Body Systems Review PDF

Objectives (1) Identify the structure and function of the cell and the integumentary, musculoskeletal, nervous, cardiovascular, respiratory, digestive, urinary, reproductive, endocrine, and immune systems Describe the nurse aide’s role in the provision of care for a resident w...

Objectives (1) Identify the structure and function of the cell and the integumentary, musculoskeletal, nervous, cardiovascular, respiratory, digestive, urinary, reproductive, endocrine, and immune systems Describe the nurse aide’s role in the provision of care for a resident with cancer Lalaine B. Ganas, RN 1 Objectives (2) Discuss changes in the integumentary, musculoskeletal, nervous, cardiovascular, respiratory, digestive, urinary, reproductive, endocrine, and immune systems due to aging Compare and contrast normal findings and variation of normal findings of the integumentary, musculoskeletal, nervous, cardiovascular, respiratory, digestive, urinary, reproductive, endocrine, and immune systems 2 Objectives (3) Describe common disorders of the integumentary, musculoskeletal, nervous, cardiovascular, respiratory, digestive, urinary, reproductive, endocrine, and immune systems Describe the nurse aide’s role related to a resident’s integumentary, musculoskeletal, nervous, cardiovascular, respiratory, digestive, urinary, reproductive, endocrine, and immune systems 3 Body Systems Cell Theory 4 Cell Theory – Overview Basic unit of all living tissues or organisms All living organisms made of cells Cellular function is essential process of living things Cells have several functioning structures called organelles, that carry on work of cell 5 Cells – Structure and Function Building blocks of the human body Have same basic structure; function, size, and shape may differ Need food, water, and oxygen to live and function Microscopic in size Divide, grow, and die Combine to form tissue 6 Tissue – Structure and Function Carry out a particular activity or function Types – epithelial, connective, muscle, nerve Grouped together to form organs 7 Organ – Structure and Function Made of tissue, may be several types of tissues Carries on a special function; examples are heart, stomach, bladder Some are paired; examples are kidneys, lungs Combine to form a system 8 System – Structure and Function Made of groups of several organs functioning together for a specific purpose or purposes Combine to form an organism Examples of systems? 9 In Summary, Organization of the Body 10  Organism – Structure and Function 11 Cells – Normal Findings Reproduce for tissue growth and repair in a controlled and orderly manner 12 Cells – Variation of Normal Tumor – group of abnormally growing cells; may be benign or malignant Cancer (CA) Abnormal cells grow in uncontrolled manner, invade surrounding tissue; may spread to other areas Can occur almost anywhere in or on body; commonly occurs on skin, in lung, colon, breast, prostate, uterus, ovary, bladder, and kidney 13  Cancer – Risk Factors ( 14) largest cause of death Second Age – getting older most important risk factor Tobacco – actual use and second-hand Radiation – sunlight, Infections – certain viruses and bacteria NCDHHS/DHSR/HCPEC | Module H Body Systems | July 2019 14  Cancer – Risk Factors ( 15) Immuno-suppressive drugs Alcohol Diet – high in fat, protein, calories, and red meat NCDHHS/DHSR/HCPEC | Module H Body Systems | July 2019 15  Cancer – Risk factors (3) Hormones – female hormones Obesity Environment – air pollution, second- hand smoke, and asbestos 16 Cancer – Warning Signs (CAUTION) Change in bowel or bladder habits A sore that does not heal Unusual bleeding or discharge from any body opening Thickening or lump in breast or elsewhere Indigestion or difficulty swallowing Obvious change in a wart or mole Nagging cough or hoarseness 17 Cancer Treatment Goals – cure, control, reduce signs and symptoms from disease and treatment Key is to find cancer early Dependent on type, site, size, and if it has spread Includes – surgery, radiation, chemotherapy, others (hormone, stem cell transplants, alternative) 18  Cancer – Radiation Therapy (1) Kills cancer cells using X-ray beams aimed at tumor or radioactive material implanted at or near tumor 19  Cancer – Radiation Therapy (2) Side Effects At site – sore, irritated, redness, blistering Head and neck – dry mouth, sore throat Tiredness Discomfort, nausea, Nurse aide care directed vomiting, diarrhea, at minimizing side loss of appetite effects