BASIC NURSING CARE

Instructor Ashenafi H.
MSc in Nutriton
Tuesday, March 26, 2024
Learning objectives
o Developing strategies and care plan using procedure guide
o Assessment of patient condition and purpose of care
o Indication and contraindication of procedures
o Identification of materials and tools
o Nursing care procedures
o Aseptic techniques
o Client consent and cooperation
o Patient privacy
o OHS procedures

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CHAPTER ONE

IN TRO D U C TIO N TO B A SI C N U R SIN G CA RE

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WHAT IS HEALTH?

◾ In the Oxford English Dictionary health is defined as: „the state of being free
from sickness, injury, disease, something indicating good bodily condition‟.

◾ However in W H O statement health is a state of complete mental, physical&

and social well-being not merely the absence of disease or infirmity.

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CONT …

Physical Health
◾ is concerned with anatomical integrity and physiological functioning of the body.
It means the ability to perform routine tasks without any physical restriction.
o All body parts must be present
o All body parts in natural place & position
o None of them has any pathology
o All doing their physiological function properly
o They work each other harmoniously
◾ E.g. Physical fitness needed to walk from place to place.
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CONT …
Mental Health
◾ is the ability to learn and think clearly, the thinking should be coherent.
o E.g. a person who is not mentally fit (retarded) could not learn something
new at a pace in which an ordinary normal person learns.
Emotional health
o Is related to mental health and includes feelings
o Is the ability of expressing emotions in the appropriate way, for example to
fear, to be happy, and to be angry
o The response of the body should be congruent with that of the stimuli
o Also means maintaining one’s own integrity in the presence of stressful
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CONT …

Social Health
o Ability to make and maintain acceptable interaction and communication
with other people within the social environment

o Mahler (1981): W H O ‟s definition + the ability to lead a socially

acceptable and economically productive life.

o Is resource for attaining better quality of life

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TERMINOLOGIES
◾ Illness- the subjective state of a person who feels aware of not being well.

◾ Disability- any restriction or lack of ability to perform an activity in a

manner or range considered normal for human beings.

◾ Disease- denotes the condition of the human body in which something has
gone wrong & has upset the normal functions of the body or mind.
o A state of physiological or psychological dysfunction.

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CONT …

◾ Contamination – presence of living infectious agent upon articles

◾Infestation– presence of living infectious agent on the exterior surface of

the body

◾Infection - the entry and development or multiplication of an infectious

agent in the body of man or animal

◾ Infectious agent- an agent (microbe) capable of causing infection

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DISEASE CLASSIFICATION
Diseases can be classified according to two major dimensions namely the time
course and cause.
1.Based on the time course
◾ Acute disease (characterized by a rapid onset and a short duration).
◾ Chronic disease (characterized by prolonged duration).
2.Cause
◾ Infectious (i.e. caused by living parasitic organisms such as viruses, bacteria,
parasitic worms, insects, etc.)
◾ Non-infectious (which are caused by something other than a living parasitic
organism).
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CAUSES OF DISEASES
The causes of diseases are classified epidemiologically as:
1. Primary causes
o Factors that are necessary for a disease to occur, and in whose absence
the disease will not occur (e.g. infectious agents, vitamin deficiencies)
2. Contributing, predisposing, or aggravating factors-
o Risk factors whose presence is associated with an increased probability
that disease will occur/develop later
o E.g. Poverty is the most powerful environmental determinant in the
disease occurrence, Habit of cigarette smoking leads to lung cancer.
Having multiple sexual partners‟ results in STI).
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TRANSMISSION OF DISEASE
◾ Logical sequence of factors or links of a chain that is essential for the
development of the infectious agent and propagation of disease.
◾ The six factors involved in the chain of disease transmission are:
A. Infectious agent (etiology or causative agent)
B. Reservoir
C. Portal of exit
D. Mode of transmission
E. Portal of entry
F. Susceptible Host
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CONT …
A. Infectious agent (etiology or causative agent):-
◾ An organism that is capable of producing infection or infectious disease.
The infectious agent is virus, bacteria, parasite or other microbes
B. Reservoir:-
◾ Any person, animal, arthropod, plant or soil or substance (or combination
of these) in which an infectious agent normally live, transforms, develops
and /or multiplies.
◾ Primarily for survival and where it reproduces itself in such a manner that
it can be transmitted to a susceptible host.
◾ It is the natural habitat of the infectious agent
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CONT …

C . Portal of exit: -
◾ is the route by which the infectious agent leaves the infectious hosts or
reservoirs.
◾ Many diseases have multiple reservoirs.The most common portals of exit are
the respiratory tract, genitourinary tract, gastrointestinal tract, skin, etc…
◾ Portal of exit includes:
◾Body secretions and discharges (mucus, saliva and tears, breast milk,
urethral secretion, semen, vaginal secretion, pus, cervical secretion,
exudates etc… )

