27th September Lesson Plan, LV Mdliswa PDF

KEY CONCEPTS RELATED TO HEALTH & Presenter: L.V Mdliswa BASIC HEALTH ASSESSMENT LEARNING OBJECTIVES Understand and apply key concepts related to health and caring practices Context Vulnerable Co-morbidity Risk astuteness Infection prevention and control Und...

KEY CONCEPTS RELATED TO HEALTH & Presenter: L.V Mdliswa BASIC HEALTH ASSESSMENT LEARNING OBJECTIVES Understand and apply key concepts related to health and caring practices Context Vulnerable Co-morbidity Risk astuteness Infection prevention and control Understand the term basic health assessment Know what the components of a basic health assessment are KEY CONCEPTS Context Vulnerable Co-morbidity Risk astuteness Infection prevention and control CONTEXT Various factors and circumstances that influence how care is delivered and received i.e. patient’s background (personal history, cultural beliefs, socio-economic status and living conditions) Healthcare setting: environment where care is provided Current situation: immediate health issue or condition being addressed. VULNERABLE Individuals at a higher risk of adverse health outcomes due to various factors such as age, socio-economic status, disability or chronic illness. Require additional support and tailored care to address their specific needs and mitigate roles Vulnerability sometimes depends on the context i.e. HIV/Aids and Influenza For HIV/Aids vulnerable groups are men who have sex with men, sex workers For Influenza, vulnerable groups are CO-MORBIDITY Presence of one or more additional health conditions/diseases occurring alongside a primary condition/ the simultaneous presence of two or more diseases or medical conditions in a patient. i.e. a patient with Diabetes might also have Hypertension RISK ASTUTENESS o"Risk astuteness" refers to the ability to effectively identify, assess, and manage risks. It involves understanding potential threats and opportunities, making informed decisions, and mitigating potential negative impacts while capitalizing on positive possibilities. An example: a doctor considering whether to recommend a new treatment for high blood pressure. Risk astuteness would involve assessing the treatment’s effectiveness, potential side effects and the patient’s overall health. By weighing these factors, the doctor can provide the best advice, ensuring the patient understands both the benefits and risks before making a decision. INFECTION PREVENTION AND CONTROL(IPC) Policies and procedures implemented to prevent the spread of infection in healthcare settings. Minimizing transmission: reducing risk of infection transmission between patients, healthcare workers and the environment. Standard precautions: Applying basic hygiene practices such as hand hygiene, use of personal protective equipment and safe handling of instruments and waste (segregation) Surveillance: monitoring infection rates and identifying outbreaks to implement timely interventions IPC CONTINUED… Education and Training: providing ongoing education for healthcare staff o infection control practices and protocols. Environmental control: ensuring that healthcare environments are clean, well- maintained and designed to minimize infection risks. THE CHAIN OF INFECTION Infectious agent is the pathogen (germ) that causes diseases Reservoir includes places in the environment where the pathogen lives (this includes people, animals and insects, medical equipment, and soil and water) Portal of exit is the way the infectious agent leaves the reservoir (through open wounds, aerosols, and splatter of body fluids including coughing, sneezing, and saliva) Mode of transmission is the way the infectious agent can be passed on (through direct or indirect contact, ingestion, or inhalation) Portal of entry is the way the infectious agent can enter a new host (through broken skin, the respiratory tract, mucous membranes, and catheters and tubes) Susceptible host can be any person (the most vulnerable of whom are receiving healthcare, are immunocompromised, or have invasive medical devices including lines, devices, and airways) BASIC HEALTH ASSESSMENT A basic health assessment is the collection of information (history taking) from a patient from what they say and what you observe. It is made up of subjective data( what the patient tells you) and objective data (physical examination findings and vital signs) HEALTH HISTORY TAKING These are key questions asked from the patient ( chief complaint, medical history, family history) When taking history, it is important how you structure your questions and build rapport. PHYSICAL EXAMINATION TECHNIQUES (IPPA) Inspection Palpation Percussion Auscaltation This must be done systematically (head to toe) INSPECTION Visual examination of the body. It’s the first step in any physical assessment, where nurses observe the patient’s overall appearance, body