and providing emotional support 20  Cancer – Chemotherapy (1) Affects whole body; both cancer cells and normal cells Targeted therapy can tell the difference May be given orally or intravenously, Be aware of safety needs handling body fluids 21  Cancer – Chemotherapy Side Effects (depend on drug(s) used) Hair loss Digestive disturbances Stomatitis Decreased blood cell production Changes in thinking and Nurse aide care directed memory at minimizing side effects and providing Emotional changes emotional support 22 Cancer – Nurse Aide’s Role Resident’s needs include: Pain relief or control Balance of rest and exercise Fluids and nutrition Prevention of skin breakdown Prevention of bowel problems Dealing with side effects of treatment Psychologic and social needs Spiritual needs 23 Cancer – Nurse Aide’s Role ( 24) Understand that each resident is different Social interaction Proper nutrition Pain control Assist with comfort and circulation Skin care Mouth care 24 Cancer – Nurse Aide’s Role ( 25) Observe for and report to the nurse the following: Increased weakness, fatigue, fainting Nausea, vomiting, diarrhea Change in appetite weight loss Depression, confusion, change in mental state Blood in mouth, urine, or bowel movement Changes in skin, new lumps, sores, rash Increase in pain or pain that is not relieved by medication 25  Cancer – Nurse Aide’s Role ( 26) Self-image – may be an issue; hair loss common side effect NCDHHS/DHSR/HCPEC | Module H Body Systems | July 2019 26 Nurse Aide’s Role Visitors and family – if visit is positive one, do not intrude; watch for and report negative interactions to the nurse during visits 27 Body Systems Integumentary 28 Integumentary – Overview The skin Largest organ and system in the body Has accessory structures – hair and nails Responsible for providing a natural protective covering of the body 29 Integumentary – Structure Epidermis o Outer layer o Living and dead cells o No blood vessels, only few nerve cells Dermis o Inner layer o Made up of connective tissue o Has blood vessels, nerves, sweat glands, oil glands, and hair roots Subcutaneous (fatty) tissue – thick layer of fat and connective tissue 30 Integumentary – Function Protects body from injury and pathogens Regulates body temperature Eliminates waste Contains nerve endings for cold, heat, pain, pressure and pleasure Stores fat and vitamins 31 Integumentary – Normal Findings Warm, dry Absence of breaks, rash, discoloration, swelling 32 Integumentary – Changes Due to Aging Skin is thinner, drier, more fragile Loses elasticity Fatty layer decreases; person feels colder Hair thins and may gray 33 Integumentary – Changes Due to Aging (1) Folds, lines, wrinkles and brown spots may appear Nails harden and become more brittle Reduced circulation to skin, leading to dryness and itching Development of skin tags, warts and moles 34 Integumentary – Variation of Normal Breaks in skin Pale, white or reddened areas Black and blue areas Changes in scalp or hair 35 Integumentary – Variation of Normal ( 36) Rash, itching or skin discoloration Abnormal temperature Swelling 36 Integumentary – Variation of Normal ( 37) Ulcers, sores, or lesions Swelling Dry or flaking skin Fluid or bloody drainage 37 Shingles (Herpes Zoster) Caused by virus Rash or blisters on one side of body, burning pain, numbness, and itching; lasts about 3 to 5 weeks Infectious until lesions are crusty 38 Stasis Dermatitis Skin condition affecting lower legs and ankles; occurs from buildup of fluid under skin; problems with circulation resulting in fragile skin; can lead to open ulcers and wounds 39 The Pressure Injury Any lesion caused by unrelieved pressure that results in damage to underlying tissues; friction and shear are factors Many pressure injuries occur within first 4 weeks of admission to the facility 40 Bony Prominences 41 Pressure Injury – Terms Shear – when layers of skin rub up against each other; or it could be when skin remains in place, but tissues underneath move and stretch Friction – rubbing of one surface against another Unavoidable pressure injury – a pressure injury occurs despite efforts to prevent one Avoidable pressure injury – one that develops from improper use of the nursing process 42 Pressure Injury – At Risk Risk factors – immobility, breaks in skin, poor circulation to area, moisture, dry skin, and urine and feces irritation Older residents and disabled residents are at risk due to skin changes 43 Pressure Injuries – Residents at Risk 