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CONT …
D. Mode of transmission
◾ is the mechanism by which the infectious agent escapes from a reservoir and enters
into a susceptible human host.
There are two major mechanisms of transmission
Direct transmission; the immediate transfer of infectious agents from an infected
host or reservoir to the appropriate portal of entry on the susceptible host.
o Transmission by direct contact
o Transmission by direct projection
o Trans-placental transmission
o Blood transfusion
o Organ
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CONT …

Indirect Transmission

o Airborne transmission

o Vehicle borne transmission

o Vector borne transmission

o Non vector intermediate host

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CONT …

E. Portal of entry
o Is the route through which a microorganism enters into the susceptible human
host.
o Whether an agent will establish infection depends on the suitable portal of
entry.
F. Susceptible Host
 Host factors influence an individual’s exposure, susceptibility or response to
an infectious agent
 The susceptible human host is the final link in the infectious disease
transmission process.
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CONT …

The susceptibility of the human host depends on:

o Genetic factors (including sex, blood group, ethnicity…) Immunity due
past infection or immunization
o Nutritional status
o Personal behaviors like drinking, smoking
o Anti-microbic anti-biotics availability and effectiveness etc…

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 Brainstorming

 What is Nursing ?

 Nursing is an art and a science.

 “It is assisting the individual, sick or well in the performance of

those activities contributing to health or its recovery (to peaceful
death)”

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 ◾ Involves working with individual, families, and communities to
promote wellness of body, mind, and spirit.
◾ It needs critical thinking and judgment to integrate the experience of a
patient’s biological, physical and behavioral needs
◾ Using scientific knowledge, nursing combines critical thinking skills
with caring behaviors
◾ Nursing promotes health and helps clients move to a higher level of
wellness.

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READING ASSIGNMENT

◾ Florence Nightingale
◾ Vergina Henderson
◾ Canada nursing association ( C A N )
◾ American nursing association

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 PROFESSIONAL SKILL DEVELOPMENT
◾ Florence Nightingale was the founder of modern nursing. She laid
the foundation of professional nursing.
◾ Every profession requires specialized education and intellectual
knowledge.
◾ Therefore, nursing profession is based on the criteria that a
profession must have;
 A systematic body of knowledge that provides the framework
for the profession’s practice,
 Standardized formal higher education
 Commitment to providing a service that benefits individuals
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 C O NT…

 Maintenance of a unique role that recognizes autonomy,

 Responsibility and accountability,
 Practice responsibly under the profession standards and a code of
ethics,
 Evidence based practice
 Commitment to members of the profession through professional
organizations and activities.

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  The nurse’s primary professional responsibility is providing nursing
care for patients, family and community.

◾ Nurses have a lot of responsibility. Such as:-

1. Facilitating safe and therapeutic environment for the patients
2. Delivering holistic and personalized care
3. Maintaining accurate and up to date records and report
4. Protecting patient’s legal rights and privacy,

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 C O NT…

5. Maintaining collaborative relationship with other health workers

6. Working within ethical and legal boundaries

7. Delegating responsibility appropriately

8. Providing health education

9. Focusing on evidence-based practice and

10. Contributing to the professional development of themselves and

the profession.
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 ◾ Nursing students has to participate in extracurricular activities that enriches
academic experiences and fosters professional development.
◾ Nurses are able to specialize with a wider range of scope. Such as;
 Psychiatric Nurse
 Cardiac Nurse
 ICU Nurse (critical and emergency nurse)
 Pediatric Nurse
 Adult Nurse
 Surgical Nurse
 Ophthalmic Nurse
 Neonatal Nurse
 OR Nurse
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 C O NT…

◾ This requires provision of wide range of unique service to individuals

and society

◾ Nursing profession must expand it’s knowledge base to meet the

demand of health care delivery and increase advanced technology,
new nursing research and theories with new practice settings

◾ Nurse has to be individually accountable to the public and provide

care in accordance with nursing standards
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 C O NT…

◾ Autonomy and the ability to develop policy about the discipline control
of the activity of one’s member
◾ A code of ethics to which its members adhere to and provide quality of
care
◾ In a field as varied as nursing, there is no typical answer.
Responsibilities can range from making acute treatment decisions
to advocating at the policy level.

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 CONT…

◾ Nurses worked in collaboration with other health care professionals

in providing community-based services and in developing evidence
based practice among diverse health care settings.
◾ Evidence-based practice:-
 is the application of the best available empirical evidence, including
recent research findings to clinical practice in order to aid clinical
decision-making

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 DEVELOPING STRATEGIES AND CARE PLAN USING
PROCEDURE GUIDE

◾ Nurses develop a plan of care, working collaboratively with physicians,

therapists, the patient, the patient's family, and other team members that
focuses on treating illness to improve quality of life.
◾ Clinical nurse specialists and registered nurse practitioners,
diagnose health problems and prescribe the correct medications and
other therapies, depending on particular state regulations.

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 CONT…

◾ Nurses may help coordinate the patient care that can be done by other
members of a multidisciplinary (therapists, doctors and lab
technicians)
◾ Nurses provide care both interdependently, for example, with
physicians, and independently as nursing professionals.
◾ Nurses provide care and support, educate the public, promote health
and wellness, and do an overall good for the society.

