate! change! and a!!i!t! the client
$a*e! $di"icatin! in the li"e!t)le t %r$te health. - hel%! the client t !%ea* #% "r the$!el(e!. NNN 0atient $#!t
de(el% !el" a+arene!!.
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I. Leader - $#t#al %rce!! " inter%er!nal in"l#ence thr#gh +hich the n#r!e hel%! a client $a*e deci!in! in
e!ta&li!hing and achie(ing gal! t i$%r(e clientF! +ell-&eing. A. Manager - %lan!1 gi(e! directin1 de(el%! !ta""1
$nitr! %eratin!1 gi(e! re+ard "airl) and re%re!ent! &th !ta"" $e$&er! and ad$ini!tratin a! needed. H.
Re!earcher - %artici%ate! in !cienti"ic in(e!tigatin and #!e! re!earch "inding! in %ractice. 3>. .lla&ratr - initiate!
n#r!ing actin! +ithin the health tea$ .
+34ND+D CR++R RO5+S 6OR NURS+S::
EO0ANDED .AREER ROLES FOR NURSES/ 3. N#r!e 0ractitiner 4. .linical N#r!e S%eciali!t 5. N#r!e Ane!theti!t
6. N#r!e Mid+i"e 7. N#r!e Re!earcher ;. N#r!e Ad$ini!tratr I. N#r!e Ed#catr A. N#r!e Enter%rene#r
:
Fc#! " N#r!ing 3. -ealth and Gellne!! 0r$tin - hel%ing %e%le de(el% re!#rce! t $aintain r enhance their
+ell-&eing. 4. Illne!! 0re(entin - $aintain %ti$al health &) %re(enting di!ea!e. 5. -ealth Re!tratin - hel%ing
%e%le t i$%r(e health "ll+ing health %r&le$! r illne!!. 6. .are " the D)ing - c$"rting and caring "r %e%le
" all age! +hile the) are d)ing.
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The 6 MaBr .nce%t!/ 3. 0er!n - reci%ient " the n#r!ing care. 4. -ealth - the degree " +ellne!! and +ell &eing that
a %er!n eE%erience!. 5. En(irn$ent - %ertain! t the internal and eEternal !#rr#nding! that a""ect! a %er!n. 6.
N#r!ing - %ertain! t attri&#te!1 characteri!tic! and actin! " the n#r!e %r(iding care in &ehal" " the client r in
cnB#nctin +ith the client.
NURSING T7+ORI+S :
NURSING T-EORIES
G+N+R5 T7+ORI+S:
GENERAL T-EORIES 3. NightingaleF! En(irn$ental Ther) > "c#!e! n the %atient and hi! en(irn$ent. > her
+r* in .ri$ea :3A76-3A7;< earned her the title ?The Lad) +ith the La$%@. > al! *n+n a! the Fir!t N#r!e Scienti!t
Theri!t "r her +r*1 Nte! n N#r!ing/ Ghat it i! and Ghat it i! Nt :3A;><. > !he "c#!ed n changing and
$ani%#lating the en(irn$ent in rder t %#t the %atient in the &e!t %!!i&le cnditin! "r nat#re t act.
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4. ,irginia -ender!nF! Nat#re " N#r!ing Mdel > cnce%t#ali'e! the n#r!eF! rle a! a!!i!ting !ic* r health)
indi(id#al! t gain inde%endence in $eeting 36 FUNDAMENTAL NEEDS. > !he %!t#lated that the #ni2#e "#nctin "
a n#r!e i! a!!i!t the indi(id#al1 !ic* r +ell1 in the %er"r$ance " th!e acti(itie! cntri&#ting t health r it! rec(er)
:r %eace"#l death< that he +#ld %er"r$ #naided i" he had the nece!!ar) !trength1 +ill r *n+ledge. > !he "#rther
&elie(ed that n#r!ing in(l(e! a!!i!ting the client in gaining inde%endence a! ra%id a! %!!i&le1 " a!!i!ting hi$
achie(e! %eace"#l death i" rec(er) i! n lnger %!!i&le.
14 8,$ic C-/!-"e"t$ -9 N#r$i"% C,re cc-rdi"% t- :ir%i"i, 7e"der$-" :
36 8a!ic .$%nent! " N#r!ing .are Accrding t ,irginia -ender!n 3. 8reath nr$all) 4. Eat and drin*
ade2#atel) 5. Eli$inate &d) +a!te! 6. M(e and $aintain de!ira&le %!t#re 7. Slee% and re!t ;. Select !#ita&le
clthe! I. Maintain &d) te$%erat#re +ithin nr$al range &) adB#!ting clthing r $di")ing the en(irn$ent A. Cee%
the &d) clean and +ell-gr$ed and %rtect the integ#$ent H. A(id danger! in the en(irn$ent and a(id inB#ring
ther!
Slide 3':
3>. .$$#nicate +ith ther! in eE%re!!ing e$tin!1 need!1 "ear! r %inin! 33. Gr!hi% accrding t neF! "aith
34. Gr* in !#ch a +a) that there i! a !en!e " acc$%li!h$ent 35. 0la) r %artici%ate in (ari#! "r$! " recreatin
36. Learn1 di!c(er r !ati!") the c#ri!it) that lead! t the nr$al de(el%$ent and health and #!e the a(aila&le
health "acilit) 3-H 0h)!ilgic .$%nent 3> P 36 0!)chlgical 33 S%irit#al 34 P 35 Scilgical
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5. Martha RgerF! Science " Unitar) -#$an 8eing! > .n!ider! $an a! a #nitar) h#$an &eing c-eEi!ting +ith in
the #ni(er!e1 (ie+! n#r!ing %ri$aril) a! a !cience and i! c$$itted t n#r!ing re!earch. > Fi(e a!!#$%tin! a&#t
h#$an &eing!/ 3. I! an irred#ci&le1 "#r-di$en!inal energ) "ield identi"ied &) %attern. 4. Mani"e!t! characteri!tic!
di""erent "r$ the !#$ " the %art!. 5. Interact! cntin##!l) and creati(el) +ith the en(irn$ent. 6. 8eha(e! a! a
ttalit). 7. A! a !entient &eing1 %artici%ate! creati(el) in change.
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6. Drthea Ore$F! Sel"-.are De"icit Ther) > e$%ha!i'e! the clientF! !el"-care need!1 n#r!ing care &ec$e!
nece!!ar) +hen client i! #na&le t "#l"ill &ilgical1 %!)chlgical1 de(el%$ental r !cial need!. > !he de"ined !el"-
care a! ? the %ractice " acti(itie! that indi(id#al! initiate t %er"r$ n their +n &ehal" in $aintaining li"e1 health +ell-
&eing. > cnce%t#ali'ed 5 N#r!ing S)!te$!/ 3. Ghll) c$%en!atr) 4. 0artiall) c$%en!atr) 5. S#%%rti(e-
Ed#cati(e
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5 NURSING S9STEMS/ G-OLL9 .OM0ENSATOR9 - n#r!e act! "r the %atient= %atient ha! n acti(e rle.
0ARTIALL9 .OM0ENSATOR9 - &th n#r!e and %atient %er"r$ care $ea!#re!. SU00ORTI,E -EDU.ATI,E -
%atient i! a&le t %er"r$. - %atient nl) need! health teaching.
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7. Si!ter .alli!ta R)F! Ada%tin Mdel > (ie+! client a! an ada%ti(e !)!te$. > She (ie+ed each %er!n a! a #ni"ied
&i%!)ch!cial !)!te$ in cn!tant interactin +ith a changing en(irn$ent. > gal " n#r!ing i! t enhance li"e
%rce!!e! thr#gh ada%tatin in "#r :6< ada%ti(e $de! . 3. 0h)!ilgic $de 4. Sel"-cnce%t $de a. %h)!ical !el"
&. %er!nal !el" 5. Rle "#nctin $de 6. Interde%endence $de
Slide 41:
;. I$gene M. CingF! Gal Attain$ent Ther) > N#r!ing %rce!! i! de"ined a! a d)na$ic inter%er!nal %rce!!
&et+een n#r!e1 client and health care !)!te$. > She de!cri&ed n#r!ing a! a hel%ing %r"e!!in that a!!i!t!
indi(id#al! and gr#%! in !ciet) t attain1 $aintain and re!tre health1 I" i! thi! nt %!!i&le1 n#r!e! hel% indi(id#al!
die +ith dignit).
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I. 8ett) Ne#$anF! -ealth .are S)!te$F! Mdel > &a!ed n t+ c$%nent! - STRESS and REA.TION TO
STRESS FOUR .ON.E0TS/ A..LIENT 3. FLEOI8LE LINE OF DEFENSE - *ee%! !)!te$ "ree "r$ !tre!!r
reactin! r !)$%t$atlg) = eE%and! in the %re!ence " !tre!!r! t %rtect the cre. 4. LINES OF RESISTAN.E -
cn!i!t " internal de"en!i(e %rce!!e!. 5. NORMAL LINE OF DEFENSE - #!#al le(el " +ellne!!= !tandard #!ed t
$ea!#re de(iatin "r$ health.
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8. EN,IRONMENT - ha! %tential t alter !)!te$ !ta&ilit) d#e t internal and eEternal !tre!!r!= al! %r(ide!
re!#rce! "r $anaging !tre!!r! - eE. I$$#ne !)!te$1 gd c%ing !*ill!1 "a$il) !#%%rt1 c$$#nit) health center.
STRESSORS .AN 8E/ 3. EOTRA0ERSONAL - eE. #ne$%l)$ent1 $icrrgani!$!1 %eer %re!!#re 4.
INTER0ERSONAL - &et+een 4 r $re indi(id#al!= eE. %arent-child eE%ectatin!1 cn"lict a$ng clleag#e! 5.
INTRA0ERSONAL K eE. anger1 %h)!ical a&ilitie!1 "inancial cnditin
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.. -EALT- - cnditin in +hich all %art! and !#&%art! are in har$n) +ith the +hle client. RE.ONSTITUTION -
%rce!! &) +hich a %er!n %rgre!!e! "r$ hi! nr$al line " de"en!e t a higher r l+er !tate " +ellne!!.
GELLNESS - cc#r! a"ter ada%tatin t !tre!!r!.
Slide 45:
D. NURSING NURSING INTER,ENTION MODALITIES OF 0RE,ENTION/ 3. 0ri$ar) 0re(entin - %r$tin "
client +ellne!! and %rtectin " nr$al line " de"en!e &) !trengthening "leEi&le line " de"en!e thr#gh the red#ctin
" ri!* "actr! and !tre!! %re(entin. 4. Secndar) 0re(entin - %rtectin " &a!ic !tr#ct#re &) !trengthening internal
line " re!i!tance. 5. Tertiar) %re(entin - %r$tin " eEi!ting recn!tit#tin &) !#%%rting eEi!ting !trength! and
re!#rce.
Slide 4':
A. Drth) Dhn!nF! 8eha(iral S)!te$ Mdel > "c#!e! n h+ the client ada%t! t illne!!= the gal " n#r!ing i! t
red#ce !tre!! ! that the client can $(e $re ea!il) thr#gh rec(er). > ,ie+ed the %atientF! &eha(ir a! a !)!te$1
+hich i! a +hle +ith interacting %art!. I S#&!)!te$! " 8eha(ir/ 3. Inge!ti(e - ta*ing in n#ri!h$ent in !ciall) and
c#lt#rall) acce%ta&le +a)!. 4. Eli$inati(e - ridding the &d) " +a!te in !ciall) and c#lt#rall) acce%ta&le +a)!.
