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FUNDAMENTALS 2

CHP.28,35,42

QuestionAnswer
What does ‘Complementary Health Approaches (CHA)’ mean? I.E ACUPUNCTURE, CHIROPRACTIC-HERBAL REMEDIES- Non-conventional practices to maintain health •Previously referred to as ‘Complementary and Alternative Medicine (CAMs)’ I.E LOTS OF TRIAL AND ERROR-NOT EVIDENCE BASED PRACTICE HOLISTIC-CAN BE COMBINED WITH MEDICAL TREATMENT NOT MEDICAL PRACTICE
IMPORTANCE?? QSEN standards –QUALITY-SAFETY-ENVORIMENT-NURSING individualized patient care•Continuation of preferred health models •Cultural competence -INCORPORATE PT OWN HEALTH PRACTICE INTO CARE •Patient education -EDUCATE ON SAFETY ON THEIR ADJUNCT TREATMENT
IMPORTANCE OF CHA?
Conventional Medicine ? Allopathic Medicine • Emergent or acute care •Evidence-based practice EVIDENCE-BASED PRACTICE TRIAL AND ERROR
Holism General adaptation syndrome (GAS)-ONE PART ISN'T WELL, ALL PARTS AREN'T WELL •Basis for several CHAs •Holistic nursing -MIND-BODY-SPIRIT-
CHA in the United States •Mind-Body Practices•Natural Products•Other Prevalence OVER 50% IN USA USED THIS TREAT WITH DIET-HERBAL INTERVIEW:KNOW WHAT TAKING( EATING-DRINKING AT HOME) EXERCISE HERBAL SUPPLEMENT
CHA and Nursing Practice incorporated in care •Assessments •Education -KNOW HOW PATIENT TAKES CARE OF THEMSELVES-
Define Pain Pain is universal and individual•Pain is subjective •Nociceptive pain is a physiological process BODY RESPONSE TO LACK OF HOMEOSTASIS
The Physiology of Pain Transduction•Transmission•Perception•Modulation
Transduction Nociceptors respond to stimuli •Neurotransmitters -CHEMICAL MESSENGER-INFO TO BRAIN(HISTAMINE-PROSTAGLANDIN) •Examples of stimuli •Mechanical -INJURED TO TISSUE •Thermal-SUN BURN •Chemical -ACID BURN •Electrical -VOLTAGE
Transmission Afferent nerve pathways •A-delta-fiber-LARGE AND FAST-ACUTE-MECHANICAL AND THERMAL •C-fibers-DIFFUSED AND SMALL-PERSISTENT •Efferent nerve pathways
Perception Interpretation and Pain threshold -LOW AND HIGH PAIN TOLERANCE(WHAT IS A COMFORTABLE PAIN LEVEL FOR YOU? •Adaptation -YOU GET USED TO PAIN-AND RESPONSE DIFFERENTLY
Modulation Neuromodulators•Endorphins •Enkephalins PREVENT RELEASE OF NEUROTRANSMITTERS(BRADYKININS-) BLOCK NEUROTRANSMITTER-BODY NATURAL RETURN TO HOMEOSTASIS
Classifying Pain Duration •Acute-SHORT RAPID ONSET-damage tissue, triggers autonomic sys,=increased hr, bp i.e surgery, Chronic- •Remission-NO SYMPTOMS •Exacerbation-SYMPTOMS COMES BACK(s/s of acute and chronic-persistent)
LOCATION •Cutaneous SUPERFICIAL -skin, subq tissue Somatic • DEEP DIFFUSE PAIN-TENDON AND BONES Visceral -poorly localized STOMACH-FIRST INDACTION THAT SOMETHING IS OFF Referred-HEART ATTACK-GALLBLADDER-NOT OCCURRING AT SPECIFIC ORGAN LOCATION-MI
ETIOLOGY •Nociceptive- SOMATIC-VISCERA NORMAL PAIN PROCESS NEUROPATHIC-NERVE- CAUSED BY LESION, DISEASSE DIABETIC-BURNING, SHOOTING, STABBING •Phantom AMPUTED LEG, ABSENT RECEPTORS Intractable-CHRONIC PAIN-RESISTAT TO THERAPY
Pain Responses PSYCHOGENIC PAIN-MENTAL EVENT Behavioral (Voluntary)-SLEEP- •Physiologic (Involuntary)-NOT TALKING-BP-HR-RR-GO UP-PALE-HOLDING PART-SYMPATHETIC -MODERATE-SUPERFICIAL, PARSYMPATHETIC- N/V, LOW BP, FAINTING •Affective (Psychological) ANXIETY-DEPRESSION-ANOREXIA-FEAR=CHRONIC PAIN
The Individual Pain Experience Culture and Ethnicity-ADMITTING TO PAIN MAY SEEM AS BEING WEAK-MEN PAIN AS EVIL-LOW ECONOMIC STANDING -Religion- Family-Sex/Gender-BEING OVER TAKEN CARE OFF MIGHT WORSEN YOUR HEALTH STATUS
The Individual Pain Experience Age- Environment - Anxiety - Past experiences Effect of the pain experience on activities and lifestyle
The Nursing Process: Assessment Patient’s description (quality, intensity) Patient’s verbalization and description Duration , Location ,Quantity and intensity, Quality , Chronology Aggravating & Alleviating factors Patient’s description (quality, intensity)-PROVIDE PRIVACY Location-HEAD TO TOE- Duration-PAIN-WHERE IT IS-HOW LONG-TAKEN SOMETHING Aggravating/Alleviating factors -WHAT MAKES IT WORSE OR BETTER- Physiological and/or Behavioral Indicators -GARBLING
