VIH100 Variations in Health I Session 7 PDF

VIH100 Variations in Health I Session 7 _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 1 At the end of this Session, you should be able to:...

VIH100 Variations in Health I Session 7 _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 1 At the end of this Session, you should be able to: Describe pathophysiology as it relates to the common presentation of illness Identify the nursing management of disease and illness of disease and illness for body systems across the lifespan. Identify appropriate evidence-informed research and practice resources. _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 2 Session Overview Introduction to pathophysiology Nursing management, including assessment (holistic assessment, data collection including lab values and diagnostics); pharmacology; identification of real/potential problems; nursing diagnoses; planning of specific nursing interventions; implementing culturally sensitive and aware care; evaluation of care; collaborating with other members of the health care team; health promotion; client teaching. Introduction to diagnostics _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 3  Digestive System Introduction _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 4 Anatomy and Physiology of the Upper Digestive Tract Mouth Pharynx Esophagus Stomach Small intestine Large intestine and anus Figure 1 https://www.google.com/url?sa=i&url=https%3A%2F%2Fstudiousguy.com%2Fdigestive-system-diagram- function%2F&psig=AOvVaw1aoHe_Bg- wQHprOfxQyPNY&ust=1617160961933000&source=images&cd=vfe&ved=0CAIQjRxqFwoTCPD6wKCI1- 8CFQAAAAAdAAAAABAD _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 5 Accessory Organs Anatomy and physiology of the liver Anatomy and physiology of the biliary tract Anatomy and physiology of the pancreas Figure 2 https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.cancer.org%2Fcancer%2Fbile-duct-cancer%2Fabout%2Fwhat-is-bile-duct- cancer.html&psig=AOvVaw2iPDvvMGwQZBuUSuXCbgcE&ust=1617161875251000&source=images&cd=vfe&ved=0CAIQjRxqFwoTCNjE-tCL1-8CFQAAAAAdAAAAABAD _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved une 2023 6 Accessory Organs - Pancreas Figure 3 https://www.google.com/url?sa=i&url=https%3A%2F%2Fen.wikipedia.org%2Fwiki%2FFile%3A1820_The_Pancreas.jpg&ps ig=AOvVaw1U4DgNXN9AdqhIS29N1HQz&ust=1617162095620000&source=images&cd=vfe&ved=0CAIQjRxqFwoTCICCurq M1-8CFQAAAAAdAAAAABAT _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 7 Age-Related Changes Teeth are mechanically worn down with age The jaw may be affected by osteoarthritis A significant loss of taste buds with age Xerostomia (dry mouth) is common Walls of esophagus and stomach thin with aging, and secretions lessen Production of hydrochloric acid and digestive enzymes decreases _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 8 Age-Related Changes Gastric motor activity slows No significant changes in the small intestine; some vitamin/mineral absorption changes Large intestine: muscle layer and mucosa atrophy Movements of colon contents is slower Anal sphincter tone, and strength decreases _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 9 Assessment Health history Presenting symptoms Past health history Functional assessment Physical examination Head and neck Chest and abdomen Rectum and anus Figure 4 https://nursecepts.com/wp-content/uploads/2018/07/Gastrointestinal- System-Assessment_Four-Quadrants.jpg _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 10 Diagnostic Tests and Procedures Endoscopic examination Radiologic studies Liver biopsy Laboratory studies _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 11 Drug Therapy Antacids Antiulcer drugs Laxatives Antidiarrheal drugs Antiemetics Antibacterial and antifungal drugs Anti-inflammatory drugs Other classes Vitamins and minerals, albumin, diuretics, hormones, antihypertensive agents, antispasmodics, pancreatic enzymes, insulin _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 12 Common Therapeutic Measures Gastrointestinal intubation Total parenteral nutrition Digestive tract surgery Preoperative care Postoperative care Figure 4 https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.amyspeechlanguage therapy.com%2Ftube-feeding.html&psig=AOvVaw2q5-GlKgRp30- lSyBMRhFW&ust=1617163002976000&source=images&cd=vfe&ved=0CAIQjRxqFw oTCNDO1-aP1-8CFQAAAAAdAAAAABAf _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 13 Question 1 Which of the following is NOT considered a main part