introduction to medical surgical nursing.pptx

9. Feb 2023

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introduction to medical surgical nursing.pptx

  2. Brief historyof evolution of modern medicine & surgery HOMEOPATHY NATUROPATHY UNANI SIDDHA YOGA AYURVEDA AYUSH ALLOPATHY
  3. Briefhistoryof evolution of modernmedicine& surgery  Indian medicine is ancient. Its earliest concepts are set out in the sacred writings called the Vedas. According to a later writer , the system of medicine called Ayurveda was received by a certain Dhanvantari from Brahma and Dhanvantari was defined as the god if medicine .  The period of vedic medicine lasted until about 800 BC. The vedas are rich in magical practices for the treatment of diseases and in charms for the expulsion of the demons traditionally supposed to cause diseases. The chief condition mentioned are fever, cough, constipation, diarrhea, dropsy, abscesses, seizures, tumors and skin diseases ( including leprosy).
  4. Cont…  At that time , the Hindus were prohibited by their religion from cutting the dead body , their knowledge of anatomy was limited. The Hindus believed that the body contained three elementary substances, microcosmic representatives of the three divines universal forces , which they called spirit (air), phlegm and bile.  The spirit has its seat below the navel, the phlegm about the heart and the bile between the heart and the navel. The seven primary constituents of body are blood, flesh, fat, bone , marrow , chyle and semen are produced by the action of elementary substances .
  5. Cont…  In Surgery, ancient Hindu medicine reached its zenith. It has been said that Hindus knew all ancient operations were grouped broadly such as excision of tumours, incision of abscesses punctures of collection of fluid in the abdomen , extraction of foreign body and stitching of wound.  The instruments used are sharp and blunt. The sharp instruments included knives of various pattern , scissors and needles. And the blunt instruments are forceps, specula, tubes, hooks and probes.
  6. brief history  A brief description of chronological events related to development of health and medicine in India is given below -  3000 BC: Health was given high priority in daily life and this concept of health included physical, mental, social and spiritual well-being.  2000 BC : Rigveda marks the beginning of Indian system medicines. Medicines was considered part of Vedas. Good health implies and ideal balance between tridoshic factors that are wind bile and phelgm(vata, pita and kapha)
  7. Cont…  1000 BC : Atharvaveda mentions the twin aims of medical sciences as health and longevity and curative treatment. Hygiene and dietetics are considered important in treatment.  600 BC : A treatise by kashyapa mainly dealing with Pediatrics.  100 BC : Charaka Samhita , the first classical exposition of Indian system medicines deals with all branches of medicines , anatomy, physiology, etiology, prognosis , pathology and treatment.
  8. Cont…  500 – 600 AD: Vagbhata wrote Astanga Hridaya (8 limbs and heart ). The 8 limbs are therapeutics, surgery, ear, nose and throat(ENT), mental and superstitious diseases, infantile diseases and treatment, toxicology, arresting physical and mental decay and rejuvenation or regaining lost virility potency.  1300 – 1600 AD: It contains the list of diseases and their symptoms and complete list of drugs including many not mentioned in earlier works. It includes etiology and treatment of syphilis, a disease brought into India by Portuguese seamen.
  9. Important Events  1871 : Basic program for combined general nursing and midwifery formulated.  1874 – 1885 : Christian Mission Hospitals began training of Indian nurses only Christian girls have opted training.  1926 : A nursing council constituted in Madras ( now Chennai ).  1949 : The Indian Nursing Council was constituted.  1951 : Training program of 2 years for Auxillary Nurse Midwife (ANM) program started at Punjab .  1971 : College of nursing started at Bangalore , Karnataka.
  10. Nursing in India  In India the first person to improve the medical care was King Ashoka.  The first important thing was to prevent diseases. Hygiene practice were adopted , people must wear clean clothes, should keep their nails short and cut. The women after delivery should live in rooms, which are clean and well ventilated.  The era of modern nursing begin with the work of FLORENCE NIGHTINGALE in the Crimean War (1854 – 1856). She was born on May 12, 1820. She was the daughter of wealthy English parents. She felt that God had called her to full fill ‘Mission of Mercy’. She observed the life of poor and tried to relieve the sick.
  11. Cont…  She was born in Florence Italy, on May 12, 1820, and was named after her birthplace, died on August 13, 1910, London, England.  During the Crimean War, Nightingale was put in charge of nursing British and allied soldiers in Turkey. She spent many hours in the wards and during nights provide care to the wounded laid on the ground, established her image as the “Lady with the Lamp”.  Every year May 12 is celebrated as International Nurses day to remember her birth and recognize the important role of nurses in providing health care .
  13. Concept of health, wellness, disease and illness  Health  “health is a state of complete physical, mental and social wellbeing and not merely an absence of disease or infirmity”.  the state of being free from illness or injury.  health is a state that allows the individual to adequately cope with all demands of daily life.
