NRSG 1500 Chapter 6: Health and Wellness PDF

NRSG 1500 CHAPTER 6: HEALTH AND WELLNESS  HEALTHY PEOPLE Initiative which provides evidence-based, 10-year national objective for promoting health and preventing disease Healthy People 2030 je Society in which all people live long...

NRSG 1500 CHAPTER 6: HEALTH AND WELLNESS  HEALTHY PEOPLE Initiative which provides evidence-based, 10-year national objective for promoting health and preventing disease Healthy People 2030 je Society in which all people live long, healthy lives Identifies leading health indicators which are high-priority health issues in the United States Examples? Promoting Health - Preventing Disease  DEFINITION OF HEALTH A state of complete physical, mental and social well-being, not merely the absence of disease or infirmity (WHO, 1947, 2021a) What is health? Loading… State of being that people define in relation of their own values, personality, and lifestyle What influences health? Examples Nursing must consider the total person and their environment Finance- pythosocialgit- Past experenice education GeoGraphics - Culture/life style  MODELS OF HEALTH AND ILLNESS Models help explain complex concepts, such as health and illness 1. Health Belief Model relationship between a person’s beliefs and behaviors 2. Health Promotion Model health is a positive, dynamic state; NOT merely the absence of disease 3. Maslow’s Hierarchy of Needs basic human needs are necessary for survival and health mind-body-Spirt 4. Holistic Health Model considers emotional, spiritual, social and cultural of physical wellness must important creativity MASLOW’S HIERARCHY OF NEEDS south personal & confidence status - Loading… Vistis Family precautions Fall PPE Wearing Vital Signs Pain Bo HEALTH & WELLNESS Health promotion helps individuals maintain or enhance present health nutrition, immunizations exercise , Health education helps people develop a greater understanding of their health, increases management of health risks Illness prevention protects people from actual or possible health threats about cultural Self Reflection - first thing to do 61. Box LEVELS OF PREVENTION Primary true prevention, goal is to reduce the incidence of annual wellness, education disease EXAMPLES: immunization g Nutrition : exercise , Secondary focuses on prevention the spread of disease, illness, or infection AFTER it has occurred EXAMPLES: screening - Tertiary disease is permanent, minimizing effects of disease and disability (think rehabilitation) EXAMPLES: renab, highest level of function,  RISK FACTORS Risk factor anything that increases the vulnerability of an individual or group to illness or accident Genetics history , family Ethinancy Gender 1. Nonmodifiable can not Change-Age , , 2. Modifiable lifestyle practices and behaviors Examples: Smoking , exercise, nutrition , stress level , job 3. Environment where we live or work and surrounding conditions Examples: crowded city - coal mine - live or work  NRSG 1500 Chapter 29: Vital Signs  29 2 Box. # GUIDELINES FOR MEASURING VITAL SIGNS Establishes a baseline for a patient! When to measure VS? as ordered post op before , , meds VS are YOUR responsibility Understand and clinical judgment for abnormal VS communication Use an organized, systematic approach Must be measured correctly Considerations? kid]- VS measurements to determine indications for medication administration * musta VITAL SIGN ADULT RANGES Temperature: 96.8 to 100.4 F Pulse: 60 – 100 beats/min, strong, regular Loading… Pulse Oximetry (SpO2): Equal to or Greater than 95% Respirations: 12-20 breaths/min, deep, regular Blood Pressure: Systolic < 120 mmHg Diastolic tissue/fot Heat loss skin structure and environment - sweating Skin regulates temperature though insulation Behavior control healthy individuals clothing old? Young  BODY TEMPERATURE below Hot-about  FACTORS AFFECTING BODY TEMPERATURE old-more Sensenity Age - young and Exercise increase temp. Hormone Level Not Flashes · - temp) Ovulation Enigher Circadian Rhythm - Sleep/6 Am-4pm (hottest) Stress increase Environment  96. 8 - 100 4. TEMPERATURE ALTERATIONS Fever/Pyrexia/Febrile Occurs when heat-loss are unable to keep up with health production Defense mechanism Temp > 100.4 Hyperthermia - anastera Body cannot promote heat loss Conditions? Heatstroke body temp > 104 Hypothermia - post code Heat loss from prolonged exposure to cold  A febrile - Without ever ↑ Without MEASUREMENT OF TEMPERATURE 3 than back tempanic less on and T Overbball Oral temporal Temp Dot.  