Fundamental of Nursing PDF 2023-2024, Beni Suef University
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Beni-Suef University
2024
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This document is a textbook titled "Fundamental of Nursing" for first-year nursing students at Beni Suef University. It covers topics on nursing care.
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Fundamental of Nursing Beni Suef University Faculty of Nursing Medical Surgical Nursing Department 1st Year Students 1st Term Part I 2023 – 2024 3rd Edition 1 Fundamenta...
Fundamental of Nursing Beni Suef University Faculty of Nursing Medical Surgical Nursing Department 1st Year Students 1st Term Part I 2023 – 2024 3rd Edition 1 Fundamental of Nursing Prepared by The Staff of Fundamental Nursing Department REVISED BY: Assist.Prof. Sheren ELsayed Shrief Assistant Professors Eslam Moktar Mona Mohamed Rasha Nabil Lecturers Eman Mawaad Asmaa Daif Alla Esraa Hamdy Hanem Saad Abeer Badawy Nora Mahfouz Kariman Mahmoud Fundamental of Nursing Faculty Vision and Mission Faculty Vision The faculty of nursing Beni-Suef University is looking for to achieve a leading position within the corresponding colleges locally and regionally in the development of the nursing profession. Faculty Mission The faculty of nursing Beni-Suef University is going to graduate qualified nursing and distinct scientifically and professionally and familiar with the latest scientific methods and modern techniques and are able to provide high quality nursing care in all health institutions, enabling them to compete in the local and regional labor market in accordance with the quality standards of university education as well as the preparation of scientific researchers contribute effectively in solving health problems of the community. Fundamental of Nursing Medical Surgical Nursing Department-1st Year Department Vision:- To be leading medical surgical nursing between faculties of nursing regionally and demonstrate excellence in nursing practice, education, administration and research. Department Mission:- We are committed to promote excellence in medical surgical nursing throughout prepare nursing students to be competent and professional nurses by utilizing high quality of education, research, evidence-based practice and clinical training. Department Objectives:- 1. Keep the latest development in the field of medical surgical nursing. 2. Promote advanced nursing procedures in medical surgical areas. 3. Updated the students and faculty of change in protocols and policies in medical surgical nursing field. 4. Facilitate research activities by the student and faculty members in the medical surgical nursing branches. 5. Develop guidelines for clinical conduct in the medical surgical nursing field. 6. Ensure critical evaluation of faculty and student activities in the field of medical surgical nursing. 7. Encourage collaboration activities with other departments in the nursing faculty and beni suef university. Fundamental of Nursing Content Topic Page No. Introduction of Nursing. 11 Health, Wellness & Disease. 17 Vital Signs. 18 Body Temperature. 20 Pulse. 29 Respiration. 35 Oxygen Saturation. 39 Blood Pressure. 41 Pain 48 Documentation. 54 Patient admission, transfer & discharge. 63 Hygienic Care. 80 Medical & Surgical Asepsis. 89 Wound healing process 100 Human Needs. 110 Nutritional Needs. 134 Safety Needs. 143 Comfort, Rest & Sleep. 150 Intestinal Elimination. 157 Urinary Elimination. 172 Medication Administration. 187 Fundamental of Nursing Introduction of Nursing General Objectives:- At the end of this lecture the student should be able to demonstrate basic knowledge related to Introduction of Nursing. Specific Objectives:- At the end of the lecture the student must be able to: Define of Nurse & Nursing Know role of Nursing. Clarify the Functions of the nurse Fundamental of Nursing Introduction to nursing Introduction Nursing is an applied health discipline dealing with the health conditions of the individual, family, and the community, which has succeeded in renewing and adapting itself to the daily social, cultural, and technological changes from the past to the present. The Nurses‘ Day began to be celebrated since May 12, 1954 in honor of Florence Nightingale‘s birthday. It has been defined by the International Nursing Council (ICN) as ―a profession that helps to protect and improve the health of the individual, the family, and the community, and provides support for the rehabilitation and recovery from the diseases‖. The key role of nursing in health services was highlighted in all International Health Promotion Conferences, especially in Alma-Ata, followed by those in Ottawa and Helsinki (2013) and also in the Commission Report of Social Determinants of World Health Organization. Nursing is one of the leading professions that has an indispensable role in the protection and improvement of human health. The significance of the profession arises from the fact that the nurses‘ work in a position where they help the most precious being in the world, i.e., individuals, in case of failure to meet basic needs themselves, protect and enable them to recover from illness, and so on. It is, therefore, imperative that nurses are trained thoroughly so that they are competent and capable enough to learn affective behaviors, cognitive, and technical skills in the provision of quality public nursing services. Today, nurses have been able to perform functions fulfilled by professionals such as doing research, theory development, being member of professional organizations, and taking part in political activities, as well as providing health care. Thus, the concepts of professionalism. Definition of nursing According to the American Nurses Association (2004), nursing is defined as ‗‗The Protection, Promotion, and Optimization of health and abilities, Prevention of illness and injury‖. Aims & Purposes of nursing Fundamental of Nursing 1. Achieve therapeutic relationship. 2. Caring and Curing rids the client of the disease or disability; caring nurtures the person even if the disorder is incurable. 3. Facilitating comfort by alleviating pain and promoting as much client autonomy as possible. 4. Promoting healthy lifestyle behaviors. 5. Preventing the development of illness and injury. 6. Restoring individuals to their optimal level of functioning. 7. Improving client satisfaction with the delivery of health care services. Roles of the Nurse - Care giver. - Communicator. - Teacher. - Client Advocate. - Counselor. - Change Agent. - Leader. - Manager. - Case Manager. - Researcher. - Researcher Consumer. Functions of the nurse Include the following; 1. Providing direct care to the ill person, such as administering medications, baths, and specific procedures and treatments. 2. Performing diagnostic and assessment procedures, such as measuring blood pressure and examining feces for occult blood. 3. Consulting with other health care professionals about client problems. Fundamental of Nursing 4. Teaching clients about recovery activities, such as exercises that will accelerate recovery after a stroke. 5. Rehabilitating clients to their optimal functional level following physical or mental illness, injury, or chemical addiction. Fundamental of Nursing Health, Wellness &Disease General Objectives:- At the end of this lecture the student should be able to demonstrate basic knowledge related to Health, Wellness & Disease. Specific Objectives:- At the end of the lecture the students must be able to: Define the Health, Wellness &Illness. Clarify the Dimensions of Wellness. Alit Models of Health and Illness. List Risk Factor of the Disease. Know the Illness Behavior Identify the Impact of the Disease. Understand of the Approaches to Health Maintenance. Outlines:- Definition of the Health, Wellness &Illness. Dimensions of Wellness. Models of Health and Illness. Risk Factor of the Disease. Illness Behavior. Impact of the Disease. Approaches to Health Maintenance. Fundamental of Nursing Health, Wellness &Disease Health Defining health is difficult. The World Health Organization (WHO) defines health as a “state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity”. ―All people free of disease are not equally healthy.‖ Views of health have broadened to include not only physical well-being, but also mental, social, and spiritual well-being and a focus on health at the family and community levels. Factors Influencing Health and Health Beliefs and Practices: Many factors influence a person's health beliefs and practices. Internal and external variables influence how a person thinks and acts. A. Internal factors 1. Developmental Stage (a child, adolescent, or adult). 2. Intellectual Background (shaped in part by the person's knowledge, lack of knowledge, or incorrect information about body functions and illnesses, educational background, traditions, and past experiences. These variables influence how a patient thinks about health). 3. Perception of Functioning: The way people perceive their physical functioning affects health beliefs and practices. When you assess a patient's level of health, gather subjective data about the way the patient perceives physical functioning such as level of fatigue, shortness of breath, or pain. Then obtain objective data about actual functioning such as blood pressure, height measurements, and lung sound assessment. This information allows you to more successfully plan and implement individualized approaches, such as self-care and mobility. 4. Emotional Factors: The patient's degree of stress, depression, or fear can influence health beliefs and practices. The manner in which a person handles stress throughout each phase of life influences the way he or she reacts to illness. Fundamental of Nursing 5. Spiritual Factors. B. External factors 1. Family Practices: The way that patients' families use health care services generally affects their health practices. Their perceptions of the seriousness of diseases and their history of preventive care behaviors (or lack of them) influence how patients think about health. 