of the digestive tract? A. Esophagus B. Small intestine C. Liver D. Anus J _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved une 2023 14 Question 2 Which is an age-related change in the lower digestive tract? A. Increased muscle tone B. Muscle layer atrophy C. Increased speed of movements of intestinal contents D. Increased anal sphincter tone _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 15 Chapter 38 Upper Digestive Tract Disorders _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved 16 Hiatal Hernia Pathophysiology Causes Signs and symptoms Medical diagnosis Medical treatment Nursing care Figure 5 https://www.google.com/imgres?imgurl=https%3A%2F%2Fwww.clevelandclinic.org%2Fhealthinfo%2FShowImage.ashx%3FPIC%3D4453 %26width%3D450&imgrefurl=https%3A%2F%2Fmy.clevelandclinic.org%2Fhealth%2Fdiseases%2F8098-hiatal- hernia&tbnid=Rmwex8YURP_bQM&vet=12ahUKEwjG4P7vkNfvAhUYmp4KHf3YBF8QMygAegUIARDTAQ..i&docid=- btwuqaOv0ORzM&w=450&h=261&q=hiatal%20hernia&hl=en&ved=2ahUKEwjG4P7vkNfvAhUYmp4KHf3YBF8QMygAegUIARDTAQ _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 17 GERD Pathophysiology Signs and symptoms Medical diagnosis Medical treatment Nursing care Figure 6 https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.ge mhospitals.com%2Fis-there-a-cure-for- gerd%2F&psig=AOvVaw1XLpfEFKTEjlmk_VH0ek07&ust=16171634 27716000&source=images&cd=vfe&ved=0CAIQjRxqFwoTCIDO0Le R1-8CFQAAAAAdAAAAABAD _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 18 Peptic Ulcer Pathophysiology Causes Signs and symptoms Complications Medical diagnosis Medical treatment Nursing care Figure 7 https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.cgh journal.org%2Farticle%2FS1542-3565(18)30383- 5%2Ffulltext&psig=AOvVaw2yfv6NeBOMsleqyTtA9LmD&ust=1617 163509881000&source=images&cd=vfe&ved=0CAIQjRxqFwoTCKD WwtqR1-8CFQAAAAAdAAAAABAD _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 19 Patient Education to Promote Normal Bowel Function Good handwashing and proper food-handling People who recognize that stress affects their gastrointestinal function may benefit from relaxation techniques and stress-management training Signs and symptoms of digestive problems should be reported for prompt diagnosis and treatment if indicated Teaching patients what is normal, how to promote normal function, and how to detect problems can help to avoid serious gastrointestinal dysfunction _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 20 Chapter 40 Liver, Gallbladder, and Pancreatic Disorders _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved 21 Hepatitis Inflammation of the liver Local effects of severe inflammation: Bile channels compressed – increased bilirubin and jaundice Blood flow to the liver impaired – increased pressure in the portal circulation Systemic effects: altered metabolic functions Types of hepatitis: Hepatitis A, B, C, D, and E Noninfectious hepatitis (drugs/toxins) S&S: 3 phases of disease when symptomatic 1)Preicteric, 2)Icteric and 3)Posticteric Complications: become carriers, the risk for cancer Dx: lab work for liver function (ALT, AST, GGT, PT) _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 22 Hepatitis Tx: no cure, promote healing and manage symptoms Prevention: Vaccines Nursing care: Possible bed rest Repositioning q2h to prevent skin breakdown Deep Breathe and Cough q2h to prevent pneumonia Figure 8:https://www.google.com/url?sa=i&url=https%3A%2F% Activity limitations 2Fhepatitiseducation.med.ubc.ca%2Ftypes-of-viral- hepatitis%2F&psig=AOvVaw1z0r0qPIvzaplpF9QrI1d0&ust =1617165643263000&source=images&cd=vfe&ved=0CAI Good nutrition QjRxqFwoTCKCFqtOZ1-8CFQAAAAAdAAAAABAp Adequate fluid volume _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 23 Alcohol-Induced Liver Disease Fatty liver: reversible if alcohol intake ceases Alcoholic hepatitis: inflammation of the liver; common with heavy consumption Figure 9 https://www.google.com/url?sa=i&url=https%3A%2F%2F Alcoholic www.verywellhealth.com%2Fdifference-between-hepatitis- and-cirrhosis- cirrhosis: liver 1760108&psig=AOvVaw1z0r0qPIvzaplpF9QrI1d0&ust=161 7165643263000&source=images&cd=vfe&ved=0CAIQjRxq tissue replaced FwoTCKCFqtOZ1-8CFQAAAAAdAAAAABAN with scar tissue _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 24 Cirrhosis Chronic, progressive disease of liver Compensated Cirrhosis: fibrosis and nodules are present, may not look ill Decompensated Cirrhosis: fibrosis, nodules + ascites, bleeding varices, encephalopathy or jaundice, ill 4 Major Types of cirrhosis based on