44 Pressure Injury – Stages 45  Pressure Injury – Pressure Points Occur over bony areas; include back of head, ears, shoulder blades, hips, spine, sacrum, knees, ankles, and heels 46  Objects can Pressure Injury contribute to – Sites pressure injury – eye glasses, oxygen tubing, tubes, casts, braces Obese people can have pressure areas occur where skin is in contact with skin 47 Pressure Injury – Prevention is the Key Identify residents at risk Measures directed at 1) handling, moving, and positioning of the resident and 2) providing skin care 48 Handling, Moving, and Positioning Follow repositioning schedule Use assistive devices (pillows, foam wedges); support feet properly Do not position on red area, pressure injury, on tubes or other medical devices Prevent bed friction Prevent shearing Keep feet and heels off bed 49 The 30o Lateral Position Bed is not raised more than 30o Pillows are placed under head, shoulder, and leg Position lifts up the hip to avoid pressure on the hip at about a 30o angle Person does not lie on hip as with the side-lying position 50 Providing Skin Care Inspect skin Do not use hot water; use cleansing agent Prevent incontinence Check for drainage Apply moisturizer Give a back rub when repositioning Keep linen clean, dry, and free of wrinkles Avoid scrubbing vigorously No heat directly on pressure injury 51 Body Systems Musculoskeletal 52 Musculoskeletal – Overview Provides structure and movement for the body Protects and gives the body shape 53 Muscles – Structure Over 600 muscles Involuntary – cannot made up of elastic be controlled tissue Cardiac – in the heart; Some connected to striated bones by tendons Smooth – control action of organs; smooth Voluntary can be controlled Skeletal – attached to the bones; arms and legs; striated 54 Muscles – Function Power movement of skeleton Give body form (or posture) Produce most of body heat, through contraction 55 Skeleton and Bones – Structure Bones Outside is hard and rigid Covered with periosteum, Bone marrow, located inside; soft and spongy The Skeleton Connected to other Has 206 bones bones by ligaments Framework of Connected to muscles the body by tendons 56 Skeleton and Bones – Function The skeleton Provides framework for body Bones Protects organs Allow body to move Store calcium Make and store blood cells (in bone marrow) 57 Joints – Structure Point where bones meet; made up of cartilage Synovial membrane lines joints May be movable, slightly movable, or immovable Ligaments hold bones together Types – ball-and-socket, hinge, and pivot 58 Types of Joints 59 Musculoskeletal – Normal Findings ( 60) Ability to perform routine movements and activities of daily living Ability to perform full range of motion exercises bilaterally, without pain 60 Musculoskeletal – Normal Findings ( 61) Abduction of the arms bilaterally without pain 61 Musculoskeletal – Normal Findings ( 62) Adduction of the arms bilaterally without pain 62 Musculoskeletal – Normal Findings ( 63) Extension of arm bilaterally without pain 63 Musculoskeletal – Normal Findings ( 64) Flexion of arm bilaterally without pain 64 Musculoskeletal – Normal Findings ( 65) Extension of leg bilaterally without pain 65 Musculoskeletal – Normal Findings ( 66) Flexion of leg bilaterally without pain 66 Musculoskeletal – Normal Findings ( 67) Pronation bilaterally without pain 67 Musculoskeletal – Normal Findings ( 68) Supination bilaterally without pain 68 Musculoskeletal – Normal Findings (69) Dorsiflexion bilaterally without pain 69 Musculoskeletal – Normal Findings (70) Plantar flexion bilaterally without pain 70 Musculoskeletal – Normal Findings (71) Opposition bilaterally without pain 71 Musculoskeletal – Changes Due to Aging (1) Muscles weaken and lose tone Bones lose density and become brittle Slower muscle and nerve interaction Joints stiffen; become less flexible and become painful 72 Musculoskeletal – Changes Due to Aging (2) Height decreases from 1 to 2 inches Slowed recovery from position changes and sudden movement Pain when moving Reaction time, movement speed, agility, and endurance decrease Poorer response to stimuli 73  Musculoskeletal – Variation of Normal (74 ) History of falls Difficulty with holding or lifting objects Loss of muscle strength and tone Generalized weakness and tiredness Bruising Slow and unsteady body movement 74 Musculoskeletal – Variation of Normal (75 ) 75 Arthritis Inflammation or swelling of the joints; causes stiffness, pain, and decreased