Slide 40:
5. A""iliati(e - !ec#rit) !ee*ing &eha(ir. 6. Aggre!!i(e - !el"-%rtecti(e &eha(ir. 7. De%endence - n#rt#rance-!ee*ing
&eha(ir. ;. Achie(e$ent - $a!ter " ne!el" and neF! en(irn$ent accrding t internali'ed !tandard! "
eEcellence. I. SeE#al and Rle Identit) &eha(ir
Slide 48:
H. -ildegard 0e%la#F! Inter%er!nal Relatin! in N#r!ing > de"ined n#r!ing a! a thera%e#tic1 inter%er!nal %rce!!
+hich !tri(e! t de(el% a n#r!e-%atient relatin!hi% in +hich the n#r!e !er(e! a! a re!#rce %er!n1 c#n!elr and
!#rrgate. 0e%la#F! 0ha!e! " N#r!e-0atient Relatin!hi%/ 3. Orientatin 0ha!e - le(eling "" &et+een n#r!e and
client in ter$! " eE%ectatin! 4. Identi"icatin 0ha!e - !electi(e re!%n!e " the client t th!e +h can $eet hi!Mher
need!= a""ected &) clientF! &elie"! 5. EE%litatin 0ha!e - client ta*e! cntrl " the !it#atin &) eEtracting hel% "r$
the n#r!e 6. Re!l#tin 0ha!e - e(al#atin " care and di!charge " client
Slide 41:
3>. Madeleine LeiningerF! Tran!c#lt#ral .are and Uni(er!alit) Ther) Tran!c#lt#ral N#r!ing - i! c#lt#rall) c$%etent
n#r!ing care "c#!ed n di""erence! and !i$ilaritie! a$ng c#lt#re!1 +ith re!%ect t caring1 health and illne!!1 &a!ed
n the clientF! c#lt#ral (al#e!1 &elie"!1 and %ractice!. > !he ad(cated that n#r!ing i! a h#$ani!tic and !cienti"ic $de
" hel%ing a client thr#gh !%eci"ic c#lt#ral caring %rce!!e! :c#lt#ral (al#e!1 &elie"! and %ractice!< t i$%r(e r
$aintain a health cnditin.
Slide 52:
33. Ida Dean OrlandF! D)na$ic-N#r!e Relatin!hi% > NURSING i! a di!ci%lined %r"e!!inal re!%n!e > T)%e! "
N#r!ing re!%n!e/ a. deli&erate - :&a!ed n crrect identi"icatin " %atient need!< &. a#t$atic actin > N#r!ing
"#nctin i! cncerned +ith %r(iding direct a!!i!tance t indi(id#al! in +hate(er !etting t a(id1 di$ini!h1 relie(e1 r
!#re indi(id#alF! !en!e " hel%le!!ne!!
Slide 51:
34. Dean Gat!nF! 0hil!%h) and Science " .aring > N#r!ing i! the !cience " caring > .aring i! $re
?healthgenic@ than c#ring > Main "c#! " n#r!ing i! n carati(e "actr! that are deri(ed "r$ h#$ani!tic
%er!%ecti(e! c$&ined +ith a !cienti"ic &a!e TEN .ARATI,E FA.TORS/ 3. Fr$atin " a h#$ani!tic-altr#i!tic (al#e
!)!te$. 4. Faith-h%e. 5. .#lti(atin " !en!iti(it) t !el" and ther!.
Slide 52:
6. E!ta&li!hing a hel%ing-tr#!t relatin!hi%. 7. EE%re!!in " "eeling!1 &th %!iti(e and negati(e. ;. Re!earch and
!)!te$atic %r&le$-!l(ing. I. 0r$tin " inter%er!nal teaching-learning. A. 0r(i!in! "r a !#%%rti(e1 %rtecti(e
and crrecti(e $ental1 %h)!ical1 !ci-c#lt#ral and !%irit#al en(irn$ent H. A!!i!tance +ith the grati"icatin " h#$an
need!. 3>. All+ance "r eEi!tential-%hen$enlgical "actr!.
Slide 53:
35. Fa)e Glenn A&dellahF! 43 N#r!ing 0r&le$! > de"ined n#r!ing a! ha(ing a %r&le$-!l(ing a%%rach1 +ith *e)
n#r!ing %r&le$! related t health need! " %e%le. > She al! de"ined n#r!ing a! a !er(ice t indi(id#al and
"a$ilie!= there"re the !ciet). NNN .r#cial in n#r!ing %ractice i! the crrect identi"icatin " n#r!ing %r&le$!/ a.
O,ERT/ a%%arent cnditin! &. .O,ERT/ hidden cnditin!
Slide 54:
A&dellahF! 43 NURSING 0RO8LEMS / 3. T $aintain gd h)giene and %h)!ical c$"rt. 4. T %r$te %ti$al
acti(it)= eEerci!e1 re!t and !lee% 5. T %r$te !a"et) thr#gh the %re(entin " accident!1 inB#r) r ther tra#$a and
thr#gh the %re(entin and !%read " in"ectin. 6. T $aintain gd &d) $echanic! and %re(ent and crrect
de"r$itie!. 7. T "acilitate the $aintenance " a !#%%l) " E)gen t all &d) cell!. ;. T "acilitate the $aintenance "
n#tritin " all &d) cell! I. T "acilitate the $aintenance " eli$inatin.
Slide 55:
A. T "acilitate the $aintenance " "l#id and electrl)te &alance. H. T recgni'e the %h)!ilgical re!%n!e! " the
&d) t di!ea!e cnditin!- %athlgical1 %!)chlgical and c$%en!atr). 3>. T "acilitate the $aintenance "
reg#latr) $echani!$! and "#nctin!.. 33. T "acilitate the $aintenance " !en!r) "#nctin 34. T identi") and acce%t
%!iti(e and negati(e eE%re!!in!1 "eeling! and reactin!. 35. T identi") and acce%t the interrelatedne!! " e$tin!
and rganic illne!!. 36. T "acilitate the $aintenance " e""ecti(e (er&al and nn(er&al c$$#nicatin.
Slide 5':
37. T %r$te the de(el%$ent " %rd#cti(e inter%er!nal relatin!hi%!. 3;. T "acilitate %rgre!! t+ard
achie(e$ent " %er!nal !%irit#al gal!. 3I. T create andMr $aintain thera%e#tic en(irn$ent. 3A. T "acilitate
a+arene!! " !el" a! an indi(id#al +ith (ar)ing %h)!ical1 e$tinal and de(el%$ental need!. 3H. T acce%t the
%ti$#$ %!!i&le gal! in the light " li$itatin!1 %h)!ical and e$tinal. 4>. T #!e c$$#nit) re!#rce! a! an aid
in re!l(ing %r&le$! ari!ing "r$ illne!!. 43. T #nder!tand the !cial %r&le$! a! in"l#encing "actr! in the ca!e "
illne!!.
Slide 50:
36. Nla D. 0enderF! -ealth 0r$tin Mdel -ealth 0r$tin/ - directed t+ard! increa!ing the le(el " +ell-&eing
and !el"-act#ali'atin " a gi(en indi(id#al r gr#%. eE. $aintaining ; t A h#r! " dail) !lee% Di!ea!e %re(entin r
-ealth 0rtectin/ - acti(itie! directed t+ard! decrea!ing the %r&a&ilit) " eE%eriencing illne!! &) acti(e %rtectin
" the &d) again!t %athlgical !tre!!r!. eE. 8.G (accinatin
Slide 58:
37. L)dia E. -all Ther) " .are1 .re and .#re > %atient i! c$%!ed " three ele$ent!/ the 8d) :care<1 0athlg)
:c#re<1 and the 0er!n :cre<. > n#r!ing %erate! in ALL three ele$ent!. NN.are - re%re!ent! n#rt#rance and i!
eEcl#!i(e t n#r!ing. NN.re - in(l(e! the thera%e#tic #!e " !el" and e$%ha!i'e! the #!e " re"lectin. NN.#re -
"c#!e! n n#r!ing related t the %h)!icianF! rder!.
Slide 51:
3;. M)ra E!trin Le(ineF! F#r .n!er(atin 0rinci%le! " N#r!ing > She ad(cated that n#r!ing i! a h#$an
interactin and %r%!ed "#r cn!er(atin %rinci%le! " n#r!ing +hich are cncerned +ith the #nit) and integrit) "
the indi(id#al. > The F#r .n!er(atin 0rinci%le! are a! "ll+!/ 3. .n!er(atin " Energ) 4. .n!er(atin "
Str#ct#ral Integrit) 5. .n!er(atin " 0er!nal Integrit) 6. .n!er(atin " Scial Integrit)
Slide '2:
MAN and -i! 8a!ic -#$an Need!
Slide '1:
.ON.E0T OF MAN A. ATOMISTI. A00ROA.- The at$i!tic !t#d) " $an (ie+! $an a! an rgani!$ c$%!ed "
di""erent rgan !)!te$! +here each !)!te$ i! c$%!ed " rgan! and ear rgan i! c$%!ed " ti!!#e! and cell!.
8. -OLISTI. A00ROA.- Thi! (ie+ trace! $anF! relatin!hi% +ith ther h#$an &eing! in the !#%ra!)!te$ " !ciet).
Thi! a%%rach (ie+! $an a! a +hle rgani!$ +ith interrelated and interde%endent %art! "#nctining t %rd#ce
&eha(ir. Man a! a +hle there"re i! di""erent "r$ and $re than the !#$ " hi! c$%nent %art!. The di$en!in!
" $an incl#de the %h)!ical1 !cial1 !%irit#al1 cgniti(e and %!)chlgical a!%ect!.
Slide '2:
- Man a! a !cial &eing i! ca%a&le " relating +ith ther!. -i! "ir!t agent " !ciali'atin i! the "a$il) +here he i!
n#rt#red1 +here he learn! hi! "ir!t lang#age and +here he "ir!t learn! t !ciali'e. - Man a! a !%irit#al &eing i!
ca%a&le " !#ch (irt#e! a! "aith1 h%e and charit). Faith i! the #n2#e!tining &elie" in !$ene r !$ething. It i! the
"#ndatin +here h%e re!t!. .harit) $ean! the l(e " $an "r hi! "ell+$en. Man a! a !%irit#al &eing &elie(e! in a
%+er &e)nd hi$!el" and " tran!cending neF! li$itatin!.
Slide '3:
- Man a! a thin*ing &eing i! ca%a&le " %erce%tin1 cgnitin1 and c$$#nicatin. -e i! al! ca%a&le " lgical
thin*ing and rea!ning. - Man a! a %!)chlgical &eing i! ca%a&le " ratinalit). -i! ratinal !ide $a*e! hi$ $erci"#l1
*ind and c$%a!!inate. - Man a! a %h)!ical &eing ha! !#ch characteri!tic! a! genetic end+$ent1 !eE1 ther
%h)!ical attri&#te!1 %h)!ical !tr#ct#re and "#nctin!.
Slide '4:
A&raha$ Ma!l+F! -ierarch) " 8a!ic -#$an Need! NEED - i! !$ething that i! e!!ential t the !#r(i(al " h#$an!.
A &a!ic need i! !$ething +h!e/ 3. A&!ence $a) lead t illne!! 4. 0re!ence $a) !ignal health r %re(ent illne!! 5.
I" #n$et need! are $et r "#l"illed1 health $a) &e re!tred
Slide '5:
FIRST LE,EL/ 0h)!ilgical Need! a. OE)gen e. Eli$inatin &. Fl#id! ". Shelter c. N#tritin g. Re!t d. Te$%erat#re
-. SeE SE.OND LE,EL/ Sa"et) and Sec#rit) Need! 3. 0h)!ical Sa"et)/ - in(l(e! red#cing r eli$inating threat! t
the &d) !#ch a! illne!!1 accident and en(irn$ental eE%!#re. 4. 0!)chlgical Sa"et) / - #nder!tanding and the
a%%r%riatene!! " +hat t eE%ect "r$ ther!1 "r$ ne+ eE%erience! and "r$ enc#nter! +ith the en(irn$ent.
Slide '':
T-IRD LE,EL/ L(e and 8elnging Need! - need t e!ta&li!h !cial relatin!hi%! and t eE%erience e$tinal
n#rt#rance and care t and "r$ ther!. FOURT- LE,EL/ E!tee$ and Sel"-E!tee$ Need! - lin*ed +ith the de!ire "r
!trength1 achie(e$ent1 ade2#ac)1 c$%etence1 cn"idence1 and inde%endence. FIFT- LE,EL/ Need "r Sel"-
Act#ali'atin - highe!t le(el " all need!.
Slide '0:
.haracteri!tic! " a !el"-act#ali'ed indi(id#al/ 3. Sl(e! +n %r&le$!. 4. A!!i!t! ther! in %r&le$-!l(ing. 5.
Acce%t! !#gge!tin! " ther!. 6. -a! &rad intere!t in +r* and !cial t%ic!. 7. 0!!e!!e! gd c$$#nicatin
!*ill! a! a li!tener and c$$#nicatr. ;. Manage! !tre!! and a!!i!t! ther! in $anaging !tre!!. I. EnB)! %ri(ac). A.
See*! ne+ eE%erience! and *n+ledge. H. Sh+! cn"idence in a&ilitie! and deci!in!. 3>. Antici%ate! %r&le$! and
!#cce!!e!. 33. Li*e! !el".
Slide '8:
.haracteri!tic! " 8a!ic -#$an Need!/ 3. Need! are #ni(er!al 4. Need! $a) &e $et in di""erent +a)!. 5. Need! $a)
&e !ti$#lated &) eEternal and internal "actr!. 6. 0riritie! $a) &e altered. 7. Need! $a) &e de"erred. ;. Need! are
interrelated.
