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   Is a personal state in which
    the person feels unhealthy

   Physical, emotional,
    intellectual, social,
    developmental or spiritual
    functioning is diminished
    or impaired compared with
    previous experience
   Illness is not synonymous
    with disease

   Disease is an alteration in
    body functions resulting in
    reduction of capacities or
    a shortening of the normal
    life span
   Heredity



   Behavioral factors



   Environmental
    factors
1. Symptom Experience

   Transition stage

   The person believes
    something is wrong

   Experiences some symptoms
    (physical, cognitive,
    emotional)
2. Assumption of Sick Role


   Acceptance of the illness

   Seeks advice, support for
    decision to give up some
    activities
3. Medical Care Contact

   Seeks advice of health
    professionals for the
    following reasons:

 Validationof real illness
 Explanation of symptoms
 Reassurance or prediction of
  outcome
4. Dependent Patient Role

   Becomes dependent to health
    professionals

   Accepts/rejects health professional’s
    suggestions

   Becomes more passive and accepting

   May regress to an earlier behavioral
    stage
5. Recovery/ Rehabilitation

   Gives up the sick role and
    returns to former roles
    and functions
   One is not held responsible for his condition

   One is excused from social roles

   One is obliged to get well as soon as possible

   One is obliged to seek for competent help
   Is    any    situation,    habit,  social    or
    environmental       condition,    physiological
    psychological condition, developmental or
    intellectual condition, or spiritual or other
    variable that increases the vulnerability of an
    individual or group to an illness or accident

   The presence of risk factors does not mean
    that a disease will develop
   Genetic and
    physiological factors

   Age

   Environment

   Lifestyle
The goal of risk factor identification is to
 merely assist clients in visualizing those
 areas in their life that can be modified or
 even eliminated to promote wellness and
 prevent illness
Purposes of Inflammation are:

 To localize tissue injury
 To protect tissue from injury
 To prepare tissue for repair
INFLAMMANTS                       1. Physical
                                       2. Mechanical
                                       3. Chemical
                                       4. Microbial
     TISSUE INJURY                     5. Electrical




1.   VASCULAR RESPONSE
    Transitory vasoconstriction followed immediately by
     vasodilation (histamine, bradykinin, prostaglandin E
INCREASED CAPILLARY PERMEABILITY




HYPEREMIA:               FLUID/ CELLULAR EXUDATION
Redness (rubor)
Heat (calor)


                                                EXUDATES
       Edema (tumor)
Pain (dolor)
Compression of nerve endings by
edema fluids
Injury to nerve endings
Release of bradykinin




        Impaired function
   Promote rest to enhance
    recovery

 Reduce swelling
 Position: elevate the
  affected body part to
  promote venous return
   Heat and cold application:
    cold for first 72 hours;
    heat after 72 hours
   Relieve pain

   Increase excretion of
    microorganism by
    adequate hydration

   Provide adequate
    nutrition: high caloric,
    high protein with
    vitamin A and C rich
    foods
   Administer medication as ordered:

   Analgesic/antipyretic: aspirin,
    acetaminophen, paracetamol, mefenamic acid

   Anti-inflammatory: NSAIDs
       N – no alcohol
       S – Side effect is “BIRTH”
       A – aspirin sensitivity – do not give
       I – inhibits prostaglandins
       D – do take with food
       S – stop 5 to 7 days before surgery
   Surgery

   Incision and drainage: to remove
    inflammatory exudates to promote healing
    process

   Debridement: to remove necrotic tissue

 Surgicaland mechanical debridement
 Mechanical debridement is performed using
  the wet-to-dry dressing method
   The     reparative   process     begins at
    approximately the same time as the injury
    and is interwoven with inflammation

   Healing proceeds after    the   inflammatory
    debris has been removed

   May occur by regeneration or replacement
   REGENERATION

 Labile   cells multiply constantly to replace
    worn out cells (epithilial cells of the skin and
    the GI tract)

 Permanent    cells (neurons) may have
    permanent destruction, but axons may
    regenerate

 Stable    cells have a latent ability to regenerate,
    if they are damaged or destroyed, they are
    able to regenerate (kidney, liver, pancreas)
   REPLACEMENT

 Primary   intention healing – wound is clean
    and dry and the edges are approximated, as
    in a surgical wound, with little scar and heals
    in a week

 Secondary    intention healing – the wound or
    defect is larger and gaping and has necrotic
    or dead material, the repair time is longer,
    the scarring is greater, with loss of
    specialized function
   Hypertrophy

o   Increase in cell size leading to increase in
    organ size

o   The stimulus is increased workload

o   Leg muscles of runners
o   Arm muscles in tennis players
o   Cardiac muscles in person with hypertension
   Atrophy

o   shrinkage in size of cell, leading to decrease
    in organ size

o   Stimuli are decrease in use, blood supply,
    nutrition, hormonal, stimulation, innervations

o   Extremity immobilized in cast, secondary sex
    organs in aging person
   Hyperplasia

o   Increase in number of new cells

o   Stimulus is hormonal influence

o   Breast changes of a girl in puberty or
    pregnant woman, regeneration of liver cells,
    new RBCs in blood loss
   Dysplasia

o   Change in the appearance of cells after they
    have been subjected to chronic irritation

o   Stimulus is reproduction of cells with
    resulting alteration of their size and shape

o   Alterations in epithelial cells of the skin
   Metaplasia

o   Transformation of highly specialized cell to
    less specialized cell

o   Serves as a protective function because less
    specialized cells are more resistant to stress

o   Ciliated columnar epithelium lining the
    bronchi of smokers is replaced by squamous
    epithelium
ASSIGNMENT (1 whole):

