01272020 ➢ Needs may be deferred.

➢ Needs may be interrelated.

CONCEPTS OF MAN AND HIS BASIC HUMAN NEEDS ➢ An unmet human need results in disruption of
normal body activities and frequently leads to
Four Major Attributes of a Human Being eventual illness.
1. The capacity to think or conceptualize on the
abstract level. Health and Illness
2. Family formation
3. The tendency to seek and maintain territory Health
4. The ability to use verbal symbols as language, a • State of well-being and using every power the
means of developing and maintaining culture individual possesses to the fullest extent.
(Nightingale)
Concepts of Man • State of complete physical, mental, and social well-
• Man is a BIOPSYCHOSOCIAL and SPIRITUAL being being and not merely the absence of disease or
who is in constant contact with the environment. infirmity. (WHO)
• As a biologic being, man is like other men. • A dynamic state of being in which the
• As a psychologic being, man is like no other man. developmental and behavioral potential of an
• As a social being, man is like some other man. individual is realized to the fullest extent possible.
• As a spiritual being, man is like all other men. (ANA, 1980)
• Man is composed of subsystems and • Freedom from signs of disease and pain as much as
suprasystems. possible; being active and able to do what they
• Man is a unified whole composed of parts which want/must; being in good spirits most of the time.
are interdependent and interrelated with each (lay definition)
other.
• Man is composed of parts which are greater than Wellness – An integrated method of functioning oriented
and different from the sum of all his parts. towards maximizing the potentials of an individual within
the environment where he is functioning. (Dunn)
MARTHA ROGERS – Man is an open system in constant Well-Being – A subjective perception of balance,
interaction with a changing environment. harmony, and vitality. (Leddy & Pepper)
Illness – It is a personal state in which the person’s
As an energy unit, physical, emotional, intellectual, social, developmental,
SISTER CALLISTA ROY – Man is an individual with vital or spiritual functioning is thought to be diminished;
reparative processes to deal with disease and desirous ▪ Disturbance in normal functioning.

Basic Human Needs Classification of Illness

• Each individual has a unique characteristic but 1. Acute Illness
certain needs are common to all people. Characterized by severe symptoms of
• Human needs are physiologic and psychologic relatively short duration.
conditions that an individual must meet to 2. Chronic Illness
achieve a state of well-being. The one that lasts for an extended period, 6
months or longer.
Human Needs It has slow onset and often have periods of
Need remission, when the symptoms disappear,
• Necessary, useful, or desirable to maintain well- and exacerbation, when symptoms reappear.
being & life; motivation for behavior
• May be met consciously or unconsciously 01312020

Disease
Characteristics of Basic Human Needs
➢ Needs are universal. Alteration in body functions resulting in a
➢ Needs may be met in different ways. reduction of capacities or shorting of normal lifespan
➢ Needs may be stimulated by external and internal
factors. Ex. Cancer, cardiovascular condition or disease, organ
➢ Needs may be altered by individual priorities. damage risks the normal function
Common Causes of Disease 3. Environment- physical and social factor external
to the host that may or may not predispose the
• Biologic Agents
person to development of the disease (e.g. living
• Inherited Genetic and Developmental Defects conditions, economic status)
• Physical and Chemical Agents
• Tissue response to irritation/ injury Dunn’s High-Level Wellness
• Faulty chemical/metabolic process The intersection of the two axes form four
• Emotional/ physical reaction to stress health/wellness quadrants:
Sickness – Status or social entity associated with disease 1. High-level Wellness in a favorable environment-
or illness healthy lifestyle with resources to support
The 7 Components of Wellness 2. Emergent High-Level Wellness – knowledge in
lifestyle but cannot implement because of some
1. Physical- ADIs, self-care, nutrition, no vices, etc. resources.
2. Emotional- positive feeling of self, enthusiasm 3. Protected poor health in a favorable environment
towards life, etc. – needs are met by health care system
3. Social- relationship with others, contribution to 4. Poor health in an unfavorable environment
society, etc.
4. Intellectual- engaging in stimulating and creative
mental activities to increase knowledge, etc.
5. Occupational- engage in activities that provides
personal satisfaction and enrichment if life
6. Spiritual- seeking meaning and purpose in life
7. Environment- clean water, sufficient food, clean air