  14. Cont…  Wellness  An integrated method of functioning which is oriented toward maximizing the potential of which the individual is capable within the environment where he is functioning.  High level wellness is a method of functioning oriented towards maximizing individual potential within the environment.  High level wellness Involves-  Progression toward a higher level of functioning, integration of the whole being and an open-ended future within the challenge of full potential.
  15. Wellness model
  16. Cont… Disease  Any harmful deviation from the normal structural or functional state of an organism.
  17. CAUSE OF DISEASE  A disease is an abnormal condition affecting the body of an organism.  It is a medical condition affecting the signs and symptoms .  Disease may be caused by :- Mechanical cause: trauma and extreme temperature. Biological cause: genetics defect, infection, alteration in immune system Normative cause: normative causes are physiological but involve a body mind interactions, here manifestations occur in response to psychological disturbance. Nutritional causes: malnutrition and over nutrition. Environmental causes: toxic chemicals, cigarette smoking, pollutants and infectious agents such as viruses and bacteria.
  18. cont…  Illness  It is the deviation from wellness. It is alteration in health.  Illness may be acute, chronic or terminal illness.  Acute illness- it is a type of illness resulting from exposure to cause. Acute illness may terminate to death or full recovery.  Myocardial Infarction, gas poisoning, head injury.  Chronic illness- it is long lasting illness usually interfere with patient’s routine daily activities.  Diabetes mellitus, hyperthyroidism.  Terminal illness- it is a type of illness that is expected to result in death.  Advanced cancer.
  19. Stages of illness  Illness is body response to a disease.  It varies from person to person.  Some people become panic to illness and some take it very casually.  The stages of illness are mentioned below:- 1. Experiencing symptoms: As the body is exposed to pathogens/external stimuli, some physiological changes will occur. 2. Assuming the sick role: at this stage, symptoms persists, person starts assuming himself as sick. He starts discussing this with his close family members and colleagues.  .
  20. Cont… 3. Seeking medical care: In this stage, person consults the doctor for his illness. 4. Assuming a dependent role: As the symptoms persist and person starts taking treatment, he perceives himself as a dependent. 5. Achieving recovery and rehabilitation: This is the last stage of illness. Recover phase stints as the body starts responding to treatment. It will be completed at home and at the hospital settings.
  21. EFFECTS OF ILLNESS  Illness leaves a great impact on human life, whether it is a patient or family members.  Effect of illness vary depending upon the type of illness, severity of illness and prognosis.  The effect of illness on patients and his family members separately are:  Effect of illness on individual As discussed earlier, individuals respond differently to the illness. Some person respond it and some take it seriously. Person who take it seriously ,experience a lot of changes in his behaviour. In chronic illness, person have feeling of helplessness, powerlessness and sorrowness.
  22. Cont… Effect of illness on family Family members of patients with chronic illness experience stress, role strain, powerlessness and grieve because of decreased socialization, lost income and increased medical expenses. They may be exhausted in doing their new roles along with routine activities. Effect of illness on elderly person When an elderly person is ill, a son or a daughter often assumes the role of parent to the elderly person, providing housing, meals and assistance with daily needs over a prolonged time. This role reversal may be only temporary and may end when the illness ends or it may become permanent.
  23. Cont… Effect of illness on elderly person When the sick person is a parent, the degree to which the family experiences change is related to the responsibilities. e.g. When a father is sick for a long time, his roles are usually taken over by the mother. Effect of illness in children A child is dependent on parents for so many daily needs , both sick children and their families may need to make fewer role adjustments than sick adults and their families.
  24. THEORIES OF ILLNESS Supernatural theory of disease In the early past, the disease was thought to be caused due to either the curse of god or due to the evil force of the demons and the movements of the planets. As germs cannot be seen through naked eyes, they had no knowledge about this. They believed that disease is caused due to deeds of individuals. These supernatural beliefs are perpetuated by ignorance, illiteracy and poverty.
  25. Cont… Ecological theory  According to this theory, disease occurs when there is imbalance in human and its environment.  Hippocrates is the first epidemiologist who advise to search the environment for the cause of disease.  It is the first scientific approach or reasoning regarding disease causation.
  26. Cont… Pasteur’s germtheory  Germ theory believed that microbes (germs)were found to be the cause for many known diseases.  Pasteur, Henle and Koch discovered the microorganisms in the patient’s secretions/excretions.  Henle and Koch have postulated that each disease is caused by a germ, and that germ can again be isolated from that sick animal.  Though these postulates are true to some extent for infectious disease, they cannot explain the etiology of all diseases, particularly non-infectious diseases.