Slide '1:
-EALT- and ILLNESS
Slide 02:
.ON.E0T OF -EALT-1 GELLNESS1 GELL-8EING AND ILLNESS -EALT- > i! the "#nda$ental right " e(er)
h#$an &eing. It i! the !tate " integratin " the &d) and $ind. - i! a !tate " c$%lete %h)!ical1 $ental1 and !cial
+ell-&eing1 and nt $erel) the a&!ence " di!ea!e r in"ir$it). :G-O< - i! the a&ilit) t $aintain the internal $ilie#.
Illne!! i! the re!#lt " "ail#re t $aintain the internal en(irn$ent. :.la#de 8ernard<
Slide 01:
> i! &eing +ell and #!ing neF! %+er t the "#lle!t eEtent. -ealth i! $aintained thr#gh the %re(entin " di!ea!e!
(ia en(irn$ental health "actr!. :Flrence Nightingale< > i! the a&ilit) t $aintain h$e!ta!i! r d)na$ic
e2#ili&ri#$. :Galter .annn< > i! a d)na$ic !tate in the li"e c)cle. Illne!! i! an inter"erence in the li"e c)cle. :I$gene
Cing< > i! a !tate " a %rce!! " &eing &ec$ing an integrated and a +hle a! a %er!n. :Si!ter .ali!ta R)<
Slide 02:
GELLNESS AND GELL-8EING > Gellne!! i! a !tate " +ell-&eing. > Gell-8eing i! a !#&Becti(e %erce%tin "
&alance1 har$n) and (italit). > Gellne!! ha! di""erent di$en!in! / 3. 0h)!ical - the a&ilit) t carr)-#t dail) ta!*!
:gr$ing1 $&ilit)1 etc.< and t achie(e "itne!! " the di""erent rgan !)!te$! " the &d). 4. E$tinal - the a&ilit) t
$anage !tre!! and t eE%re!! e$tin! a%%r%riatel).
Slide 03:
5. Scial - a&ilit) t interact !#cce!!"#ll) +ith %e%le and +ithin the en(irn$ent " +hich each %er!n i! a %art1 t
de(el% and $aintain inti$ac) +ith !igni"icant ther! and t de(el% re!%ect and tlerance "r th!e +ith di""erent
&elie"!. 6. Intellect#al - the a&ilit) t learn and #!e in"r$atin e""ecti(el) "r %er!nal1 "a$il)1 and career
de(el%$ent. 7. S%irit#al - the &elie" in !$e "rce :nat#re1 !cience1 religin1 r a higher %+er< that !er(e! t #nite
h#$an &eing! and %r(ide $eaning and %#r%!e " li"e. ;. Occ#%atinal - a&ilit) t achie(e &alance &et+een +r*
and lei!#re ti$e.
Slide 04:
MODELS OF -EALT- AND GELLNESS 3. LEA,ELL P .LARCFS AGENT--OST-EN,IRONMENT MODEL r
E.OLOGI.AL MODEL Thi! $del ha! three d)na$ic interacti(e ele$ent!/ 3. Agent / an) en(irn$ental "actr r
!tre!!r :&ilgic1 che$ical1 $echanical1 %h)!ical1 and %!)chlgical< +h!e %re!ence r a&!ence can lead t illne!!
r death 4. -!t / %er!n:!< +h $a) r $a) nt &e at ri!* " ac2#iring a di!ea!e &a!ed n "a$il) hi!tr) " di!ea!e1
li"e!t)le ha&it! and age 5. En(irn$ent / all "actr! eEternal t the h!t that $a) r $a) nt %redi!%!e the %er!n t
the de(el%$ent " di!ea!e
Slide 05:
-EALT--ILLNESS .ONTINUA DUNNFS -IG--LE,EL GELLNESS GRID - A health grid in +hich the health aEi! and
the en(irn$ent aEi! inter!ect t de$n!trate interactin. The health aEi! eEtend! "r$ %ea* +ellne!! t death and
the en(irn$ental aEi! eEtend! "r$ (er) "a(ra&le t (er) #n"a(ra&le. The inter!ectin "r$! "#r healthM+ellne!!
2#adrant!/
Slide 0':
3. -igh-le(el +ellne!! in a "a(ra&le en(irn$ent / - eEa$%le i! a %er!n +h i$%le$ent! health) li"e!t)le &eha(ir!
and ha! ecn$ic re!#rce! t !#%%rt thi! li"e!t)le and a "a$il) r !cial en(irn$ent +h al! %ractice! r
enc#rage! the %ractice " health) li"e!t)le. 4. E$ergent high-le(el +ellne!! in an #n"a(ra&le en(irn$ental -
eEa$%le i! a %er!n +h *n+! the i$%rtance " i$%le$enting a health) li"e!t)le &#t c#ld nt d ! &eca#!e "
"a$il) re!%n!i&ilitie!1 B& de$and! r lac*! the re!#rce! t d !.
Slide 00:
5. 0rtected %r health in a "a(ra&le en(irn$ent - eEa$%le i! an ill %er!n cn"ined in a h!%ital and +h!e need!
are $et &) the h!%ital %er!nnel1 +h can a""rd a%%r%riate $edicatin1 %r%er diet and ther treat$ent! needed.
6. 0r health in an #n"a(ra&le en(irn$ent - eEa$%le i! a !tar(ing )#ng child in a re"#gee ca$% in Mindana.
Slide 08:
-EALT- 8ELIEF MODEL :-8M< 8ec*er1 3HI7 > de!cri&e! the relatin!hi% &et+een a %er!nF! &elie" and &eha(ir. >
indi(id#al %erce%tin! and $di")ing "actr! $a) in"l#ence health &elie"! and %re(enti(e health &eha(ir.
Slide 01:
Indi(id#al %erce%tin! incl#de! the ""/ 3. 0ercei(ed !#!ce%ti&ilit) t an illne!!. 4. 0ercei(ed !eri#!ne!! " an illne!!.
5. 0ercei(ed threat " an illne!!. Mdi")ing "actr! incl#de the ""/ 3. De$gra%hic (aria&le! 4. Sci%!)chlgic
(aria&le! 5. Str#ct#ral (aria&le! 6. .#e! t actin
Slide 82:
TRA,ISF ILLNESS-GELLNESS .ONTINUUM - The $del ill#!trate! that $(e$ent t the right " the ne#tral %int
indicate! increa!ing le(el! " health and +ell-&eing "r an indi(id#al. Thi! i! achie(ed thr#gh a+arene!!1 ed#catin
and gr+th. In cntra!t1 $(e$ent t the le"t " the ne#tral %int indicate! a %rgre!!i(el) decrea!ing !tate " health.
Slide 81:
SMIT-FS MODEL OF -EALT- 3. .linical Mdel - a&!ence " !ign! and !)$%t$! " di!ea!e. 4. Rle 0er"r$ance
Mdel - a&ilit) t "#l"ill !cietal rle!. 5. Ada%ti(e Mdel - (ie+! health a! a creati(e %rce!! and di!ea!e a! a "ail#re
in ada%tatin r $al-ada%tatin. 6. E#dae$ni!tic Mdel - health i! a cnditin " act#ali'atin r reali'atin " a
%er!nF! %tential.
Slide 82:
Di!ea!e and Illne!! Di!ea!e K alteratin in the &d) "#nctining +hich re!#lt! in the red#ctin " ca%acitie! and
!hrtening " li"e !%an. Illne!! K a %er!nal !tate in +hich the %er!n "eel! #nhealth). In ther +rd!/ Di!ea!e i! an
illne!! +ith &Becti(e "act! +hile Illne!! i! a !#&Becti(e %erce%tin " nt &eing +ell.
Slide 83:
Stage! " Illne!!/ Stage 3. S)$%t$! EE%erience - eE%erience !$e !)$%t$!1 %er!n! &elie(e! !$ething i!
+rng. 5 a!%ect! K %h)!ical1 cgniti(e and e$tinal. Stage 4. A!!#$%tin " the Sic* Rle - acce%tance " illne!!1
!ee*! ad(ice. Stage 5. Medical .are .ntact - !ee*! ad(ice t %r"e!!inal! "r (alidatin " real illne!!1 eE%lanatin
" !)$%t$!1 rea!!#rance r %redict " #tc$e.
Slide 84:
Stage 6. De%endent 0atient Rle - the %er!n &ec$e! a client de%endent n the health %r"e!!inal "r hel%=
acce%t! r reBect! health %r"e!!inalF! !#gge!tin!= &ec$e! $re %a!!i(e and acce%ting. Stage 7.
Rec(er)MReha&ilitatin - gi(e! #% the !ic* rle and ret#rn! t "r$er rle! and "#nctin!.
Slide 85:
.la!!i"icatin " Di!ea!e!/ 3. Accrding t Etilgic Factr!/ A. -ereditar) K d#e t de"ect in the gene! " ne r ther
%arent +hich i! tran!$itted t the ""!%ring. 8. .ngenital K d#e t de"ect in the de(el%$ent1 hereditar) "actr! r
%renatal in"ectin .. Meta&lic K d#e t di!t#r&ance r a&nr$alit) in the intricate %rce!!e! " $eta&li!$ D.
De"icienc) K re!#lt! "r$ inade2#ate inta*e r a&!r%tin " e!!ential dietar) "actr E. Tra#$atic K d#e t inB#r)
Slide 8':
F. Allergic K d#e t a&nr$al re!%n!e " the &d) t che$ical and %rtein !#&!tance! r t %h)!ical !ti$#li G.
Ne%la!tic K d#e t a&nr$al r #ncntrlled gr+th " cell -. Idi%athic K ca#!e i! #n*n+n= !el"-riginated= "
!%ntane#! rigin I. Degenerati(e K re!#lt! "r$ the degenerati(e change! that cc#r in the ti!!#e! and rgan! D.
Iatrgenic K re!#lt "r$ the treat$ent " the di!ea!e
Slide 80:
4. Accrding t D#ratin r On!et/ A. Ac#te Illne!! K ha! !hrt d#ratin and i! !e(ere. Sign! and !)$%t$! a%%ear
a&r#%tl)1 inten!e1 and "ten !#&!ide a"ter a relati(el) !hrt %erid. 8. .hrnic Illne!! K #!#all) lnger than ; $nth!1
and can al! a""ect! "#nctining in an) di$en!in. I! characteri'ed &)/ > Re$i!!in K %erid! d#ring +hich the
di!ea!e i! cntrlled and !)$%t$! are nt &(i#!. > EEacer&atin! K di!ea!e &ec$e! $re acti(e gi(en at a
"#t#re ti$e1 +ith rec#rrence " %rn#nced !)$%t$!. .. S#&-Ac#te K !)$%t$! are %rn#nced &#t $re
%rlnged than the ac#te di!ea!e.
Slide 88:
5. Di!ea!e $a) al! &e de!cri&ed a!/ A. Organic 8. F#nctinal .. Occ#%atinal D. ,enereal E. Fa$ilial F. E%ide$ic
G. Ende$ic -. 0ande$ic I. S%radic
Slide 81:
Ri!* Factr! " a Di!ea!e/ 3. Genetic r 0h)!ilgic - genetic %redi!%!itin. 4. Age - increa!e r decrea!e clientF!
!#!ce%ti&ilit) t ac2#ire di!ea!e. 5. En(irn$ent - !#rr#nding! that can a""ect the %er!n. 6. Li"e!t)le - ha&it! that
increa!e! the chance " ac2#iring a di!ea!e. 7. SeE - gender.
Slide 12:
Le(el! " 0re(entin/ 3. 0ri$ar) 0re(entin - a%%lied n health) indi(id#al. "c#!/ health %r$tin1 di!ea!e
%re(entin 4. Secndar) 0re(entin - a%%lied n %atientF! +ith !ign! and !)$%t$!. "c#!/ !creening1 diagn!ing1
ca!e-"inding1 earl) detectin1 %r$%t treat$ent 5. Tertiar) 0re(entin - a%%lied n %atient! +ith chrnic and
de&ilitati(e di!ea!e. "c#!/ reha&ilitatin
Slide 11:
STRESS MANAGEMENT 3. Ma!!age K $ani%#latin " the clientF! !*in t %r$te &ld circ#latin. 4. G#ided
I$ager) K !#gge!tin " i$age! +hich hel%! red#ce anEiet). 5. Mediatin K relaEatin " the $ind1 &d) and !#l. 6.
