VNSG 1500
Nursing in Health and Illness I
Unit I – Health Promotion and Maintenance Across the Lifespan
Behavioral Objectives
1.
Discuss ways to incorporate growth and development
principles into vocational nursing practice.
Content
I.
Incorporating Principles of Growth & Development
into Nursing Care
A. Review stages of development
B. Support developmental stages typical of certain
ages
C. Respect uniqueness
D. Anticipate possible regression in periods of
crisis
E. Be aware of environmental and cultural
influences
F. Provide teaching to aid in understanding of
growth and development
G. Provide environment and experiences that are
developmentally challenging
2.
Discuss the concepts of health and basic human
needs.
II. Health Care Needs Across the Lifespan
A. Concept of health
1. Definitions
2. Health illness continuum
3. High level wellness
4. Health belief model
5. Factors influencing health & illness
B. Basic Human Needs
1. Physiological
2. Safety and security
3. Love and belonging
4. Self-esteem
5. Self-actualization
3.
Discuss promotion of health across the lifespan.
III. Health promotion across the lifespan
A. Principles of health promotion
B. General Health
1. Nutrition
2. Self-esteem
3. Hygiene
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Learning Opportunities
Read
Neeb, K. Fundamentals of Mental Health Nursing:
Chapter 4
Williams, L, & Hopper, P. Understanding Medical Surgical
Nursing Chapter 14
View Video
#1128 – “Communicating with Clients & Colleagues
from Different Cultures”
VIDEO TVCC Website
Age Specific Competencies
Read
Burton, M. Fundamentals of Nursing Care:
Chapter 7
Burton, M. Fundamentals of Nursing Care:
Chapters 13, 15, 19, 23, 24
11/2012
Behavioral Objectives
Content
Learning Opportunities
4. Dental care
5. Physical fitness
6. Rest & sleep
7. Accident prevention
8. Sexuality/sex education
9. Birth control
B. Preventive Health Care
1. Health screenings
2. Immunizations
3. Preventing infections
4. Assistance with stopping smoking
5. Prevention of substance abuse
6. Prevention of suicide
C. Community Resources
1. Health fairs
2. American Red Cross
4.
Discuss the use of the nursing process in the care of
clients with basic health care needs.
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IV. Health Maintenance for Basic Health Care
Needs
A. Sleep/Rest
1. Assessment
a. Factors influencing sleep
b. Sleep assessment
c. Common sleep disorders
d. Nursing diagnoses
2. Planning/Implementing/ Evaluation
a. Patient teaching to promote sleep
b. Progressive relaxation
c. Back massage
d. Provide restful environment
e. Promote bedtime rituals
f. Offer appropriate bedtime snack
g. Promote comfort
h. Respect normal sleep/wake patterns
i. Schedule nursing care to avoid
disturbing
j. Use of medications
k. Rest/sleep lifestyle counseling
l. Developmental variations
m. Cultural variations
Burton… Chapter 19
11/2012
Behavioral Objectives
Content
B. Comfort
1. Pain Theories
a. Specificity
b. Gate-control
c. Neurochemical-endorphins
2. Assessment
a. Factors influencing
b. Types of pain
c. Components of pain assessment
d. Rating scales
e. Characteristics of acute vs. chronic pain
f. Physiological/behavioral/affective
responses
g. Nursing diagnoses
3. Planning/Implementing/ Evaluation
a. Pharmacological management
1.) Anti-inflammatory
2.) Anesthetics
3.) Narcotics/non-narcotics
4.) Patient controlled analgesia (PCA)
5.) Use of placebos
b. Guidelines for managing pain
c. Eliminate cause of pain
d. General nursing comfort measures
e. Cutaneous stimuli
f. Transcutaneous electrical nerve
stimulation (TENS)
g. Imagery
h. Distraction
i. Relaxation techniques
j. Patient teaching
k. Refer to pain clinics
l. Neurosurgical procedures
m. Developmental considerations
C. Oxygenation
1. Assessment
a. Signs/symptoms of oxygenation level
b. Pulse oximetry
c. Breath sounds
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Learning Opportunities
Hopper… Chapter 10
VIDEO TVCC Website
The Pain Process & Patient Assessment
Burton… Chapter 28
Hopper… Chapter 29
11/2012
Behavioral Objectives
Content
2.
D. Safety
1. Assessment
a. Environmental hazards
b. Influencing factors
c. Signs/symptoms of inflammation/
infection
d. Nursing diagnoses
2. Planning/Implementation/ Evaluation
a. Patient teaching to prevent falls/burns
b. Safety guidelines
c. Use of restraints
1.) Legal issues
2.) Alternatives
d. Standard precautions
e. Transmission based precautions
f. Infection control measures
g. Seizures
1.) Seizure precautions
2.) Actions in case of actual seizure
h. Developmental considerations
E. Elimination (Urinary)
1. Assessment
a. Characteristics of urine
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Learning Opportunities
d. Nursing diagnoses
Planning/Implementing/ Evaluation
a. Positioning
b. Incentive spirometry
c. Breathing techniques
d. Oxygen therapy
e. Water-seal drainage
f. Suctioning
g. Promoting and controlling coughing
h. Adequate fluid intake
i. Providing humidified air
j. Chest physiotherapy
k. Using nebulizers
l. Artificial airways
m. Developmental considerations
Hopper… Chapter 48
Burton… Chapter 31
11/2012
Behavioral Objectives
Content
2.