mobility; two common types Osteoarthritis – elderly; may occur with aging or joint injury; usually weight-bearing hips and knees involved Rheumatoid arthritis – any age; starting with smaller joints then progressing to larger ones 76 Arthritis – Nurse Aide’s Role 77 Osteoporosis Bones lose density causing them to become porous and brittle; bones break easily; has low back pain, stooped posture, becoming shorter, and broken bones 78 Fracture Broken bone caused by an accident or osteoporosis; closed or open break; most common – fractures of arms, wrists, elbows, legs and hips Goal: to put bone back in alignment so it can heal; bone tissue grows and fuses area together, but must be allowed to do so by not moving area 79 Hip Fracture 80 Total Knee Replacement (TKR) Replacement of knee with a prosthesis; performed to relieve pain and restore mobility damaged by arthritis or injury Goals – prevent blood clots, special stockings and machines used; speed up recovery, decrease stiffness, increase range of motion 81 Amputation Surgical removal of some or all of a body part; occurs – arm, hand, leg, foot; causes: disease or accident Assist with activities of daily living Provide support if phantom statements made; do not argue Assist with position changes and range of motion exercises Follow care plan in regards to prosthetic care 82 Contracture and Muscle Atrophy Contracture – muscle or tendon shortens, freezes, becomes inflexible; permanent disability Muscle atrophy – muscle wastes away, decreases in size; becomes weak, from disuse Prevention of these two conditions critical 83 Musculoskeletal System Nurse Aide’s Role Prevention, Prevention, Prevention! 84 Body Systems Nervous System 85  Nervous – Overview Controls and coordinates all body functions Reflex centers for heartbeat and breathing Senses and interprets information and responds to changes 86 Nervous – Overview (1) Consists of two main divisions 1. Central nervous system (CNS) – brain and spinal cord 2. Peripheral nervous system – includes nerves that travel throughout the body 87  The Neuron (Nerve Cell) Basic unit of nerves and the nervous system Carries messages or impulses through spinal cord to and from the brain 88 The Brain – Structure and Function 89  Brain – The Cerebrum Divided into right and left hemispheres Right hemisphere controls movement and function of left side Left hemisphere controls movement and function of right side Any illness or injury to right hemisphere affects function of left side; any illness or injury to left hemisphere affects function of right side Cerebral cortex – outer layer; ideas, thinking, analysis, judgment, emotions, memory occurs, guides speech, interprets messages from senses, controls voluntary muscle movement 90  Brain – The Cerebrum Each side of your brain contains four lobes Frontal Temporal Parietal Occipital 91  The Brain Cerebellum Controls balance and regulates voluntary muscles Produces and coordinates smooth movements Brain Stem Regulatory center Controls heart rate, breathing, swallowing, opening/closing blood vessels 92 Spinal Cord and Sensory Organs Spinal Cord Located within the spine Connected to the brain Conducts messages between the brain and the body by pathways Sensory Organs Include skin, tongue, nose, eyes, and ears Receive impulses from environment and relay impulses to brain 93 Nervous – Normal Findings Alert and oriented, with clear short-term/ long-term memory Sensory function intact Ability to sense heat, cold, pain Straight gait; coordination of limbs Reflexes present 94 Nervous – Changes in Aging Some hearing loss Appetite decreases Less tear production Vision decreases Problems seeing blue and green Pupils less responsive to light Changes in memory; most likely with short- term memory 95 Nervous – Changes in Aging Loss of nerve/brain cells Decreased sensitivity to heat and cold Slowed response and reflex time Reduced sense of touch Reduced sensitivity to pain Reduced blood flow to brain Forgetfulness Decreased function in senses 96 Nervous – Variation in Normal Changes in speech, vision, or hearing Loss of feeling or inability to move one side of body Numbness, dizziness, nausea Jerking motions or tremors Changes in gait or movement Paralysis Seizures Confusion 97 Stroke (CVA, Cerebrovascular Accident) Caused when (1) a blood vessel leaks or breaks in the brain; or (2) when oxygen to an area is disrupted the blood supply to part of the brain is blocked 98  Stroke Cerebrum is divided into right