Geriatric Prelims PDF

LESSON 1: CARE AND OVERVIEW OF CARE OF THE These needs include physiological, ADULTS psychological, social and spiritual aspects of HISTORY...

LESSON 1: CARE AND OVERVIEW OF CARE OF THE These needs include physiological, ADULTS psychological, social and spiritual aspects of HISTORY human well-being. 1. 1964- WHO developed 3 countries Hendersons work has had a significant impact a. These 3 dimensions provide a on nursing education and practice and it comprehensive understanding for provides a comprehensive and systematic understanding and promoting health, approach to patient care. this recognizes that health is not only Her contribution to the field has help to define the absence of disease but includes the role of nurses and the essential services that psychological and social well being. they provide i. Physical health- refers to the state of body and function Dimension of health- basically refers to a different includes aspect like absence of aspect that contributes to a person's overall well- being. disease and physical fitness and These dimension are interdependent and ability to perform activities and interconnected meaning they affect each other: healthy body weight 1. Physical Dimensions: state of body and its ii. Mental- state of psychological structure and ability to resist disease well being includes positive self a. Examples: fitness, butrion, sleep, energy esteem , ability to cope up with level, absence of disease and injury. stress, absence of mental illness 2. Cognitive Dimensions: Mental process that and emotional resilience allows us to think learn, remember and reason iii. Social- refers to the ability to out interact with others and a. Examples: memory, attention span, participate in society. It includes problem solving skills, creativity, and aspects such as strong social learning ability (everything that use our relationships, to communicate mind effectively, sense of belonging 3. Emotional Dimensions: Manage emotions and positive contribution to effectively and maintain positive relationship society. with others 2. 1981- Ng et al distinguish wellness and illness a. Examples: self- esteem, emotional 3. 2004- updating of definition resilience, ability to manage stress, skills Numerous definitions were given to wellness to socialize and mental well being because if its complexity and multifactorial 4. Environmental Dimensions: impact of environment on person health and wellbeing HEALTH - Complete state of physical, mental and social a. Examples: clean air quality, water well-being quality, healthy food, safe living 1972 conditions and environmental toxins Rene Dubos, expanded view of health in 5 5. Social Dimension: refers to the individual dimensions interaction with other and form healthy Rene Dubos known for holistic approach to relationship science and interesting the relationship a. Examples: social support network, between humans and their environment community involvement and sense of He wrote books like “so human and animal and belonging the marriage of health” which explores Person’s overall health required harmony complexity of human health and impact of environmental factors on diseases. WELLNESS 5 dimension Is the integration of all dimension in positivity 1. Physical health Way of life 2. Mental health Ability to adapt 3. Social health Hood (2013)- conceptualized wellness having 4 4. Spiritual health components 5. Environmental health ○ Physical- he referring to state of body and structure (nutrition, sleep and 1955 overall physical health) Virginia Henderson ability to meet 3 basic needs ○ Emotional- Manage emotions and Nursing theorists and educators and best known positive relationships with others like for developing the Hendersons 9 nursing needs self- esteem, emotional resilience etc framework which outlines fundamental needs ○ Social wellness- interaction with others that nurses address in patients. and healthy relationship to family, friends etc GERIA | PRELIM | MCM 1  ○Spiritual - sense of purpose of ○ Pain individual like religious beliefs, ○ Fatigue philosophical values or personal sense ○ weakness of spirituality emotional distress: Person’s overall health required harmony ○ Sadness among 4 aspects ○ Anxiety ○ Fear Wellness functional impairment: It means active pursue of optimal health and ○ difficulty in performing daily activities happiness and it involves making conscious ○ difficulty in fulfilling social roles choices and engaging in behaviors that promote highly personal and vary greatly from person to physical, mental, emotional, and spiritual person wellbeing illness can be caused by components of wellness ○ Disease ○ physical health ○ Injury ○ emotional health ○ psychological factors ○ mental health ○ social factors ○ social health physical damage to body ○ spiritual health ○ psychological factors: ○ occupational health Stress ○ environmental health Anxiety regular exercise, eating balance diet, practicing depression mindfulness, and building strong relationships ○ social factors: process of achieving optimal health and Poverty happiness lack of access to health care active pursue of optimal health and happiness social isolation ○ can be both acute and chronic Well being Balance between one's challenges and one's Disease resources is an objective term referring to diagnosable More transient that wellness abnormalities in organs, body systems or state of being that encompasses a sense of physiology. happiness, satisfaction and fulfillment Derived from the word "dis" and "ease" a reflects person's overall quality of life and condition with disturbed ease (Brunner & includes both internal and external factors Suddarth 2018) similar wellness well being is also influenced by specific diagnosis and treatment physical health, emotional health, mental can be identified trough causes and symptoms health, social health, spiritual health, abnormal condition of an organism occupational health, and environmental health caused by infection, heredity, and Example of high well being: environmental factors ○ being contented can manifest in various ways