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  1. 1. MEDICAL- SURGICAL NURSING INTRODUCTION Prepared by: Mr.J.G Sambad MSC.NSG.NUN.
  2. 2. INTRODUCTION • MSN is specialized and skilled branch of nursing. • MSN can be considered to be the foundation of nursing because it has served as a lunch pad to the several interdisciplinary advanced specialization in several vital area of nursing, such as: - Cardiology - Neurology - Oncology etc.
  3. 3. DEFINITION • Medical surgical nursing is a specialized branch of nursing that involve the nursing care of adult patients, whose disease condition are treated medically, surgically and pharmacologically. - Sharon L Lewis
  4. 4. Con.. • Medical- surgical clinical nurses are specialist who are involved in the direct clinical practices and play a vital role at several stages of treatment of the patient. • They served the responsibility of caring for the patient before, during as well as after the surgical intervention for the treatment of the disease.
  5. 5. Clinical Nurses Responsibilities 1. Collection of information and setting care priorities 2. Applying novel method of care and treatment modalities and their evaluation. 3. Planning in individual care 4. Taking patient histories and performing physical examination. 5. Ordering laboratory test and diagnostic procedure.
  6. 6. Criteria of MSN speciality I. Criterion-A: “ MSN speciality defined new competencies in the discipline for nursing practice.” II. Criterion-B: “ MSN speciality involve designing of special procedure for nursing care for the patients.”
  7. 7. ROLE OF MEDICAL-SURGICAL NURSE 1. Get set of skills:  They must have sound knowledge of all aspect of human health.  They must be competent enough to provide care to individual, sick or well, utilizing the various nursing processes.  They must be able to asses the nursing requirement of patient from birth to death.  They must able to preparing plan in crisis situation.  They must be able to promote self care & practical prioritization of skills.  They must be able to assist in research activities.
  8. 8. 2. Ability to advocate for the patients • They must able to understand the importance of measuring and improving the quality of care delivered. • They must consider the safety of the patient as the top priority. • They must support patient to the best of their health interests. • They must be evaluate the effectiveness of the nursing care. • They must able to work as a team with the team of health workers & must be use her knowledge of good communication skills and relations at work.
  9. 9. 3.Ability to make a difference in a patient’s life everyday • To provide psychological and physical comfort to the patient. • They must use ethical values in professional and personal life. • To assist patient in rehabilitative activities. • They must posses the basic skills of educating and counseling of patient about the preventive actions.
  10. 10. 4. Ability to become the backbone of health care system of the society • They must participate as member of the health team in delivery of curative, preventive, promotive and rehabilitative health care services. • They must able to utilize their administrative skills and leadership qualities while working in team for the cause of health and community welfare schemes.
  11. 11. Concept of Health & Concept of Health & disease disease PREPARED BY: J.G SAMBAD PREPARED BY: J.G SAMBAD
  12. 12. Dimension and Determinants of Health Health is difficult to define but easier to understand. To many of us it may mean absence of disease or infirmity and to many it may mean sound body and sound mind and sound function of the body.
  13. 13. • To an anatomist Healthy body means it should confirm to normal anatomical structures. • To a physiologist Health means normal body functions
  14. 14. • To a biochemist It means normal biochemical levels / values • To a pathologist It means normal cellular make up.
  15. 15. • To a geneticist It means correct existence of genetic potential Similarly to a clinician it means no abnormality in structure and function of the body. When a clinician fails to detect anything abnormal by his clinical wisdom and laboratory tests he labels a person no abnormality detected (NAD).
  16. 16. • To a psychiatrist It means well adjusted and a balanced personality
  17. 17. Definition “Health is a state of complete physical, mental and social well being and not merely the absence of disease or infirmity”. WHO’s 1991 member states have endorsed this statement.
  18. 18. Physical Health It means adequate body weight, height and circumference as per age and sex with acceptable level of vision, hearing, locomotion or movements, acceptable levels of pulse rate, blood pressure, respiratory rate, chest circumference, head circumference, waist hip ratio.
  19. 19. It means The body structure and functions confirming to laid down standards within the range of normal development and functions of all the systems.
  20. 20. Mental health
  21. 21. Mental health is defined “as a state of well being in which the individual realized his or her own abilities, can cope with normal stresses of life, can work productively and fruitfully and is able to make a contribution to his or her community”.
  22. 22. A mentally normal person has the ability to mix up with others, he/she makes friendship, behaves in a balanced manner, keeps himself tidy and observes adequate personal hygiene, well oriented to time, place and person and environments and he is unduly not suspicious of others.
  23. 23. He is cheerful and happy and enjoys life with a purpose and he thinks positively and has normal development and contributes fully and is useful and productive to society and nation.