MEASUREMENT OF TEMPERATURE Core Depends on critical state of patient Prob foley Cather Examples esophageal temp. Oral, rectal, skin rely on effect blood circulation at site rectal--most acturiant Tympanic relies on radiation of body heat to infrared sensor  Temporal Artery detects cutaneous blood flow 5 29. ACUTE CARE FEBRILE PATIENTS Goals reduce heat production, increase heat loss, prevent complications Nursing Interventions identify bacterium Obtain cultures urine, sputum, blood as ordered - ALWAYS prior to starting antibiotics Reduce covering of patient without causing shivering Provide fluids to replace insensible loss Administer antipyretics - fever reducers Control environmental temperature (70-80F) Avoid these therapies tepid baths, cooling fans, ice packs to axillae and groin Reason Shiver cause increase in temp  PULSE Palpable bounding of blood flow in a peripheral artery Indicator of circulatory status Electrical impulses originating from the sinoatrial (SA) node travel through the heart muscle to stimulate cardiac contraction Range: 60-100 bpm (Adult)  ASSESSMENT OF PULSE Locations: Temporal Carotid - neck Apical BEST for any irregularity or abnormal recheck Brachial infants and children pinky Radial thumb most common UlnarRime-Allens test Femoral Gran Popliteal behind knee ankie Posterior Tibial by Dorsalis Pedis tor or foot  Assessment of Pulse - Auscultate apical pulse - Bell (smaller circular piece) is used to heat low-pitched sounds- heart and vascular (low velocity blood movement) - Diaphragm (larger circular piece) is used to heat high-pitched sounds (high velocity movements, bowel, lung, heart) bell Brewry-with  CHARACTER OF PULSE Rate regular If regular, count to 30 second x 2 = bpm strengh Apical noting rate and rhythm of S1 and S2, MUST do for complete minute Rhythm Regular interval occurs between each pulse or heartbeat Interrupted by early, late or missed beat = dysrhythmia Usually AFir Strength The volume and pressure of blood ejected against the arterial wall with each beat Grading: +4, bounding; +3, full/strong; +2 expected; +1 diminished; +0 absent dopler Equality  PULSE RATE ABNORMALITIES Bradycardia Below HR < 60 beats/min Tachycardia Above HR > 100 beats/min Pulse Deficit Inefficient contraction of heart wave = failure of pulse wave to peripheral site How to assess? Measure radial and apical rates at the same time; the difference = pulse deficit  FACTORS INFLUENCING HEART RATE overtime decrease Exercise increase Temperature increase (ferbrice) - hypotherine (decrease) Acute pain increase Emotions increase Vang blood) Medications Hemorrhage Acute (increase) (decrace Massive Postural Changes Pulmonary Conditions O2-in CO2 -out RESPIRATIONS The mechanisms of exchanging of respiratory gases (O2 & CO2) between cells of the body and atmosphere Respiration Involves: Ventilation movement of gases in and out of lungs A Diffusion movement of O2 and CO2 between alveoli and RBC Perfusion distributing of RBC to and from pulmonary capillaries Mechanics of Breathing: Inspiration Expiration Ranges: 12-20 breaths/min Euprea-normal breathing regular-deep-even  ASSESSMENT OF VENTILATION Respiratory Rate Observe a full inspiration and expiration when counting Expected = eupnea Ventilatory Depth Note depth by observing movement of the chest Note if shallow, deep, or labored Ventilatory Rhythm Describes the breathing pattern Note regular versus irregular A ALTERATIONS IN BREATHING PATTERN. 29 Bradypnea regular, abnormally slow (20 breaths/min) Hyperpnea Respirations labored, increased in depth and rate Apnea cease for several seconds, often results in arrest Hyperventilation rate and depth increase, hybocarbia can occur Hypoventilation rate is low and decreased depth, hypercarbia can occur Cheyne-Stokes irregular rate and depth, periods of apnea and hyperventilation metabolic asbosis Kussmaul’s abnormally deep, regular, increased rate - Biot’s abnormally shallow for two or three breaths, followed by irregular period of apnea  ASSESSMENT OF DIFFUSION AND PERFUSION Determined by measuring the oxygen saturation of the blood Percent of hemoglobin that is bound with oxygen is the percent of saturation of hemoglobin Range SpO2: Greater than or equal to 95% Considerations r/t inaccuracy? Examples Capnography: intitle CO2 35-us normal range usually with per Pumps  BLOOD PRESSURE Blood pressure = force exerted on the walls of an artery by the pulsing blood under pressure from the heart Loading… Systolic = ventricles of the heart contract to push blood into aorta Diastolic = ventricles relax, heart fills and pressure of the blood in the arteries Pulse Pressure = difference between the systolic and diastolic pressure top minus bottom number  BLOOD PRESSURE Physiology of arterial blood pressure Cardiac Output HRX Stroke volume /amount of possure Peripheral Resistance Vasusual tone (diameter) - from left Ventical ( Blood Volume - aboutnow much you have in body Viscosity -increases Pressure (thick like surp( Elasticity increase stiffening : increase blood pressor  FACTORS AFFECTING BLOOD PRESSURE Age increases usually Stress increase Ethnicity and genetics African America's Gender - No Clinical Difference Daily Variation - rest or relax - Decrease Medications Varry Activity and weight up butover time will go down) Smoking Vaso constrict -  HYPERTENSION AND HYPOTENSION two or more reading Hypertension - often asymptomatic, major factor related to heart attack and & Normal: < 120 / < 80 stroke e Stage 1 HTN: 130-139 / 80-89 Elevated: 120-129 /