from physical ○ being optimistic symptoms mental disorders ○ being connected to others deviation from normal state, can change in outcome of the state of being healthy, being structure, function, and behavior happy, and being fulfilled state of being that encompasses happiness impairment: disease often impaired the body to satisfaction and fulfillment function normally this can lead to pain, discomfort, disability, and death both wellness and wellbeing are interconnected and etiology: cause of the disease essential for a fulfilling life and by actively engaging in infection wellness practices individuals can cultivate a greater genetic factors sense of wellbeing environmental factors ( exposure to toxins, pollutants, harmful substances) Illness lifestyle factors High subjective Acute, chronic, terminal types of disease state of being unwell or being unhealthy acute disease subjective experience that can be influence by ○ develop rapidly and short duration physical or psychological factors (colds and flu) broader range of symptoms and experience physical discomfort: GERIA | PRELIM | MCM 2  chronic disease i. self acceptance ○ slower ( heart disease, diabetes, and ii. self confidence cancer) iii. self control infectious disease iv. includes trust ○ caused by pathogens ( tuberculosis, c. ability to deal with stress to be flexible malaria, HIV) and attitude toward self, help to cope non infectious and become comfortable with emotions ○ Not caused by pathogens ( heart d. 2 beliefs disease, Cancer, and stroke) i. it is better to be aware of and 2 process understand feeling than deny prevention them ○ measures to prevent diseases ( ii. it is better to be optimistic than vaccines, healthy lifestyle choices, and pessimistic environmental protection) 4. Social treatment a. goodness of being able to contribute in ○ depending on the disease and severity the society and an individual must know of the disease ( medication, surgery, how to communicate with the people in and therapy) the community b. 2 beliefs LESSON 2: MODELS OF HEALTH AND WELLNESS i. it is better to be able to contribute to the welfare of the 6 Dimensions of Wellness Model by Dr. Bill Hettler; community than think only of 1. Physical our self a. physical fitness, body weight, ability to ii. it is better to be live in harmony perform activities of daily living, can be with others and the maintained by eating healthy diet, environment than to live in regular exercise, avoiding unhealthy conflict with them habits, and receiving medical care 5. Spiritual b. 2 beliefs a. it focuses on the purpose and meaning i. better to consume food and of life beverages that will promote b. aspects good health rather than those i. being able to forgive that will impair it ii. show compassion ii. it is better to be physical fit iii. show love and be love than out of shape c. religion beliefs and practices are also 2. Mental part of this spiritual wellness it includes a. creative and mentally activities and relationship with other living things and openness to new ideas and school of ones perception and appreciation with thoughts, the ability to analyze and nature and the meaning of life synthesize ideas and react to new d. helps a person to be equipped with information ethics, values and morals that guide b. a person who is intellectually well decision welcomes life long intellectual growth e. 2 beliefs and simulation and look for interaction i. it is better to fonder the with world around us meaning of life and to be c. 2 beliefs tolerant on the belief in life of i. better to stretch and challenge others than to be closed the mind with intellectual and minded and become intolerant creative pursuits than to ii. it is better live each day become self satisfied and following self values and beliefs unproductive rather than live otherwise and ii. it is better to identify potential become untrue to self problem and choose 6. Occupational appropriate course of action a. this applies career satisfaction as a based on available information person strive the contribution of the than wait, worry, and contend individual skills and talents will also be with major concerns later evident or improve in progress 3. Emotional b. 2 beliefs a. ability to move on with the rigors of life i. it is better to choose a career or with the challenges of life that is consistent to personal b. aspects under emotional wellness beliefs, values and interest than GERIA | PRELIM | MCM 3  to stay with something that you ○ coping self feel so unrewarding ○ social self ii. it is better to develop functional ○ essential self and transferable skills through ○ physical self involvement rather than remaining active and NWI (National Wellness Institute)model of wellness uninvolved defined wellness as the active process through which people become aware of and make DIMENSIONS OF HEALTH choices towards a more successful existence 1. Physical Dimension this includes positive, holistic and affirming a. this is the most common aspect of outlook in life health which is concerned about the take note “make choices toward” which means functional state of a person and a that wellness is something to look forward and person is said to be in good state if not necessarily an achievement he/she without experiencing any pain it is a way of life or process and it is shaped by or difficulties our behavior it is about the path we travel to 2. Cognitive Dimension achieve out full potential a. refers to the intelligence of a person this the National Wellness Institute model presented is similar to the mental dimensions of 6 dimensions which included the wellness dimensions ○ occupational i. the capacity to make decisions, ○ physical recognize and solve problems, ○ social memorize things and ○ intellectual understand and communicate ○ spiritual with others ○ emotional b. what can affect cognitive dimensions NWI is the same as the holistic model of health i. certain disease, trauma or and wellness which was conceptualize by experiences can infer thinking gordon reasoning and memory functioning Wellness continuum model- Health illness