HNN320 Lecture Notes - Hypervolemia, Ace Inhibitor, Peripheral Edema
8 Jun 2018
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WEEK TWO: PSYCHOSOCIAL IMPACT CHRONIC ILLNESS
• Describe the psychosocial impact that chronic illness can have on the person in relation to
self, family and community.
• Show an understanding of psychosocial care in a nursing context.
▪ Therapeutic relationship based on trust, open, honesty, mutual goals.
▪ Empathy and support.
▪ Prepare for unique responses due to culture, religion and previous experiences.
▪ Pt centred care-individualisation, maintain quality of life.
▪ Encourage empowerment for decisions, peer support, goal setting.
▪ Dot defie y illess.
• Uderstad the eaig of Disaility
• Implement nursing interventions for potential and actual problems related to chronic
heart failure management
• Prepare, perform and document venepuncture procedure and perform a fluid assessment
• Prepare a patient for discharge home
• Perfor a ursig hadoer of a patiets aageet usig the I“BA‘ tool.
PSYCHOSOCIAL IMPACT CHRONIC ILLNESS.
• Effect of psychological, physical and social aspects of health
- Life, education, lifestyle, communication culture, perceptions, self-esteem, physical
wellbeing.
- Denial, shock, loss, grief, prognosis.
• Anxiety: coping, function, stigma.
• Social isolation: depression and anxiety assoc with or the limitations disease is causing.
• Powerlessness
• Need time to adjust: symptoms, stress of treatment, vulnerability, loss control, low self-
esteem, economic concerns, family concerns.
• Nurse:
- Therapeutic relationship based on trust, open, honesty, mutual goals.
- Empathy and support.
- Prepare for unique responses due to culture, religion and previous experiences.
- Pt centred care-individualisation, maintain quality of life.
- Encourage empowerment for decisions, peer support, goal setting.
- Dot defie y illess.
DISABILITY.
• Fist sigs Pakisos: fatigue, lak sellig , a stopped sigig, tippig oe
feet, shuttering in bed.
- Side effects medicine caused cholitis.
• Symptoms: rigid muscles/spasms, bradykinesia, tremors, difficult walk, poor posture, loss
balance, loss extention, soft speech/slurred, loss facial expression, fatigue, constipation, dry
eyes, depression.
• Definition disability: relates to function; areas of lost function yet main focus on what is able
to be done.
• Progression: fluctuates.
• ADLs impaired, loss independence, exercise esp walking.
• Emotional aspect challenging-remembers independence, frustration, impatience,
vulnerability, anxious.
find more resources at oneclass.com
find more resources at oneclass.com
• Celebrate abilities not inabilities.
• Treat normal, ask they need from you to promote independence.
VENIPUNCTURE PROCEDURE.
• The olletio of lood fo the ei fo diagosti puposes o to oito patiets
response to treatment.
• Determining ID, consent, pt history coag disorder, standard precautions.
• Collect:
- Bluey, tourniquet, clean gloves, vacucontainer, butterfly, blood tube, sharps, swab,
gauze and tape.
• Steps:
- HH> tourniquet non dominant hand, assess vein (for visual and bounce)>assemble
equipment> lower arm to engorge vein> prep tape and gauze> position pillow and
hae i staight lie ith sheet udeeath>sueeze ad elease ad u had
upward to dilate vein> round and firm vein> HH and gloves> swab in circles outward
from site> use non dominant hand to taut the skin and vein> remove cover butterfly
needle in right hand and hold upward, parallel to vein> angle will be 30-50 degrees
depending on size vein> push into vein until blood appears> reduce angle when flash
back visual or when in vein> hold with non-dominant hand> push blood tube into
vacutainer> release tourniquet> add gauze> remove at same angle to avoid tearing>
add pressure after removal to prevent damage intima vein> dispose sharps>
continue pressure and place dry dressing> agitate tube to prevent haemolysis>
remove gloves> HH>doc with your initials, time, date, sign lab slip> dispose
contaminated in contaminated waste bin.
FLUID MANAGEMENT PROCEDURE.
• 55-60%
• Carry blood cells for nutrients, hydration, sweat, saliva, mucosal membranes moist, body cell
regrowth, removal waste products, lubricant, oxygen delivery, aids digestion, shock
absorption, helps brain produce hormones and neurotransmitters.
• Excess-55% oedema.
- Gravity legs or sacral.
- Pitting oedema: indents skin for extended time.
- Further oedema causes ascites- boggy, squishy and damp to touch as fluid leaks out.
- Bounding pulse ie palpitation, difficulty breathing, crackles, wheezing.
➢ Nurses assess to prevent acute pulmonary oedema, orbital spaces for
oedema.
➢ Palpate to check oedema pitting and assess sacral areas and lower limbs.
➢ Assess jugular veins and pulse: should not be easily seen or palpable.
➢ Daily weight for fluid load.
➢ Intake and output monitor.
READINGS:
Week to: Fluid aageet strategies i heart failure.
- Fluid retention (hypovolemia) often leads to decompensated heart failure.
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Week two: psychosocial impact chronic illness: describe the psychosocial impact that chronic illness can have on the person in relation to self, family and community. Psychosocial impact chronic illness: effect of psychological, physical and social aspects of health. Life, education, lifestyle, communication culture, perceptions, self-esteem, physical wellbeing. Social isolation: depression and anxiety assoc with or the limitations disease is causing: anxiety: coping, function, stigma, powerlessness, need time to adjust: symptoms, stress of treatment, vulnerability, loss control, low self- esteem, economic concerns, family concerns, nurse: Therapeutic relationship based on trust, open, honesty, mutual goals. Prepare for unique responses due to culture, religion and previous experiences. Encourage empowerment for decisions, peer support, goal setting. Fi(cid:396)st sig(cid:374)s pa(cid:396)ki(cid:374)so(cid:374)(cid:859)s: fatigue, la(cid:272)k s(cid:373)elli(cid:374)g (cid:1005)(cid:1013)(cid:1013)(cid:1012), (cid:1006)(cid:1004)(cid:1004)(cid:1012) a(cid:396)(cid:373) stopped s(cid:449)i(cid:374)gi(cid:374)g, t(cid:396)ippi(cid:374)g o(cid:448)e(cid:396) feet, shuttering in bed. Venipuncture procedure: the (cid:272)olle(cid:272)tio(cid:374) of (cid:271)lood f(cid:396)o(cid:373) the (cid:448)ei(cid:374) fo(cid:396) diag(cid:374)osti(cid:272) pu(cid:396)poses o(cid:396) to (cid:373)o(cid:374)ito(cid:396) patie(cid:374)t(cid:859)s response to treatment, determining id, consent, pt history coag disorder, standard precautions, collect:
