Introduction To Medical Surgical Nursing

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Introduction to Medical Surgical

Nursing

By: Shegaw Zeleke (Lecturer)

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Objectives
• Define Medical-surgical nursing.

• Describe the major roles of nurses.

• Discuss expanded nursing roles.

• Describe nursing care delivery models.

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Definition of Medical Surgical Nursing

• Medical-surgical nursing is a nursing care that is given


to patients/clients with medical and surgical problems.

• Medical-surgical nursing enables nurses to develop


knowledge and skills that are necessary to give care for
individuals with medical as well as surgical problems.

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The Patient’s Basic Needs
• Certain needs are basic to all people and require satisfaction
accordingly.

• Such needs are addressed on the basis of priority, meaning that


some needs are more pressing than others.

• Once an essential need is met, the person experiences a need on a


higher level.

• Approaching needs according to priority reflects Maslow’s


hierarchy of needs (see figure below).

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Maslow’s Hierarchy Needs
• Maslow ranked human needs as follows:
– physiologic needs;
– safety and security;
– belongingness and affection;
– esteem and self-respect; and
– self-actualization, which include self-
fulfillment, desire to know and understand, and
aesthetic needs.
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Maslow’s Hierarchy Needs
cont’d
• Lower-level needs always remain, but a person’s ability to
pursue higher-level needs indicates that he or she is moving
toward psychological health and well-being.

• Such a hierarchy of needs is a useful organizational


framework that can be applied to the various nursing models
for assessment of a patient’s strengths, limitations, and need
for nursing interventions.

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Maslow’s Hierarchy Needs

cont’d
Understanding the needs of health care consumers and the
health care delivery system is a foundation for the delivery of
nursing care.

• Patients’ needs vary depending on their problem, associated


circumstances, and past experiences.

• One of the nurse’s important functions in health care delivery is


to identify the patient’s immediate needs and take measures to
address them.

• General Observation of Patients conditions are used to


identify patient’s immediate
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By Shegaw Z(MSCc in AHN) 8
General Observation of Patients
1. Posture and Stature
 The posture that a person assumes often provides valuable
information about the illness.

 Eg. Patients who have breathing difficulties (dyspnea)


secondary to cardiac disease prefer to sit

 Those pts with abdominal pain due to peritonitis prefer to lie


perfectly still and guarding their abdomen

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General Observation of Patients
cont’d
2. Body Movements
• Abnormalities of body movement may be of two general kinds:

– generalized disruption of voluntary or involuntary movement

eg. Park sons disease, ARF

– asymmetry of movement

e.g. stroke

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General Observation of Patients
cont’d
3. Nutrition

• Obesity may be generalized as a result of excessive intake of


calories or if it is localized to the trunk with endocrine disorders
(Cushing’s disease)

• Loss of weight may be generalized as a result of inadequate


caloric intake or with disorders that affect protein synthesis.

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General Observation of Patients
cont’d
4. Speech Pattern

• Speech may be slurred because of


• CNS disease or

• Damage to cranial nerves

– E.g. Recurrent damage to the laryngeal nerve will


produce hoarseness

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General Observation of Patients
cont’d
5. Emotional Status
• Recognize the patient’s emotional state and assist
the patient to explore his or her feelings.
6. Vital Signs

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The Nursing Profession

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The Nursing Profession
NURSING DEFINED

• The American Nurses Association (ANA), defined


nursing as “the diagnosis and treatment of human
responses to health and illness”.

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FLORENCE NIGHTINGALE
(The lady with the lamp)

5/18/2018 (12 May 1820 – By


13Shegaw
Aug Z(MSCc
1910)in AHN) 16
Definitions of nursing….
 Florence Nightingale who is the founder of modern

nursing defined nursing as:

 “utilizing the environment of the patient to assist him/her in

his/her recovery.” or

 ‘is to put patient in the best possible condition for nature to act

upon him.’

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Florence Nightingale
• 1st Nursing Theorist

• Nursing is separate and distinct from medicine

• All women are natural nurses

• Emphasized importance of environment: fresh air, cleanliness,


nutrition

• Maintained accurate records, 1st Nursing Researcher

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Florence Nightingale favorite dictum/ motto
• “Do the Patient no harm”

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Definitions of nursing….
• World health origination (WHO) defined nursing: “the art
and science based on knowledge, skill and attitude aimed
at assisting the individual and community in health and
illness to maintain health , to prevent illness, to alleviate
physical, biological and psychological pain, to avoid
complication and to fulfill self-reliance in meeting daily,
health needs.