continuum 3. Emotional Dimension model a. ability to perceive own emotion and it is assumed that many of us are in the neutral behavior as well as those of others point and depending on many factors we b. it includes persons to manage stress escalate to going to either site of peak wellness and develop a sense of hope and or death enthusiasm it helps people to relate before we reach one site of the continuum we with other take several phases or stages 4. Environmental Dimension an individual may proceed to the end of the a. this is concerned with the components continuum or go back to neutral point or to the of living situation such as quality of air, previous stage depending on the decision of the water, noise pollution and surroundings individual which can have an effect with the help the continuum model tells us that every phase of the people of the stage changes may happen either going 5. Social Dimension more positive aspect or to the aggravating side a. this is the ability to establish and reaching the end of the continuum is dependent maintain truthful relationships with on the capacity and decision a person family, friends, coworkers and community and it can include Models of Health & Wellness relationship with neighbors and people Holistic Model of Health with the workplace defines health in terms of the whole person and b. “jowa here jowa there” not about the diseased part of the body which means that a person may be sick but still able to Model of wellness- WOW (Wheel of Wellness) model function normally (ex. a person experiencing by WHO fracture which caused him to be absent at work defined as the way of life oriented towards but the person may still choose to work from optimal health and wellbeing in which the mind, home because he can still perform his duty as body and spirit are integrated by the individual an employee) to love life more fully within the human and natural community integrated 5 second order dimension ○ creative self GERIA | PRELIM | MCM 4 Medical Model - (5) "Ds" Health Belief model A person who is not sick or not suffering from describes health behavior of people according any disease is healthy to what they believe about themselves and help 5ds in relation to decision making process is seeking ○ disease healthcare services ○ death according to this model an individual is ○ discomfort expected to take actions if they believe that ○ disability they are susceptible to acquire a condition and ○ dissatisfaction a person may take action to prevent it, yo go a person should not be suffering from any under consultation or control negative health sickness or abnormalities to be called healthy situation that may lead them to serious and the absence of 1 or more of the 5ds are also consequences or it may affect their lifestyle define person health condition the action of the person will benefit by either if we you medical model our focus as nurses is reducing the chances of acquired disease and to help the person become free from any the cost of action to take precautions and waste disease or illness to be considered healthy the benefit he will get what if the person is experiencing headache 4 sub components then that person is not considered healthy ○ perceived susceptibility- they are because there is a presence of discomfort and susceptible to a particular disease dissatisfaction ○ perceived severity- when the individuals believe they may be potential serious in Environmental Model their health this model uses modern analysis of echo system ○ perceived benefit- taking preventive and environmental risk to human health action and reducing the severity or in this model health is defined in terms of susceptibility to a particular disease quality of persons ability to adapt to the existing ○ perceived barriers- to taking preventive environment where he is currently in this means action rather than the benefits of taking that health or wellness is achieved when a a preventive action person can adapt to the present environment modified health model Education Health system model Economic circumstances health as a value between wellness and illness Culture as defined by betty neuman health is influenced by the person's educational according to betty neuman wellness is a attainment the status in the society or social condition in which all parts of the system is class and the culture which influence health working in harmony with each other and illness practices as part of the habits and practices is the state in which an organ feels to perform its normal function with other needs unsatisfied Beliefs about the causes and treatment of Illnesses are she defined health as a condition with stability examples of: Cultural Factors in the systems and optimum wellness is achieved when systems need are met however Lesson 3: Concept of health, wellness, well-being and when needs are not satisfied illness will occur illness Introduction Agent Host Environment model Health and illness continuum will focus on which identifies risk factors in the interaction understanding the factors which affect the health between agent, host and environment and condition of older client, understanding acute and health depends on the balance of the 3 chronic illness and the aspects of sick role according to this model is useful in determining the causes of Parson. Stages of illness according to the concept of disease the 3 factors are believe to interact with Suchman will assist the students in planning for the care each other in ways that result in developing risk plan and be able to anticipate future interventions using factors and being able to understand this is the stages as the guide. The impact of illness will important for the promotion and maintenance provide the students the opportunity to design of health programs which will help older clients optimize their an agent is an environmental factor or stressor potential through way of prevention and rehabilitation that must be present or absence for an illness to occur FACTORS AFFECTING HEALTH STATUS, BELIEFS and a host is an living organism capable of being PRACTICES infected