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PERIODS OF NURSING HISTORY

I. INTUITIVE PERIOD
SHAMAN
TREPHNNG

RISE IN CIVILIZATION

a. BABYLONIANS
CODE OF HAMMURAB




b. EGYPTIANS
ART OF EMBALMNG


c. HEBREW
Teachings of MOSES
MOSAC LAW


d. CHINA
"MATERA MEDCA
FACTORS THAT HAMPERED THE ADVANCEMENT OF
MEDCNE:
Baby boys given girl's name
Prohibits dissecting of human body thus thwarting scientific study



e. INDIA
SUSHURUTO



f. GREECE





g. ROMANS
FABOLA
1
st
hospital in the Christian world





II. APPRENTICE PERIOD
There was a struggle for religious, political, and economic power
Crusades


MILITARY RELIGIOUS ORDERS AND THEIR WORKS
KNGHTS OF ST. JOHN OF JERUSALEM (TALAN)
TEUTONC KNGHTS (GERMAN)
KNGHTS OF ST.LAZARUS
ALEXAN BROTHERS

ST. VNCENT DE PAUL.
LOUSE de GRAS

NURSING SAINTS
ST. CLARE OF ASSS

ST. ELZABETH OF HUNGARY

St. CATHERNE OF SENA


III. DARK PERIOD OF NURSING
Period of Reformation
THEODORE FLEDNER
FLORENCE NGHTNGALE
IV. EDUCATIVE PERIOD
Florence Nightingale era
OTHER SCHOOLS OF NURSNG
Bellevue Training School for Nurses New York City
Alexian Brothers Hospital School of Nursing in US exclusively for
men. t opened in 1348 and it closed down in 1969.


V. CONTEMPORARY PERIOD
World War present
DEVELOPMENT AND TRENDS:








NURSING LEADERS
FLORENCE NGHTNGALE
CLARA BARTON
LLAN WALD
LAVNA L. DOCK
MARGARET HGGNS SANGER


HISTORY OF NURSING
(PHILIPPINE SETTING)
EARLY BELEFS AND PRACTCES
EARLY CARE OF THE SCK
EARLY HOSPTALS:
O Hospital Real de Manila 1577
O San Lazaro Hospital 1578
O Hospital de ndios 1586
O Hospital de Aguas Santas 1590
O San Juan de Dios Hospital 1596

PERSONAGES:
O Dona Hilaria de Aguinaldo
O Dona Maria Agoncillo de Aguinaldo
O Josephine Bracken
O Melchora Aquino
O Anastacia Giron Tupaz
O Cesaria Tan
O Socorro Sirilan
O Rosa Militar
O Socorro Diaz
O Conchita Ruiz

EARLY NURSNG SCHOOLS
O loilo Mission Hospital and School of Nursing
O PGH School of Nursing 1907
O St. Paul School of Nursing 1907
O St. Luke's School of Nursing 1907
O UST 1946
O MCU 1947
O Fatima 1947

NURSE: DEFINITION




PATIENT: DEFINITION


NURSING PROGRAMS
Licensed Vocational Nursing Program / Licensed Practical Nursing
Program (LVN,LPN)

REGSTERED NURSNG PROGRAMS:
Community College / Associate Degree

Diploma Program

Baccalaureate Degree Program

GRADUATE NURSNG EDUCATON:
Master's Degree

Doctoral Degree

External Degree

ROLES OF A NURSE
Caregiver
Communicator
Teacher
Client Advocate
Counselor
Change Agent
Leader
Manager
Case Manager
Research Consumer
Role Model
Administrator
Expanded Career Roles

SCOPE OF NURSING PRACTICE
FOUR AREAS:
O Promoting Health and Wellness
O Preventing llness
O Restoring Health
O Care of the Dying


CONSENT
KNDS OF CONSENT:
nformed Consent




mplied Consent


CONSENT
NURSE'S RESPONSBLTY


PEOPLE WHO ARE NOT ALLOWED TO PROVDE CONSENT:




PROFESSIONAL STANDARDS IN NURSING PRACTICE
ProfessionaI Standards in Nursing Practice

ETHCS and VALUES
Ethics : Basic Terms
O Autonomy

O Beneficience

O Nonmalificence

O Justice

O Fidelity

O Veracity

Code of Ethics for Nurses
O Board Resolution # 202
4 Registered Nurses and People
4 Registered Nurses and Practice
4 Registered Nurses and C-Workers
4 Registered Nurses, Society and
Environment
4 Registered Nurses and the Profession