F.
b. Elimination patterns
c. Urinalysis
d. Collection of specimens
e. Nursing diagnoses
Planning/Implementing/ Evaluation
a. Guidelines to promote elimination
b. Continence training guidelines
c. Catheterization
d. Guidelines for catheter care
e. Caring for urostomy
f. Maintaining normal voiding habits
g. Promoting appropriate fluid intake
h. Strengthen musculature
i. Caring for incontinent client
j. Developmental considerations
Elimination (Bowel)
1. Assessment
a. Stool characteristics
b. Elimination patterns
c. Testing for blood
d. Factors influencing elimination
e. Nursing diagnoses
2. Planning/Implementing/ Evaluation
a. Guidelines to promote elimination
b. Removal of fecal impaction
c. Use of cathartics/ laxatives
d. Enemas
e. Managing fecal incontinence
f. Providing ostomy care
g. Developmental considerations
G. Mobility
1. Assessment
a. Alignment
b. Gait and posture
c. Ease of movement
d. Joint strength, function, range of
motion
e. Muscle strength, mass, tone
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Learning Opportunities
Hopper… Chapter 12
Burton… Chapter 30
Hopper… Chapter 34
Burton… Chapter 16, 19
Hopper… Chapter 47
11/2012
Behavioral Objectives
Content
Learning Opportunities
f.
g.
h.
2.
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Endurance
Nursing diagnoses
Complications of immobility
1.) Disuse syndrome
2.) Muscular system
a.) weakness
b.) atrophy
c.) decreased tone
3.) Skeletal
a.) poor posture
b.) contractures
c.) foot drop
4.) Cardiovascular
a.) impaired circulation
b.) thrombus (clot formation
c.) dependent edema
5.) Respiratory
a.) pooling of secretions
b.) shallow respirations
c.) atelectasis
6.) Urinary
a.) oliguria
b.) urinary tract infections
c.) calculi (stone) formation
d.) incontinence
7.) Gastrointestinal
a.) anorexia
b.) constipation
c.) fecal impaction
8.) Integumentary
a.) pressure sores
9.) Endocrine
a.) decreased metabolic rate
b.) decreased hormonal secretions
10.) Central Nervous
a.) sleep pattern disturbance
b.) psychosocial changes
Planning/Implementing/
Evaluation
a. Proper positioning
11/2012
Behavioral Objectives
Content
b.
c.
d.
e.
f.
g.
h.
i.
j.
H. Skin Integrity
1. Assessment
a. Risk factors
b. Physiological assessment
c. Stage of pressure sores
d. Factors affecting skin integrity
e. Nursing diagnoses
2. Planning/Implementing/ Evaluation
a. Principles of skin care
b. Patient teaching
c. Dental care
d. Foot care
e. Nail care
f. Guidelines for preventing pressure
sores
g. Use of dressings
h. Irrigation of wounds
i. Hot and cold applications
j. Regimen for changing positions
k. Interventions to control infection
l. Developmental considerations
I.
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Learning Opportunities
Range of motion
Active
Passive
Assisting to ambulate
Ambulatory devices
Guidelines to increase activity tolerance
Provide appropriate nursing care for
patients in casts, traction, and slings
Use of prosthetic devices
Developmental considerations
Fluid & Electrolyte Balance
1. Assessment
a. Monitor for signs/ symptoms of fluid
imbalance
1.) Extracellular fluid deficit
a.) Hypovolemia
b.) Dehydration
Hopper… Chapter 53, 54
Video
#M141 “Pressure Ulcers”
Burton… Chapter 29
Hopper… Chapter 6
11/2012
Behavioral Objectives
Content
2.
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2.) Extracellular fluid excess
a.) Hypervolemia
b.) Primary water excess
b. Monitor of signs/ symptoms of
electrolyte imbalance
1.) Sodium
a.) Hypernatremia
b.) Hyponatremia
2.) Potassium
a.) Hyperkalemia
b.) Hypokalemia
3.) Calcium
a.) Hypercalcemia
b.) Hypocalcemia
c. Monitor for signs/ symptoms of
acid/base imbalance
1.) Acidosis
a.) Respiratory
b.) Metabolic
2.) Alkalosis
a.) Respiratory
b.) Metabolic
d. Monitor for signs/ symptoms of shock
1.) Hypovolemic
2.) Normovolemic
a.) Cardiogenic
b.) Neurogenic
c.) Vasogenic
i.) Anaphylactic
ii.) Septic
e. Intake and output
f. Daily weights
g. Vital signs
h. Laboratory studies
1.) Electrolytes
2.) Arterial blood gases (ABGs)
3.) Urine specific gravity
i. Nursing diagnoses
Planning/Implementing/ Evaluation
a. Maintain accurate I & O
Learning Opportunities
Video
#226 “Respiratory Alkalosis & Acidosis”
#227 “Metabolic Alkalosis & Acidosis”
11/2012
Behavioral Objectives
Content
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
l.
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Learning Opportunities
Increase or restrict fluid intake as
appropriate
Monitor vital signs
Monitor and report lab values
Interpret ABGs
Providing IV fluid therapy
1.) Hypotonic solutions
2.) Isotonic solutions
3.) Hypertonic solutions
Administering blood products
Providing parenteral nutrition
Observe for signs/ symptoms of
imbalances
Patient teaching
Developmental considerations
Manage shock
1.) Positioning
2.) IV therapy
3.) Pharmacological support
4.) Psychological support
5.) Emergency equipment available
11/2012