health & nursing process

1. Higher Institute of Health Professions
Department of Nursing
Medical – surgical – nursing
Lecture (1)
HEALTH & NURSING PROCESS
Prepared
MSc. Wael Lazim Amalki

2. What is HEALTH???
HEALTH IS: The state of total physical, spiritual
and social well-being, and not only the absence
of illnesses and physical defects.

3. What does our health depend on:
Human body consists of twelve systems, that
are divided by principle of performed functions:
cardiovascular, digestive, respiratory,
reproductive etc.
Systems consist of organs, organs consist of
tissues, tissues consist of cells.

4. Factor Important For Staying In Good Health
1. Physical Environment.
2. Social Environment.
3. Cleanliness (Personal Hygiene and Public Cleanliness).
4. Good Food.
5. Good economic conditions.
6. Social Equality and harmony (an example of how
community issues effect individual health).

6. What is Disease???
•Webster defines disease as “a condition in which
body health is impaired, a departure from a state
of health, an alteration of the human body
interrupting the performance of vital functions”.
•The oxford English Dictionary defines disease as “ a
condition of the body or some part or organ of the body
in which its functions are disturbed or deranged”.

7. CAUSES OF DISEASES
There are many causes and types of diseases such as:-
1. Infectious disease(Caused By pathogens).
2. Physical diseases.
3. Sexually transmitted.
4. Mental diseases(Alzheimer's disease).
5. Manic depressive illness.
6. Deficiency disease.
7. Degenerative diseases.

9. Distinction between Disease, Illness and Sickness
The term disease literally means “without ease”
(uneasiness), when something is wrong with bodily function.
Disease is a physiological/psychological dysfunction.
Illness refers to the presence of a specific disease, and also
to the individual’s perceptions and behavior in response to
the disease, as well as the impact of that disease on the
psychosocial environment.
Illness is a subjective state of the person who feels aware of
not being well.
Sickness refers to a state of social dysfunction.
Sickness is a state of social dysfunction i.e. a role that the
individual assumes when ill (sickness role).

10. Level Of Living
It consists of nine components : health, food consumption,
education, occupation and working conditions, housing, social
security, clothing, recreation ‫أستجمام‬ and leisure ‫راحة‬ , human
rights.
These objective characteristics are believed to influence
human wellbeing. It is considered that health is the most
important component of the level of living because its
impairment always means impairment of the level of living.

11. Quality Of Life
The condition of life resulting from the combination of the
effects of the complete range of factors such as those
determining health, happiness (including comfort in the
physical environment and a satisfying occupation), education,
social and intellectual attainments, freedom of action, justice
and freedom of expression.- WHO (1976)
A composite measure of physical, mental and social
wellbeing as perceived by each individual or by group of
individuals- that is to say, happiness, satisfaction and
gratification as it is expressed in such life concerns as health,
marriage, family work, financial situation, educational
opportunities, self-esteem, creativity, belongingness, and
trust in others.

12. Nursing process
is a systematic method for providing care to
clients allows nurses to communicate plans and
activities to Clients, Families, and Community.
# Nursing process Encourages orderly thought,
analysis, planning.

13. Process: “A series of steps or acts that lead to
accomplishment of some goal or purpose”
Purpose of Nursing Process:-
to provide client care that is:
1. Individualized. ‫فردية‬
2. Holistic. ‫كلي‬
3. Effective. ‫فعال‬
4. Efficient. ‫كفوء‬
Overview of the Nursing Process

14. Overview of the Nursing Process
Consists of 5 steps
1. Assessment
2. Diagnosis
3. Planning
4. Implementation
5. Evaluation
Build on each other, Not linear
Nursing process is:
• Dynamic and requires creativity in its application.
• Steps remain the same.
• Application and results different.
• Used throughout the life span in any care setting.

16. Critical thinking
“thinking that is purposeful, reasoned and goal
directed” (Halpern, 1989). is used to ensure that the
nursing process continues to be tailored to meet the
individual needs of the patient.
Critical thinking:— A cognitive strategy by which one
reflects on and analyzes personal thoughts, actions, and
decisions.

17. Assessment:— The ongoing, systematic collection,
validation, and documentation of data about the client; it
is the first step of the nursing process
Involves the following steps:
1. Collecting data.
2. Validating the data.
3. Organizing the data.
4. Interpreting the data.
5. Documenting the data.
1. Collecting Data:
Conduct through 4 Strategies:-
1. Inspection.
2. Palpation.
3. Percussion.
4. Auscultation.
1- Assessment

18. 1- Assessment
2. Validating Data
Validation prevents omissions, misunderstandings, and incorrect
inferences and conclusions.
3. Organizing Data
Collected information must be organized to be useful.
Data Clustering is a useful tool to identify issues.

19. 1- Assessment
4. Interpreting Data
Three critical components:
• Distinguishing between relevant and irrelevant data.
• Determining whether and where there are gaps in the data.
• Identifying patterns of cause and effect.
5. Documenting Data
Assessment data must be recorded and reported.
Accurate and complete recording of assessment data is essential for
communicating information to health care team.