RelaEatin Techni2#e K 2#ite en(irn$ent1 %a!!i(e attit#de1 c$"rta&le %!itin1 c$"rta&le clthing. 7. A#tgenic
Training K teaching the $ind and &d) t "ll+ (er&al c$$and!. ;. Thera%e#tic T#ch K #!ed t $anage anEiet)1
relie" "r$ %ain.
Slide 12:
I. 9ga K c$&inatin " eEerci!e and $editatin. A. 0rgre!!i(e M#!cle RelaEatin K !erie! " ten!ing and relaEing
gr#% " $#!cle! !)!te$aticall). H. Th#ght St%%ing K !t%%ing the negati(e th#ght!. 3>. A&d$inal 8reathing K
&reathing +ith the #!e " the dia%hrag$. 33. Di!tractin K di(erting neF! attentin "r$ ne th#ght t anther. 34.
0har$acthera%) K the #!e " $edicatin.
Slide 13:
.OMMUNI.ATION in NURSING
Slide 14:
.$$#nicatin - eEchange " idea!1 "eeling!1 and in"r$atin "r$ ne %er!n t anther. 3. I! the $ean! t
e!ta&li!h a hel%ing-healing relatin!hi%!. All &eha(ir c$$#nicatin in"l#ence! &eha(ir. 4. .$$#nicatin i!
e!!ential t the n#r!e-%atient relatin!hi%. 5. I! the (ehicle "r e!ta&li!hing a thera%e#tic relatin!hi%. 6. I! the $ean!
&) +hich an indi(id#al in"l#ence! the &eha(ir " anther1 +hich lead! t the !#cce!!"#l #tc$e " n#r!ing
inter(entin.
Slide 15:
.$%nent! " .$$#nicatin 0rce!!/ 3. Sender K i! the %er!n +h encde! and deli(er! the $e!!age. 4.
Me!!age K i! the cntent " the c$$#nicatin. 5. .hannel K i! the $edi#$ #!ed t cn(e) the $e!!age. 6.
Recei(er K i! the %er!n +h recei(e! the $e!!age. 7. Re!%n!eMFeed&ac* K i! the $e!!age ret#rned &) the
recei(er. It indicate! +hether the $eaning " the !enderF! $e!!age +a! #nder!td.
Slide 1':
Mde!MT)%e! " .$$#nicatin/ 3. ,er&al - #!e " !%*en r +ritten +rd!. 4. Nn(er&al - #!e " ge!t#re!1 "acial
eE%re!!in!1 %!t#reMgait1 &d) $(e$ent!1 %h)!ical a%%earance and &d) lang#age.
Slide 10:
.haracteri!tic! " .$$#nicatin/ 3. Si$%licit) - the #!e " c$$nl) #nder!td +rd!. 4. .larit) - !a)ing +hat i!
act#all) $eant. - !%ea* !l+l) and en#nciate +rd!. 5. Ti$ing and Rele(ance - a%%r%riate ti$e. - cn!ider clientF!
cncern! and intere!t!. 6. Ada%ta&ilit) - a&ilit) t adB#!t. - cn!ider circ#$!tance! and &eha(ir 7. .redi&ilit) -
%ertain! t +rthine!! " +rd! and relia&ilit)
Slide 18:
RE.ORDING AND RE0ORTING
Slide 11:
Recrd - a "r$al and legal dc#$ent that %r(ide! e(idence " the clientF! care. 0#r%!e!/ 3. .$$#nicatin 4.
0lanning client care 5. A#dit and 2#alit) a!!#rance 6. Re!earch 7. Ed#catin ;. Rei$&#r!e$ent I. Legal
dc#$entatin A. Stati!tic!
Slide 122:
Re!%n!i&le "r the di!%!al " $edical recrd! in g(ern$ent h!%ital/ - DO- .riteria "r di!%!al/ - DO- accredited
DO- Recrd! Mgt P Archi(e O""ice Ghere t get the chart " a %t +h ha! &een di!charged/ - Medical Recrd!
Sectin Ghere t &tain the clientF! chart d#ring %erid " h!%itali'atin / - N#r!eF Statin
Slide 121:
4 T)%e! " Recrd! 3. 0r&le$ Oriented Medical Recrd - data are arranged &a!ed n the clientF! %r&le$ rather
than the !#rce " in"r$atin. 8a!ic .$%nent!/ A. Data&a!e - %ri$ar) in"r$atin a&#t the client. 8. 0r&le$
Li!t - in(l(e! all a!%ect! " the %er!nF! li"e that re2#ire! health care. .. Initial Order! and -ealth .are 0lan! D.
0rgre!! Nte! - SOA0IE1 Gra%hic Fl+ Sheet1 Di!charge Nte!
Slide 122:
4. S#rce Oriented Medical Recrd - chart i! di(ided P rgani'ed accrding t the di""erent !#rce! " data. 8a!ic
.$%nent!/ A. Ad$i!!in Sheet 8. 0h)!icianF! Order .. Medical -i!tr) D. N#r!eF! Nte! E. S%ecial Recrd! and
Re%rt!
Slide 123:
RE0ORTING/ - either ral1 ta%ed r +ritten eEchange! " in"r$atin &et+een n#r!e! r ther $e$&er! " the health
care tea$. 0#r%!e/ T %r$te cntin#it) " care. CINDS/ I. .hange " Shi"t Re%rt! - eEchange " in"r$atin "r$
the n#r!e " the %re(i#! !hi"t t the neEt !hi"t. A. Oral 8. A#dita%e recrding .. N#r!ing R#nd!
Slide 124:
II. Tele%hne Order! P Re%rt! - re%rt! and rder! (ia tele%hne. 0h)!ician/ ca%a&le " rdering the $edicatin RN/
recei(e! the $edicatin rder "r$ the dctr I$%rtant/ 3. It $#!t &e c#nter!igned &) the %h)!ician +ithin 46 hr!. 4.
I" it +a! nt !igned +ithin 46 h#r!1 nti") the -ead N#r!e. 5. Ideall)1 4 n#r!e! $#!t recei(e the tele%hne rder.
Slide 125:
III. Incidence Re%rt! - recrd " accident! r #n#!#al e(ent! that cc#r! in the agenc). 0#r%!e/ T %re(ent "#t#re
har$Maccident!. Data Incl#ded/ 3. .lientF! na$e and ID n#$&er 4. Date1 ti$e and %lace " the incidence 5. Fact! "
the incidence 6. .lientF! acc#nt " the incident 7. Gitne!!e! " the incident ;. E2#i%$ent! and $edicatin! in(l(ed
Fact! t Re$e$&er/ 3. It $#!t &e "iled +ithin 46 h#r!. 4. It !h#ld &e !#&$itted t the Ri!* Manager. 5. It !h#ld nt
&e incl#ded in the %atientF! chart.
Slide 12':
DO.UMENTATION
Slide 120:
DO.UMENTATION - i! an)thing +ritten r %rinted that i! relied n a! recrd r %r" "r a#thri'ed %er!n. N#r!ing
dc#$entatin $#!t &e/ Acc#rate. .$%rehen!i(e. FleEi&le en#gh t retrie(e critical data1 $aintain cntin#it)
" care1 trac* client #tc$e!1 and re"lect! c#rrent !tandard! " n#r!ing %ractice. A! $e$&er! " the health care
tea$1 n#r!e! need t c$$#nicate in"r$atin a&#t client! acc#ratel) and in ti$el) $anner. E""ecti(e
dc#$entatin en!#re! cntin#it) " care1 !a(e! ti$e and $ini$i'e! the ri!* " errr. Data recrded1 re%rted1 r
c$$#nicated t ther health care %r"e!!inal! are .ONFIDENTIAL and $#!t &e %racticed.
Slide 128:
Di""erent Sheet!/ 3. N#r!ing -ealth -i!tr) and A!!e!!$ent Gr*!heet - c$%leted #%n ad$i!!in. > 8igra%hic
data > Age1 !eE and addre!! > Methd " ad$i!!in 4. Gra%hic Fl+!heet - it all+! the n#r!e t recrd !%eci"ic
$ea!#re$ent! n a re%eated &a!i!. > ,ital !ign! > Inta*e and O#t%#t 5. Medicine P Treat$ent recrd - all+! "r the
re%eated recrding " $edicatin and treat$ent " the %atient n a re%eated &a!i!.
Slide 121:
6. N#r!ing CardeE R K Readil) acce!!i&le. E K En!#re cntin#it) " care. S K Serie! " "li%! card! *e%t at a %rta&le
indeE "ile at the n#r!eF! !tatin. T K Tl "r c$$#nicatin. 4 0art!/ 3. Acti(it) and Treat$ent Sectin 4. N#r!ing
.are 0lan
Slide 112:
7. Di!charge S#$$ar) - hel%! en!#re that the clientF! cnditin d#ring di!charge i! in de!ira&le #tc$e. F K Final
%h)!ical a!!e!!$ent. I K In!tr#ctin! a&#t $edicatin! and treat$ent regi$en. R K Recrd %ertinent data. A K
A!!e!! the client !#%%rt !)!te$. - K -ealth teaching.
Slide 111:
G#ideline! " L#alit) Dc#$entatin and Re%rting/ 3. Fact#al > A recrd $#!t cntain de!cri%ti(e1 &Becti(e
in"r$atin a&#t +hat a n#r!e! !ee!1 hear!1 "eel! and !$ell!. > The #!e " (ag#e ter$! !#ch a! a%%ear! 1 !ee$!
and a%%arentl) 1 i! nt acce%ta&le &eca#!e the!e +rd! !#gge!t that the n#r!e i! !tating an %inin. 4. Acc#rate >
The #!e " eEact $ea!#re$ent! e!ta&li!h acc#rac) . > Dc#$entatin " cnci!e data i! clear and ea!) t
#nder!tand. > It i! e!!ential t a(id the #!e " #nnece!!ar) +rd! and irrele(ant detail!.
Slide 112:
5. .$%lete > The in"r$atin +ithin a recrded entr) r a re%rt need! t &e c$%lete1 cntaining a%%r%riate and
e!!ential in"r$atin. 6. .#rrent > Ti$el) entrie! are e!!ential in the client! nging care. T increa!e acc#rac) and
decrea!e #nnece!!ar) d#%licatin1 $an) healthcare agencie! #!e recrd! *e%t near the clientF! &ed!ide +hich
"acilitate i$$ediate dc#$entatin " in"r$atin a! it i! cllected "r$ a client. 7. Organi'ed > The n#r!e
c$$#nicate! in"r$atin in a lgical rde r.
Slide 113:
Legal G#ideline! "r Recrding/ Dra+ !ingle line thr#gh errr1 +rite +rd errr a&(e it and !ign )#r na$e r
initial!. Then recrd nte crrectl). D nt +rite retaliatr) r critical c$$ent! a&#t the client care &) ther health
care %r"e!!inal!. Enter nl) &Becti(e de!cri%tin! " clientF! &eha(ir= clientF! c$$ent! !h#ld &e 2#ted.
.rrect all errr! %r$%tl). Errr! in recrding can lead t errr! in treat$ent. A(id r#!hing t c$%lete charting1
&e !#re in"r$atin i! acc#rate. D nt lea(e &lan* !%ace! in n#r!eF! nte!. .hart cn!ec#ti(el)1 line &) line= i"
!%ace i! le"t1 dra+ line hri'ntall) thr#gh it and !ign )#r na$e at end.
Slide 114:
Recrd all entrie! legi&l) and in &lan* in*. Ne(er #!e %encil1 "elt %en. 8lac* in* i! $re legi&le +hen recrd! are
%htc%ied r tran!"erred t $icr"il$. I" rder i! 2#e!tined1 recrd that clari"icatin +a! !#ght. I" )# %er"r$
rder! *n+n t &e incrrect1 )# are B#!t a! lia&le "r %r!ec#tin a! the %h)!ician i!. .hart nl) "r )#r!el".
Ne(er chart "r !$ene el!e. 9# are acc#nta&le "r in"r$atin )# enter int chart.
Slide 115:
A(id #!ing generali'ed1 e$%t) %hra!e! !#ch a! ?!tat#! #nchanged@ r Qhad gd da)@. 8egin each entr) +ith ti$e1
and end +ith )#r !ignat#re and title. D nt +ait #ntil end " !hi"t t recrd i$%rtant change! that cc#rred
!e(eral h#r! earlier. 8e !#re t !ign each entr). Fr c$%#ter dc#$entatin *ee% )#r %a!!+rd t )#r!el".
Maintain !ec#rit) and cn"identialit). Once lgged int the c$%#ter d nt lea(e the c$%#ter !creen #nattended.
