FUNDA Notes
FUNDA Notes
FUNDA Notes
HISTORY OF NURSING
PERIODS OF NURSING
INTUITIVE NURSING/ PRIMITIVE NURSING/ INSTINCTIVE NURSING
(Primitive times – 6th century)
PRIMITIVE TIMES
- Women practice nursing because of low status in society.
- Took care of children and sick members of the family.
- Personalistic cause of disease.
- Sickness is due to active intervention of:
a. human – caused by witchcraft.
b. non human – caused by ghosts.
c. superhuman beings – caused by deities.
- Superstitious and believes in magic.
- Slave society “slave nurses”
- Wet nursing, take care of babies/children of their masters
- Women also practices midwifery.
- Masters/healers are the people who are responsible in decision making when it comes to health.
6th CENTURY
- Founding of religious orders.
3 Attributes of Nurses
1. Self denial
2. Devotion to hard work and duty.
3. With spiritual calling.
Main Guiding Principles
1. “Love thy neighbor as thy self”.
2. Parable of the Good Samaritan.
- Beneficence (doing good to others).
2 Types of Beneficence
1. Ordinary – doing good to others.
2. Ideal – entails sacrifice.
PROFESSION – a special calling that requires special, skills, knowledge and attitudes.
7 CRITICAL ATTRIBUTES OF PROFESSION
1. Specialized education
2. Code of ethics
3. Research of orientation
4. Autonomy
5. Body of knowledge
6. Service orientation
7. Professional Organization
SOCIALIZATION – process where a person learns the ways and means or skills, knowledge, attitudes of the
group to which he belongs to.
BENNER LEVEL OF PROFICIENCY
1. Novice – student nurse entering a clinical setting where he has no experience at all.
2. Advance – nurse who demonstrates a marginally acceptable performance: depends on rules and maxims.
3. Competent – 2 – 3 years experience demonstrates organizational ability but lacks speed and flexibility of a
proficient nurse.
4. Proficient – concerned with long term goals, performance is fluid and flexible compared to competent nurse
- has a wholistic view of the client.
5. Expert – no longer relies on maxims, performance is highly proficient, fluid flexible and has a wholistic view.
- has high perceptual acuity or a clinical eye.
DIMENSIONS OF NURSING
1. Nursing Practice
2. Nursing Education
3. Nursing Research
FOCUS OF NURSING
1. Health Promotion – improve clients well being.
2. Health Maintenance
3. Health Instauration – help clients with illness to recover.
4. Care of the Dying – clients with cancer.
LEVELS OF CLIENTELE
1. Individual
2. Family
3. Community
4. Population Groups – special groups with special needs attributed to the following:
a. Cultural characteristics – indigenous people.
b. Developmental stage
c. Occupation – commercial sex workers are more prone to STD’s.
ROLES OF NURSE
1. Nurse Educator
- 3 domains of learning
a. Cognitive – knowledge aspect
b. Psychomotor – skills
c. Affective – interest/emotion
2. Caregiver
- Attends to physical/emotional (mostly physical) needs of the client.
3. Nurses as Leader
- Process of influencing people to work towards the attainment of goals.
4. Manager
- Organizational goals/works within an organization.
PROCESS OF MANAGEMENT
a. Planning (resources)
b. Organizing (delegating tasks/tasking)
c. Directing (motivating people)
d. Controlling – evaluation of output against standards.
5. Client advocate – protects rights of clients.
6. Change agent – improvement in organization.
7. Researcher – research process
8. Facilitator
RESTORATION WILL
NURSES PERSON
MAINTENANCE
STRENGTH
PEACEFULENVIRONMENT
DEATH
B. SYSTEM THEORIES
5. SISTER CALLISTA ROY’S ADAPTATION MODEL
- Grounded on humanism.
- Person is adaptive system with coping mechanism.
- Goal of nursing is to promote persons adaptation.
STIMULI
1. Focal - immediate
2. Contextual – other internal and external factors
3. Residual – may or may not have effect like attitudes and beliefs.
COPING MECHANISMS
1. Regulator – neural – chemical – endocrine.
2. Cognator – processed through cognition.
ADAPTIVE MODES
- Physiologic – adaptive mode
- Self concept mode
- Interdependence mode
- Role function mode
- Adaptive/effective response
- Maladaptive/ineffective response
B. ENVIRONMENT
- Environment has potential to alter system stability due to internal and external stressors.
STRESSORS CAN BE
1. Extra personal – unemployment, microorganisms, peer pressure, radiation.
2. Inter personal – between 2 or more individual (parent expectations).
3. Intra personal – anger, physical abilities, financial condition.
- Environment can also be source of resources that may help client cope with stressors.