20. 1- Assessment
• Purpose of assessment:
To establish a database concerning a client’s physical,
psychosocial, and emotional health.
To identify health-promoting behaviors as well as actual and/or
potential health problems.

21. 1- Assessment
• Types of assessment:
A. Comprehensive assessment: Provides baseline data including
complete health history and current needs assessment (Physical
& psychosocial).
B. Focused Assessment: Limited in scope in order to focus on a
particular need or actual or potential risk(Screening for a specific
problem, Short stay).
C. Ongoing assessment: Includes systematic monitoring and
observation related to specific problems (Follow-up).

22. 1- Assessment
Sources of Data
A.Primary sources
1.Client
2.Interview
3.Physical examination
B.Secondary sources
1.Medical records
2.Family members
3.Other health care providers

23. 1- Assessment
Types of data
1. Subjective (symptoms):
a. Data from the client’s point of view and sometimes family (Feelings,
Perceptions, Concerns).
b. Main way to collect subjective data (Interview).
2. Objective (Signs):
a. Observable & measurable data.
b. Main way to collect objective data (Physical assessment, Lab and
diagnostic testing).

24. 2- Diagnosis
• Second Step in the nursing process that represent Formulating a nursing
diagnosis conduct through which analysis and synthesis of data.
•Nursing diagnosis: A clinical judgment about individual,
family or community responses to actual or potential health
problems / life processes.
•A nursing diagnosis provides the basis for selection of
nursing interventions to achieve outcomes for which the
nurse is accountable.

25. 2- Diagnosis
•Types of Nursing diagnosis:
1. Actual nursing diagnosis: A problem exists, like acute
pain.
2. Risk nursing diagnosis: A problem does not yet exist, but
special risk factors are present.
3. Wellness nursing diagnosis: Indicates client’s desire to
attain higher level of wellness in some area of function.

26. 2- Diagnosis
•Nursing diagnosis Statement:
1. A problem statement or diagnostic label: that describes
the client’s response to an actual or potential health
problem or wellness condition.
2. The etiology: the related cause or contributor to the
problem.
3. Defining characteristics: the collected data, also known
as signs and symptoms, subjective and objective data, and
clinical manifestations.

27. Nursing vs. Medical diagnosis
• N.D: Is a clinical judgment about individual, family, or community responses
to actual or potential health problems / life processes.
• M.D: Is a clinical judgment by the physician that determines a specific
disease, condition or pathological state.
N.D: Focuses on the clients responses to actual or potential health.
M.D: Focuses on illness, injury or disease processes.
N.D: Changes as the clients response and/or the health problem changes.
M.D: Remains constant until a cure is effected.
N.D: e.g. Body image disturbance.
M.D: e.g. Breast cancer.

28. 2- Diagnosis
Nursing diagnosis Medical diagnosis
Ineffective Breathing patterns. Chronic obstructive pulmonary disease
Activity intolerance Cerebrovascular accident
Acute Pain Appendectomy
Body image disturbance Amputation
Risk for altered Body temperature. Strep. throat

29. 3- Planning
Planning:— The identification of goals and outcomes and
nursing interventions that address client problems, nursing
diagnoses; it is the third step of the nursing process.
It is concerned with identifying priorities, establishing goals
and expected outcomes, and selecting nursing interventions
that will help the client achieve those goals and expected
outcomes.

30. 3- Planning
Types of planning:
1. Initial planning.
2. Ongoing planning.
3. Discharge planning.
Types of Goals:
1. Short term goals
• Hours to days (less than a week)
2. Long term goals
• Weeks to months

31. 4- Implementation (Intervention)
•Implementation:— It is the fourth step of the nursing
process that mean organization, management, and
implementation of planned nursing actions that involves
thinking and doing.
•Intervention is defined as “any treatment based upon
clinical judgment and knowledge that a nurse performs
to enhance client outcomes”.

32. 4- Implementation (Intervention)
•Types of nursing interventions
1. Independent nursing interventions:
• No order needed.
• Elevate edematous legs
2. Interdependent nursing interventions:
• In conjunction with an interdisciplinary team member.
• Assist client with physical therapy exercises.
3. Dependent nursing interventions:
• Require an order.
• Administering of medications.

33. Maslow’s Hierarchy of Basic Human Needs

34. 5- Evaluation
Evaluation:- The fifth step of the nurse process, involves
issues related to structure, process, and client outcomes.
The nurse first reassess the client to identify client
responses to interventions (actual outcomes) and then
compares the actual outcomes with expected outcomes
to determine goal achievement.

35. 5- Evaluation
•Final step of the Nursing Process but also done
concurrently throughout client care
•A comparison of client behavior and response to the
established outcome criteria
•Continuous review of the nursing care plan
•Examines if nursing interventions are working
•Determines changes needed to help client reach stated
goals.
•To determine effectiveness of NCP.

36. 5- Evaluation
•Factors that impede goal attainment:
1. Incomplete database.
2. Unrealistic client outcomes.
3. Nonspecific Nsg interventions.
4. Inadequate time for clients to achieve outcomes.

37. Questions?
Thank you for listening.