Patient's BiII of Rights
O Considerate and respectful care
O Obtain from his doctor complete current information
O Receive from his doctor information necessary to give
informed consent
O Refuse treatment to the extent permitted by law and
be informed of the medical consequences of his
action
O Every consideration regarding his privacy concerning
his own medical care program
O Expect that all communications and records
pertaining his care should be treated as confidential
O Expect that within its capacity, a hospital must make
reasonable response to the request of a patient for
service
O Obtain information as to any relationships of his
hospital to other health care and educational
institutions in so far as his care is concerned
O Be advised if the hospital proposes to engage in or
perform human experimentation affecting his care or
treatment
O Examine and receive explanation of his bill,
regardless of the source of payment
O Know what hospital rules and regulations apply to his
conduct as a patient


NURSE THEORISTS

FIorence NightingaIe

O Lady with the Lamp
O Environmental Model- putting the patient in the best
condition for nature to act upon him






Virginia Henderson
O Definition and Components of Nursing
O Principles and Practice of Nursing
O Basic Principles of Nursing
O Nature of Nursing






Dorothy Johnson
O Behavioral Systems Model
O Each individual has patterned, purposeful, repetitive ways
of acting
O Actions/ behaviors form an organized and integrated
functional unit







Jean Watson
O Transpersonal Caring Theory








Betty Neuman
O The Neuman Systems Model








Dorothea Orem
Self-Care Deficit Nursing Theory
O The Theory of Self-Care
O The Theory of Self-Care Deficit
O The Theory of Nursing Systems







Imogene King
O Systems Framework
O The Theory of Goal Attainment




Ida Jean OrIando
O Nursing Process Discipline







MadeIeine Leininger
Theory of Culture Care Diversity and Universality
O Transcultural Nursing Theory
O Ethnonursing
O Crosscultural Nursing










HiIdegard PepIau
O nterpersonal Relations in Nursing










Myra Estrin Levine
O The Conservation Principles: A Model for Health








Sister CaIIista Roy
O The Adaptation Model










Lydia HaII
O Care, Core, Cure








Josephine Paterson & Loretta Zderad
O Humanistic Nursing







Martha Rogers
O Science of Unitary Human Beings












HEALTH AND ILLNESS
I. Concepts
O Disease

O Etiology

O Risk Factors of a disease:

O Wellness


. HEALTH AND LLNESS MODELS

1. Health Belief Models

a. Locus of Control Model


b. Rosenstock and Becker's Health Belief Model




2. Agent Host-Environment Model


3. Smith's Models of Health:
O Clinical Model
O Role Performance Model
O Adaptive model
O Eudaemonistic model



4. Health Promotion
O Any activity undertaken for the purpose of achieving a
higher level of health & well being

5. Empowerment Model




6. Health- llness Continua
a. Travis' llness-Wellness Continuum



b. Dunn's High Level Wellness Grid




Stages of llness:
1. Symptom Experience
2. Assumption of Sick Role
3. Medical Care Contact
4. Dependent Patient Role
5. Recovery/rehabilitation

Levels of Prevention:
1.Primary Prevention
2. Secondary Prevention
3. Tertiary Prevention

Anxiety
O Mild anxiety
O Moderate anxiety
O Severe anxiety
O Panic


NURSING PROCESS


1. ASSESSMENT

Types of Assessment
O nitial
O Problem-focused
O Emergency
O Time-lapsed

$teps in the Assessment Process
O Data Collection
O Data Organization
O Data Validation
O Documentation




1. DATA COLLECTION

%508 of Data
O Subjective
O Objective


Sourc08 of Data
O Primary
O Secondary


M0thod8 of Data Coll0ction
O Observation
O nterview
O Physical Assessment
O Review of Records



. DATA ORGANIZATION
Gordon's 11 Functional Health Patterns
Review of Systems


3. DATA VALIDATION





4. DOCUMENTATION






. NURSING DIAGNOSIS

Types of Nursing Diagnosis
Actual
Risk Nursing Diagnosis
Welless Diagnosis

omponents of a NANDA Nursing Diagnosis

Problem (Diagnostic Label)
Definition
Etiology
Defining Characteristics

"ualifiers
Deficient
mpaired
Decreased
neffective
Compromised
Acute
Chronic


3. PLANNING

Activities:
Setting Priorities
Establishing client goals/ desired outcomes
Selecting Nursing nterventions
Writing Nursing Orders