cause: alcoholic, postnecrotic, biliary and cardiac _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 25 Cirrhosis (cont…) Dx: lab and urine tests, imaging, liver biopsy Tx: limit deterioration of liver, prevent complications, rest Nursing care: nutrition, activity level, skin and breathing support _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 26 Cirrhosis cont'd S&S: Early: weight loss, unexplained fever, fatigue, dull/heavy RUQ Progression: impaired metabolism of foods (nausea, vomiting/anorexia, diarrhea), resistance to blood flow, dilated and bulging veins ->hematologic disease (bruise easily, nosebleeds) Later: jaundice, hormone excesses, confusion and decreased LOC due to impaired ammonia metabolism, peripheral neuropathy _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 25 End-Stage Liver Disease From injury or chronic disease Injury from acute hepatitis, drug toxicity, or obstruction of the hepatic vein Liver failure associated with injury: fulminant liver failure _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 27 Cancer of the Liver Rarely begins in the liver, but is a frequent site of metastasis Cirrhosis is a predisposing factor S&S: liver enlargement, weight loss, anorexia, nausea, vomiting, dull pain in the upper right quadrant of the abdomen Tests: CT scan, MRI, liver scan and biopsy, hepatic arteriography, endoscopy, and measurement of alpha-fetoprotein levels Tx: If the cancer is confined to one area, a lobectomy may be done; otherwise chemotherapy is the primary treatment _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 28 Liver Transplantation Only cure for end-stage liver disease Transplantation for cancer confined to the liver; for patients with congenital disorders Ranked by acuity and need and entered into a national computer network Lifelong drug therapy needed to prevent rejection - Tacrolimus (Prograf) Recipient must be monitored for signs of rejection J _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved une 2023 29 Question 1 Hepatitis _____ is transmitted from one person to another by way of water, food, or medical equipment that has been contaminated with infected fecal matter. A. A B. B C. C D. D _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 30 Chapter 41System Introduction Urologic _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved 31 Anatomy of the Urinary System Kidneys and ureters Bladder and urethra Figure 10: https://www.google.com/url?sa=i&url=https%3A%2F%2Foncolo gypro.esmo.org%2Feducation-library%2Fessentials-for- clinicians%2Fgenitourinary-tract-tumours%2Ftumours-of-the- urinary- system&psig=AOvVaw0bPYWzJ6tosc_BtASIUN7Q&ust=1617200 171559000&source=images&cd=vfe&ved=0CAIQjRxqFwoTCNCZ kKKa2O8CFQAAAAAdAAAAABAD _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 32 Physiology of the Urinary System Regulation and excretion Urine production Urine elimination Regulation of serum calcium and phosphate Regulation of blood pressure Hormonal stimulation of red blood cell production _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 33 Age-Related Changes in the Urinary System Loss of nephrons, thickening of membranes in nephrons, and sclerosis of renal blood vessels Creatinine clearance decreases with age Nocturia: awaken from sleep to void Bladder muscles weaken; connective tissue increases Incontinence not normal consequence of age, but it is common In men, urethral obstruction is often a problem _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 34 Assessment Health history Reason for seeking care Present health Past health history Family history Review of systems Functional assessment Physical examination Figure 11: https://www.google.com/url?sa=i&url=https%3A%2F %2Fwww.grhosp.on.ca%2Fcare%2Fvisitors%2Fcompl iments-and- concerns&psig=AOvVaw3Rjtn5WGnbZ8IGmVGVkUZT &ust=1617200481191000&source=images&cd=vfe&v ed=0CAIQjRxqFwoTCIiS_Lab2O8CFQAAAAAdAAAAAB AP _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 35 Diagnostic Tests and Procedures Urine tests Blood tests Radiographic tests and procedures Ultrasound Invasive procedures Urodynamic studies _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 36 Therapeutic Measures Catheterization Ureteral catheter Nephrostomy tube Urinary stent Urologic surgery Drug therapy _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 37 Activity: Access the online nursing resource: BCCNM LPN Scope of Practice Identify LPN limits with: A)Suprapubic catheters B)Coude tip catheters _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 