Slide 11':
T-E NURSING 0RO.ESS
Slide 110:
N#r!ing 0rce!! - %r(ide! the "ra$e+r* in +hich n#r!e! #!e their *n+ledge and !*ill! t eE%re!! h#$an caring
and t hel% client! $eet their health need!. - a !)!te$atic1 ratinal $ethd " %lanning and %r(iding care #!ing the
%rce!! " AD0IE. Ste%!/ 3. A SSESSMENT 4. D IANOSIS 5. 0 LANNING 6. I M0LEMENTATION 7. E ,ALUATION
Slide 118:
.haracteri!tic! " the N#r!ing 0rce!!/ 3. S)!te$atic 4. S*ill! and Cn+ledge-&a!ed 5. .)clical 6. D)na$ic 7. .lient-
centered ;. Inter%er!nal and .lla&rati(e I. Uni(er!al A. Gal-riented H. 0ririt)-&a!ed
Slide 111:
0-ASE I/ ASSESSMENT - i! . llecting1 O rgani'ing1 , alidating1 and R ecrding data a&#t a clientF! health !tat#!.
0#r%!e/ - T e!ta&li!h a data &a!e .
Slide 122:
6 T)%e! " A!!e!!$ent/ 3. Initial A!!e!!$ent - c$%leted #%n ad$i!!in. - EE. N#r!ing -i!tr)1 A!!e!!$ent
Gr*!heet 4. 0r&le$-Fc#!edMOnging A!!e!!$ent - n-ging a!!e!!$ent %er"r$ed d#ring n#r!ing care. - -#rl)
A!!e!!$ent " Inta*e and O#t%#t
Slide 121:
5. E$ergenc) A!!e!!$ent - ra%id a!!e!!$ent " the %atientF! A8. d#ring an) %h)!ilgic and %!)chlgic cri!i!. -
.ardiac Arre!t1 S#icidal Ideatin 6. Ti$e-La%!e Rea!!e!!$ent - a!!e!!$ent %er"r$ed in t+ %erid! " ti$e. -
O%eratin Ti$&ang1 A!!e!!$ent "r -)%erten!in
Slide 122:
Di""erent Methd! " A!!e!!$ent/ 3. O&!er(atin - gathering data #!ing the 7 !en!e!. 4. Inter(ie+ - a %lanned and
%#r%!i(e cn(er!atin &et+een the n#r!e and the client. A. Directi(e inter(ie+/ - ?highl) !tr#ct#red@ - elicit! !%eci"ic
in"r$atin. 8. Nndirecti(e inter(ie+/ - ?le!! !tr#ct#red@ - all+! the client t (er&ali'e hi! th#ght! and "eeling!.
Slide 123:
5 T)%e! " Inter(ie+ L#e!tin!/ 3. .l!ed-ended 4. O%en-ended 5. Leading 2#e!tin! 5. 0h)!ical EEa$inatin -
!)!te$atic data cllectin $ethd #!ing the techni2#e! " I00A. - &Becti(e data are cllected. 4 T)%e! " Data/ 3.
S#&Becti(e - data that are a%%arent nl) t the %er!n a""ected. 4. O&Becti(e - data that can &e !een1 heard1 "elt1
!$elled1 r e(en ta!ted.
Slide 124:
0-ASE II/ NURSING DIAGNOSIS - i! a clinical B#dg$ent a&#t indi(id#al1 "a$il)1 r c$$#nit) re!%n!e! t act#al
and %tential health %r&le$!Mli"e %rce!!e!. . K cl#!tering A K anal)!i! N K n#r!ing diagn!i! "r$#latin
Slide 125:
T90ES OF NURSING DIAGNOSIS/ 3. A.TUAL DIAGNOSIS - B#dg$ent a&#t a clientF! re!%n!e t a health
%r&le$ at the ti$e " a!!e!!$ent and !igni"ied &) the %re!ence " a!!ciated !ign! " !)$%t$!. EEa$%le!/ Fl#id
(l#$e de"icit Ine""ecti(e air+a) clearance 4. RISC NURSING DIAGNOSIS - a clinical B#dg$ent that a client i! $re
(#lnera&le t de(el% the %r&le$ than ther! in the !a$e !it#atin. EEa$%le!/ Ri!* "r inB#r) Ri!* "r in"ectin
Slide 12':
5. 0OSSI8LE NURSING DIAGNOSIS - e(idence a&#t a certain health %r&le$ i! #nclear r the ca#!ati(e "actr!
are #n*n+n= need! cllectin " $re data either t !#%%rt r re"#te it= nt a real t)%e r n#r!ing diagn!i!.
EEa$%le!/ 0!!i&le !cial i!latin 0!!i&le ine""ecti(e c%ing 6. GELLNESS DIAGNOSIS - i! a clinical B#dg$ent
a&#t an indi(id#al1 "a$il)1 r c$$#nit) in tran!itin "r$ a !%eci"ic le(el " +ellne!! t a higher le(el " +ellne!!.
EEa$%le/ Readine!! "r enhanced !%irit#al +ell-&eing
Slide 120:
.OM0ONENTS OF A NURSING DIAGNOSIS/ 3. 0r&le$ - clientF! re!%n!e t hi!Mher illne!!. - eE. Eli$inatin1
8reathing %attern1 air+a) clearance N L#ali"ier! K +rd! added t gi(e $eaning t the diagn!tic !tate$ent. - eE.
Decrea!ed1 Ine""ecti(e1 I$%aired 4. Etilg) - related "actrM%r&a&le ca#!e. 5. Sign! and !)$%t$! - de"ining
characteri!tic!. - e(idence! r $ani"e!tatin!.
Slide 128:
G#ideline! "r Griting N#r!ing Diagn!i!R 3. Grd the !tate$ent ! that i! legall) ad(i!a&le. EEa$%le/ I$%aired !*in
integrit) related t i$%r%er %!itining R 4. Ma*e !#re that &th ele$ent! " the !tate$ent d nt !a) the !a$e
thing. EEa$%le/ I$%aired !*in integrit) related t !*in #lceratin . 5. Ma*e !#re t #!e #ni(er!all) acce%ted
a&&re(iatin!. EEa$%le/ Ine""ecti(e air+a) clearance related t acc#. " !ecreFn! R
Slide 121:
6. U!e n#r!ing ter$inlg) rather than $edical ter$ t de!cri&e the clientF! re!%n!e. EEa$%le/ Ine""ecti(e air+a)
clearance related t %ne#$nia . 7. U!e nn-B#dg$ental !tate$ent!. EEa$%le/ Ine""ecti(e !eE#alit) %attern related t
!eE#al rle cn"#!in . ;. Grd the diagn!i! !%eci"icall) and %reci!el) t %r(ide directin "r %lanning n#r!ing
inter(entin. EEa$%le/ I$%aired ral $#c#! $e$&rane related t nEi#! agent .
NURSING DIGNOSIS :+RSUS M+DIC5 DIGNOSIS:
NURSING DIAGNOSIS ,ERSUS MEDI.AL DIAGNOSIS N#r!ing Diagn!i! Medical Diagn!i! Fc#! n identi")ing
h#$an re!%n!e! t health and illne!! Identi"ie! di!ea!e! De!cri&e %r&le$! treated &) n#r!e! +ithin the !c%e "
inde%endent n#r!ing %ractice De!cri&e %r&le$! "r +hich the %h)!ician direct! the %ri$ar) treat$ent .hange! "r$
da) t da) a! the client re!%n!e! change Re$ain! the !a$e "r a! lng a! the di!ea!e i! %re!ent
Slide 131:
0-ASE III/ 0LANNING - a deli&erati(e1 !)!te$atic %ha!e " the n#r!ing %rce!! that in(l(e! deci!in $a*ing and
%r&le$ !l(ing. - the n#r!e re"er! t the a!!e!!$ent data and the diagn!tic !tate$ent. - the end %rd#ct i! the
creatin " N.0. - &egin! #%n the ad$i!!in and end! +hen n#r!e-%atient relatin!hi%! end!.
Slide 132:
0LANNING in(l(e! the "ll+ing acti(itie!/ E!ta&li!hing %riritie!. Griting gal!M#tc$e! and de(el%ing an
e(al#ate !trateg). Selecting n#r!ing !trategie!Minter(entin!. De(el%ing n#r!ing care %lan! .$$#nicate the %lan "
n#r!ing care.
Slide 133:
T)%e! " 0lanning/ 3. INITIAL 0LANNING - the n#r!e +h %er"r$! the initial ad$i!!in a!!e!!$ent de(el%! the
initial c$%rehen!i(e %lan " care= need! re"ine$ent! +hen $i!!ing data &ec$e! a(aila&le. 4. ONGOING
0LANNING - #!ing inging a!!e!!$ent data1 the n#r!e carrie! #t dail) %lanning "r the "ll+ing %#r%!e!/ a. t
deter$ine +hether the clientF! health !tat#! ha! changed &. t !et the %riritie! "r the clientF! care d#ring the !hi"t c.
t decide +hich %r&le$! t "c#! n d#ring the !hi"t d. t crdinate the n#r!e!F acti(itie! ! that $re than ne
%r&le$ can &e addre!!ed at each client cntact
Slide 134:
5. DIS.-ARGE 0LANNING - the %rce!! " antici%ating and %lanning "r need! a"ter di!charge= i! &ec$ing a
cr#cial %art " c$%rehen!i(e healthcare. E""ecti(e di!charge %lanning &egin! at the ti$e " ad$i!!in +here each
client i! a!!e!!ed "r/ a. %tential health need! &. a(aila&ilit) and a&ilit) " the clientF! !#%%rt net+r* t a!!i!t +ith
the!e need! c. h+ the h$e en(irn$ent !#%%rt! the client1 and d. client1 "a$il)1 and c$$#nit) re!#rce!
Slide 135:
T)%e! " Di!charge 0lanning/ A. Si$%leM8a!ic - %atient ha! &een di!charged "r$ the agenc) and %rceeded directl)
int hi!Mher h$e. 8. .$%leE - %atient i! di!charged "r$ the agenc) and ret#rned t anther health care in!tit#tin.
Setting 0riritie! - the %rce!! " e!ta&li!hing the %re"erential !e2#ence r ran* " inter(entin! in accrdance t the
clientF! $!t i$$ediate need!.
Slide 13':
N#r!ing GalMEE%ected O#tc$e - declaratin " %#r%!al intentin +hich direct! inter(entin!. T)%e! " Gal!/ 3.
Shrt Ter$ - can &e achie(ed in a !hrt %erid " ti$e. 4. Lng Ter$ - re2#ire! lnger %erid " ti$e t &e
acc$%li!hed.
Slide 130:
0UR0OSE " GOALSMEO0E.TED OUT.OMES/ 3. 0r(ide directin "r %lanning n#r!ing inter(entin!. 4. 0r(ide a
ti$e !%an "r %lanned acti(itie!. 5. Ser(e a! a criteria "r e(al#atin " client %rgre!! 6. Ena&le client and n#r!e t
deter$ine +hen the %r&le$ ha! &een re!l(ed. 7. -el% $ti(ate client and n#r!e &) %r(iding a !en!e "
achie(e$ent.
Slide 138:
G#ideline! in Griting Gal! and O#tc$e!/ 3. The gal! $#!t %ertain t the client. 4. It !h#ld &e reali!tic. 5. It
!h#ld &e c$%ati&le +ith the thera%ie! " ther health %r"e!!inal!. 6. It $#!t &e !%eci"ic. 7. It $#!t &e +ritten in
&eha(iral ter$!. ;. It !h#ld &e $ea!#ra&le. I. It !h#ld &e ti$e-&#nded.
Slide 131:
Inter(entin Selectin 3. Inde%endent - n#r!e-initiated. EEa$%le/ -ealth Teaching1 Ta*ing ,ital Sign!1 Ma*ing N.0 4.
De%endent - %h)!ician-initiated. - %er"r$ed #nder the dctrF! rder and !#%er(i!in. EEa$%le/ Medicatin!1 8ld
Tran!"#!in1 .atheteri'atin 5. .lla&rati(eMInterde%endent - (erla%%ing "#nctin! a$ng health care tea$.
EEa$%le/ Diet1 La&ratr) EEa$! N#r!ing .are 0lan K ?&l#e%rint " the n#r!ing %rce!!@
Slide 142:
0-ASE I,/ IM0LEMENTATION - i! %#tting the n#r!ing care %lan in actin. Acti(itie!/ 3. Rea!!e!!ing 4. Set %riritie!
