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:

Validation of 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 orenvironmental condition, physiologicalpsychological condition, developmental orintellectual condition, or spiritual or othervariable that increases the vulnerability of anindividual or group to an illness or accident

The presence of risk factors does not meanthat a disease will develop

Genetic and physiological factors

Age

Environment

Lifestyle

The goal of risk factor identification is tomerely assist clients in visualizing thoseareas in their life that can be modified oreven eliminated to promote wellness andprevent illness

Purposes of Inflammation are:

To localize tissue injury

To protect tissue from injury

To prepare tissue for repair

INFLAMMANTS

TISSUE INJURY

1. VASCULAR RESPONSE Transitory vasoconstriction followed immediately by

vasodilation (histamine, bradykinin, prostaglandin E

1. Physical2. Mechanical3. Chemical4. Microbial5. Electrical

INCREASED CAPILLARY PERMEABILITY

HYPEREMIA:Redness (rubor)Heat (calor)

FLUID/ CELLULAR EXUDATION

EXUDATESEdema (tumor)

Pain (dolor)Compression of nerve endings byedema fluidsInjury to nerve endingsRelease 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

Surgical and mechanical debridement

Mechanical debridement is performed using the wet-to-dry dressing method

The reparative process begins atapproximately the same time as the injuryand is interwoven with inflammation

Healing proceeds after the inflammatorydebris 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