The Nursing Process: Diagnosis ACUTE PAIN CHRONIC PAIN-HOW LONG-BETTER WORSE-TREATED? WITH WHAT? PAIN AS THE ETIOLOGY -ANXIETY MAKES PATIENT ANXIOUS-CONSTIPATION- FEAR OF PAIN LEADING SOMETHING ELSE
The Nursing Process: Outcome/Goal/Planning -PROCEDURE AS EVIDENCE BY PAIN 20 DEVELOP TO TREAT PATIENT Acute pain relief Chronic pain management -COMMUNITY RESOURCES WHILE SENDING PT HOME
The Nursing Process Implementation/Interventions REVIEW CHART PRIOR TO MED-HOW OFTEN WAS IT TAKEN-WAS IT HELPFUL-ADJUST MED BASED O PAIN(CONSTANTLY ASSESS PAN Complementary Health Approaches -MASSAGE-REPOSITIONING-CALM MUSIC-AROMA THERAPY Communication-TALK AND LISTEN TO ESTABLISH TRUSTING REPORT Pharmacological -OPIOD ANALGESIC AND OPIOD NON-ANALGESIC-PCA-OPIOID PUMP TO HELP PATIENT CAN'T ORDER IT
The Nursing Process: Evaluation S- 1-A&O 2-slightly drowsy but easily aroused 3-drowsy and drifting off during conversation; however, he can be aroused. 4-no arousal to stimuli-somnolent Reassess •Patient response-PAIN ASSESMMENT 30MINS ATER GIVING MED-DOCUMENT-DID IT WORK? •Change in status -DO VS- WORK ON DISCHARGE PLAN, AS SOON AS PATIENT IS ADMITTED
CONSIDERATION Ethical/Legal implications -DOCUMENTING SUBJECTIVE-TREAT-EDUCATE PATIENT AS HE/SHE LEAVES- •Personal reflection -EVALUATE CARE-TREAT BASED ON PT PREFERENCE •Family input -EDUCATE SPO USE-FAMILY MEMBER
Stress What is stress?• CHANGE IS HOMEOSTASIS IN BODY OR LIFE Negative or Positive-LAS A MOTIVATION-PERCEIVED DIFFERENTLY •Individualized
Stressors Physiologic -virus and bacteria, hypoxia •Chemical DRUG •Physical -ON BODY-temp, trauma •Infectious •Genetic or autoimmune disorders •Nutritional imbalances -LACK OF RBC DUE TO POOR IRON INTAKE
STRESSORS Psychosocial •Environment -accdent •Relationships •Life events-TAKE SOMEONE ELSE EXPERIENCE AND PUT IT ON ONESELF •Previous experiences -COULD CAUSE STRESS WHILE EXPlAINING-LEARN AND ADAPT
Adaptation-LEARNING TO TOLERATE BIG TO SMALL THINGS Homeostasis Autonomic Nervous System •Parasympathetic (normal function) •Sympathetic (function under stress) •“Fight or Flight” Endocrine System •Pituitary •Adrenals-EPINEPHRINE AND NOREPINEPHRINE •Thyroid-REULATE METABOLISM-GRAVE DISEASE
Stress Responses EXHAUST-PASS OUT FROM THAT-BODY OT ABLE TO REGULATE STRESS Local Adaptation Syndro •Reflex pain response- •Inflammatory response-CUT ON FINGER-STOPPING BLOOD General Adaptation Syndrome Alarm reaction-STRESSORS ACTIVATED DEFENSE MECHANISMS- •Stageresistance-CONTROL VS-HORMONE- exhaustion -death or recovery
Psychological Homeostasis Feeling loved Sense of belonging Safe and Secure Self-esteem ESTABLISHING A COPING MECHANISM POSITIVE-PRAYING NEGATIVE-DRUG-SLEEP
Psychological Stress Response Mind-Body Interaction-IBS-DARRHEA AND CONSTIPATION-FLUSH-MUSCLE AGE Psychosomatic Disorders-PALPITATION Anxiety
Anxiety Mild -INCREASES ALERTNESS Moderate-NARROW FOCUS-I MEDIATE CONCERN Severe-INTERFERE WITH EVERYDAY LIFE -DIZZINESS-TACHYCARDIA-CONSTANT STRESS Panic - Anxiety-Disorders -
Coping Mechanisms•Behaviors used to decrease stress and anxiety REGRESS DENIAL OF HAVING A PROBLEM( ALCOHOL AND DRUG) •Defense Mechanisms•Protect a person’s self-esteem with mild to moderate anxiety PUTTING PROBLEM ON SOMEONE , INSTEAD OF OWNING TO IT
Sources of Stress Developmental stress Family stress Situational stress-UNPREDICTABLE EFFECT Crisis situation
Nursing Process: Stress PATIENTS ARE STRESSED WHILE BEING AT THE HOSPITAL PUT THEM ON PPI Assessments-VS-SYMPATHETIC RESPONSE-ASK TME-WHAT MIGH CAUSE THE STRENGH Diagnosis Plan/Goal/Outcome-MAINTAIN STABLE VITAL SIGNS Intervention/Implementations-BUILD A REPORT-SUPPORT SYSTEM-MEDICATION-CHA-EXERCISE-REST-SLEEP-PT EDUCATION Evaluation -VS-
Created by: Seka_nurse
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