Setting priorities







4. IMPLEMENTATION






5. EVALUATION








INFECTION CONTROL AND MEDICAL ASEPSIS
nfection
Disease
Trauma
Etiology


The Infection Chain
AGENT

RESERVOR

PORTAL OF EXT

MODES OF TRANSMSSON

PORTAL OF ENTRY

SUSCEPTBLE HOST


Non-Specific Defenses
Anatomic and PhysioIogic Barriers
Intact skin and mucous membranes

2 Oral cavity

3 Gastrointestinal Tract

4 Vagina

5 Urinary meatus

6 Inflammation
Dolor
Rubor
Calor
Tumor
Functio laesa

Specific Defenses
Immunity
1. Active mmunity
Natural
Artificial- antigens/ vaccines
a. nactivated
b. Attenuated
c. Toxoids
d. Subunits
2. Passive
Natural
Artificial

Stages of Infection
ncubation Period
Prodromal Stage
Full Stage of llness
Convalescence

Breaking the Chain of Infection
Cleaning
Use of Antiseptics
Povidone odine
Chlorhexidine Gluconate
Hydrogen Peroxide
Disinfecting
sopropyl alcohol
Chlorine
Sterilizing
Moist heat (steam)
Steam under pressure
Free steam
Gas
Boiling
Radiation

ASEPSIS

Types:

. Medical Asepsis


Tier 1: Standard Precautions



Tier 2: Transmission-Based Precautions


1. Airborne Precautions


2. Droplet Precautions


3. Contact Precautions


. Surgical Asepsis




VITAL SIGNS

1. BODY TEMPERATURE

Types of Body Temperature
Core Temperature

Surface Temperature

Factors Affecting The Body's Heat Production








Processes Involved in Heat Loss











Factors Affecting Temperature










Alterations in Body Temperature









Types of Fever
ntermittent Fever
Remittent Fever
Relapsing Fever
Constant Fever

CLNCAL SGNS OF FEVER

1. Onset/ Cold/ Chill Stage of Fever




2. Course of Fever




3. Defervescence (Fever Abatement)





Methods of Temperature Taking

1. Oral




2. Rectal







3. Axillary





4. Tympanic







. PULSE

Factors Affecting Pulse Rate








Pulse sites










Assessment of the Pulse
O Rate.

O Rhythm


O Volume ( Amplitude).


O Arterial wall elasticity.


O Bilateral equality
3. RESPIRATION
O Ventilation
4 nhalation
4 Exhalation
O Diffusion
O Perfusion

Two types of breathing
Costal/ Thoracic
Diaphragmatic/ Abdominal

Respiratory centers:
O Medulla oblongata
O Pons
O Pneumotaxic center
O Apneustic center
O Carotid and aortic bodies
O Muscles and joints

Assessing Respiration
O Rate
O Depth
O Rhythm
O Quality or Character

Major Factors Affecting RR






4. BLOOD PRESSURE




Determinants of Blood Pressure







Factors Affecting Blood Pressure










PHYSICAL ASSESSMENT

Types of PhysicaI Assessment
1. Complete Physical Assessment
2. Focused Physical Assessment

Preparation for the Examination










Techniques of PhysicaI Assessment
1. Inspection
O Direct
O ndirect


. PaIpation
O Light Palpation
O Deep Palpation


3. Percussion
Plexor and pleximeter

O Direct Percussion
O ndirect Percussion

4. AuscuItation
Direct/ indirect


COMPREHENSIVE PHYSICAL ASSESSMENT


O General Survey, Mental Status Exam, and Vital Signs

O Skin, Hair and Nail Assessment

O Head and Neck Assessment

O EYE ASSESSMENT

O EAR ASSESSMENT

O Mouth, Throat, Nose, and Sinus Assessment

O Thoracic and Lung Assessment

O BREAST AND LYMPHATC ASSESSMENT

O HEART AND NECK VESSEL ASSESSMENT

O PERPHERAL VASCULAR ASSESSMENT

O ABDOMNAL ASSESSMENT

O FEMALE GENTALA ASSESSMENT

O MALE GENTALA ASSESSMENT

O ANUS, RECTUM AND PROSTATE ASSESSMENT

O MUSCULOSKELETAL ASSESSMENT

O NEUROLOGC ASSESSMENT


ACTIVITY AND EXERCISE
O Mobility

O Body Alignment

omponents of Good Posture
O Line of gravity
O Center of gravity
O Base of support