1.   Give me at least 3 ways of assessing pain
     and how it is performed

2.   Write a sample pain assessment using the
     OLDCART and PQRST mnemonics

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Concept of Illness

  • 1.
  • 2.
  • 3. Is a personal state in which the person feels unhealthy  Physical, emotional, intellectual, social, developmental or spiritual functioning is diminished or impaired compared with previous experience
  • 4. Illness is not synonymous with disease  Disease is an alteration in body functions resulting in reduction of capacities or a shortening of the normal life span
  • 5. Heredity  Behavioral factors  Environmental factors
  • 6. 1. Symptom Experience  Transition stage  The person believes something is wrong  Experiences some symptoms (physical, cognitive, emotional)
  • 7. 2. Assumption of Sick Role  Acceptance of the illness  Seeks advice, support for decision to give up some activities
  • 8. 3. Medical Care Contact  Seeks advice of health professionals for the following reasons:  Validationof real illness  Explanation of symptoms  Reassurance or prediction of outcome
  • 9. 4. Dependent Patient Role  Becomes dependent to health professionals  Accepts/rejects health professional’s suggestions  Becomes more passive and accepting  May regress to an earlier behavioral stage
  • 10. 5. Recovery/ Rehabilitation  Gives up the sick role and returns to former roles and functions
  • 11. One is not held responsible for his condition  One is excused from social roles  One is obliged to get well as soon as possible  One is obliged to seek for competent help
  • 12. Is any situation, habit, social or environmental condition, physiological psychological condition, developmental or intellectual condition, or spiritual or other variable that increases the vulnerability of an individual or group to an illness or accident  The presence of risk factors does not mean that a disease will develop
  • 13. Genetic and physiological factors  Age  Environment  Lifestyle
  • 14. The goal of risk factor identification is to merely assist clients in visualizing those areas in their life that can be modified or even eliminated to promote wellness and prevent illness
  • 15.
  • 16.
  • 17. Purposes of Inflammation are:  To localize tissue injury  To protect tissue from injury  To prepare tissue for repair
  • 18. INFLAMMANTS 1. Physical 2. Mechanical 3. Chemical 4. Microbial TISSUE INJURY 5. Electrical 1. VASCULAR RESPONSE  Transitory vasoconstriction followed immediately by vasodilation (histamine, bradykinin, prostaglandin E
  • 19. INCREASED CAPILLARY PERMEABILITY HYPEREMIA: FLUID/ CELLULAR EXUDATION Redness (rubor) Heat (calor) EXUDATES Edema (tumor)
  • 20. Pain (dolor) Compression of nerve endings by edema fluids Injury to nerve endings Release of bradykinin Impaired function
  • 21. Promote rest to enhance recovery  Reduce swelling  Position: elevate the affected body part to promote venous return  Heat and cold application: cold for first 72 hours; heat after 72 hours
  • 22. Relieve pain  Increase excretion of microorganism by adequate hydration  Provide adequate nutrition: high caloric, high protein with vitamin A and C rich foods
  • 23. Administer medication as ordered:  Analgesic/antipyretic: aspirin, acetaminophen, paracetamol, mefenamic acid  Anti-inflammatory: NSAIDs N – no alcohol S – Side effect is “BIRTH” A – aspirin sensitivity – do not give I – inhibits prostaglandins D – do take with food S – stop 5 to 7 days before surgery
  • 24. Surgery  Incision and drainage: to remove inflammatory exudates to promote healing process  Debridement: to remove necrotic tissue  Surgicaland mechanical debridement  Mechanical debridement is performed using the wet-to-dry dressing method
  • 25. The reparative process begins at approximately the same time as the injury and is interwoven with inflammation  Healing proceeds after the inflammatory debris has been removed  May occur by regeneration or replacement
  • 26. REGENERATION  Labile cells multiply constantly to replace worn out cells (epithilial cells of the skin and the GI tract)  Permanent cells (neurons) may have permanent destruction, but axons may regenerate  Stable cells have a latent ability to regenerate, if they are damaged or destroyed, they are able to regenerate (kidney, liver, pancreas)
  • 27. REPLACEMENT  Primary intention healing – wound is clean and dry and the edges are approximated, as in a surgical wound, with little scar and heals in a week  Secondary intention healing – the wound or defect is larger and gaping and has necrotic or dead material, the repair time is longer, the scarring is greater, with loss of specialized function
  • 28. Hypertrophy o Increase in cell size leading to increase in organ size o The stimulus is increased workload o Leg muscles of runners o Arm muscles in tennis players o Cardiac muscles in person with hypertension
  • 29. Atrophy o shrinkage in size of cell, leading to decrease in organ size o Stimuli are decrease in use, blood supply, nutrition, hormonal, stimulation, innervations o Extremity immobilized in cast, secondary sex organs in aging person
  • 30. Hyperplasia o Increase in number of new cells o Stimulus is hormonal influence o Breast changes of a girl in puberty or pregnant woman, regeneration of liver cells, new RBCs in blood loss
  • 31. Dysplasia o Change in the appearance of cells after they have been subjected to chronic irritation o Stimulus is reproduction of cells with resulting alteration of their size and shape o Alterations in epithelial cells of the skin
  • 32. Metaplasia o Transformation of highly specialized cell to less specialized cell o Serves as a protective function because less specialized cells are more resistant to stress o Ciliated columnar epithelium lining the bronchi of smokers is replaced by squamous epithelium
  • 33.
  • 34. ASSIGNMENT (1 whole): 1. Give me at least 3 ways of assessing pain and how it is performed 2. Write a sample pain assessment using the OLDCART and PQRST mnemonics