2. Psychosocial and Socioeconomic Factors. 3. Cultural Background: Cultural background influences beliefs, values, and customs. It influences the approach to the health care systems, personal health practices, and the nurse-patient relationship. Wellness - Wellness can be defined as ―the act of practicing healthy habits on a daily basis to attain better physical and mental health outcomes”. - WHO defines wellness as “the optimal state of health of individuals and groups,” and wellness is expressed as ―a positive approach to living.‖ - The primary difference between health and wellness is that health is the goal and wellness is the active process of achieving it. Dimensions of Wellness:- 1. Physical:- The ability to carry out daily tasks, achieve fitness (e.g. pulmonary, cardiovascular, gastrointestinal), maintain adequate nutrition and proper body fat, avoid abusing drugs and alcohol or using tobacco products, and generally to practice positive lifestyle habits. 2. Social:- The ability to interact successfully with people and within the environment. 3. Emotional:- The ability to manage stress and to express emotions appropriately, Emotional wellness involves the ability to recognize, accept, and express feelings. 4. Intellectual:- The ability to learn and use information effectively for personal, family, and career development 5. Spiritual:- The belief in some force (nature, science, religion, or a higher power) that serves to unite human beings and provide meaning and purpose of life. Fundamental of Nursing 6. Occupational:- The ability to achieve a balance between work and leisure time, A person's beliefs about education, employment, and home influence personal satisfaction and relationships with others. 7. Environmental:- The ability to promote health measures that improve the standard of living and quality of life in the community. Illness and Disease Illness defined as “a state in which a person's physical, emotional, intellectual, social, developmental, or spiritual functioning is diminished or impaired”. Or “an unhealthy condition of body or mind‖. Illness is not synonymous with disease. Although nurses need to be familiar with different types of diseases and their treatments, they often are concerned more with illness, which may include disease but also includes the effects on functioning and well-being in all dimensions. Disease: defined as ―A particular distinctive process in the body with a specific cause and characteristic symptoms‖. Risk factors of Disease & Illness: 1. Genetic and physiological factors 2. Age 3. Environment 4. Lifestyle Types of illness Items Acute illness Chronic illness Onset Sudden, rapid onset Gradual , up and down onset Cause Usually one Many Duration Short duration < 4 weeks Long duration > 6 months Changes Reversible Irreversible Intensity Severe Fluctuated from mild to severe effect Effect Potentially life-threatening. Fluctuate between maximal functioning and serious health relapses that may be life threatening. May cause disability. Treatment Cure is common Cure is rare Fundamental of Nursing Role of professional Select and conduct therapy Teacher and partner Role of patient Follow orders Partner of health professionals, reasonable of daily management. Types of diseases: Impact of Illness on the Patient and Family:- On the patient - Behavioral and emotional changes. - Loss of autonomy. - Self-concept and body image changes. - Lifestyle changes. On the Family Depends on - Member of the family who is ill. - Seriousness and length of the illness. - Cultural and social customs the family follows. Family Changes Role changes. - Task reassignments. - Increased demands on time. Fundamental of Nursing - Anxiety about outcomes. - Conflict about unaccustomed responsibilities. - Financial problems. - Loneliness as a result of separation and pending loss. - Change in social customs. Approaches to health maintenance Health maintenance is a guiding principle in health care that emphasizes health promotion and disease prevention rather than the management of symptoms and illness. Through … - Health promotion. - Health protection. - Disease prevention. 1. Health promotion: The science and art of helping people change their lifestyle to move toward a state of optimal health. 2. Health Protection Activities: - Prevent accidents. - Occupational safety & health. - Ensuring the safety of food & drugs. - Environmental strategies. 