Factors Influencing Our Definition of Health

1. Developmental status- stages of development,

understand how different age groups adapt to
situations
2. Social and cultural influences- adherence to
therapeutic regimen, understanding of health (of
family)
3. Previous experiences- traumatic exposure to doctors
or the health care facility
4. Expectations of self- can I overcome this illness.
5. Perception of self- considering I’m infected, can I
handle the expenses, do I have support groups or Travis- Illness-Wellness Model
my family?
• High level wellness (awareness, education,
MODELS OF HEALTH growth)
• Premature death (disability, symptoms, signs)
Leavell and Clark Model- Ecologic Triad • llness–wellness continuum ranges from optimal
Agent, Host, Environment Model health to premature death
• Right of neutral point indicates increasing levels
1. Agent- environmental factors/stressor that by of health and wellness for an individual. This is
presence or absence can lead to disease (e.g. achieved through health knowledge, disease
lack of essential nutrients) prevention, health promotion, and positive
2. Host- person who may or may not be at risk of attitude.
acquiring a disease • Left of neutral point indicates progressively
decreasing levels of health
Rosenstock-Becker’s Health Belief Model - Assist clients to increase levels of health
- Educate clients to be effective health care
Originally intended to predict which people
consumers
would or would not use preventive health services (ex.
- Assists clients to develop ad choose health-
flu shot, HIV testing, hypertension screening, etc.)
promoting options
Based on motivational theory: - Guide development of effective problem-solving
and decision-making
Assumption: - Reinforce client’s personal and family health-
- Rosenstock- good health is an objective common to promoting behaviors
all people - Advocate in the community for changes that
- Becker: consider positive health motivation promote a healthy environment

Individual Perceptions: OTHER HEALTH MODELS

1. Perceived susceptibility- high risk due to family 1. Holistic Health Model

history of a disorder Promotes the active involvement of the client in
2. Perceived seriousness- based on the perception of the improvement and maintenance of his health
the individual 2. Clinical Model
3. Perceived throat- combination of perceived No sickness or illness is wellness; no signs and
susceptibility and seriousness symptoms =wellness
3. Role Performance Model
Variable Influencing Health and Health Beliefs and Individual can accomplish task = wellness
Practices 4. Adaptive Model
A. Internal Variables With manifestation, address and educate self;
1. Biological Dimensions- developmental level and adapt based on the symptoms
genetic makeup 5. Eudemonistic Model
2. Psychologic Dimensions- mind-body interactions Comprehensive approach to health care;
and self-concept application of health promotion and disease
3. Cognitive Dimensions- lifestyle choices and prevention
spiritual and religious beliefs Levels of Prevention
B. External Variables
1. Family practices 1. Primary
2. Socio-economic factors - Health promotion programs
3. Cultural background - Specific protection
2. Secondary
Health Promotion Model (Nola Pender) - Early diagnostics and prompt treatment
Related to Kurt Lewin Theory: Change Theory - Disability limitations
3. Tertiary
HEALTH PROMOTION - Restoration and rehabilitation
- Not disease oriented Factors that Cause Illness
- Motivated by personal, positive approach to
wellness 1. Etiologic Factors
- Seeks to expand positive potential for health o Cause of particular disease
- optimum well-being, personal fulfillment and 2. Predisposing Factors
productive living. (action outcome of the nurse o A previous condition that influence
towards positive health) susceptibility or tendency to illness
Nurses Role in Promotion o E.g. Family history of heart disease, diabetes
mellitus
- Model healthy lifestyle
- Facilitate client involvement 3. Contributory factors
o A condition that helps bring about the illness
- Teach self-care strategies
 o E.g. Smoking, sedentary life, obesity-contributed 02032020
to heart attack
4. Precipitating Factors PREVENTION OF TRANSFER OF MICROORGANISMS
o A condition that hastens or aggravates the illness Importance of Biologic Safety
o E.g. heart attack brought about by sudden death
of a loved one Microorganisms are naturally present in the
environment. Some are beneficial and some are not.
Risk Factors
Some are harmless to most people and others are
any situations, habit, social, or environmental harmful to may persons. Still, others are harmless except
condition, physical condition, developmental, in certain circumstances.
intellectual, spiritual variables that increases the
vulnerability of an individual to an illness or accident. Terms