5. 0er"r$ n#r!ing inter(entin 6. Recrd actin! .$%!ed " 5 DF!/ 3. Ding 4. Delegating 5. Dc#$enting
Slide 141:
Ding N .gniti(e S*ill! K ? intellect#al !*ill!@ N Technical S*ill! K ?%!)ch$tr !*ill!@ N Inter%er!nal S*ill! K
?c$$#nicatin !*ill!@ Acti(itie!/ 3. Rea!!e!!ing the client. 4. 0re%are the client %h)!icall) and %!)chlgicall). 5.
0re%are the e2#i%$ent and !#%%lie!. 6. I$%le$ent the inter(entin!. 7. .$$#nicate the n#r!ing actin!.
Slide 142:
Delegatin - the tran!"er " re!%n!i&ilit) r ta!* t a !#&rdinate +ith c$$en!#rate a#thrit) +hile retaining
acc#nta&ilit) "r the #tc$e. 7 Right! t Delegatin 3. Right Ta!* 4. Right .irc#$!tance 5. Right 0er!n 6. Right
DirectinM.$$#nicatin 7. Right S#%er(i!in
Slide 143:
Acti(itie! that cannt &e delegated/ 3. Initial and nging a!!e!!$ent. 4. 0lanning1 n#r!ing diagn!i! "r$#latin and
e(al#atin. 5. Ed#catin and !#%er(i!in " the n#r!ing %er!nnel. 6. S%ecial acti(itie! K li*e Sterile %rced#re!. 7.
S%eech and !igning " na$e!. Acti(itie! that can &e delegated/ 3. R#tine acti(itie!. - ,ital !ign! ta*ing - 8ed &ath 4.
.lean %rced#re. - Ene$a - Ear irrigatin
Slide 144:
0-ASE ,/ E,ALUATION - i! a!!e!!ing the clientF! re!%n!e t n#r!ing inter(entin! and then c$%aring the
re!%n!e t %redeter$ined !tandard! r #tc$e criteria. 0#r%!e/ T a%%rai!e the eEtent t +hich gal! and
#tc$e criteria " n#r!ing care ha(e &een achie(ed.
Slide 145:
5 T)%e! " E(al#atin/ 3. Onging 4. Inter$ittent 5. Ter$inal 5 0!!i&le D#dg$ent! d#ring E(al#atin/ 3. Gal $et 4.
Gal %artiall) $et 5. Gal nt $et 6 T)%e! " O#tc$e E(al#ated/ 3. .gniti(e 4. 0!)ch$tr 5. A""ecti(e 6.
0h)!ilgic
Slide 14':
L#alit) A!!#rance 3. Str#ct#re E(al#atin - %h)!ical !etting!1 cnditin thr#gh +hich care i! gi(en. 4. 0rce!!
E(al#atin - %ertain! t the $anner n h+ the care +a! gi(en. 5. O#tc$e E(al#atin - %ertain! t an) change! in
the clientF! health !tat#! a! a re!#lt " the n#r!ing inter(entin.
Slide 140:
OO9GENATION
Slide 148:
.he!t O-ra) - %r(ide! in"r$atin regarding the anat$ical lcatin and a%%earance " the l#ng!. 8e"re O-ra)/ >
A!!e!! %re!ence " %regnanc). > Re$(e Be+elrie! and $etal! n the clientF! che!t. > In!tr#ct the client t inhale
and hld &reath. A"ter O-ra)/ > A!!i!t the client t dre!! #%.
Slide 141:
0ULSE OOIMETER/ - de(ice that $ea!#re! O 4 !at#ratin le(el &e"re !ign! and !)$%t$! " h)%Ee$ia de(el%!.
> le(el/ H7-3>>S > h)%Ee$ia/ T O 4 in the &ld > &rain/ $!t !en!iti(e rgan in h)%EiaMh)%Ee$ia :3 !t !ign/
re!tle!!ne!!< N
Slide 152:
4 T)%e! " 0#l!e OEi$eter/ 3. Adhe!i(e 4. .li% > i" allergic t adhe!i(e #!e cli% %#l!e Ei$eter > acetne/ #!ed t
re$(e nail %li!h >alchl/ #!ed i" thereF! n nail %li!h
Slide 151:
Site! "r %#l!e Ei$eter/ "inger!1 ear l&e1 n!e1 and "rehead > h+ "re2#ent i! the changing " !ite/ U cli%/ 2 4V U
adhe!i(e/ 2 6-;V > it i! nece!!ar) t IMMO8ILIWE T-E SITE &eca#!e $(e$ent! are detected a! %#l!atin > i" the
!#n i! !hining (er the %#l!e Ei$eter !ite c(er the !ite.
Slide 152:
T-ORA.ENTESIS > re$(e "l#id > a!%iratin " "l#id "r$ the %le#ral ca(it) > %!Fn/ rth%neic %!Fn1 !itting %!Fn1
!ide l)ing %!Fn at #na""ected !ite > !ec#ring the cn!ent R.N. nt getting dctr > lcal ane!the!ia
Slide 153:
> in!tr#ctin t the client d#ring needle in!ertin P +ithdra+al eEhale P !ta) !till :ta*e !hall+ &reath< > a"ter
thracente!i!/ %!itin/ !ide-l)ing :%re(ent lea*age " %le#ral "l#id< > client c#ghing red !%#t#$ K red tinged !ali(a
A& nti") the %h)!ician X l#ng %er"ratin > a"ter thracente!i!1 the dctr +ill rder .OR t r#le #t
0NEUMOT-ORAO :deadlie!t c$%licatin< N
Slide 154:
.-EST 0-9SIOT-ERA09 - de%endent n#r!ing actin " #!ing %!itining1 (i&rating1 and %erc#!!ing t re$(e
tenaci#! re!%iratr) !ecretin!. 3. De%endent n#r!ing actin - need! dctrF! rder t *n+ i" the client can tlerate
the %rced#re. 4. .rrect !e2#ence " .0T 0 !itining 0e rc#!!in ,i &rating --- 0O0E ,I
Slide 155:
5. Gra(itatinal "rce/ "rce that drain! the !ecretin 6. 0!itining > Orth%neic/ t drain !ecretin! "r$ A0EO
0OSTERIOR SEGMENT > Trendelen&#rg1 leaningMl)ing n a&d/ t drain !ecretin! "r$ l+er l&e %!terir
!eg$ent 7. 0!itin i! ar#nd 3> $in!. ;. MaE. ti$e " .0T/ 5> $in!. I. 8e!t ti$e in %er"r$ing %!t#ral drainage/
earl) in the $rning #%n +a*ing #% &e"re $eal! Nri!* "r a!%iratin :!a$e in general ane!the!ia<
Slide 15':
0erc#!!ing/ -- !tri*ing " the !*in #!ing a c#%%ed hand li*e !c%ing - 4 O t di!ldge clientF! tenaci#! !ecretin!. >
%re(entin "r reddening/ %#t a la)er " clth > "rce c$e "r$ the +ri!t > %erc#!! "r 3> $in!. :3-4 $in!.M!eg$ent<
> t chec* i" crrect/ %%%ingM&$ing !#nd
Slide 150:
,i&ratin/ -- (igr#! 2#i(ering " the heel " the hand > Ghen t !tart (i&rating #!ing the handY - ta*e dee% &reath
then eEhale > 0!t %rced#re/ c#gh Z3 .n!ideratin/ Tleratin " %atient t the %rced#re .ntraindicatin/
Ina&ilit) t tlerate the %rced#re N I" the #%%er l&e " the l#ng! i! a""ected/ !ide l)ing +ith head [ t 5>V R L
Slide 158:
SU.TIONING/ -- re$(al " !ecretin #!ing a catheter cnnected t a !#ctining $achine. NN!#ctining i! dne a!
needed :0RN< &eca#!e it i! ha!!le P can ca#!e h)%Ee$ia P !ti$#latin " the (ag#! ner(e > %!itining/
cn!ci#!/ !e$i-"+lerF! #ncn!ci#!/ !ide-l)ing >l#&ricatin/ n!e/ !terile1 +ater-&a!ed $#th/ 0NSS
Slide 151:
Mea!#re$ent "r S#ctining/ > r%har)ngeal/ - $#th t earl&e > rtracheal/ - $#th t $id!tern#$ >
na!%har)ngeal/ - n!e t earl&e > na!tracheal/ - n!e t earl&e t nec* N h)%er(entilate the %t. +ith 3>>S O 4
&e"re !#ctining N a%%l) !#ctin nl) d#ring the +ithdra+al - t %re(ent tra#$a in the $#c#! $e$&rane.
Slide 1'2:
0re!!#re " the S#ctin Ga#ge/ Gall 0rta&le 3. In"ant &el+ H7 $$-g &el+ 7 $$-g 4. .hild H7-3>> $$-g 7-3>
$$-g 5. Ad#lt a&(e 33> $$-g a&(e 3> $$-g N d#ratin/ - 3>-37 !ecnd! N i" re%eated1 inter(al i!/ - 4> t 5>
!ecnd!
Slide 1'1:
%atient !#ctin .TT :5 Ga) 8ttle S)!te$< > Drainage 8ttle > Gater-!eal 8ttle > S#ctin .ntrl &ttle -- dra+ "l#id
P air "r$ the %le#ra. 3 4 5
Slide 1'2:
N8ttle 3/ Drainage / n &#&&ling N8ttle 4/ Gater !eal / (i!i&le &#&&ling1 inter$ittent >i" cntin##! &#&&ling/ thereF!
lea*age1 d#$%M cla$% the t#&e >i" thereF! n &#&&ling/ 3. :\< &!tr#ctin t crrect/ 0RESS K RELEASE MET-OD i"
n chice/ MILC T-E TU8E 4. L#ng reeE%an!in N8ttle 5/ S#ctin / gentle cntin##! &#&&ling > cntin##!
&#&&ling N N
Slide 1'3:
DIS.ONNE.TION OF TU8E/ A. .he!t/ > #!e (a!-ccl#!i(e dre!!ing > i" (a!-ccl#!i(e dre!!ing i! nt a(aila&le -
#!e ,ASELINIWED DRESSING 8. 8ttle/ > i" !till intact/ -- re-in!ert the t#&e int the &ttle > i" &r*en/ -- i$$er!e
t#&e in 0NSS NN I" the t#&e di!cnnect! / re-in!ert
Slide 1'4:
N#r!ing .n!ideratin!/ 3. Maintain a!e%tic techni2#e. 4. 0al%ate "r cre%it#!. Ratinale/ T deter$ine %re!ence "
!#&c#tane#! e$%h)!e$a. 5. Mini$i'e cla$%ing and %ening " the t#&e. Ratinale/ T %re(ent %ne#$thraE. 6.
Re$(al " the che!t t#&e i! dne &) the %h)!ician. 0!itin/ U%right %!itin In!tr#ctin/ Inhale and hld the &reath
and then d the ,al!al(a $ane#(er.
Slide 1'5:
N U T R I T I O N
Slide 1'':
N U T R I T I O N De"initin " Ter$!/ 3. Dige!tin - the %rce!! in +hich "d! are &r*en d+n "r the &d) t #!e.
4. A&!r%tin - the %rce!! in +hich dige!ted .-O1 .-ON1 Fat!1 Gater and Mineral! are tran!%rted int the &ld
circ#latin. 5. Meta&li!$ - c$%leE che$ical %rce!! that cc#r! in a cell in +hich n#trient! are #tili'ed "r energ)
!#rce1 cell gr+th and cell re%air.
Slide 1'0:
Mea!#re! t !ti$#late a%%etite/ 3. Ser(e "d in a %lea!ant and attracti(e $anner. 4. 0r(ide c$"rt. 5. Enhance
"d +ith clr!. 6. Engage in %lea!ant cn(er!atin.
Slide 1'8:
.OMMON T-ERA0EUTI. DIETS .lear Li2#id Diet 0#r%!e/ Relie(e thir!t and hel% $aintain "l#id &alance. U!e/
0!t-!#rgicall) and "ll+ing ac#te ($iting " diarrhea. Fd! all+ed/ .ar&nated &e(erage!= c""ee :ca""einated
and deca"<1 tea= "r#it-"la(red drin*!1 !trained "r#it B#ice!1 clear1 "la(red gelatin!= &rth1 %%!icle!1 c$$erciall)
%re%ared clear li2#id! and hard cand). Fd! a(ided/ Mil* and $il* %rd#ct! 1 "r#it B#ice! +ith %#l%1 and "r#it.