Body Mechanics


EXERCSE
Aerobic
Strengthening
sometric
sotonic
sokinetic
Range-of-Motion

Factors Affecting Mobility






HYGIENE

Factors Influencing Individual Hygiene Preferences





Definitions and Descriptors for Functional Levels
0: ompletely Independent
+1: requires use of equipment/ device
+2: $emidependent
+3: Moderately dependent
+4: Totally dependent



Bathing

1. Cleansing bath
Complete bed bath
Self-help bath
Partial bath
Towel bath
Tub bath
Shower
2. Therapeutic bath

Foot Hygiene



Mouth



Hair



Eye



Ears




SAFETY AND SECURITY
Factors Affecting $afety











Promoting $afety










R08traint8
Classification
Physical
Chemical
Kinds of Physical Restraints
4 Jacket restraints
4 Belt restraints
4 Mitt/ Hand Restraints
4 Limb Restraints
4 Mummy restraints



HEALTHY LIFESTYLE

NUTRITIONAL PRACTICES











PHYSICAL ACTIVITY













STRESS MANAGEMENT

GAS:
1. Alarm reaction
2. Resistance
3. Exhaustion
LAS:

Coping

Anxiety
O Mild anxiety
O Moderate anxiety
O Severe anxiety
O Panic

Types of Stress:
Distress
Eustress
Other Types:
Work Stress
Family stress
Chronic stress
Acute stress
Daily hassles
Trauma
Acute stress disorder
Posttraumatic stress stress
Flashbacks
Crisis

Aspects of the stressor that would influence the stress response:








Characteristics of the individual that would influence the stress
response:



REST AND SLEEP
Sleep
Physiology
Circadian Rhythm
Sleep regulation
RAS Reticular Activating System
BSR Bulbar Synchronizing Region
Phases of Normal Sleep
NREM
4 $tage
4 $tage 2
4 $tage 3
4 Stage 4
REM Sleep

Sleep disorders
a. dyssomnias
a.1. intrinsic sleep disorders
a.2. extrinsic sleep disorder
a.3. circadian rhythm sleep disorders
b. parasomnias
Bruxism
Enuresis
Night terrors

Factors Affecting sleep











SMOKING









ALCOHOL CONSUMPTION










PLANNING
IMPLEMENTATION: EXERCISE
PhysicaI Exercise
a.1. Promote Aerobic and Anaerobic exercise
a.1.1. Aerobic
a.1.2. Anaerobic
a.2. Exercise Principles

IMPLEMENTATION: DIET


Strategies








IMPLEMENTATION: SMOKING CESSATION
RA 9211 Tobacco regulation act of 2003

Phases of the Long Term Treatment
Pre-contemplation
Contemplation
Preparation
Action

IMPLEMENTATION: SLEEP AND REST












OXYGENATION

FACTORS AFFECTNG THE RATE OF OXYGEN TRANSPORT



Alterations in Respiratory Function





Abnormal Chest Movements







SECRETONS AND COUGHNG







DAGNOSTC STUDES
ulture and sensitivity
Cytology
Acid-fastbacillus (AFB)
THROAT CULTURE
BLOOD SPECMENS
PULMONARY FUNCTON TESTS
X-RAY EXAMNATON
LUNG SCAN
LARYNGOSCOPY AND BRONCHOSCOPY
THORACOCENTESS (Thoracentesis)


PIanning

ImpIementation
Prevention
Vaccine
Environmental modifications: Clean Air Act
Health promotion
DBE and Coughing exercises
Hydration
Medications
Lung inflation devices-S
Percussion, Vibration and Postural Drainage
Oropharyngeaal and Nasopharyngeal
Suctioning

Oxygen Therapy

OXYGEN DELVERY Systems
CANNULA
FACE MASK
Simple Face Mask
Partial Rebreather Mask
Nonrebreather Mask
VENTUR MASK
FACE TENT
TRANSTRACHEAL OXYGEN DELVERY

Artificial Airways
Oropharyngeal ntubation
Nasopharyngeal ntubation
Endotracheal Tubes
Tracheostomy Tubes