1. Genetic and physiologic factors • Infection- Successful entry and multiplication of

2. Age microorganisms into our body
3. Environment • Disease- Abnormal functioning of the tissue
4. Lifestyle
Types of Infection
STAGES OF HEALTH BEHAVIOR CHANGE
1. Nosocomial
1. Pre-contemplation- no change -Iatrogenic
2. Contemplation- considers a change - from endogenous or exogenous sources
3. Preparation- plans to change 2. Subclinical/asymptomatic
4. Action- changes in action 3. Infectious disease
5. Maintenance- changes in actions becomes a a) Non-communicable- already on treatment
habit
for two weeks
6. Termination- convinced health problem is no
b) Communicable
longer a threat
Epidemiologic/Ecologic Triad
STAGES OF ILLNESS BEHAVIOR
Agent-Host-Environment
1. Symptom experience – awareness of signs or
symptoms » self-diagnose » self-medicate Stages of the Infectious Process
2. Assumption of Sick Role – sick leave, free from
social obligations 1. Incubation Period- interval between the initial
3. Medical Care Contact – consultation; medical infection and the first appearance of any signs or
shopping symptoms
4. Dependent Client Role (Sick Role)- self-care
Time of incubation depends on:
deficit
5. Recovery/Rehabilitation – restoration; • Specific microorganism involved
relinquishes the sick
• Virulence
IMPACT OF ILLNESS ON THE CLIENT AND FAMILY • Number of infecting microorganisms
• Resistance of the host
➢ Behavioral and Emotional Changes
2. Prodromal- A relatively short period that follows the
➢ Impact on Body Image
➢ Impact on Self-Concept incubation period in some diseases. Characterized by
➢ Impact on Family Roles early, mild symptoms of diseases, such as headaches
➢ Impact on Family Dynamics and malaise.
3. Illness period
• Disease is most acute.
 • The person exhibits overt signs of the symptoms ➢ Indirect- vehicles of transmission; vectors
of the disease ➢ Airborne- more than 3ft; dust particles; droplet
• Patient’s immune response and other defense nuclei
mechanisms overcome the pathogen, and the
Portal of Entry
period of illness ends.
• When the disease is not successfully overcome, ➢ Respiratory tract- inhalation
the patient will die in this period. ➢ GIT- ingestion
4. Convalescence ➢ Genito-urinary- sexual intercourse
• The person regains strength and the body ➢ Skin- needle prick, body piercing
returns to its pre-diseased state ➢ Blood- blood transfusion, sharing in the “works”
• Recovery has occurred. ➢ Placental Entry

Chain of Transmission or Infectious Cycle Susceptible Host

Agent-Reservoir-Portal of Exit- Mode of Transmission- Factors Influencing Susceptibility of Host