38 Question 1 Which of the following does not occur in urine production? A. Glomerular filtration B. Red blood cell production C. Tubular reabsorption D. Tubular secretion _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 39 Question 2 During tubular secretion, _______ and hydrogen ions are secreted into the tubules from the blood. A. oxygen B. magnesium C. potassium D. sodium J _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved une 2023 40 ChapterUrologic 42 Disorders _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved 41 Urethritis Inflammation of the urethra Cause: microorganisms, trauma or hypersensitivity to chemical in products Common: Escherichia coli, Chlamydia, Trichomonas, Neisseria gonorrhoeae S&S: dysuria, frequency, urgency, bladder spasms Dx: pt symptoms, U/A, urethral smear Tx: antimicrobials Nursing care: sitz bath to soothe and reduce pain, peri care from front to back, void before and after sexual intercourse, void after swimming, avoid irritating vaginal products _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 42 Cystitis Inflammation of the urinary bladder S&S: urgency, frequency, dysuria, hematuria, nocturia, bladder spasm, incontinence, low- grade fever, cloudy, dark urine, fatigue, pelvic/abdominal discomfort Some have bacteria in urine, but no symptoms, no treatment planned Dx: urine specimen for U/A, C/S, elevated WBCs in urine Tx: antibiotics Nursing Care: fluids to flush the urinary tract, complete medication treatment, pain control _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 43 Interstitial Cystitis Chronic inflammatory disease of the bladder Cause: unknown S&S: moderate to severe bladder and pelvic pain, urinary frequency and urgency, bleeding from formed ulcers in the bladder lining Dx: cystoscopy Chronic inflammation causes bladder scarring and reduces the capacity Tx: symptom management, finding possible causes, medications to relieve spasms, surgical bladder stretching, extreme: bladder removal Nursing Care: empathy for physiologic illness, teaching and support _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 44 Chronic Kidney Disease Progressive destruction of the nephrons of both kidneys Damage is in stages, the final stage is end-stage renal disease Causes: hypertension, diabetes mellitus,atherosclerosis S&S: Azotemia: increased nitrogenous waste products in the blood Uremia: kidneys cannot maintain fluid, electrolyte and acid-base balance Insulin resistance, hypocalcemia, metabolic acidosis, anemia, dry itchy skin, grey coloured skin Fluid balance: retain Na and H20 -> hypernatremia and hypervolemia - > elevated BP+ edema -> Heart failure Potential for infection, GI disturbances from ammonia _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 46 Chronic Kidney Disease Tx: IV medications, dialysis for life-saving measures: Hemodialysis Peritoneal Dialysis Nursing care: Excess fluid volume Imbalanced nutrition Risk for acute confusion Ineffective coping Risk for infection Constipation Diarrhea Risk for injury _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 47 Renal Transplantation Kidney donation Preoperative nursing care of recipient Surgical procedure Postoperative nursing care of recipient Care of kidney donor _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 48 Chapter 43 Musculoskeletal System Introduction _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved 49 Anatomy and Physiology of the Musculoskeletal System Bone Cartilage Ligaments Tendons Joint structure and function Skeletal muscle Figure 11: https://www.google.com/url?sa=i&url=https%3A%2 F%2Fwww.pinterest.com.au%2Fpin%2F5038402770 59966595%2F&psig=AOvVaw2u0nXgkP5gkJNZ2Wxo 7D- b&ust=1617203380615000&source=images&cd=vfe &ved=0CAIQjRxqFwoTCND7v5um2O8CFQAAAAAdAA AAABAD _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 50 Age-Related Changes Loss of bone mass and bone strength Osteoporosis is common in women but affects men Put the older patient at risk for fractures Cartilage gradually loses elasticity; becomes soft and frayed Water content decreases, and cartilage may ulcerate, leaving bony joint surfaces unprotected and promoting the growth of osteophytes (bony spurs) Can result in pain and limited mobility _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 51 Assessment Health history Reason for seeking care Present health Past health history Family history Review of systems Functional assessment Figure 13 https://www.google.com/url?sa=i&url=https%3A%2F%2F