language, and any visible signs of health or illness. When performing an inspection, ensuregood lighting. Compare both sides of the body for symmetry. Look for abnormal skin color, swelling, or lesions. Observe movement, posture, and non-verbal cues such as discomfort or pain. Common Areas: Skin, eyes, respiratory effort, and any visible signs of infection or injury. PALPATION Involves using your hands to feel the body for texture, size, tenderness, or lumps. To palpate you must use the pads of your fingers for sensitivity. Start with light palpation and gradually apply more pressure for deeper palpation. Assess temperature, moisture, and organ size. What to Feel For: Tenderness, masses, swelling, temperature differences, and pulse. PERCUSSION Tapping on the body surface to evaluate underlying structures based on the sound produced. How to Perform: Strike the middle finger of one hand placed on the patient with the fingertip of the other hand. Listen for the resulting sound, which varies depending on whether the underlying structure is solid (e.g., liver), air-filled (e.g., lungs), or fluid-filled. Sounds to Identify: Resonant: Normal lung tissue. Dull: Liver, fluid, or a mass. Hyper-resonant: Emphysema of the lungs. Tympanic: Air-filled stomach or intestines. ASSESSMENT VIDEO https://www.youtube.com/watch?v=sYHPO2n9lwY CASE SCENARIO You are a nursing team working in the outpatient clinic of a rural healthcare center. A 45-year-old male patient presents with the following complaints: Persistent cough lasting for 3 weeks, Shortness of breath, especially when lying down, Occasional chest discomfort, Mild fever and night sweats. History of smoking for 20 years. The patient denies any history of trauma but mentions that he recently recovered from a mild respiratory infection. His vital signs are: Temperature: 37.9°C Pulse: 100 bpm Respiratory rate: 22 breaths per minute Blood pressure: 135/85 mmHg Oxygen saturation: 94% GROUP WORK Divide into groups of four and identify what you would expect to find during: 1.Inspection: Look for visible abnormalities, skin changes, posture, or breathing patterns that may indicate respiratory distress or other issues. 2.Palpation: Explore areas of tenderness, masses, or abnormalities in the chest or other related areas. 3.Percussion: Assess the underlying structures of the chest by noting resonance or dullness, which could indicate air, fluid, or solid masses. 4.Auscultation: Listen for any abnormal lung sounds, such as crackles, wheezes, or diminished breath sounds. EXPECTED FINDINGS Inspection: Palpation: Respiratory effort: Patient may have  Chest expansion: Symmetrical chest expansion labored breathing or use of accessory might be reduced, especially in areas where the muscles due to shortness of breath. lungs are affected. Chest wall: No obvious deformities, but you  Tactile fremitus: Decreased tactile fremitus could may observe shallow or rapid breathing. indicate areas of pleural effusion or emphysema. Cough: The patient may be observed Increased tactile fremitus might suggest lung coughing during the examination. consolidation (e.g., pneumonia). Skin: Normal skin color or slightly pale. You  Tenderness: There might be tenderness over the might check for cyanosis (bluish color around chest wall, though it's usually absent unless there's lips or fingers), indicating poor oxygenation. an underlying chest wall problem. Posture: Patient may adopt a leaning-  Skin temperature: Mild warmth due to low-grade forward posture (tripod position) to aid fever. breathing. EXPECTED FINDINGS CONT… Percussion Auscultation Normal percussion note: Resonant sounds Normal breath sounds: Vesicular breath sounds over healthy lung tissue. are expected over most lung fields. Abnormal percussion note: Abnormal breath sounds: Crackles (rales): Fine or coarse crackles may be Dullness over areas of fluid accumulation heard, especially in lower lung fields, indicating (e.g., pleural effusion) fluid in the lungs (e.g., pneumonia or heart failure) Hyperresonance could indicate trapped air, Wheezing: Suggests airway obstruction or such as in emphysema or pneumothorax. narrowing, possibly due to smoking-related lung changes (e.g., chronic bronchitis). Symmetry: Percussion sounds should be compared on both sides of the chest to Decreased or absent breath sounds: May be identify any asymmetry. heard in areas of pleural effusion or pneumothorax. REFERENCES https://www.doforms.com/annual-physical-exam-checklist/ https://infectionpreventionandyou.org/protect-your-patients/break-the-chain-of- infection/ https://mypositiveparenting.org/wp-content/uploads/2015/04/influenza- vulnerable-groups1.jpg https://slideplayer.com/slide/13346389/ https://study.com/academy/lesson/what-is-comorbidity-definition-examples-in- psychology.html https://www.theglobalfund.org/en/key-populations/ https://www.youtube.com/watch?v=sYHPO2n9lwY