Slide 1'1:
F#ll Li2#id Diet 0#r%!e/ 0r(ide an ade2#atel) n#triti#! diet "r %atient! +h cannt che+ r +h are t ill t d
!. U!e/ Ac#te in"ectin +ith "e(er 1 GI #%!et!1 a"ter !#rger) a! a %rgre!!in "r$ clear li2#id! Fd! all+ed/ clear
li2#id!1 $il* drin*!1 c*ed cereal!1 c#!tard1 ice crea$1 !her&et!1 eggng1 all !trained "r#it B#ice!1 crea$ed
(egeta&le! !#%!1 %#dding!1 $a!hed %tate!1 in!tant &rea*"a!t drin*!1 )g#rt1 $ild chee!e !a#ce r %#reed $eat1
and !ea!ning. Fd! a(ided/ n#t!1 !eed!1 ccn#t!1 "r#it Ba$ and $ar$alade.
Slide 102:
S"t diet 0#r%!e/ 0r(ide ade2#ate n#tritin "r th!e +h ha(e tr#&led che+ing. U!e/ 0atient +ith n teeth r ill-
"itting dent#re!= tran!itin "r$ "#ll li2#id t general diet and "r th!e +h cannt tlerate highl) !ea!ned1 "ried r
ra+ "d! "ll+ing ac#te in"ectin! r ga!trinte!tinal di!t#r&ance! !#ch a! ga!tric #lcer r chlelithia!i!. Fd!
all+ed/ ,er) tender $inced1 gr#nd1 &a*ed &riled1 ra!ted1 !te+ed r crea$ed &ee"1 la$&1 (eal1 li(er1 %#ltr) r
"i!h1 cri!% &acn r !+eat &read= c*ed (egeta&le!= %a!ta= all "r#it B#ice!= !"t ra+ "r#it!= !"t &read and cereal!1 all
de!!ert! that are !"t and chee!e!.
Slide 101:
Fd! a(ided/ car!e +hle grain cereal! and &read1 n#t!= rai!in!= ccn#t!= "r#it! +ith !$all !eed!= "ried "d!=
high "at gra(ie! r !a#ce!= !%ic) !alad dre!!ing!= %ic*led $eat1 "i!h r %#ltr)= !trng chee!e!= &r+n r +ild rice=
ra+ (egeta&le!1 a! +ell a! li$a &ean! and crn!= !%ice! !#ch a! hr!eradi!h1 $#!tard1 and cat!#%= and %%crn.
Slide 102:
Sdi#$ Re!tricted Diet 0#r%!e/ Red#ce !di#$ cntent in the ti!!#e and %r$te eEcretin " +ater. U!e/ -eart
"ail#re1 h)%erten!in1 renal di!ea!e1 cirrh!i!1 tEe$ia " %regnanc) and crti!ne thera%). Mdi"icatin!/ Mildl)
re!tricti(e 4g !di#$ diet t eEtre$el) re!tricted 4>>$g !di#$ diet
Slide 103:
Fd! a(ided/ Ta&le !alt= all c$$ercial !#%!1 incl#ding &#illn1 gra()1 cat!#%1 $#!tard1 $eat !a#ce!1 and !)
!a#ce= &#tter$il*1 ice crea$1 and !her&et= !da!= &eet green!1 carrt!1 celer)1 and !%inach= all canned (egeta&le!=
"r'en %ea! / All &a*ed %rd#ct! cntaining !alt= &a*ing %+der1 r &a*ing !da= %tat chi%! and %%crn= "re!h r
canned !hell"i!h= all chee!e!= !$*ed r c$$erciall) %re%ared $eat!= !alted &#tter r $argarine= &acn1 li(e! and
!alad dre!!ing!.
Slide 104:
Renal Diet 0#r%!e/ .ntrl %rtein1 %ta!!i#$1 !di#$ and "l#id le(el! in the &d). U!e/ Ac#te and chrnic renal
"ail#re1 he$dial)!i! Fd! all+ed/ - -igh-&ilgical %rtein! !#ch a! $eat1 "+l1 "i!h1 chee!e and dair) %rd#ct!-
range &et+een 4> and ;> $gMda) - 0ta!!i#$ i! #!#all) li$ited t 37>>$gMda) - ,egeta&le! !#ch a! ca&&age1
c#c#$&er and %ea! are l+e!t in %ta!!i#$ - Sdi#$ i! re!tricted t 7>> $gMda) - Fl#id inta*e i! re!tricted t the
dail) (l#$e %l#! 7>> $l1 +hich re%re!ent! in!en!i&le +ater l!! - Fl#id inta*e $ea!#re! +ater in "r#it1 (egeta&le!1
$il* and $eat
Slide 105:
Fd! a(ided/ .ereal!1 &read1 $acarni1 ndle!1 !%aghetti1 a(cad!1 *idne) &ean!1 %tat chi%!1 ra+ "r#it!1
)a$!1 !) &ean!1 n#t!1 ginger&read1 a%rict!1 &anana!1 "ig!1 gra%e"r#it1 range!1 %erclated c""ee1 cca-cla1
range cr#!h1 !%rt drin*! and &rea*"a!t drin*! !#ch a! tang r a+a*e.
Slide 10':
-igh 0rtein1 -igh .ar&h)drate Diet 0#r%!e/ T crrect large %rtein l!!e! and rai!e! the le(el " &ld al&#$in.
Ma) &e $di"ied t incl#de l+ "at1 l+ !di#$ and l+ chle!terl diet!. U!e/ 8#rn!1 he%atiti!1 cirrh!i!1 %regnanc)1
h)%erth)ridi!$1 $nn#cle!i!1 %rtein de"icienc) d#e t %r eating ha&it!1 geriatric %atient +ith %r inta*e1
ne%hriti!1 ne%hr!i!1 and li(er and gall &ladder di!rder. Fd! all+ed/ General diet +ith added %rtein. Fd!
a(ided/ Re!trictin! de%end n $di"icatin! added t the diet. The $di"icatin! are deter$ined &) the %atientF!
cnditin.
Slide 100:
0#rine - Re!tricted Diet 0#r%!e/ De!igned t red#ce inta*e " #ric acid- %rd#cing "d!. U!e/ -igh #ric acid
retentin1 #ric acid renal !tne! and g#t. Fd! all+ed/ General diet %l#! 4-5 2#art! " li2#id dail). Fd! a(ided/
.hee!e cntaining !%ice! r n#t!1 "ried egg!1 $eat1 li(er1 !ea"d1 lentil!1 dried %ea! and &ean!1 &rth1 &#illn1
gra(ie!1 at$eal and +hle +heat1 %a!ta1 ndle! and alchlic &e(erage!. Li$ited 2#antitie! " $eat1 "i!h1 and
!ea"d all+ed.
Slide 108:
8land Diet 0#r%!e/ 0r(i!in " a diet in l+ "i&er1 r#ghage1 $echanical irritant!1 and che$ical !ti$#lant!. U!e/
Ga!triti!1 h)%erchlrh)dria :eEce!! h)drchlric acid<1 "#nctinal GI di!rder!1 ga!tric atn)1 diarrhea1 !%a!tic
cn!ti%atin1 &iliar) indige!tin and hiat#! hernia. Fd! all+ed/ ,aried t $eet indi(id#al need! and "d tlerance
Slide 101:
Fd! a(ided/ Fre!h "d! incl#ding egg!1 $eat1 "i!h1 and !ea"d1 chee!e +ith added n#t!1 r !%ice!1
c$$erciall) %re%ared l#nchen $eat!1 c#red $eat! !#ch a! ha$= gra(ie!= and !a#ce! and ra+ (egeta&le! / 0tat
!*in!= "r#it B#ice! +ith %#l%= "ig!= rai!in!= "re!h "r#it!= +hle +heat= r)e &read= &ran cereal!= rich %a!trie!= %ie!=
chclate= Ba$! +ith !eed!1 n#t!1 !ea!ned dre!!ing!1 c""ee1 !trng tea1 cca1 alchlic and car&nated &e(erage!
and %e%%er.
Slide 182:
L+-Fat1 .hle!terl Re!tricted Diet 0#r%!e/ Red#ce h)%erli%edi$ia1 %r(ide dietar) treat$ent "r $ala&!r%tin
!)ndr$e! and %atient! ha(ing ac#te intlerance "r "at!. U!e/ -)%erli%edi$ia1 ather!cler!i!1 %ancreatiti!1 c)!tic
"i&r!i!1 !%r#e :di!ea!e " inte!tinal tract characteri'ed &) $ala&!r%tin<1 ga!trect$)1 $a!!i(e re!ectin " !$all
inte!tine1 and chlec)!titi!. Fd! all+ed/ Nn-"at $il*= l+-car&h)drate1 l+-"at (egeta&le!= $!t "r#it!= &read!=
%a!ta!= crn$eal= lean $eat!. Fd! a(ided/ Re$e$&er t a(id the "i(e .F! " chle!terl K c*ie!1 crea$1 ca*e1
ccn#t1 chclate= +hle $il* r crea$ %rd#ct!1 a(cad!1 li(e!1 c$$erciall) %re%ared &a*ed gd! !#ch a!
dn#t! and $#""in!1 %#ltr) !*in1 highl) $ar&led $eal!.
Slide 181:
Dia&etic Diet 0#r%!e/ Maintain &ld gl#c!e a! near a! nr$al a! %!!i&le= %re(ent r dela) n!et " dia&etic
c$%licatin!. U!e/ Dia&ete! $ellit#! Fd! all+ed/ .h!e "d! +ith l+ gl)ce$ic indeE c$%!e "/ - 67-77S
car&h)drate! - 5>-57S "at! - 3>-47S %rtein
Slide 182:
/.""ee1 tea1 &rth1 !%ice! and "la(ring can &e #!ed a! de!ired. / EEchange gr#%! incl#de $il*1 (egeta&le!1 "r#it!1
!tarchM&read1 $eat :di(ided in lean1 $edi#$ "at1 and high "at<1 and "at eEchange!. /The n#$&er " eEchange! all+ed
"r$ each gr#% i! de%endent n the ttal n#$&er " calrie! all+ed. / Nn-n#triti(e !+eetener! :!r&itl< in
$deratin +ith cntrlled1 nr$al +eight dia&etic!. Fd! a(ided/ cncentrated !+eet! r reg#lar !"t drin*!
Slide 183:
-igh- "i&er Diet 0#r%!e/ S"ten the !tl / EEerci!e dige!ti(e tract $#!cle! / S%eed %a!!age " "d thr#gh
dige!ti(e tract t %re(ent eE%!#re t cancer-ca#!ing agent! in "d / L+er &ld li%id! / 0re(ent !har% ri!e in
gl#c!e a"ter eating U!e/ Dia&ete!1 h)%erli%edi$ia1 cn!ti%atin1 di(ertic#liti!1 anticarcingenic! :cln< Fd!
all+ed/ Rec$$ended inta*e a&#t ; g$! cr#de "i&er dail / All &ran cereal / Gater$eln1 %r#ne!1 dried %eache!1
a%%le +ith !*in1 %ar!ni%1 %ea!1 &r#!!el! !%r#t1 !#n"l+er !eed!.
Slide 184:
L+- Re!id#e Diet 0#r%!e/ Red#ce !tl &#l* and !l+ tran!it ti$e. U!e/ 8+el in"la$$atin d#ring ac#te
di(erc#liti! r #lcerati(e cliti!1 %re%aratin "r &+el !#rger)1 e!%hageal and inte!tinal !ten!i!. Fd! all+ed/
Egg!= gr#nd r +ell c*ed tender $eat1 "i!h1 %#ltr)= $il*= chee!e!= !trained "r#it B#ice! : eEce%t %r#ne<= c*ed r
canned a%%le!1 a%rict!1 %eache!1 %ear!1 ri%e &anana!= !trained (egeta&le B#ice/ canned r c*ed r !trained
a!%arag#!1 &eet!1 green &ean!1 %#$%*in1 !2#a!h1 !%inach1 +hite &read1 re"ine cereal! :crea$ " +heat<.
Slide 185:
Eli$inatin/ URINAR9 N A!!e!!ing the #rine/ 3. A$#nt %er h#r 5>-;> ccMhr >;> ccMhr/ %l)#ria ]5> ccMhr/ lig#ria
an#ria/ ?!tate " !#!%en!in@ >-3> ccMhr 4. .lr > !tra+1 a$&er1 )ell+1 clear > he$at#ria/ +ith &ld > tea clred/
he%atiti!Mdeh)dratin N N
Slide 18':
5. clarit)/ clear > i" t#r&id :cl#d)</ UTI 6. Odr/ ar$atic 7. Sterilit)/ !terile ;. %-/ acidic :;.>< I. S%eci"ic gra(it) >
3.>3-3.>47 r 3.>5> > [ !%eci"ic gra(it)/ greater than 3.>5> [ in %article!M!l#te/ dar* in clr deh)drated > T !%eci"ic
gra(it)/ le!! than 3.>3 "l#id +ith light/ (erdeh)dratin1 dia&ete! in!i%id#! N N
Slide 180:
.llecting Urine S%eci$en "r .MS/ 3. .lean catch/ $id!trea$ clean catch > cleaning the #rinar) $eat#! a. Fe$ale/
#!e %(idne idine > +i%e "rnt t &ac* &. Male/ #!e %(idne idine > circ#lar $tin= inner t #ter= hld the %eni!
