PPT On Concepts Of Community Health Nursing practice

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 Concepts Of Community Health Nursing practice Presentation Transcript

1.INTRODUCTION AND DEFINITION
Community health nursing is synonymous with public health nursing.
According to the American Nursing Association (ANA), public health nursing is the practice of promoting and protecting the health of populations using knowledge from nursing, social and public health sciences (Waldorf,1999).

 2.GOALS

• The primary goal of community health nursing is to help a community protect and preserve the health of its members
• The secondary goal is to promote self-care among individuals and families.

3.Trends in health-care delivery: the move towards the community 

• Changing demographics, changing disease patterns, an increase in chronic illnesses resulting in underestimated health-care expenditure
• A reform in the health financing system, and a renewed focus on health promotion open up new opportunities for providing community-based care in community settings
• Emphasis is placed on promoting health and access to care by addressing the health-care needs of people where they live and work.
   

4.COMMUNITY HEALTH-CARE DEMANDS

(1) Clinical care
(2) Health care
(3) Support for healthy activities
(4) Welfare
Other support; comprehensive community health care to cover all the bases for health problems and risks.

5.KEY ACTORS IN THE COMMUNITY HEALTH-CARE SYSTEM

In most developing countries, the community health-care system represents at least five layers of care that respond to the comprehensive healthcare demands of its people.
The five layers include:

(1) Individual self-care
(2) Family care
(3) Care and support among neighbours and groups in the community
(4) Care and support given by health-care providers and healers

6.PRACTICAL IMPLICATIONS COMMUNITY HEALTH NURSING

• Community health nursing is a population-focused, community-oriented approach aimed at health promotion of an entire population, and prevention of disease, disability and premature death in a population.
• Unique to community health nursing is the opportunity for nurses to learn and develop partnership skills with all stakeholders and key actors in their communities.
• Nurses who work for the community must be knowledgeable and aware of community concepts
• Community health nursing practice synthesizes nursing theory and public health science, and places priority on prevention, protection and promotion of health.
• Nurses must be sensitive to the community culture, competent in utilizing the social capital and resources of the community.

7.COMMUNITY-BASED NURSING

• Community-based nursing covers nursing care provided to individuals, families and groups wherever they live, work, play or go to school.
• Community based nursing is a philosophy of care that is characterized by collaboration, continuity of care, client and family responsibility for self-care, and preventive health care (Hunt, 2005).
• Community-based nursing focuses on an individual and is family-centred in orientation.
• Partnerships with clients are developed and awareness cMajor activities include case management, patient education, individual and family advocacy, and an interdisciplinary approach
• Major activities include case management, patient education, individual and family advocacy, and an interdisciplinary approach

8.ROLES AND RESPONSIBILITIES

• Whatever the practice setting, community health nurses should perform the roles of clinician, advocator, collaborator, consultant, counselor, educator, researcher and case manager.
• Community health nursing includes clinical care to individuals when needed.
• Family-centred care is directed towards self-care, healthy living conditions and healthy lifestyle choices.
• Individual and family-centred care are carried out to reach the goal of care of the entire community.

9.FOR MORE INFORMATION REFER TO PPT

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PPT On Benign Uterine Tumour

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Benign Uterine Tumour Presentation Transcript

1.INTRODUCTION :
    Leomyomas, also called myomas or fibroid of the uterus are benign tumor of the uterine muscles.

2.INCIDENCE :
    Leomyomas are the most common tumour of the female genital tract. They occur in more than 20-30% of all women during their menstrual years. Firboids are more common in women approaching menopause.

3.ETIOLOGY :
 The exact cause is unknown. The growth of leomyomas seems to be related to estrogen stimulation because the fibroids often enlarge with pregnancy and decrease in size with menopause. Leomyomas begin as simple proliferation of smooth muscle cells. This proliferation is stimulated by physical or mechanical means and may occur at points of maximal stress within the myometrium. With the stress within the uterus as a result of contractions there are often multiple fibroids.

4.PATHOPHYSIOLOGY :
    Frequently leomyomas are asymptomatic, symptoms appear generally relate to tumour size, location and number. Abnormal bleeding resulting in hypermenorrhea.
Secondary Changes :

• Hyalin degeneration : When tumour outgrows the blood supply.
• Cystic degeneration : When the tumour becomes liquefied and ultimately cystic.
• Calcification : more common in large tumours.
• Infection : Which is more common in submucosal tumour.
• Sarcomatus Degeneration : Rare and suspected with rapidly enlarging tumours.
• Acute torsion of the pedicle which leads to acute disruption of blood supply with gangrenous changes and symptoms of acute abdomen.

5.CLINICAL MANIFESTATIONS :

• Symptoms vary widely and occur in about half of women with leomyomas. They relate to the size,   location and number of the leomyomas.
• The onset occur in late 410 and early 50 just before menopause.
• The most common clinical manifestations are :-
• Abnormal uterine bleeding recursive in amount or duration.
• Associated with anaemia.
• Tiredness, lethargy and weakness.
• Urinary frequency is common as tumour probes on the bladder.
• Urinary retention, constipation and abdominal pain are less common symptoms. 

6.DIAGNOSTIC ASSESSMENT : A characteristic history, confirmed by abdominal and pelvic examination findings establishes the diagnosis.Ultrasonography may indicate an abnormal uterine shape. Various disorders such as cancer or a problem pregnancy may be ruled out before treatment is planned.

7.MEDICAL MANAGEMENT :

•  Plan of treatment depends on symptoms, age, location and size of the tumours, onset of complications and the client’s desire to become pregnant.
•  If a woman is near to menopause and uterus size is small then conservative treatment is given. If the client experiences rapid increase in the size of the leomyomas more definitive therapy that is myomactomy is done.

8.SURGICAL MANAGEMENT
    Younger, asymptomatic women may require no treatment. When definitive treatment is indicated such as myomactomy (removal of a tumour without removal of the uterus). Uterine leiomyomas are a common indication for a hysterectomy.

9.NURSING MANAGEMENT :
ASSESSMENT :
    Many women may be asymptomatic, however many will seek medical help because of abnormal uterine bleeding. The nurse must obtain a thorough history from the client and assess the knowledge of her condition and the surgery if planned.

NURSING DIAGNOSIS, PLANNING AND IMPLEMENTATION

• Nursing Diagnosis : Knowledge deficit related to surgical procedure and possible outcome
• Planning : Expected outcome : The client will discuss surgery and outcomes.
• Implementation : The woman needs assistance in understanding her problem and the surgery being performed to correct it, either a myomectomy or a hysterectomy. She needs informations as how to care for herself postoperatively. If she had myomectomy, pregnancy is still option and she must continue to receive regular gynecologic examinations. If she had a total abdominal hysterectomy with bilateral salpingo oophorectomy, menopause and estrogen replacement therapy should be discussed. 

10. FOR MORE INFORMATION REFER TO PPT

11. THANK YOU