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 CONT…

◾ Nurses use different strategies to develop a care plan for each

special individuals ( pregnant women, aged people, neonate and
child….).

◾ For example

:- administration of an oxygen for acute Asthmatic patient

:- medication administration for hospitalized patients
:- ambulation of unable or disabled patients
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 DEVELOPING A CARE PLAN

◾ Nursing care plans are an important part of providing quality

patient care.
◾ Care plan helps to define the role in patient’s treatment, provide
consistency of care and it allows to customize interventions for
each patient.
◾ It promotes holistic treatment of the patient and helps define
specific goals for the patient.
◾ Writing the best nursing care plan requires a step-by-step
approach to correctly complete the parts needed for a care plan.
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 ◾ Nursing Care Plan (NCP)

 is a formal process that correctly identifies existing needs and

recognizes potential needs or risks.

◾ Care plans provide communication among nurses, their patients, and

other healthcare providers to achieve health care outcomes.

◾ Therefore, without the nursing care planning process, the quality

and consistency of patient care would be lost.

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 ◾ Developing Nursing care planning begins when the client is admitted
to the health facility and is continuously updated throughout in
response to the client’s changes in condition and evaluation of goal
achievement.

◾ Planning and delivering individualized or patient-centered care is the

basis for excellence in nursing practice

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 TYPES OF NURSING CARE PLANS

◾ Care plans can be informal or formal:

1. Informal nursing care plan is a strategy of action that exists in

the mind of the nurse.

2. Formal nursing care plan is a written or computerized guide

that organizes the client’s/ patient care information.

◾ Formal care plans are further subdivided into two

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 C O NT…

I. Standardized Care Plans

◾ Specify the nursing care for groups of clients with everyday needs.

II. Individualized Care Plans

◾ Are tailored to meet the unique needs of a specific client or needs

that are not addressed by the standardized care plan.

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 OBJECTIVE OF CARE PLAN

1. Promote evidence-based nursing care

2. Support holistic care which involves the whole person including
physical, psychological, social and spiritual in relation to management
and prevention of the disease.
3. Establish a care pathways that involves a team effort
4. Identify and distinguish goals and expected outcome.
5. Review communication and documentation of the care plan.
6. Measure nursing care or monitoring and evaluation

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 PURPOSE OF CARE PLAN
1. Defines nurse’s role.
◾It helps to identify the unique role of nurses in attending the overall
health and well-being of clients without having to rely entirely on a
physician’s orders or interventions.
2. Provides direction for individualized care of the client.
◾It allows the nurse to think critically about each client and to develop
interventions that are directly tailored to the individual.
3. Continuity of care.
◾ Nurses from different shifts or different floors can use the data to
render the same quality and type of interventions to care for clients,
therefore allowing clients to receive the most benefit from treatment.
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 CONT…
4. Documentation.
◾It should accurately outline which observations to make, what
nursing actions to carry out, and what instructions the client or
family members require.
◾If nursing care is not documented correctly in the care plan,
there is no evidence the care was provided.
5. Serves as guide for assigning a specific staff to a specific client.
◾There are instances when client’s care needs to be assigned to a
staff with particular and precise skills.

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 CONT…

6. Serves as guide for compensation(reimbursement).

◾In some other countries, medical records are used by the

insurance companies.

7. Defines client’s goals.

◾It does not only benefit nurses but also the clients by involving
them in their own treatment and care
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 STEPS OF CARE PLAN DEVELOPMENT
Step 1: Data Collection or Assessment
◾Is collecting of relevant information and baselines
Step 2: Data Analysis and Organization.
◾Categorizing and arranging the findings, analyzing it to get useful
information
Step 3: Formulating Your Nursing Diagnoses.
◾Stating Actual or potential health problems that can be prevented or
resolved by independent nursing intervention are termed nursing
diagnoses.
Step 4: Setting Priorities.
◾Is establishing a preferential sequence for addressing nursing
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diagnoses and interventions.
 CONT…

Step 5: Establishing Client Goals and Desired Outcomes.

◾Setting goals that describe what the nurse hopes to achieve by
implementing the nursing interventions derived from the client’s
nursing diagnoses.
Step 6: Selecting Nursing Interventions.
◾Activities or actions that a nurse performs to achieve client goals.
Step 7: Providing Rationale.
◾Scientific explanations, explain why the nursing intervention was
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 CONT …

Step 8: Evaluation

◾ Assessing the progress of the patient towards achieving goals or desired

outcomes and the effectiveness of the nursing care plan

◾ Conclusions drawn from this step determine whether the nursing

intervention should be terminated, continued, or changed

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 CLASSWORK QUESTIONS

1. List the topics that you learned today?

2. Write at least 5 responsibilities of nurses?

3. What is the aim of providing nursing care?

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SAMPLE FOOTER TEXT 49
NEXT CHAPTER

IDE NTIF Y C LIE NT S N E E D TO I N D IVID UA L I Z E D N U R S I N G C A RE

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