or affected by an agent. the host Many factors actually affect an individual's reaction is influenced by family, the family health status beliefs, behavior or practices. history, age and health habits there are factors maybe controlled by the person and there are some that just cannot. GERIA | PRELIM | MCM 5  Health behavior is something that can be perception has limited ability to controlled depending upon on choices however response environmental there are some which we cannot do anything hazards. about such as yung gender, age, genetic Psychologic makeup, culture and geographical environment. ○ psychological dimensions of emotional there are 2 types of variable which affect a factors influence health include mind, person. body interaction and self concept. Mind ○ Internal body interactions may positively or ○ external negatively affect the health status of a person. In the same manner. Internal Variables: are also called non modifiable ○ Individual responses to stress may also variable because we cannot change it, we cannot do affect body functions for example- anything about it. students maybe have different reaction Biologic to stress during examinations some may ○ this are age, sex, genetic make up and experience urinary frequency or some developmental level of which influence may experience diarrhea a person who health status of a person, so when we may be worried about surgery talk about genetic make up it has procedures or a person worried about a impact on temperament, biological possible outcome may engage to chain characteristic activity level and smoking if emotional distress will be intellectual potential. prolong it may be a reason ○ It is also link to persons susceptibility to interpretability to organic disease or develop disease such as diabetic and possible aggravate. cancer. For instance both the parents of ○ Emotional distress can influence the the mother and father have history of immune system by a central nervous diabetes then it is more likely that the system and alteration in the endocrine offspring of both the mother and father system. In an immune system alteration also develop diabetes later on. is associated with incidence of infection, ○ Sex or gender affect disease cancer and auto immune disease. distribution because there are some ○ There is now increasing attention given diseases that are common only to one to a person’s mind ability to influence gender for example- osteoporosis and body function and there is why autoimmune disease such as recognition to relaxation, meditation rheumatoid arthritis these are and biofeedback techniques which uses common to females while stomach by some people to reduce incidence of ulcer and abdominal hernia and hypertension. respiratory diseases are common to ○ Emotional reactions exist in response male. to body conditions for example fear and ○ age is also a significant factor. The depression they occur when a person is presence of the diseases varies with age diagnosed with terminal illness for example - atherosclerosis heart self-concept now will step in. it is who a disease is common to older man but is person perceives self needs, roles and not common to middle age. Then the abilities it effects how people handle wing cap and measles are common in and view situations. children but not common in adults. ○ Attitude influence in health practices ○ Developmental level has great impact bodies responses to stress and illness on health status for example since and the period treatment is resorted for infants still have immature or example a person who is suffering from underdeveloped physiologic anorexia maybe deprived of herself of psychologic factors they are food and needed nutrition because she more prone to a required sees herself as too fat even though she infection because of weak is already underweight and defenses. undernourished. Toddlers who are learning to Cognitive- walk has no stable balance are ○ Now what about cognitive dimension prone to falls and injuries. we called it intellectual factors- also Adolescents experiencing peer influence health this includes lifestyle pressure are more prone to risk choices and spiritual and religion taking behaviors. beliefs. when we talk about lifestyle While for elderly who have generally speaking it is a persons way of declining physical and sensory GERIA | PRELIM | MCM 6  life this includes living conditions and future that there are still a future after pattern of behavior. today. ○ it is something that people have control They believe that illness cannot over it can have either positive or be prevented and the present negative effects on health on the other problem is so great and all hand practices which negatively effect efforts are exerted for survival. health is called risk factors for example Its like survival of the fittest. a person who is overeating doesn’t the environment of the engage in physical activities or exercise depressed areas have affect on may become overweight or develope the overall health status of the diabetes, heart disease, atherosclerosis people. and hypertension. They Have poor sanitation, ○ a person who smokes heavily may garbage are seen everywhere, develop enlycema and cardiovascular house are crowded as well as disease. household diba ang dami nila ○ while spiritual and religious beliefs can member of the family inside, notable influence health behaviors for Fire and crimes high and threat example some religious group are is always possible there are no vegetarian because they didn’t want to recreation places for people kill an animals and eat the meat. therefore child play on the ○ There are also religion that maybe streets that’s why they are against blood transfusions. There are prone to accidents. Occupation some who believe that when a person also play a role in the health develops serious illness it is a community people for example punishment from God. and there are some may have exposure to other behavior that are influence by carcinogenic agents spiritual beliefs and religion. socioeconomics status can influence stress and may later External Variable