Medical Surgical Nursing

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 Ã
define ealth as 6






 
 
   



    
 igh-Level Ãellness is further
conceptualized as self-actualization and
maximization of person·s potential.
 
 
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 ¬ing·s Goal Attainment Theory
ealth is a dynamic life experience. ´Dynamicµ implies continuous adjustment to stressors in internal and external
environment and the use of one·s resources to achieve maximum potential.

 Leininger·s transcultural Model

ealth refers to ´belief,values, and action patterns that are culturally known and used to preserve and maintain
personal or group well-being and to perform daily role activities.
 Levine·s Conservation Principles

ealth is defined in terms of an ANGL
SAX
N word meaning ´Ã
LEµ. Patterns of wholeness change with growth and
development. ealth and disease patterns reflect adaptive changes.

 Neuman·s System Model

ealth is a condition in which the parts and subparts of the whole person are in harmony

 Newman·s ealth as expanding Consciousness

ealth is composed of a pattern of human ²environment interaction in which the person is evolving or transforming to
higher levels of consciousness characterized by new levels of undersatnding and decision making capacity.


rem Self-Care Model

ealth is a State of wholeness, including a person·s parts and modes of functioning
 
 
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 Pender·s health promotion Model

ealth is a manifestation of evolving pattern of person-environment interaction throughout the life span

 Roger·s Unitary Person Model

ealth and Illness are seen as expressions of the interaction of a person and the environment in the
process of unfolding consciousness.

 Roy·s adaptation Model

ealth is a process or state of being and a process of becoming an integrated whole.

 Ãatson·s Model of uman Caring

ealth is more than the absence of disease. It is a harmony within the mind, body and soul.

  

6 Accdg. To Dunn,
igh level wellness is an 6  
   
 
   

     

  
  
  
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Ãellness  
   



  
 
 
 
Illness Neutral point igh Level
Ãellness

Premature death Extended life

No discernible
illness or wellness

Signs Awareness

Symptoms Education

Disabilities Self-actualization

 
 

6 Illness

  
 

 


   



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Smith·s 4 Client Model of ealth
Clinical Model
A client consider themselves healthy if they are free from the Clinical signs &
Symptoms of Illness

Adaptive Model
A client consider themselves healthy if they are able to adapt to Day-to-day Challenges of
environment and the unexpected events

Role-performance Model
A client consider themselves healthy if they can Function well in all of their roles

Eudaimonistic model
A client consider themselves healthy if they are manifesting
appiness,Cheerfulness and Full of energy
 
  
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6 Self-Management Support Strategies
-evidence-based strategies that helps a client changes his behaviors towards
health.

Categories of skills needed by the client to care for themselves

1.Medical/Behavioral Management
      

2. Role Management
     
  

3.Affective/emotional
   
 

   

  
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6 ealthy Eating
Nutritional Labels

!6 
 "!6 ² is designed to assist consumers in making
informed decisions regarding the foods they purchase.

ealth Problem concerning Poor eating patterns

besity
Management
· Improve Quality versus Quantity of foods eaten
1.Decreasing portion size
2.Modify the composition of the diet through substitution and modification of foods
consumed
3.Changing eating behaviors
· Improve activity Patterns
Assessment
·Client·s current eating patterns

1.24 hour diet recall

- ideal for obtaining information at the time of the nurse-client encounter
2. 3-day dietary log
- includes not only what food was eaten by the client but also when, why, and how the
client ate.
Intervention
ÿ Change the foods eaten should include substituting foods(e.g., carrots for candy)
ÿ Increasing certain food(e.g, fruits & vegetables)
ÿ Decreasing other foods(e.g., fats)
ÿ Modifying eating circumstances ( e.g. adding a breakfast meal, not eating after the evening
meal, setting the eating utensil down between bites, and eating only at the table)
Diet & Management of Risk for Disease
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6 Stress
-the body response to demands

Negative Effect of Stress

ʉ Behavioral Responses (decreased ability to think clearly and function, increased tobacco and
alcohol use, overeating and disrupted sleep patterns)
ʉ Emotional Responses ( depression, anger, decreased self-esteem, apathy, and impatience)
ʉ Physical Responses ( tight, sore neck and shoulder ,muscles, increased blood pressure and
heart rate, palpitations, chest discomfort, headaches, gastrointestinal upset and fatigue)

Assessment
ʍ Get the history of the cognitive, emotional, and physical manifestation

ʍ Assess the problem or situation that seems to precipitate stress

ʍ Coping mechanism used by the client

Intervention
ʃ Stress Management
· Stress resistance
-involves decreasing the body·s response to stress; adopting healthy eating patterns, engaging in
physical activity, and using relaxation techniques can help reduce the stress response.

 Positive stressor ² activity that requires an adaptive response when perform properly and it results
in physical changes that counter the normally negative effects of stress.
 Progressive Relaxation ² technique of slowly focusing on each muscle group, tensing the muscles
for 5 to 7 seconds, and then relaxng them.
 Meditation ² once considered an alternative practice, is an established relaxation therapy.
·Cognitive Reappraisal ( Restructuring)
- the goal is to change the perception or interpretation of events as stressors.
ÿ Thought stopping
ÿ Refuting irrational Ideas
ÿ Guided imagery
·Effective coping
-involves recognition of the problem causing stress and, through problem solving skills, development
and implementation of a effective strategy to cope with or solve the problem

 
 

6 Accidents
- leading cause of death in young & middle aged adult.
Alcohol Abuse
Screening tool in assessing problem in alcohol Drinking

C ² ave you ever felt you ought to CUT down drinking?

A ² ave people ANN
ED you by criticizing your drinking?
G - ave you ever felt GUILT about your drinking?
E ² ave you ever had a drink first thing in the morning to steady your nerves or
get rid of a hangover ( EE
PENER)?