"ir$l) 4. .llect/ 5>cc 5. .nta$inated a"ter 5> $in!. 6. Sterile techni2#e
Slide 188:
Urinar) .atheter 3. !el"-!ealing r#&&er catheter/ t)%e " catheter +herein cllectin can &e dne 4. +i%e the cllectin
%art +ith alchl 5. 5>-67V/ angle " needle in!ertin 6. 5>cc " #rine "r #rinal)!i!/ 5cc " #rine "r .MS 7. i" thereF! n
#rine/ cla$% &el+ the in!ertin %int= 5> $in!. %#t the !)ringe a&(e the cla$% %art
Slide 181:
.AT-ETERIWATION > cntraindicated +ith %el(ic "E1 %erineal herniatin1 #rethral !trict#re > French 3;-3A/ 44-46/
gr!! he$at#ria 3. .#de catheter/ > 46 h#r Fle) catheter > cntraindicated/ 36 French Fle) catheter > Z3
c$%licatin/ UTI > Z3 ca#!e/ N!c$ial in"ectin > Z3 ca#!ati(e agent/ E.cli N
Slide 112:
0!itin/ Fe$ale/ dr!al rec#$&ent > *nee! are "leEed P a(id eEtending *nee! Male/ !#%ine L#&ricant/ !terile
+ater-&a!ed > Fe$ale/ #ntil #rine &egin! t "l+= in!ert 3-4 inche! "#rtherM5-6 inche! > Male/ ;-A inche! D#ring
in!ertin P +ithdra+al/ > act a! i" (iding > eEhale Male/ hld the %eni! H>V again!t the &d)
Slide 111:
0!itin in ta%ing/ Fe$ale/ inner thigh Male/ inner thigh > a&d$en :%re(ent %re!!#re at !crt#$ P erectin < N!ec#re
the &ag at &ed "ra$e N#!e 7-3>cc di!tilled - 4 O/ -- %#re 0NSS can ca#!e %reci%itate "r$atin P cr)!talli'atin.
Slide 112:
Eli$inatin/ FE.AL NA!!e!!ing the !tl/ clr :)ell+1 &r+n1 greeni!h< NFr &rea!t"eeding in"ant!1 eE%ect a glden
)ell+ !tl > Odr/ ar$atic > A$#nt/ 5>>g t 7>>gMda) > Fre2#enc)/ 3-5EMda) 3EM4 da)! -irch!%r#ng/ at &irth1 n
de"ecatin > Sha%e/ c)lindrical > .n!i!tenc)/ !e$iM"r$ed N
Slide 113:
ENEMA >intrd#ctin " a !l#tin t the clientF! rect#$ "r 5 %#r%!e!/ 5 T)%e! Accrding t 0#r%!e/ 3. .lean!ing
ene$a :clean!e the &+el< 4. Retentin :!"ten P l#&ricate< 5. .ar$inati(e :eE%el "lat#!< 4 T)%e! " .lean!ing
Ene$a 3. -igh clean!ing ene$a > 3A inche! :height< > 3 liter " "l#id > indicated t clean the entire cln 4. L+
clean!ing ene$a > 34 inche! :height< > 7>>$l " "l#id > "r$ !ig$id t de!cending cln
Slide 114:
> 0!itin/ le"t !ide l)ing > U!e/ Medical M .leaning > Length/ !h#ld %a!! the internal !%hincter= 5-6 inche! Ni" thereF!
an) re!i!tance1 ne(er "rce the &!tr#ctin > t relaE/ inhale > I" client eE%erience cra$%ing P %ain/ cla$% "r 5>
$in!. NN rectal !#%%!itr)/ 5-6 inche!
Slide 115:
MEDI.ATION .OM0UTATION
Slide 11':
TEM0ERATURE .OM0UTATION/ 3. V. ^ VF _ V. E 3A \ 54 VF ^ V. _ VF K 54 M 3.A
Slide 110:
DRUGS I, _ $L Mhr h#r! _ $L gtt! M$in Dr#g!/ > D E L S N ?U 6>@ _ 6> #nit!M $L > D _ SEL > S _ DML Dr% Factr/
I,_ (l : $L < E dr% "actr > Ad#lt/ 37 hr! > 0edia / ;> rdered a$#nt " dr#g _ #n*n+n 2#antit) needed :O<
a$#nt " dr#g n hand *n+n 2#antit) " dr#g
Slide 118:
Sa$%le .$%#tatin/ D!age calc#latin "r #nit! :!$e $edicatin! !#ch a! he%arin and %enicillin are rdered in
#nit!< 3. The rder i! %enicillin I7>1>>> #nit!. The (ial read! 5>>1>>> #nit!M4$L. -+ $an) $L +ill &e gi(enY 4.
Ordered a$#nt " dr#g i! I7>1>>> #nit!= a$#nt " dr#g n hand i! 5>>1>>> #nit!. 5. Un*n+n 2#antit) i! O= *n+n
2#antit) i! 4 $L
Slide 111:
6. .alc#latin!/ a. I7>1>>> #nit! _ O 5>>1>>> #nit! 4$L &. :5>>1>>> #nit!< :O< _ :I7>1>>> #nit!< :4$L< c. 5>>1>>> O _
317>>1>>> 51>>>1>>> #nit! 5>>1>>> d. O _ 37> 5> e. O _ 7 $L
Slide 222:
Ad$ini!tratin " Medicatin/ Medicatin - a !#&!tance ad$ini!tered "r diagn!i!1 c#re1 treat$ent1 relie" r
%re(entin " di!ea!e. - al! called dr#g. E""ect! " the Dr#g. 3. Thera%e#tic e""ect K %ri$ar) e""ectM%!iti(e e""ect. 4.
Side e""ect K !ecndar) e""ectMnegati(e e""ectM#nintended e""ect. 5. Dr#g tlerance K #!#all) l+ %h)!ilgic re!%n!e
t a dr#g +hich re2#ire! additinal d!age t achie(e the de!ired e""ect. 6. Dr#g a&#!e K ina%r%riate #!e " the dr#g
either cntin#all) r ha&it#all). 7. Dr#g de%endence K clientF! reliance n the dr#g.
Slide 221:
0rinci%le! in Ad$ini!tering Medicatin! 3. O&!er(e the 3> ?right!@ " dr#g ad$ini!tratin. 3. Right Medicatin 4. Right
D!age 5. Right .lient 6. Right Ti$e 7. Right R#te ;. Right Dc#$entatin I. A. H. 3>.
Slide 222:
4. 0ractice a!e%!i!= +a!h hand! &e"re and a"ter %re%aring $edicatin!. 5. 8e *n+ledgea&le and acc#nta&le a&#t
the $edicatin! that )# ad$ini!ter. 6. 8e"re ad$ini!tering the $edicatin1 identi") the client crrectl). 7. D nt
lea(e the $edicatin at &ed!ide. ;. The n#r!e +h %re%are! the dr#g ad$ini!ter! it. I. I" the client ($it!1 re%rt thi!
t the n#r!e in-charge r %h)!ician!. A. Ghen a $edicatin errr i! $ade1 a!!e!! the client and re%rt it i$$ediatel)
t the n#r!e in charge r %h)!ician.
Slide 223:
R#te! " Dr#g ORAL Ad(antage!/ 3. M!t acce!!i&le 4. Sa"e 5. .!t e""ecti(e Di!ad(antage!/ 3. Ina%%r%riate "r
client +ith na#!ea and ($iting. 4. Ina%%r%riate "r clientF! +ith di""ic#lt) " !+all+ing. 5. Ina%%r%riate "r %atientF!
+ith decrea!e ga!tric $tilit). 6. Ma) ha(e #n%lea!ant ta!te r di!clr the teeth. 7. Ma) ca#!e a!%iratin.
Slide 224:
Di""erent Fr$! " Oral Medicatin!/ 3. Slid K ta&let1 ca%!#le1 %ill!1 ca%let1 %+dered 4. Li2#id > S)r#% K !#gar-
&a!ed > E$#l!in K il-&a!ed > S#!%en!in K +ater-&a!ed > EliEir K alchl-&a!ed N All+ 5> $in#te! t ela%!e
&e"re gi(ing a gla!! " +ater. 5. S#&ling#al 6. 8#ccal 7. Rectal ;. ,aginal I. T%ical A. Tran!der$al
Slide 225:
0arenteral R#te! 3. Intrader$al Ad(antage/ !l+ a&!r%tin rate1 #!ed "r dr#g te!ting. Di!ad(antage/ re2#ire!
!terile techni2#e1 ca#!e! anEiet)1 can nl) ad$ini!ter !$all a$#nt " dr#g. Site!/ inner "rear$1 anterir che!t1
#nderneath " the !ca%#la Angle " needle/ 3>-37 angle1 al$!t %arallel t the !*in Ga#ge/ 471 4;1 4I Length/ 5MA1
7MA1 ` inch MaEi$#$ cc/ >.3cc t >.4cc
Slide 22':
4. S#&c#tane#! Ad(antage/ "a!ter than ral r#te!. Di!ad(antage/ eE%en!i(e1 re2#ire! !terile techni2#e1 !l+er than
IM and I,1 can ca#!e anEiet)1 !$e dr#g! can ca#!e %ain and irritatin1 &rea*! the client !*in integrit). Site!/ #%%er
ar$1 #ter thigh1 a&d$en1 (entrgl#teal1 dr!gl#teal Angle " needle/ 67 angle= &e!e and in!#lin ad$ini!tratin -
H> angle Ga#ge/ 471 4;1 4I Length/ 5MA1 7MA1 ` inch MaEi$#$ cc/ 3-5 $l
Slide 220:
5. Intra$#!c#lar Ad(antage/ "a!ter a&!r%tin1 can red#ce %ain and irritatin "r$ irritating dr#g!. Di!ad(antage/
re2#ire! !terile techni2#e1 can ca#!e anEiet)1 it &rea*! the clientF! !*in integrit) Site!/ (entrgl#teal1 dr!gl#teal1
(a!t#! laterali!1 rect#! "e$ri!1 deltid Angle " needle/ H> angle
Slide 228:
W-trac*R > retract the !*in laterall) a+a) "r$ the !ite > %ierce the !*in 2#ic*l) and !$thl) at H> > a!%irate :7-
3>cc< > inBect the dr#g !l+l) and !teadil) :3> !ecM$l< > +ait "r 3> !ec! and all+ the $edicatin t di!%er!e > d
nt $a!!age
Slide 221:
5. Intra(en#! Ad(antage/ ra%id e""ect Di!ad(antage/ li$ited "r highl) !l#&le !l#tin! nl)1 %r circ#latin can
inter"ere a&!r%tin NN Intra(a!c#lar Ga#ge/ 461 451 441 431 4> Length/ 31 3 `1 4 inche! MaEi$#$ cc/ I, %#!h K 3> $l
I, in"#!in K 6L %er da)
Slide 212:
8LOOD TRANSFUSION
Slide 211:
> Unit " &ld _ de%end! n agenc) - 67> cc1 7>> cc1 47> cc1 46> cc > 0NSS/ - nl) "l#id c$%ati&le d#ring 8T >
ga#ge/ 3H1 3A1 3I1 3; > T &acteria= ad$ini!tered +ithin 5> $in!. > $aE. ti$e/ 6 h#r! > RN t chec*/ 4 RN > i" &ld
i! t cld/ - c(er the &ld +ith a dr) clth
Slide 212:
> &e!t +a) t chec* clientF! identit) &e"re tran!"#!in - thr#gh ID 8andM&racelet > $iE the &ag " &ld &) tilting the
&ld "r$ !ide t !ide > Ad(er!e reactin/ d#ring the "ir!t 4> $in! :37 $in!< at 4> gtt!M$in > SMSE " ad(er!e rEn/ -
itchine!!1 hi(e!1 [ te$%.1 chill!1 "e(er1 P %ain. 3 !t ad(er!e rEn/ di''ine!!Mheadache I,/ STO01 RUN 0NSS1 NOTIF9
T-E DO.TOR - &ring &ld t the la&ratr) - get a #rine !%eci$en
Th,t;$ ll 6-l<$!:
ThatF! All Fl*!!