  24. 24. Social wellbeing It is the third dimension of health. It means ability of a person to adjust with others in his social life, at home, at work place and with people. Men interact with men and they inter-relate and inter depend on each other and pay their effective role in accordance with a situation.
  25. 25. Essentially social wellbeing includes inter-relation and interaction of human beings. Social wellbeing is a composite function of income level, literacy, occupation and working conditions marital harmony, institution of a family, social groups and have good cultural and behavioral patterns of the society.
  26. 26. Social wellbeing can be measured on scale by taking in to consideration of indicators like income, literacy and occupation (as discussed under socio economic status of family).
  27. 27. Determinants of health Heredity Health services  Promotive, preventive, curative, rehabilitative Environment  Physical, social, biological and man- made Behavior  Actions  Habits  Reactions  Belief, attitudes  Practices (Lifestyles) Health
  28. 28. Environment The environment is considered to be the most important determinant and input of health.
  29. 29. Man made environment Health is influenced in the man made environment or artificial environment too. It included items like housing, transport, industries and communication.
  30. 30. Health services Availability, accessibility, affordability and acceptability of health services are considered an important determinant / input to health.
  31. 31. Health indicators It is some what easier to defined health for an individual. But to define “community health” it is some what more difficult. “Community health” parameters are different from health parameters of an individual.
  32. 32. “Community health” can be measured through indicators of economics, (gross national product gross national income and per capita income), life expectancy, under five mortality, infant mortality, literacy level, composite index of human development, maternal mortality etc.
  33. 33. A community is healthy when it enjoys sound health where disease and death rate is acceptably low, it is not threatened with bad environments and its economy is sound and the health resources are available, practices are sound and based on scientific evidences.
  34. 34. Its literacy levels are high and demographically it has balanced sex ratio and people live long, quality of life is good and human development index is high.
  35. 35. A village is said to be healthy if it has: safe sources of improved water supply, safe method of waste water disposal, paved streets, disposal of garbage refuse and animal excreta by manure pits, people use sanitary latrines, female literacy is high, girls enrolment is universal, deliveries are conducted by trained persons, birth rate and death rate are within acceptable limits, immunization coverage is high and housing condition is good.
  36. 36. Health is a fundamental human right. The attainment of highest possible level of health is the most important world wide social goal.
  37. 37. The meaning of “Disease” is “without ease” (uneasiness) Either a Physiological /Psychological dysfunction What is Disease
  38. 38. Not only presence of disease but involvement of individual's perceptions and behavior in response to disease are included. Disease is very subjective. Sickness includes a state of social dysfunction too. i.e. The role, an individual assumes when ill. Illness Illness
  39. 39. The environment related The environment related to disease to disease This refers not only to the environment the man lives. Various environmental factors are categorized as follows.
  40. 40. 1. 1. Physical Environment Physical Environment Physical aspects of environment Physical aspects of environment Air, water, light, heat, radiation, gravity, pressure, and chemical agents etc. man tries a great deal to control these factors.
  41. 41. 2. Biological Environment 2. Biological Environment Certain diseases do not occur in some areas because agents or vectors can not exist in that environment due to biological reasons.
  42. 42. Biological environment Biological environment includes includes Infectious agents of diseases, reservoirs of infective agents, vectors that transmit diseases, plants and animals.
  43. 43. 3. Social Environment 3. Social Environment The social factors relevant to health include socio-economic status, social customs, traditional believes, etc.
  44. 44. Natural History of Disease Natural History of Disease Refers to the course of a disease over a period of time, unaffected by treatment.
  45. 45. Disease occurrence is usually insidious. Chronic diseases evolve over a long period and have their own progression. The history and time period that it spread is different from disease to disease. Most of the diseases pass through the following pattern.
  46. 46. Disease Impairment Disability Handicap Impairment “Any loss or abnormality of psychological, physiological or anatomical structure or function”. e.g. Loss of foot, defective vision, mental retardation. Sequence of events Sequence of events
  47. 47. Impairment will be ♦ visible or invisible ♦ temporary or permanent ♦ progressive or regressive
  48. 48. Disability “Any restriction or lack of ability to perform an activity in the manner or within or within the range considered normal for a human being”.
  49. 49. Handicap Definite disadvantages for a given individual resulting from an impairment or a disability that limits or prevents the fulfillment of a role that is normal for him/her depending on his/her age, sex, social and cultural factors or for that individual. e.g. Accident Disease Loss of foot Impairment Cannot walk Disability Unemployed Handicap
  50. 50. Ten Major Health Issue For The Nation 1. Access to health care 2. Malnutrition 3. Immunization 4. Institutional maternity care 5. Childhood disease –diarrhea & respiratory infection 6. Control of communicable disease 7. Sanitation and safe drinking water 8. Increasing non-communicable disease 9. Injury and violence 10.Mental health Key: I AM 3i MSCc.

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