and left sides: right controls left; left controls right Each side contains four lobes Area of brain and size of the area affected by injury will impact severity, signs and symptoms, extent of disability, and prognosis 99  After the Stroke, Resident May Experience Hemiplegia Loss of bowel and Hemiparesis bladder control Expressive aphasia Cognitive Receptive aphasia impairment Emotional lability Dysphagia Loss of sensations 100 Stroke – Nurse Aide’s Role 101 Parkinson’s Disease Progressive, incurable disease causes a part of the brain to degenerate Nurse aide’s role – protect resident, assist with ambulation assist with activities of daily living and assist resident with self-care 102 Head and Spinal Cord Injuries Diving accidents, sports injuries, motor vehicle accidents, and war injuries; injuries range from mild concussion to coma, paralysis, and death 103  Head and Spinal Cord Injuries ( 104) Head injuries may cause permanent brain damage; disabilities related to part of brain injured Severity of spinal cord injuries depend on level and force of injury in regards to spinal cord; higher the injury, greater the loss of function 104 Head and Spinal Cord Injuries ( 105) Nurse aide’s role: provide emotional support and realize that the resident may exhibit feelings of anger and frustration 105 Body Systems Cardiovascular 106  Cardiovascular System Also called the circulatory system The continuous movement of blood through the body 107 Cardiovascular – Changes Due to Aging Heart muscle less efficient Blood pumps with less force Arteries lose elasticity and become narrow Blood pressure increases 108 Cardiovascular – Variation of Normal (1) 109 Cardiovascular – Variation of Normal (2) Swelling of hands and feet Pale or bluish lips, hands, or feet Weakness and tiredness Weight gain 110 Hypertension (High Blood Pressure) Major cause is atherosclerosis or “hardening of the arteries” Arteries harden due to plaque build-up from fatty deposits May complain of headache, blurred vision, and dizziness 111 Coronary Artery Disease (CAD) 112 Angina Pectoris (Angina) Occurs when heart muscle is not getting enough oxygen Chest pain, tightness of chest, pain radiating up the jaw, down the left arm, may sweat and get short of breath Exercise, stress, excitement, digesting a big meal require additional oxygen; with CAD, the narrowed blood vessels keep heart muscle from getting enough oxygen 113 Myocardial Infarction (MI, Heart Attack) An emergency when all or part of the blood flow to the heart muscle is blocked and oxygen and nutrients cannot reach cells in the area Waste products are not removed; muscle cells in the area die Area may be small or large If resident survives, cardiac rehabilitation is ordered 114 Peripheral Vascular Disease (PVD) Poor circulation of legs, feet, arms, hands due to fatty deposits that harden in blood vessels Signs – nail beds and feet pale or blue, swelling in hands and feet, ulcers of legs and feet, pain while walking Follow care plan directive regarding elastic stockings 115  Congestive Heart Failure (CHF) When one or both sides of heart stop pumping blood effectively; all the conditions can cause severe damage to the heart muscle, resulting in heart not being able to pump effectively 116 Cardiovascular System – Nurse Aide’s Role Monitor vital signs, report abnormal values Assist with special diet needs; measure I&O Provide rest periods Report complaints of chest pain immediately Reduce stressful situations 117 Body Systems Respiratory 118 Respiratory – Structure and Function 3 Regions Thorax Upper Respiratory Tract Lower Respiratory Tract Function Involves the breathing in of oxygen (inspiration) and the breathing out of carbon dioxide (expiration) 119 Respiratory – Changes Due to Aging Respiratory muscles weaken Lung tissue becomes less elastic Shortness of breath with exertion Lung capacity decreases Oxygen in blood decreases Muscles of diaphragm become weaker Limited expansion of chest 120 Respiratory – Variation of Normal ( 121) Shallow breathing or breathing through pursed lips Coughing or wheezing Nasal congestion or discharge Productive cough Noisy respirations; gasping for breaths 121 Respiratory – Variation of Normal ( 122) Cyanosis – changes in skin color, pale or bluish color of lips and extremities Dyspnea – difficulty breathing Changes in rate and rhythm of breathing Need to sit after mild exertion Pain in chest 122 Chronic Obstructive Pulmonary Disease COPD; chronic, progressive disease