  27. Cont… Multifactorial causation theory Interaction between the agent, host and environment causes infections. Pettenkoffer stated that agent, host and environmental factor will act and interact synergistically and act as joint independent partners in causing the disease. Pettenkoffer contradicted the unifactorial theory of disease causation and emphasized that disease is multifactorial in causation. This theory of web of causation explains both the infectious and non-infectious diseases.
  28. Illness as human experience  Human behavior has the potential capacity to foster health & to prevent illness.  Health professionals are confronted in wellness and illness care settings.  It is important for nurses to be aware of certain behavior patterns that both well and ill people commonly experience.
  29. Cont…  Health behavior  The activities undertaken by healthy individuals who believe they are well to prevent or detect disease is called health behavior.  It is directed towards an individual’s health. It includes-eating well-balanced diet, adequate rest and daily exercise.  Health behavior directed toward detecting illness include seeking routine screening of vision and hearing, pap smears, physical examination, chest x-ray studies and prenatal and postnatal care.
  30. Cont… Illness Behavior  It has three components-  First person must perceive themselves to be ill. This perception is influenced by familiarity of symptoms or knowledge that illness is present.  Second, person should evaluate the degree or threat to self that the illness presents.  The last component is the action taken. This action may consist of self-treatment or seeking assistance or advice from others perceived to be able to provide the necessary assistance.  The study of illness behavior is important and it is also increase the accuracy of history taking.
  31. Review of Nursingprocess and Nursingcare plan Nursing process  It is defined as a systematic problem solving approach for giving comprehensive nursing care.  It can also defined as an orderly , systemic way of indentifying the client’s problems, making plans to solve them, initiating the plan or assigning other to implement it and evaluating the extent to which the plan was effective in resolving the problems identified.
  32. Characteristics of Nursing Process  It is systematic and orderly.  It is dynamic.  It is interpersonal.  It is outcome oriented.  Provides encouragement to nurses to work together to help clients to use their strength to meet all human needs.  This process is universally applicable in all nursing situations.
  33. Phases of Nursing Process
  34. 1. ASSESSMENT  It is a deliberate, systematic and logical collection of subjective and objective data that are helpful to identify and define problems of the client, before the nurse proceeds to plan the care.  PURPOSE OF ASSESSMENT  Gather data about the client.  Use the data for diagnosis, identifying outcomes, planning and implementing care.  ASSESSMENT SKILLS  Observation  Interviewing  Physical Examination
  35. Types of datacollectionin assessment  OBJECTIVE DATA: It is the collection of medical data that is measurable and substantiated.  This subset of data can be collected using five senses in a clinical setting.  Observation is the main component of acquiring objective data.  SUBJECTIVE DATA : It is defined as the anything patient says about the reason for their doctor’s visit.  The phrase ‘signs and symptoms’ are used to describe patient’s health problems.  The signs refer to the objective data and are based on what nurse sees.  The symptoms refer to the subjective data and based on what patients say they feel.
  36. 2. NURSINGDIAGNOSIS(“what is the problem”)  This is the second step of nursing process .  The nurse will analyse all the gathered information and diagnose the client’s needs.  Diagnosing involves analyzing data, identifying health problems, risks and strength and formulating diagnostic statements about a patient potential or actual health problems.  More than one diagnosis is sometimes made for a single patient.
  37. 3.PLANNING(“Howto manage the problem”)  It is the third step of nursing process.  It provides the direction for nursing intervention.  The planning phase is where goals and outcomes are formulated that directly impact patient care based on evidence based practice (EBP).  TYPES OF PLANNING  Initial Planning:  It is done by the nurse who conducts the admission assessment. Ongoing Planning:  It is done by all the nurses who work with the client. Discharge Planning:  It is the process of anticipating and planning for needs after discharge.
  38. 4. IMPLEMENTATION: (Putting the plan into action)  The implementation of the nursing process is when the nurse put the treatment plan into effect.  It involves action or doing and the actual carrying out of nursing intervention outlined in the plan of care.  It should be specific to patient and focus on achievable outcomes.  Process of Implementing: Reassessing the client Determining the nurse’s need for assistance Implementing the nursing interventions Supervising the delegated care Documenting nursing activities
  39. 5. EVALUATION (“Did the plan work”)  It is the fifth step of nursing process.  This final phase of nursing process is vital to a positive patient outcome.  Whenever a healthcare provider implement care , they must reassess or evaluate to ensure the desired outcome has been met.  STEPS IN EVALUATION  Collecting data  Comparing collected data with desired outcomes  Analysing client’s response relating to nursing activities  Identifying factors that contribute to success or failure  Continuing , modifying or terminating the nursing care plan  Planning for future nursing care.
  40. NCP ON fever 1. Vital signs are collected- temperature, pulse, respiration. 2. Cold sponging is provided with cotton towel. 3. Extra blanket is given to the patient. 4. Healthy diet- khichdi, Dalia, fruits and salad is given to the patient. 5. Acetaminophen is given to the patient.