on predispose to develop stress Environment- environment effects people for related diseases example tropical climate have more case of Family and cultural beliefs malaria comp and with non tropical or what we ○ lifestyle and family pattern may be call temperate climate. passed on to offspring for ex. a father The presence of pollution affect health cells. who experience physical abused during ○ Asbestos are considered carcinogenic. childhood may do the same to his ○ cigarette is dangerous to your health children and type of abuse may lead to sabi nga ng commercial. long term health problems therefore ○ Radiation from a scene and drugs are open communication with a family, part of the environment light xray and sharing, love, and Foster the fulfillment sun ultraviolet rays. scud rain contains of an individual optimum potential sulfur dioxide. ○ culture and social interaction can also ○ other sources of environmental affect person's perception experiences contaminants are pesticides which is and coping with health and illness used to plant and maybe eaten by ○ each culture has their own perception people of used in inappropriately. about health and this is commonly Standards of living passed on from parents to children ○ health, mobility and mortality are ○ there are certain groups of people that related to standard of living. Decision to believe that home remedy or tribal seek medical care, hygiene and food health customs are better that health habits vary among people depending on care practices the income group. ○ challenging old beliefs and values by ○ those who earn more have capacity to second generation may result to choose the appropriate choices of food conflict, instability, and security which that are healthy. kesa meron silang can contribute to illness pang bili. Social support networks ○ Low income family define health in ○ family friends or confidant who can be a terms of work, when they are working support of a person and helps to avoid then they are healthy low income illness people have the dependency to be ○ support people provide the one for a fatalistic because they are lack in person who is inflicted with disease to orientation about the reality of the GERIA | PRELIM | MCM 7  fight for the sick people to become well they have very limited activity some of again the older adult, they don't want to miss performing that activity especially if classification of illness they are already in to a lifestyle with 1. acute illness- reversible, short duration very limited activity a. an individual experience severe c. one this limited activity will be taken symptoms with a short duration away from them it will be cause of b. there is a abrupt onset of symptoms but disappointment and depression disappear weekly depending upon the d. nurse duty is to closely observe severity symptoms some do not require behavior of client and take note of any medical intervention however there are sign of depression some acute illness that sre serious e. a person who is normally happy and c. sample- appendicitis which requires always smiling and suddenly display a surgical intervention different behavior must be given d. many acute illness subside without the attention need of professional advise such as colds, cough which may be remedy by 2. People in the sick role is not directly taking over the counter medication responsible for their plight e. individual normally return to normal a. no person in normal cognition will do condition following the acute illness something to intentionally cause them experience harm b. our assumption when gets sick it is not 2. chronic illness- persist longer than 6 months, something he/she did on purpose similar to disability since client experience c. our duty as nurse is to understand what limitation in the ability cause the illness he/she is experiencing a. usually extended longer than 6 months so that we can promote self reliance and mostly lifetime when client becomes knowledgeable of b. it has gradual onset and have period of the factors contributing to the onset of remission when symptoms disappear the illness c. then exacerbation if symptoms d. we help our client to manage day to day reappear life optimizing their potential even d. sample: diabetes, arthritis, COPD during times that they experience e. since chronic illness meant to stay with illness the people for life our role as a nurse is e. sample: a patient is experiencing pain to help them achieve optimum state of and have difficulty in mobility the body function reason is because he has arthritis aside f. across lifespan any people may develop from the prescribe medication we help chronic illness it is not only for older client by assisting them to perform adult therefore it is our duty to help physical activity though it might not be them go through the challenges brought same as it was or used to be before he about by the illness experience pain because of arthritis but g. one of the most challenging experience at least to help look forward for to accept is when physical image and alternatives, if the client used to walk to mobility will be affected this will not not the garden to breath for fresh air in the only affect self esteem and self worth morning but cannot do it because of the but may be a reason to experience pain providing assistance or teaching or depression and anxiety which will lead client to use assistive devices may help to stress and affect other system and to make him feel a little lighter become a reason to develop another disease or problem 3. The sick person needs to try to get well as quickly as possible Parson's 4 aspects of sick role a. some elder clients have positive outlook 1. Sick person is freed from carrying out normal and may want to go back to their social roles normal life before experiencing being a. he/she suffering from an illness the sick in the case of people who are still formal duty assigned to the person is having their career in life they need to either being transferred or be kept until do everything they can to get well the person regain normal function and because they have