C. HEALTH
D. NURSING
- Primary: protection of normal line of defense.
- Secondary: protection of basic structure by strengthening internal line of resistance.
Ex. Treatment of symptoms, energy conservation
- Tertiary: promotion of reconstitution by supporting existing strengths and resources.
Nurse Patient
Counselor – identify stressor (with a need)
Resource Person – health educator
Surrogate – acts as caregiver
Congruent Goals
CONSERVATION OF
- Energy
- Structural Integrity Promotion of “wholeness” of the client towards health
- Personal Integrity maintenance or health restoration.
- Social Integrity
CONSERVATION
- Defends wholeness of living systems by ensuring their ability to confront change
LIKELIHOOD IN
ENGAGING IN
Depth of health Situational factors
HEALTH PROMOTING
BEHAVIORS
Perceived health status Behavioral factor
CONCEPT OF MAN
Atomistic – whole or sum of parts
Holistic – the whole is not equal to the sum of parts
Physiologic – genetic character, organs and functioning
Psychological – emotions, affect, rationality, merciful
Socio-cultural – socialization, family, language
Intellectual – perception, cognition
Spiritual – faith (unquestioning belief in someone, serves to unite humans), hope, charity
Charity – outward expression of love for others
Physiologic
- sex, nutrition, shelter, clothing, water, elimination, rest and sleep
Safety and Security
- physical freedom from harm, psychological knowing what to expect from others and what others expect from
you.
Love and Belongingness
- nurturance with affection
Self Esteem
- persons sense of achievement and independence, competence, confidence and strength
Self Actualization
- not all people attain self actualization (attained by only 15%)
- Accepts himself
- Balance between rest and activity
- Open mind
- Positive outlook in life
HEALTH
- Health is a state of complete physical, mental and social well-being and not merely the absence of disease or
infirmity.
WELLNESS
- State of well being
- Subjective perception of balance, harmony and vitality engaging in attitudes and behaviors that enhance the
quality of life and maximizes personal potential.
DIMENSION OF WELLNESS
- Physical: ADL, fitness of organ structures and functioning
- Spiritual: faith and hope
- Intellectual: use knowledge for personal, family, social, career development
- Emotional: able to manage stress, express feelings and emotions appropriately
- Social: interact successfully with others, tolerant of people with different beliefs
Agent
Host Environment
HEALTH AXIS
Death Peak
Wellness
Poor health Energetic, High level wellness
(in an unfavorable environment) (in an unfavorable environment)
Environmental axis
Wellness model
. . . . . .
Premature Death
Treatment Models
Neutral Point
(no discernable illness or wellness)
- Movement to the right of the neutral point indicates high level of health and well being for an individual and
this may be achieved through awareness and education and growth. In contrast, movement to the left of the
neutral point indicates a progressively decrease state of health
ILLNESS
- Highly personal state in which the person feels unhealthy or ill, may or may not be related to disease
DISEASE
- Alteration in body function resulting in a reduction of capacities or a shortening of the normal lifespan
CAUSES OF DISEASE
1. Genetic – inherited, genetic defects
2. Developmental – resulting to exposure to virus or chemicals during pregnancy
3. Biologic – microorganisms (virus, bacteria, protozoa, fungi) and their toxins and helminthes
4. Physical – temperature extremes, electricity, radiation
5. Chemical – alcohol, strong acid and base, drugs
6. Mechanical – generalized tissue response to injury or irritation (trauma shearing force, friction)
7. Physiologic and Emotional reaction to stress
8. Faulty Chemical or Metabolic Processes – excessive or insufficient production of hormones, enzymes
ASSESSMENT
- Objective (physical exam) and subjective (nursing history)
SOURCES OF DATA
1. Primary – client
2. Secondary – relatives, members of health team
NURSING DIAGNOSIS
- Clinical judgment about an individual, family or community responses to actual and potential health problems
- Professional nurses are responsible for making nursing diagnosis.
- Nursing diagnosis describe a continuum of health states.
Problem Responses
First Priority – is any threat to the vital functions of breathing, heart beat, blood pressure.
Medium Priority – health-threatening problems that may result in delayed development or cause destructive
physical or emotional changes.
Low Priority – problems that arise from normal development needs or those that require minimal nursing
support.