causing trouble breathing, particularly getting air out of lungs 123  COPD Residents with chronic lung disease may live in constant fear of not being able to breathe causing them to sit upright in attempt to improve lung expansion Residents feel out of control; fear suffocation 124  Lung of Smoker With COPD COPD Signs Chronic cough or wheeze Difficulty breathing Shortness of breath with exertion Pale cyanotic reddish-purple skin Confusion Weakness Difficulty in finishing meal Fear and anxiety 125 COPD – Nurse Aide’s Role Help sit up or lean forward supported with pillows Offer fluids and small, frequent meals Support pursed-lip breathing Observe oxygen in use (NEVER adjust) Be supportive of fears Follow infection prevention principles Encourage rest periods 126 COPD Resident Report to Nurse Signs/symptoms of colds or illness Changes in breathing, lung secretions Changes in mental state Excessive weight gain Increasing dependency on staff and family 127 Pneumonia Acute infection of lung or lungs caused by bacteria, virus, or fungus Resident with COPD at great risk for developing pneumonia, especially if weakened 128 A Person With Asthma Healthy (the blue one) and unhealthy (the red one) bronchial tubes; unhealthy one results in a constricted breathing problem 129 Asthma Chronic inflammatory disease, occurs when respiratory system is hyperreactive to irritants When bronchi become irritated, they constrict, making it difficult to breathe Responding to irritation and inflammation, mucus membranes produce thick mucus further inhibiting breathing Air is trapped in lungs causing coughing and wheezing 130 Upper Respiratory Infection (Cold) Viral or bacterial infection of nose, sinuses, and throat Signs – nasal drainage, sneezing, sore throat, fever, and tiredness Remedy – body’s immune system, fluids, and rest 131 Respiratory System – Nurse Aide’s Role Provide rest periods at intervals Encourage exercise and regular movement Encourage and assist with deep breathing exercises Limit exposure to smoke, polluted air, or noxious odors by residents with respiratory conditions Position residents in a manner to maximize lung expansion 132 Body Systems Digestive 133 Digestive System – Overview Also known as the gastrointestinal system and abbreviated as GI system 134 Digestive – Structure and Function Upper GI structures – mouth, pharynx, esophagus and stomach Lower GI structures – small intestines and large intestines Accessory structures include teeth, tongue, salivary glands, liver, gall bladder, and pancreas GI System digests food, absorbs nutrients, and eliminates waste 135 Peristalsis Involuntary contractions that move food through digestive system 136  Bowel Movement (BM) Feces or stool Involves the movement of feces from the large intestines out of the body through the anus Semi-solid material made of water, solid waste, bacteria, and mucus 137 Digestive – Normal Findings Adequate intake of a well-balanced diet, with fluids Passage of a brown, soft, formed, tubular shaped stool (feces), without pain Flat abdomen with active bowel sounds 138  Digestive – Changes Due to Aging ( 139) Decreased taste buds Slowing of peristalsis Slower absorption of nutrients Loss of bowel muscle tone Loss of sphincter muscle tone Digestion takes longer and less efficient Thinning of stomach lining 139 Digestive – Changes Due to Aging ( 140) Decrease in saliva Decrease in amount of digestive enzymes Decrease in appetite Loss of teeth Altered taste and smell Proteins, vitamins, and minerals not absorbed as well 140 Digestive – Variation of Normal ( 141) Difficulty swallowing or chewing Poor intake of diet and fluids Weight gain or loss Loss of appetite Abdominal pain and cramping Blood, pus, mucus, or other discharge in stool 141 Digestive – Variation of Normal ( 142) Nausea and vomiting Heartburn Diarrhea or constipation Pain when having a bowel movement Whitish, black, or red colored stool Incontinence 142 Gastric Ulcer and Gastritis Gastric (peptic) ulcers – raw sores in stomach caused by excessive acid secretion; can cause bleeding Gastritis – inflammation of the lining of the stomach 143 Ulcerative Colitis Chronic inflammatory disease of large intestine Serious condition that can result in a colostomy 144 Gastroesophageal Reflux Disease GERD; contents of stomach back up into esophagus; can damage lining of esophagus Heartburn most common symptom Nurse aide’s role – evening meal eaten 3 to 4 hours before bedtime; remain upright 2 to 3 