duty and obligations will be free from illness to fulfill b. for an older client it is not something b. those who are the breadwinner of the that they will be happy about because family will really have to get well as GERIA | PRELIM | MCM 8  soon as possible in the case of older a. this is the stage when the person is client those who are still having an notified that there are something wrong active life will have focused on how to with self, it is either the person himself go back to normal because they look experience something or another forward to doing the thing they enjoyed person will be able notice it from him doing they will comply with the b. sample: comments like “maputla ka” treatment and follow medication orders c. common experiences colds, cough, and cooperate in the plan, these people pain, rashes, fever, or bleeding would like to get well as quickly as d. 3 aspects possible because they do not want to i. the physical experience of the leave the life of a sick person being symptoms is when the person isolated and having restrictions in terms will be able to feel and see that of mobility diet there is something unusual c. when there is motivation to get well ii. cognitive aspect is when the immediately people will do their share person interpret the symptom of work in getting well however those and give meaning to it who have not have motivation our duty iii. emotional response in which as nurses is to help them find meaning the person will either feel in their life to have something to look anxious or feel the experiences forward to and have motivation to get and during in this stage the well person will try to do self care and ask the opinion of other 4. Clients or their families are obliged to seek people such as member of the competent help family, friends, or coworkers if a. when things do not go positively client home remedy will give good and family members will be obliged to results, then normal life will seek professional advice how to get resume, however the problem over the illness is if it did not then the person b. sample: a client experiencing pain in the will move to the next stage knee whose activity is affected will initially try to self medicate, they will try 2. Sick Role Assumption some patches, use some decoction and a. during this stage the person will still op seek to use herbal and alternative to do self medication and home medicines however since the main remedy, depending on the severity of problem and the cause of the pain is the experience the person might start not directly being treated or answered to develop fear, withdrawal, anxiety, the experience may worsen forcing the and depression client and family to seek for b. in this stage the person will be excluded professional help, these is one of the in doing his normal duties and may be problem in many people that they only given the privilege to rest and relax, think it is necessary to seek for once the symptoms will not subside or professional help when all things they when it worsen then this is the only have tried will fail time that the person will seek for c. in times the time delay is the cause of medical care and move to the next more serious problem it is not bad to stage self reliant but we need to teach out clients to identify sickness that can be 3. Medical Care Contact manage by self and family members and a. this is the point when the person seek sickness that needs to be attended to by consultation since all the remedies have professionals taken at home did not work the person d. commonly people get help with the is convinced to seek for medical help situation is already in the worse either decided upon by self or forced by scenario and more complex others because of the situation management and treatment is required specially if the condition is noticed to be this will lead to more problem, more aggravating cause, and more sad on the part of the b. during consultation 3 type of client and family information will be solicited i. validation of real illness Suchman's Stages of Illness- 1979 ii. explanation of the symptoms 1. Symptom Experience experience in understandable terminology GERIA | PRELIM | MCM 9  iii. reassurance that the person will a. some disease or illness can affect and be alright or prediction of what change body image this is evident to will the outcome will be those who experience accident and had iv. sample: a patient experience a surgery or sometimes removal of back pain and have increase organ fluid intake to flush out the b. the client self esteem and self concept bacteria because he might be is definitely affected there are many thinking that it is an incident of reasons for a person to get affected and UTI, however the symptom did develop those self esteem because of not disappear but it gets worse different reasons lost of body part and let say aside from the back pain function, disfigurement, dependence to the person now has other people, unemployment financial hematuria(presence of blood in problem urine) is what will prompt them c. duty as nurse is to make client to seek consultation, however comfortable with us to give an idea that during the consultation the we are open to support them doctor was able to assess other symptoms have been 3. Impact on self-concept experience long before which a. when we talk of disfigurement, body may contribute to worsening of parts, dependence of others, the patient, the doctor then unemployment, financial problems, may order to do some absence in social functions, damage laboratories and diagnostic relationship with others and spiritual procedures to confirm what distress this all can change the self really is the problem, so if the concept of a person person accept the explanation b. a person who is normally assuming an of the doctor he is most likely to important role in the family, career or follow the order and if not then community will experience low self he will either seek for another esteem and change its self concept opinion or seek for quasi because of the effect of illness professional who will give him diagnosis that will fit