OBJECTIVES
- Should be SMART, client centered, statement of a single human response
EVALUATION
- Conclusion and supporting data
- Goal met
- Goal partially met
- Goal not met
GROWTH
- Physical change
- Increase in size
- Periods of very rapid growth rate: pre – natal, neonatal, infancy, adolescence
DEVELOPMENT
- Increase in complexity of function and skill progression
- The behavioral aspect of growth
PRINCIPLES OF DEVELOPMENT
1 Growth and development are continuous orderly, sequential process influenced by maturational environment
and genetic factors
2. All humans follow the same pattern of growth
3. The sequence of each stage is predictable although the time of onset, the length of the stage and the effects
of each stage vary with the person.
4. Growth and development occur in cephalocaudal direction.
5. Growth and development occur in a proximal to distal direction
6. Development occurs from simple to complex or from single acts to integrated acts.
7. Development becomes increasingly differentiated, begins with generalized response and progresses to a
skilled specific response.
8. The pace of growth and development is asynchronous or uneven.
KOHLBERG’S STAGES OF MORAL DEVELOPMENT
LEVEL AND STAGE
Level I: Pre Conventional (Egocentric Focus)
Stage 1
Punishment and obedience orientation - Activity is wrong if one is punished,
(toddler – 7 years) activity is right if one is not punished.
Stage 2
Instrumental – Relativist Orientation (4 – 12 years) - Action is taken to satisfy ones needs.
Middle Age (Emptiness Stage) - Achieving adult civic and social responsibility
- Establishing and maintaining an economic
standard of living
- Assisting teenage children to become
responsible and happy adults
- Developing adult leisure time activity
- Accepting and adjusting the physiologic
changes of middle age
- Adjusting to aging parent
COMMUNICATION
- Human function that enables people to relate with each other
MODES
Verbal – spoken language
Non-Verbal – symbols, sign language
ELEMENTS OF COMMUNICATION
1. Stimulus – reason why people communicate, motivation with each other (object, ideas, feeling) referent
2. Message – idea, feelings and emotions
3. Sender – also known as encoder, one that sends the message
4. Channels – kinesthetic: tactile stimulus, visual: symbols, auditory: spoken language
5. Receiver – decoder
6. Feedback – answer to questions, whether receiver understood or not
Being specific and tentative Statements that are specific rather than general and
tentative rather than absolute
Using open ended questions Specify only topic to be discussed and invite answers
longer than one or two words
VITAL SIGNS
TEMPERATURE
1. Oral
- Most accessible and convenient
- Normal value: 37 o C – 98.6 o F
- 2 – 3 minutes
2. Rectal
- Most reliable
- Normal value: 37.7 o C – 99.6 o F
- 3 – 5 minutes
3. Axila
- Less accurate
- Normal value: 36.4 o C – 97.5 o F
- 5 – 10 minutes
4. Tympanic membrane
- Directly reflects core temperature
- Normal value: 37.7 o C – 99.9 o F
- Automatic results
CONVERSION
- Fahrenheit to Celsius = (F-32) x 5/9
- Celsius to Fahrenheit = (C x 9/5) + 32
PULSE SITE
1. Temporal 6. Femoral
2. Carotid 7. Popliteal
3. Apical 8. Posterior tibial
4. Brachial 9. Dorsalis pedis
5. Radial
When palpating for pulse use 2 – 3 fingers except when taking the apical pulse use stethoscope
Apical pulse is in the 5th intercostals space
Landmark is the angle of Louie
4th intercostals space left mid clavicular line child apical pulse
When using the stethoscope use the flat part when looking for high pitch sounds like (lung and
bowel sounds) and use the bell for vascular or heart sounds
RESPIRATION
- Adult: 12 – 20 c/min
- Newborn – 30 – 60 c/min
KOROTKOFF SOUNDS
Phases
1. Characterized by a thud, thump and tapping sound
2. Swooshing, whoosing sound
3. Sound decrease in intensity when compared to Korotkoff one
4. Muffling sound
5. Disappearance of sound
- in adults record Korotkoff 1 and Korotkoff 5 of able to hear Korotkoff 4 record also
- in children record Korotkoff 1 and Korotkoff 4
HYPERTENSION
Average of 2 or more diastolic reading on at least 2 subsequent visits is 90 mmHg or higher or when an
average of 2 or more systolic readings on at least 2 visits is higher than 140 mmHg
SYSTOLIC DIASTOLIC
Optimal/ Normal 120 – 129 80 – 84
Above Normal 130 – 139 85 – 89
Hypertension
Grade 1 (Mild) 140 – 159 90 – 99
Grade 2 (Moderate) 160 – 179 100 – 109
Grade 3 (Severe) Greater than 180 Greater than 110
Greater than 140Less 80 Less 90