www.uclahealth.org%2Fnursing%2Fworkfiles%2FContinui ngEducation2015%2FTeachBack%2FUmoveBMAT- TrainingPresentation.pdf&psig=AOvVaw1Y2- pvxgO8VEmp7zNYpD3w&ust=1617200820059000&source =images&cd=vfe&ved=0CAIQjRxqFwoTCOipxduc2O8CFQA AAAAdAAAAABAU _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 52 Diagnostic Tests and Procedures Laboratory studies Radiologic imaging studies Vascular studies Pulse volume recording Thermography Doppler ultrasound Biopsy _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 53 Common Therapeutic Measures Physical and occupational therapy Education and support Drug therapy Surgical treatment _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 54 Question 1 Which of the following is not an age-related change in the musculoskeletal system? A. Cartilage increases in elasticity B. Loss of bone mass C. Loss of bone strength D. Cartilage may ulcerate _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 55 Class Discussion Identify THREE possible care needs for a patient whose life has been affected by a connective tissue disease. _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 56 Osteoarthritis (OA) Degeneration of the articular cartilage with hypertrophy of the underlying and nearby bone.Lack of cartilage means lack of shock-absorbing protection Primary OA: unknown factor triggers to release of chemicals which break down joint cartilage Secondary OA: trauma, infection, corticosteroid tx S&S: pain with activity relieved by rest, stiffness, limited movement, mild tenderness, swelling, joint deformity Dx: radiographs, MRI Tx: physical therapy to maintain muscle mass, medications, surgery for persistent pain and disability Nursing Care: chronic pain, limited mobility, pt teaching _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 57 Osteoarthritis Figure https://www.google.com/url?sa=i&url=https%3A%2F%2Fmedcomic.com%2Fmedcomic%2Fosteoarthritis-vs-rheumatoid- arthritis%2F&psig=AOvVaw2JANQi60HWAcgVbCjssusn&ust=1617168215454000&source=images&cd=vfe&ved=0CAIQjRxqFwoTCKDvpZ2j 1-8CFQAAAAAdAAAAABAU _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 58 Rheumatoid Arthritis(RA) Chronic, progressive inflammatory disease affecting the synovial joints No single cause, autoimmune disorder Dx: lab, radiographic studies S&S: pain in the affected joints triggered by movement, morning stiffness more than 1 hour, weakness, fatigue, warmth of affected joints Tx: combined care from medicine, nursing, PT, OT and social services to reduce inflammation and symptom management Tx: rest, drug therapy, PT, OT, surgery Nursing Care: chronic pain, activity intolerance, social isolation _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 59 Osteoporosis Bone absorption is more than bone formation Loss of bone mass, the potential for fractures (common in wrist, vertebrae and hip) Greatest Risk: older women with small frames, fair skin blond/red hair Other risk factors: estrogen deficiency, physical inactivity, low body weight, inadequate calcium, protein of Vit D intake, long-term therapy with corticosteroids of heparin, excessive cigarettes/caffeine/alcohol S&S: back pain, fractures, loss of height, kyphosis Dx: Bone density tests, blood studies Tx: Calcium and Vit D supplements, physical activity, reduce/stop smoking, limit alcohol intake, estrogen replacement Nursing care: chronic pain, safety, self-care teaching _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 60 Critical Thinking Scenario A 58-year-old patient has been diagnosed with osteoarthritis and osteoporosis and has limited joint mobility. Identify topics for patient teaching by the nurse. _____________________________________________________________________________________________________ June 2023 ©2021 Stenberg College – All rights reserved 61 Any questions? _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 62 Summary Describe pathophysiology as it relates to common presentation of illness Identify the nursing management of disease and illness of disease and illness for body systems across the lifespan. Identify appropriate evidence-informed research and practice resources. _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 63 Reference Linton, A. D. & Matteson, M. A. (2023). Medical- Surgical Nursing (8th ed.). St. Louis, MO: Elsevier, Inc. _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 64  End of Presentation _____________________________________________________________________________________________________ ©2021 Stenberg College – All rights reserved June 2023 65