his 4. Impact on family roles perception something that is a. a member of a family who is ill is not acceptable to the person only the person who is affected because 4. Dependent Role we are talking about family 5. Stage of recovery or rehabilitation b. the degree and severity of the effect of illness depends on the role of the family Impact of Illness member 1. Behavioral and emotional changes c. the degree of effect of illness depends a. this changes are common to clients on 3 factors experiencing illness a person who is i. member of the family who is ill, most likely to experience behavioral and is he the father?, is he the emotional changes are those who have breadwinner?, is she the being affected by the people who are mother in charge of all experiencing something already unusual household chores b. those who are associated with short ii. seriousness and the length of term illness are commonly mild and illness how long will the effect short term of illness, the person unable to c. a person may have change in mood and perform normal function, how interest to interact with family and much does it cause when the friends if experiencing illness member go back to the normal d. may feel irritable and lack of energy, condition anxiety, anger hopelessness, iii. changes may occur as an result powerlessness of illness in the family the role e. sample: client who is experiencing heart change will we experience and attack may fear for his life and the there will be task reassignment financial burden it will bring to the as the person who usually family perform the task is unable to do so and especially if the task 2. Impact on body image cannot wait any longer that it GERIA | PRELIM | MCM 10  will be reassigned similarly it Die with comfort and dignity happens in work scenario iv. if this happen there will be Key problem areas experienced by patient with chronic increase stress and anxiety illness: because of the possible result Assessment of chronic care needs (acute of the illness, financial problem diagnosis and identification needs is important might take place loneliness will since pt often face problems in getting/ set in because of financial understanding their diagnosis) problems Maximizing benefits of chronic care ○ personalized care plans which will add 5. Impact on family dynamics physical and emotional aspect of illness; a. illness can really change a lot in family ○ maximize benefit of chronic care with dynamics effective communication with other; b. a family who is usually happy and have ○ make them adhere to treatment plans open communication may suddenly by ensuring that adhere to medications experience and feel changes the ill lifestyle changes etc person may start to change in behavior Selecting physician (pag pili ng doctor can be which will send signal to other family helpful to them who is knowledgeable and members of his unwillingness to open comfortable working with) up and to participate in the usual family Selecting chronic care coach (finding qualified activity and gathering enjoyed by the professionals that can provide support family education and guardian it might be a barrier) c. the usual happy gathering will be Increasing knowledge (pt may need to learn replaced by decision to postpone about the nature of their illness like managing normal activities as they are not open symptoms and knowledge about symptoms to idea celebrating without a member management techniques can improve quality of of the family life) Locating support group (finding a suitable group like living with other who have the same Lesson 4: Chronic Illness Problems and illness can provide support and camaraderie) Pathophysiology Making smart lifestyle choices ○ adapting healthy habits Improving capacity of older person; Aging is inevitable ○ Lifestyle changes ○ Managing stress Chronic illness affects all ages and it refers to human ○ It is all about balance but very experience of living with a condition which has been challenging existing for (6) months and longer. Use of complementary and alternative therapies Since the term chronic is related to period of existence, ○ 2 types of problem management of chronic illness will require regimes to The ones who only support keep the condition in control. complementary therapy Die hard taking medications/ Older person with chronic conditions responds seeks consultation and refuses differently. It is therefore vital for nurses to understand to accept complementary how elder population experience existing conditions therapies) and be knowledgeable of the pathophysiology of the illness. Review of pathophysiology and assessment of selected conditions Assessment is also an important part in identifying the 1. Heart Disease key areas to further evaluate the needs of the older Coronary artery disease (CAD): become population narrowed/ blocked often cause by fatty, cholesterol, cellular waster and calcium / fibrin Goals of Chronic Care a. Symptoms Maintain or improve self-care capacity (to those i. Chest pain/ angina: describes with knowledge deficit: since they lack capacity squeezing pressure/ sensation to understand self care) occurs during activity or stress Manage the condition effectively and relief when rest/ Boost the body's healing abilities medication Prevent complications ii. Shortness of breath: DOB when Delay deterioration and decline effort Achieve the highest possible quality of life iii. Fatigue: tiredness GERIA | PRELIM | MCM 11  iv. Heart palpitations v. Irregular heartbeat Regurgitation: refers to the backward flow of blood vi. Sweating with chest pain thru heart valves happens the the valves does not vii. nausea and vomiting and close properly allowing blood to leak back to chamber occurs during heart attack a. Types b. Normal heart rhythm is known as sinus i. Aortic regurgitation: blood flows rhythm (steady originates from heart backward from aorta to LV pacemaker) ii. Mitral regurgitation: blood flows i. SA node generates electrical backwards from LV to LA impulses iii. Pulmonary regurgitation: ii. Pulses nag tratravel thru backward from pulmonary artery electrical