Portal of Entry-Susceptible Host
1. Age
Agent – Bacteria, viruses, fungi, protozoa 2. Nutrition
3. Stress
Factors affecting microorganism’s capability to cause 4. Disease process
disease: 5. Medical therapy
1. Number (dose) of organisms present Body’s Defense Against Infection
2. Virulence
3. Ability to enter and survive in the host ➢ Non-specific defenses
4. Susceptibility/ resistance of the host a. Anatomic and physiologic barriers
b. Inflammatory response
Reservoir ➢ Specific defenses
Environment, area, body where pathogenic organism is Immune system
found, dependent for survival, may or may not multiply.
a. Humoral immunity
1. Human- frank cases, sub clinically infected, b. Cell-mediated defenses
carrier
2. Animals IMMUNITY
3. Plants
Natural- endogenous, already/naturally present
4. Soil
5. Fomites • Active- exposure/experience
• Passive- placental/breastfeeding
Portal of Exit
Acquired
➢ Respiratory tract- exhalation, coughing, etc.
➢ GIT- vomiting, defecation • Active- antigens (vaccines/toxoid)
➢ Genito-urinary- voiding, sexual intercourse • Passive- antibody (i.e. ATS, HRIG)
➢ Wounds- boil, scabies
Breaking the Chain of Infection
➢ Mechanical escape- I&D, needle aspiration,
bites/sting a. Isolation- separation of the infected person
based on the longest period of communicability
Mode of Transmission
of the disease.
➢ Direct- droplet (within 3ft); touching; biting;
kissing; sex
 CDC ISOLATION PRECAUTION transfer of microorganisms to others and the
Standard precautions environment
• All hospitalized persons regardless of their 7. Prevent injuries from used scalpels, needles, or other
diagnosis or probable infection status equipment, and place in puncture-resistant
• Designed to reduce risk of transmission of containers.
microorganisms from recognized and Transmission-Based Precautions- are used in addition to
unrecognized sources Standard Precautions for clients with known or
Apply to: suspected infections.
• Blood, Non-intact (broken) skin, Mucous membranes ➢ Airborne Precautions – used for clients
• Bodily fluids, excretions, and secretions except sweat suspected or known to have serious illnesses
transmitted by airborne droplet nuclei smaller
Practices than 5 microns.
1. Wash hand whether gloves are worn Practices:
➢ Wash hands immediately after removing gloves
➢ Use a non-antimicrobial soap for routine hand 1. Place client in a private room that has negative
washing air pressure.
➢ Use an antimicrobial agent or an antiseptic agent 2. If a private room is not available, place client
for the control of specific outbreaks of the with another client who is infected with the
infection. same microorganism.
2. Wear clean gloves when touching blood, bodily fluids, 3. Wear a respiratory device (N95 Respirator) when
secretions, excretions, and contaminated items. entering the room of a client who is known or
➢ Clean gloves can be unsterile unless their use is suspected of having primary tuberculosis.
intended to prevent the entrance of 4. Susceptible people should not enter the room of
microorganisms into the body. a client who has rubeola (measles or varicella
➢ Remove gloves before touching non- (chicken pox). If they must enter, they must wear
contaminated objects items and surfaces a respirator.
➢ Wash hands after immediately removing gloves 5. Limit movement of client outside the room to
3. Wear a mask, eye protection, or a face shield if essential purposes. Place a surgical mask on the
splashes or sprays of blood, bodily fluid, secretions, client during transport.
excretions can be expected. ➢ Contact Precautions – used for clients suspected or
4. Wear a clean, non-sterile gown if client care is likely known to have serious illnesses easily transmitted by
to result in splashes or sprays of blood, bodily fluids, directed client contact or by contact with items in the
secretions, or excretions. The gown is intended to client’s environment.
protect clothing. Practices:
a. Remove a soiled gown carefully to avoid transfer 1. Place the client in a private room.
of microorganisms to others. 2. If a private room is not available, place client
b. Wash hands after removing gown. with another client who is infected with the
5. Handle client-care equipment that is soiled with same microorganism.
blood, body fluids, secretions, or excretions carefully. 3. Wear gloves as described in the Standard