Chest Tubes and Drainage System
WATER SEALED DRANAGE SYSTEMS

ELIMINATION


NORMAL CHARACTERSTCS OF URNE
olor:
Odor:
Transparency:
pH:
$pecific gravity:

Factors affecting Urinary Elimination/Micturition/Voiding






COMMON URNARY ELMNATON PROBLEMS
ALTERED URNE PRODUCTON
4 POLYURA
4 OLGURA
4 ANURA
ALTERED URNARY FREQUENCY
4 FREQUENCY
4 NOCTURA
4 DYSURA
4 ENURESS


URNARY NCONTNENCE
Total ncontinence
Stress ncontinence
Urge incontinence
Functional incontinence
Reflex incontinence

URNARY RETENTON

BOWEL ELIMINATION

NORMAL CHARACTERSTCS OF STOOL

Wolor:
Wonsistency:
W$hape:
WAmount:
WOdor:
Wonstituents:

Factors affecting Bowel Elimination/Defecation











COMMON FECAL ELMNATON PROBLEMS
WCONSTPATON
WNCONTNENCE
WFECAL MPACTON
WFLATULENCE



FLUID AND ELECTROLYTES

Body water
Body fluid
Electrolytes
Movement of Fluids
WOSMOSS
WDFFUSON
WFLTRATON
WACTVE TRANSPORT

CLNCAL MEASUREMENTS
DALY WEGHTS
FLUD NTAKE AND OUTPUT

COMMON ELMNATON AND F & E PROBLEM
Diarrhea
Constipation
Nausea and vomiting
Flatulence
UT


PAIN

THEORES OF PAN:
4 PATTERN
4 SPECFCTY THEORY
4 GATE CONTROL
4 AFFECT THOERY

Factors nfluencing the Pain Experience
PAN THRESHOLD
PAN TOLERANCE
PAN PERCEPTON
HYPERALGESA

TYPES OF RESPONSES TO PAN
4 NVOLUNTARY RESPONSES physiologic
responses
4 VOLUNTARY RESPONSES
Behavioral responses
Emotional responses

CLASSFCATON OF PAN
WTypes of Pain
Cutaneous
Somatic
Visceral
Referred pain
ntractable pain
Phantom
Radiating
Psychogenic
intermittent
WLocation provides information on the organ affected
WDuration
Acute less than 6 months
Chronic more than 6 months
WCharacter client's description
Wntensity scale from 0 to 10
WFactors relieved
WEffects to/of ADL

Nursing Care
Techniques that stimulate the skin
Techniques that distract attention from pain
Techniques that promote relaxation

GRIEF, LOSS, DEATH AND DYING

Signs of mpending Clinical Death








ndicators of Death







Bodily Changes After Death
Rigor mortis
Algor mortis
Livor mortis
Skin indentation


WOUND


Wounds


Wound Repair
InfIammation
2 ProIiferation
3 RemodeIing

Factors that affect wound healing:









Factors that may interfere include:

Wound Management
1. Dressings
Purposes:






a. Gauze Dressings
b. Transparent Dressings
c. Hydrocolloid Dressings

Dressing Changes

Drains
O Open Drains

O Closed Drains

Sutures and Staples






Bandages and Binders
A bandage is a strip or roll of cloth wrapped around a
body part. One example is Crib bandage.
A binder is a type of bandage generally applied to a
particular body part such as the abdomen or breast.

Dbridement.
O Sharp Dbridement
O Enzymatic Dbridement

Wound rrigation

PRESSURE ULCERS
O Stages of Pressure Ulcers
Stage 1: epidermis; nonblanching erythema
Stage 2: epidermis/dermis; shallow opening;blisters
Stage 3: Subcutaneous tissue/fascia
Stage 4: fascia + bone, tendon, muscle, cartilage

Wound Dressings
1. Bandages
a. Types
O Conforming Bandages
O Elastic Bandages
O Retention Bandages
O Supportive / Fixation Bandages.
b. ndications and Contraindications








c. Method of use








2. Compressive
a. ndications and Contraindications






b. Application Method








3. Fixative Device
a. Examples








b. ndications and Contraindications

















MEDICATION ADMINISTRATION


Types of Doctor's Order:
Standing Order
Single Order
Stat Order.
PRN Order

The "10 Rights of drug administration.

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.




Routes of Drug Administration.