hours after eating; provide extra pillows 145 Constipation Occurs when stool moves too slowly through the intestine; Signs – abdominal swelling, gas, irritability, and verbalizing of resident that no recent bowel movement; Cause – can result from decreased fluid intake, poor diet, inactivity, medications, aging, certain diseases, or not taking the time to have a bowel movement 146 Fecal Impaction Hard stool stuck in the rectum and cannot be expelled, resulting in ongoing constipation; Signs – no stool for several days, oozing of liquid stool, cramping, abdominal distention (swelling), and pain in rectum Nurse aides are not allowed to remove fecal impactions 147 Enema Specific amount of water that may or may not have an additive and is inserted into the colon to stimulate passage of stool Doctor will write order for type and amount of fluid; four different types Tap water Soapsuds Saline Commercially prepared 148 Digestive – Nurse Aide’s Role Make sure dentures are in place Observe for choking Provide fluids with meals Keep clean and dry Provide privacy and do not rush Encourage intake of fiber and fluids Regular physical activity Bowel habits for each resident is individual and personal Facilitate ideal position for elimination 149 Body Systems Urinary 150 Urinary – Overview Filtering system of the body Responsible for ridding body of waste products from blood 151 Kidneys – Structure and Function Bean-shaped paired organs Located at back of abdominal cavity, slightly above waist About four or five inches long; an inch thick Filters waste and produces urine Help maintain water balance and blood pressure Regulate electrolytes 152 Ureters and Bladder – Structure and Function Ureters o Narrow tubes o Connect kidneys to urinary bladder o About a foot long Urinary bladder oMuscular sac oStores urine until it passes 153 Urethra – Structure and Function A tube located between urinary bladder to the outside About seven or eight inches long in males About one and a half inches long in females 154 Urethra – Male Versus Female Think about the anatomy of the female urethra and the male urethra in terms of length Note the difference between one and a half inches (female urethra) versus seven/eight inches (male urethra) and how the male and female genitalia differ 155  Urination and Urine The passing of urine from the bladder through the urethra to the outside of the body is called urination or micturition or voiding 156  Urine – Normal Findings Light yellow to amber in color Clear About 1000 to 1500 milliliters per day 157 Urinary – Changes Due to Aging Decreased o Kidney size and ability to filter blood o Capacity, elasticity, muscle tone of bladder o Ability to concentrate urine Difficulty or incomplete emptying of urinary bladder Enlargement of prostate in males 158 Urinary – Variation of Normal Changes in urine Weight loss or gain Swelling in arms or legs Dysuria Swelling in bladder or abdomen Pain in kidney or back Incontinence Fever 159 Urinary Tract Infection An infection of urethra, bladder, ureter, or kidney typically caused by E. coli, a bacteria found in the digestive system More common in females 160  Kidney Stones (Renal Calculi) Form when urine crystallizes in kidneys Can block kidneys and ureters causing excruciating pain Abdominal or back pain, painful urination, frequent urination, blood in urine, nausea, vomiting, chills, fever Strain urine 161 Benign Prostatic Hypertrophy (BPH) 162 Chronic Kidney Disease (CKD) Lasting damage of kidneys that worsens gradually; 5 stages; with the latter stages resulting in the need for dialysis Can be prevented from advancing into further stages Dialysis machine picture on slide 163  Urinary Incontinence Inability to control bladder leading to an involuntary loss of urine; not normal part of aging 164 Urination – Nurse Aide’s Role Residents with incontinence must be kept clean and dry Provide privacy; should not be rushed or interrupted Encourage residents to drink fluids often Ideal position for urination for men is standing; for women is a sitting position 165 Body Systems Reproductive 166 Reproductive System 167 Reproductive – Overview This system allows human beings to create a new human life; may be subdivided into two categories 1) The female reproductive system 2) The male reproductive system 168 Reproductive – Structure and Function Responsible for production of reproductive cells, production of hormones responsible for sex characteristics, and reproduction 169 Reproductive – Normal Findings Absence of bleeding (other than menses) and vaginal discharge/penile discharge Absence of pain and itching Absence of enlargement of prostate gland 170 Reproductive – Changes Due to Aging Decreased size and function of reproductive structures Enlargement of prostate Sagging breasts Loss of hair in vulva area Weakened muscles that hold female reproductive organs in place 171 Reproductive – Variation of Normal Bleeding other than menses Pain Vaginal/penile discharge Itching 172 Pelvic Organ Prolapse Female reproductive organs held in place by muscles and connective tissue; pelvic organs may drop down (prolapse) into vaginal canal Cystocele – when bladder drops down (pictured) Incontinence may occur Nurse aide’s role – provide perineal care and report abnormal observations 173 Body Systems Endocrine 174 Endocrine – Overview Is a system of glands that secrete chemicals directly into the bloodstream to regulate body functions Different types of glands are pictured on slide 175 Endocrine – Structure and Function Structure – glands located throughout the body that secrete hormones Function oMaintains homeostasis (balance) oInfluences growth and development oRegulates sugar in the blood and calcium in the bones oRegulates reproduction oRegulates how fast cells burn food 176 Endocrine Normal findings Skin warm/dry No variation of weight, appetite, urination from typical Awake, alert, oriented Changes due to aging Levels of hormones decrease Insulin production decreases Body is less capable to deal with stress 177 Endocrine – Blurred Vision 178 Endocrine – Variation of Normal ( 179) Headache Blurred vision Dizziness Weakness Hunger Irritability Sweating Dry skin 179 Endocrine – Variation of Normal ( 180) Confusion Weight gain/loss Appetite increase/decrease Tiredness Increase thirst Increase urination 180 Diabetes Mellitus (Diabetes) Most common disorder of endocrine system Occurs when pancreas produces too little insulin or does not use insulin properly Insulin needed for glucose to move from blood into cells; cells need glucose for energy Without enough insulin, sugar builds up in blood, causing blood glucose levels to rise 181 Diabetes – Three Types Type 1 – onset typically during childhood and early adult; pancreas does not produce insulin; lifelong condition; managed with daily doses of insulin, a special diet, and regular blood glucose testing Type 2 – develops after about age 35; pancreas secretes insulin, but does not use it well; usually controlled by diet and oral medicine 3rd type is gestational diabetes and occurs during pregnancy 182 Diabetes – Nurse Aide’s Role Ensure meals are served and resident eats his diet, report to nurse if resident refuses meal, observe intake of meal and document Encourage resident to follow exercise program Observe for signs of low blood sugar (hypoglycemia) and high blood sugar (hyperglycemia); report immediately to nurse Provide for foot care as directed and observe for irritation or sores, report immediately to nurse 183 Module H Body Systems Immune 184 Immune System Defends threats both inside and outside the body Structure – antibodies and white blood cells Function o Protects body from harmful infection-causing germs, o Provides immunity from certain diseases Changes due to aging o Immune system weakens; more prone to getting infections o Immune system may attack itself causing disease 185 Immune – Variation of Normal Signs of infection Anxiety Nausea and vomiting Stiff, swollen, painful joints 186 Acquired Immune Deficiency Syndrome (AIDS) Disease caused by a virus, HIV and attacks the immune system and destroys infection-fighting and cancer-fighting cells of the body Spread through body fluids including blood, semen, vaginal secretions, and breast milk 187 AIDS – Nurse Aide’s Role Follow Standard Precautions and Blood Borne Pathogen Standard Assist with activities of daily living as needed Provide fluids as ordered Measure and record I&O and obtain weights Encourage deep-breathing and coughing exercises as directed; Encourage self-care as tolerated Observe for and report signs of infection Provide emotional support 188 Other Common Disorders Lupus – when immune system attacks tissues causing redness, pain, swelling, and damage Graves disease – immune system attacks thyroid gland which causes it to secrete more thyroid hormone Nurse aide’s role o Observe for and report signs of infection o Provide for nutrition, hydration, and rest for the resident 189