pulses na nag cacause to RV ng contraction in coordinated iv. Tricuspid regurgitation: backward manner from RV to RA b. Symptoms iii. 60-100 bpm i. Shortness of breath c. Irregular heart rhythm or arrhythmia ii. Fatigue i. Disrupted iii. Chest pain ii. too fast or too slow iv. Palpitations iii. Irregular pattern v. Swelling legs/ ankles iv. Types vi. Dizziness 1. bradycardia c. Diagnosis: PE first may listen to heart for a 2. Tachycardia murmur cause by leaking valve through 3. Atrial fibrillation is an echocardiogram abnormal heart rhythm d. Echocardiogram: uses sound waves characterized by rapid and e. ECG: electrical activity irregular beating of the f. Stress test: how well the heart functions atrial upper chambers of during exercise the heart 4. Ventricular tachycardia Systolic heart failure: The heart muscle becomes originates from lower weak and enlarged. It can't pump enough blood chamber of the heart forward when the ventricles contract. Ejection v. Assessment/ Symptoms fraction is lower than normal 1. no symptoms at all 1. Symptoms: 2. Palpitation a. Shortness of breath 3. Chest pain b. fatigue 4. Shortness of breath c. Weakness 5. Dizziness d. Swelling of legs 6. Fainting e. Rapid heartbeat f. Chest pain Stenosis: refers to narrowing of a passage in the g. Cough at night body can occur in the various part of the body h. Gaining weight due fluid buildup depending on location 2. Cause a. Types a. CAD i. Aortic stenosis: means aorta b. Pag taas ng BP carries blood from heart to body c. Dilated myopathy: heart muscles ii. Pulmonary stenosis: narrowing of enlarged pulmonary artery carries blood d. hypertrophic cardiomyopathy: from heart to the lungs thickened heart muscles iii. Mitral stenosis: valve narrowing LA e. Valvular heart disease: heart valves and LV of the heart systolic problem iv. Aortic valve stenosis: narrowing of i. Infections aortic valve ii. Thyroid disorder v. Tracheal stenosis: narrowing of iii. Medications trachea main airway connect nose 3. Treatment to the lungs a. medications vi. Urethral stenosis: narrowing of b. Lifestyle changes urethra tube carries urine from c. Cardiac rehabilitation bladder d. surgery/ implanted devices b. Symptoms e. surgery i. Chest pain ii. DOB Diastolic Heart failure: muscles become stiff it iii. Fatigue doesn’t relax normally between contractions which iv. Dizziness keeps the ventricles from filling with blood. Ejection v. Swelling of legs/ ankles fractions is often in the normal ranges vi. Difficulty in urinating GERIA | PRELIM | MCM 12  Stroke/ cerebrovascular accident: interruption of ○ Long term irritation blood supply in the brain. ○ Cause by Smoking 1. Ischemic stroke ○ Cough a. Blood clot block blood vessels in ○ Plema the brain ○ Hirap huminga 2. Hemorrhagic stroke a. blood vessels in the brain ruptures ○ Wheezing and bleed ○ Chest congestion Symptoms ○ Eventually lead to COPD Numbness ○ Peripheral edema Confusion Treatment of chronic bronchitis speaking ○ Rest and fluids Loss of vision/ double ○ Pain reliever Headaches ○ Prescription medication Dizziness/ loss of balance Risk factors Emphysema: permanent enlargement and High Blood pressure High cholesterol destruction of air spaces distal to the terminal Smoking bronchioles; irreversible Diabetes What happens? Heart disease ○ older and thin Family history of stroke ○ dyspnea Age ○ Lubog chest Race/ ethnicity ○ xray of hyperinflation with Obesity flattened diaphragm Sedentary lifestyles Atrial fibrillation Spirometry: non invasive test measures how How to help Manage risk factors well the lungs function (into and out breathing Lifestyle changes in spirometer) Regular checkup Forced vital capacity (FVC) Force exhales volume FEV1 2. COPD: progressive lung disease: DOB cause by Use to diagnosis lung diseases damage alveoli (tiny air sacs in the lungs) Symptoms 3. Endocrine System (DM1&2) Shortness of breath Diabetes: affects our body production of insulin Coughing helps regulate blood sugar level Mucus production Type 1: inability to produce insulin Wheezing (childhood) Fatigue Type 2: cause by resistance to insulin Weight loss pancreas inability to produce insulin Blue lips/ fingertips (adulthood) Where can we get COPD? Smoking (2nd hand smoke and such) Genetic factors Treatment Bronchodilators corticosteroids for inflammation Oxygen therapy Pulmonary rehabilitation Lung surgery Bronchitis: inflammation of bronchioles tubes acute bronchitis is cause by viral Slowed healing of wounds infection Frequent infection ○ Coughing Numbness in hand and feet ○ Mucus production ○ Shortness of breath 4. Cancer: is caused by uncontrolled growth/ ○ Chest congestion spread of abnormal cells that forms tumors ○ Fever Metastasis: The spread of cancer cells from the ○ Fatigue place where they first formed to another part of ○ Within few weeks the body Chronic factors that can cause cancers GERIA | PRELIM | MCM 13  Cancer can be genetic/ inherited Unhealthy lifestyle Exposure to radiation / chemical substances Stress sometimes kasi nag papa baba siya ng immune resistance natin thus pag nangyari un nagkakaroon tau incapability to fight bad cells developing in our body Treatment Depende sa tao Surgery Radiation Chemotherapy Hormone therapy Targeted therapy Lewy Body VS. Parkinson's Disease Immunotherapy Lewy: cognitive impairment Signs Parkinsons: motor symptoms Cough Blood saliva Change in bowel habit Blood in stool/ urine Sore throat Back pain Bloating Lump Vaginal bleeding Unexpected weight loss 5. Dementia: umbrella term use to describe set of changes in memory, perception, reasoning, judgment and language that interfere person ability to function well Lewy Body: abnormal protein deposit found in brain cells of individuals (nakikita sa dementia at parkinson's disease) Protein deposits aggregates primarily composed of alpha synuclein disrupts functioning of brain cells Location: found in the cortex of brain , midbrain can lead to various symptoms ○ cognitive impairment ○ Difficulty in problem solving ○ Motor symptoms like tremors etc ○ Hallucinations ○ Sleep disturbances ○ Rapid eye movements GERIA | PRELIM | MCM 14