3. Disease Prevention Activities: - Immunization program protect patients from actual or potential threats to health. - Avoid tobacco and substance abuse. - Measures used to prevent sexual and blood, feco-oral route transmission diseases. Three Level of Prevention Primary prevention Secondary prevention Tertiary prevention Early diagnosis Specific Disability Restoration and Health promotion and prompt protection limitations rehabilitation treatment -Health education. -Use of specific Case finding -Adequate -Provision of hospital Fundamental of Nursing -Good standard of examination. measures: treatment to and community nutrition adjusted -Attention to -Individual and arrest disease facilities for retraining to developmental personal hygiene. mass process and and education to phases of life. -Use of environ -Screening prevent maximize use of -Attention to mental sanitation. activities. further. remaining capacities. personality -Protection Selective complications -Education of public and development. against examination. and sequelae. industry to use -Provision of occupational To cure and -Provision of rehabilitated persons to adequate housing hazards. prevent diseases facilities to fullest possible extent. and recreation and -Protection from process, prevent limit - Selective placement agreeable working accidents. spread of disability and work therapy in condition. -Protection from communicable prevent hospitals use of -Marriage carcinogens. disease, prevent death. sheltered colony. counseling and -Avoidance of complications sex education. allergens. and sequelae, and -Genetic shorten period of screening. disability. -Periodic selective examination. Fundamental of Nursing Vital Signs General Objectives:- At the end of this lecture the student should be able to demonstrate basic knowledge related to Vital Signs. Specific Objectives:- At the end of this lecture the student should be able to:- Define Vital Signs. Enumerate Normal Range of Vital Signs. Mention Purpose of Measuring Vital Signs. Discuss Times for Assessing Vital Signs. List Nurse Role. Outlines:- Definition of Vital Signs. Normal Range of Vital Signs. Purpose of Measuring Vital Signs. Times for Assessing Vital Signs. Nurse Role. Fundamental of Nursing Vital signs Body Temperature General Objectives:- At the end of this lecture the student should be able to demonstrate basicknowledge related to Body Temperature. Specific Objectives:- At the end of this lecture the student should be able to:- Define Body Temperature. Classify Body Temperature. Mention Purpose of Measuring Body Temperature. Discuss Factors affecting Body Temperature. Enumerate Types of thermometer. Alit Sites for Measuring Body Temperature. List Alternations in Body Temperature. Fundamental of Nursing Body Temperature Introduction Vital signs are measures of various physiological status, in order to assess the most basic body functions. When these values are not zero, they indicate that a person is alive. All of these vital signs can be observed, measured, and monitored. This will enable the assessment of the level at which an individual functioning. Normal ranges of measurements of vital signs change with age and medical condition. Vital signs are useful in detecting or monitoring medical problems. Vital signs can be measured in a medical setting, at home, at the site of a medical emergency, or elsewhere. Vital Signs Are measurements of the body's most basic functions: 1. Body temperature (Temp). 2. Pulse / heart rate (HR). 3. Respiration/ respiratory rate (RR). 4. Blood pressure (BP). Purpose:- To obtain base line data about the patient condition. For diagnostic purpose. For therapeutic purpose. To evaluate patient condition. When to Assess Vital Signs 1. Upon admission to any healthcare agency. 2. Based on agency institutional policy and procedures (for example in agency vital signs routinely measured in ICU hourly and in ward measured every 6 hour may be more or less according patient condition). 3. Any time there is a change in the patient‘s condition. Fundamental of Nursing 4. Before and after surgical or invasive diagnostic procedures. 5. Before and after activity that may increase risk. 6. Before and after administering medications that affect cardiovascular or respiratory functioning. Body Temperature Definition of Body Temperature Body temperature is the balance between the heat production due to chemical activities by the body and heat lost from the body through radiation, conduction, convection, and vaporization (evaporation) to environment. Types of body temperature: 1. Core temperature: Is the temperature of deep tissues of the body, e.g., cranium, thorax and abdominal cavity. It remains relatively constant (37Cº or 98.6 Fº). True core temperature readings can only be measured by invasive means, such as placing a temperature probe into the esophagus, pulmonary artery or urinary bladder. Non-invasive sites such as the rectum, oral cavity, axilla, temporal artery (forehead) and external auditory canal are accessible and are believed to provide the best estimation of the core temperature. 2. Surface temperature: Is the temperature of the skin, the subcutaneous tissue and fat. It, by contrast rises and falls in response to the environmental changes. Fundamental of Nursing Body temperature reading Body temperature Reading Afebrile / normo-thermic 36.5-37.5 Cº Febrile (pyrexia) >37.5 Cº Severe hyper-thermia (hyperpyrexia) >40 Cº Subnormal 28-32 Cº Severe hypothermia