a. Make sure reusable equipment is cleaned and Precautions.
reprocessed correctly. a. Change gloves after contact with infectious
b. Dispose of a single-use equipment correctly. material.
6. Handle, transport, and process linen that is soiled b. Remove gloves before leaving client’s room.
with blood, body fluids, secretions, or excretions in a c. Wash hands immediately after removing
manner to prevent contamination of clothing and the gloves. Use an antimicrobial agent.
 d. After hand washing, do not touch possibly Agents used:
contaminated surfaces or items in the room.
1. Antiseptics (alcohol, betadine, etc)
4. Wear a gown when entering the room.
2. Disinfectants (Lysol, purex, cidex, etc)
a. Remove gown in client’s room
b. Make sure uniform does not contact
d. Sterilization
5. Limit movement of the client outside the room.
e. Asepsis
6. Dedicate the use of noncritical client care
o Surgical or sterile technique
equipment to a single client or to clients infected
o Medical or clean technique
with the same infecting microorganisms.
o Droplet Precautions – used for clients suspected or Principles of surgical asepsis
known to have serious illnesses easily transmitted by
1. A sterile area or object remains sterile when touched
airborne diseases transmitted by particle droplets
by another sterile object.
larger than 5 microns.
a. Use sterile forceps/wear sterile gloves to handle
articles on a sterile tray.
Practices:
b. Touch a sterile surface only w/ another sterile
1. Place the client in a private room.
object
2. If a private room is not available, place client
2. A sterile area or object becomes contaminated when
with another client who is infected with the
touched by any un-sterile object.
same microorganism.
a. When the edge or rim of a sterile area is adjacent
3. Wear a mask if working within 3ft of client.
to or in contact with an unsterile surface,
4. Limit movement of client outside the room to
consider the rim/ edge as contaminated.
essential purposes. Place a surgical mask on the
3. A sterile object or area becomes contaminated by
client during transport.
prolonged exposure to air.
a. Keep air currents at a minimum by avoiding any
b. Cleaning
unneccesary movement of people, illness,
Steps that ensure cleanliness of an object curtains, and so forth.
b. Do not reach across a sterile field.
1. Rinse a contaminated object or article with cold
c. Avoid laughing, coughing, sneezing and
running water to remove organic material.
excessive talking across a sterile surface.
2. After rinsing, wash the object with soap and
d. Once a sterile tray has been opened, there’s a
warm water. Rinse thoroughly.
chance that it has been contaminated by air
3. Use a brush to remove dirt or material in grooves
currents, thus, articles not used from a sterile
or seams.
tray should not be returned.
4. Dry the object and prepare for disinfection or
4. A sterile area or object becomes contaminated when a
sterilization, as indicated by the intended use of
sterile object comes in contact with a wet surface thru
the item.
capillary action.
5. The brush, gloves, and sink in which the
a. A sterile porous material will serve as a barrier
equipment is cleaned should be considered
between an un-sterile surface and sterile object
contaminated and should be cleaned and dried.
only if the porous material remains dry.
c. Disinfection
b. If a porous wrapper or barrier becomes wet, do
Method: not use the article inside.
c. Use a sterile, waterproof (non-porous) material
1. Concurrent
as a barrier
2. Terminal
5. A sterile area or object becomes contaminated when
gravity causes a contaminated liquid to flow over a
sterile area.
 a. When you do a surgical scrub, hold hands above
level of elbows to keep water on arms from
flowing back over clean hands.
b. Keep the tip of transfer forceps pointed
downwards.

Procedures

I. Handwashing
1. Done before and after any procedure and
after contact w/ a patient
2. Done after removing gloves
3. Remove jewelries
4. Apply friction, paying attention to
interdigits and surfaces under the nails.
5. Flow of water when rinsing is from elbow
down to the finger tips.

II. Surgical Aseptic Techniques

1. Handling Pick-up Forceps
2. Preparing/ Opening a sterile field
3. Opening a sterile pack
4. Transferring objects to a sterile field
5. Pouring solution into a sterile container
6. Putting on gloves