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The Nursing Profession
Nurses have a responsibility to carry out their role, to
comply with the nurse practice act of the state where they
practice, and to comply with the code for nurses as
spelled out by the International Council of Nurses and
the ANA.

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THE PATIENT/CLIENT: CONSUMER OF
NURSING AND HEALTH CARE
• The central figure in health care services is patient.

• The term patient, which is derived from a Latin verb meaning “to
suffer,” has traditionally been used to describe those who are
recipients of care.

• The connotation commonly attached to the word is one of


dependence.

• For this reason, many nurses prefer to use the term client, which is
derived from a Latin verb meaning “to lean,” connoting alliance
and interdependence.
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“A Biblical Fable on Our
Origin”
• In the beginning, God created Nursing.
• He said, “I will take a solid, significant system of
nursing education and
• An adequate, applicable base of clinical nursing
research, and
• On these rocks will I build My greatest gift to
mankind = Nursing Practice.”
• On the 7th day He threw up his hands. And has left
it up to us.
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ROLES OF THE NURSE
• The professional nurse in institutional, community-based
and home care settings has three major roles:

– The practitioner role, which includes teaching and


collaborating;

– The leadership role and

– The research role.


• These roles are designed to meet the immediate and future health
care and nursing needs of consumers
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Practitioner Role
• The practitioner role of the nurse involves;
– meeting the health care and nursing needs of individual patients,
their families, and significant others.

– It is a role that can be achieved only through use of the


nursing process, the basis for all nursing practice

• This role is the dominant role of nurses in primary,


secondary, and tertiary health care settings and in home
care and community nursing.

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Leadership Role
Nursing leadership is a process involving four
components:
–Decision making,
–Relating,
–Influencing, and
–Facilitating.
Each of these components promotes change and
the ultimate outcome of goal achievement.

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Research Role
• The research role of the nurse was traditionally viewed as
one carried out only by academicians, nurse scientists,
and graduate nursing students.

• Today, participation in the research process is also


considered to be a responsibility of nurses in clinical
practice.

• The primary task of nursing research is to contribute to


the scientific base of nursing practice/Evidence-based
nursing practice
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Expanded Nursing Roles
 Nurses may receive advanced education in such specialties
as:
– Family,
– Critical care,
– Coronary care,
– Respiratory care,
– Oncologic care,
– Maternal and child health care,
– Neonatal intensive care,
– Pediatric nursing,
– Trauma,
– Psychiatry nursing
– Rural health, and
– Gerontologic nursing, to name just a few.
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COLLABORATIVE PRACTICE

• The collaborative model, should be a primary


goal for nursing—a venture that promotes shared
participation, responsibility, and accountability
in a health care environment that is striving to
meet the complex health care needs of the public.

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Figure: Collaborative practice model

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Ethical Dilemma
• Situation that requires an individual to make a choice
between two equally unfavorable alternatives.

• Conflict between one individual’s rights and those of


another, or between one individuals obligation and the
rights of another, usually form the basis of the dilemma.

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Ethical Decision Making
• Steps in Ethical Decision making are:
1. Assess the ethical/moral situations of the
problem
2. Collect information.
3. List the alternatives. Compare alternatives
with applicable ethical principles and
professional code of ethics
4. Decide and evaluate the decision.

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HEALTH, ILLNESS AND WELLNESS

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Class Activity

• Define Health, Illness and Wellness

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Health, Illness, and Wellness
• Illness is the inability of an individual’s
adaptive responses to maintain physical and
emotional balance that subsequently results in an
impairment of functional abilities.

• Wellness is the condition in which an individual


functions at optimal levels.
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Health, Illness, and Wellness
• Health is a global term because it refers to every aspect
of a person’s life, including:

– Physical status

– Emotional well-being

– Social relationships

– Intellectual functioning

– Spiritual condition
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Health, Illness, and Wellness
• The American Holistic Nurses’ Association describes
health as a maintenance of harmony and balance among
body, mind, and spirit.

• Balance refers to homeostasis, which is an equilibrium


among psychological, physiological, socio-cultural,
intellectual, and spiritual needs.

• The process by which a person adjusts to achieve


homeostasis is called adaptation.
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Health, Illness, and Wellness
• When people describe their health status,
basically three areas are considered:

– Presence or absence of symptoms (physical and


emotional)

– How they feel (emotionally and physically)

– What they are able to do (ability to function)


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Health Continuum

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