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Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 8.1
Slide 22
Coping (cont.)
• Problem-solving strategies
• Identifying the problem, generating alternatives, choosing best alternative, applying it to the
problem
• Emotion-focused strategies
• Distancing oneself from the stress-provoking situation or denying its seriousness, self-isolation
TALKING POINTS:
• How does Lazarus describe the effectiveness of coping?
Slide 23
Adaptation
• Essential to maintaining health
• Constructively coping with stressful conditions
• Depends on accurate appraisal of stressful situations and effective coping
• Can lead to physiologic and psychological well-being
TALKING POINTS:
• Some people adapt better than others to life circumstances.
• How can nurses help patients deal with stress?
Slide 24
Adaptation (cont.)
• Nurses can help patients deal with stress by identifying the patient’s usual methods of coping or
adapting
• Internal resources
Homeostasis
• The tendency of the body to maintain stability of its internal environment
• The body adapts to internal and external changes in the environment, adjusts to changes, and
14 Chapter 8 Health and Illness _______________________________________________________________
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LESSON 8.1
5
Slide 26
Health Promotion, Disease Prevention, and Health
• Maintenance
• Specific activities thought to promote health
• Adequate nutrition based on the “pyramid” concept
TALKING POINTS:
• The U.S. Department of Health and Human Services has developed a document called Healthy
6
Slide 27
The Concept of Illness
• Acute illness
• Illness or disease with rapid onset and short duration
• The condition usually responds to a specific treatment and ends in full recovery
• Chronic illness
TALKING POINTS:
• Illness is a deviation from a healthy state that may occur acutely or as a series of long-term events.
• What are some examples of acute and chronic illnesses?
7
Slide 28
Illness Behavior
• Individuals’ actions influenced by the availability and affordability of health care, perception of the
problem, others’ perceptions of problem, and the failure or success of self-prescribed treatment
• People who take no action
TALKING POINTS:
• Reactions to illness vary among individuals.
• Some people take action, whereas others may do nothing.
• What term may be used in place of “noncompliant”?
The Sick Role
• Allows time to recover from the disease
• When patients cannot get well on their own, others must care for them
_______________________________________________________________ Chapter 8 Health and Illness 15
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 8.1
Slide 30
Effect of Illness on the Family
• Three factors
• Identity of the member of the family who is ill
• Seriousness and duration of the disease
TALKING POINTS:
• Illness does not affect individuals in isolation; rather, it has an impact on the entire family.
• How may illness affect family members?
8
Slide 31
Prevent Health Problems
• Help people engage in healthier lifestyles
• Inform patients of daily activities, such as proper diet, exercise, and adequate sleep, that help
TALKING POINTS:
• Nurses can help people engage in healthier lifestyles to prevent disease.
• What factors should the nurse take into consideration when counseling patients and their families
on healthier lifestyles?
Slide 32
Henderson’s 14 Components of Basic Nursing Care
• Normal breathing
• Eating and drinking adequately
• Eliminating body wastes
TALKING POINTS:
• For people to maintain the highest levels of health and wellness, basic human needs must be met.
• What is Henderson’s philosophy on basic nursing care?
Henderson’s 14 Components of Basic Nursing Care (cont.)
• Keeping the body clean
• Avoiding dangers in the environment
TALKING POINTS:
• How are these components of basic nursing care related to Maslow’s hierarchy of human needs?
16 Chapter 8 Health and Illness _______________________________________________________________
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LESSON 8.1
Increase Adaptability
• Determine what the patient perceives as stressful and how stressful it is
TALKING POINTS:
• What is one way to assess the degree of stress a patient is experiencing?
• Older persons have particular difficulty coping with stress and adapting to new situations.
Increase Adaptability (cont.)
• During hospitalization
• Some patients and families benefit from detailed information about the disease and hospital
TALKING POINTS:
• Even people who are very dependent on hospital personnel need to believe that they have some
control over their lives.
• How do relaxation techniques help reduce stress?
Foster Independence
• Prevent and manage crises
• When symptoms flare up, a crisis situation may arise
Slide 37
Foster Independence (cont.)
• Carry out prescribed regimens
• Teach patients about need to carry out regimens
• Provide moral support and encouragement
Slide 38
Foster Independence (cont.)
• Manage symptoms
• Chronically ill individuals must learn to manage symptoms to continue desired activities
• Help patients learn about symptoms (typical onset, duration, and severity) and their ability to
control them
Foster Independence (cont.)
• Reorder time
_______________________________________________________________ Chapter 8 Health and Illness 17
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 8.1
Foster Independence (cont.)
Slide 41
Foster Independence (cont.)
• Prevent social isolation
• Chronically ill individuals and their families often become socially isolated
• The ill person may withdraw from others, or others may feel uncomfortable and withdraw
• Support groups are helpful for providing a social outlet with others in the same situation
Foster Independence (cont.)
• Normalize social interactions
• Chronically ill people need to maintain as normal a lifestyle as possible despite having to
Slide 43
Help Family Members Deal with the Patient’s Illness
• Families provide bulk of support for chronically ill members, and the burden of caregiving is heavy
for them
• Families must take on more physical work because of need to assist with activities of daily living,
TALKING POINTS:
• Many communities have adult day care centers for older adults or persons with particular chronic
illnesses.
• What can adult day care centers provide?
Help Family Members Deal with the Patient’s Illness (cont.)
• Health care providers need to assist patients and their family members in developing a
collaborative plan of care
Slide 45
alive longer than was ever possible in the past.
• What issues may the nurse need to help the family deal with?
Assist Terminally Ill Patients to a Peaceful Death
• Nurses often have the most intimate relationship with terminally ill people
• When disease is chronic, patients and families often need to make difficult decisions regarding
death
TALKING POINTS:
• In today’s health care system, with its sophisticated technology, terminally ill patients can be kept
18 Chapter 8 Health and Illness _______________________________________________________________
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 8.1
Assist Terminally Ill Patients to a Peaceful Death (cont.)
• Nurses should be supportive of decisions made by patients and families
TALKING POINTS:
• Dying patients and their loved ones should be informed of the options for care and their
consequences.
• What are advance directives?
9
Complementary and Alternative Therapies
• People are increasingly turning to therapies in addition to, or along with, conventional medicine
TALKING POINTS:
• What is an example of an alternative therapy? A complementary therapy?
Complementary and Alternative Therapies (cont.)
• Most are based on the belief that illness is caused by lack of balance or harmony within the
Slide 49
Question 1
• Which of the following is a true statement about health and illness?
A. People define health and illness according to how they view themselves as human beings
unrelated to the surrounding environment.
B. People do not need to accept responsibility for their own wellness and take an active part in
improving and maintaining it.
C. Well-being or lack of well-being for individuals fluctuates along the continuum on a daily basis.
D. In 1946, the World Health Organization defined health as “the state of complete physical and
social well-being and not merely the absence of disease or infirmity.”
TALKING POINTS:
how individuals fulfill their needs and reach their highest health potential.
Slide 50
Question 2
• Which is NOT a way that affectional-emotional needs are satisfied?
A. Memory
B. Love
C. Security
D. Care
TALKING POINTS:
_______________________________________________________________ Chapter 8 Health and Illness 19
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 8.1
Activities
Classroom Choose from below to make 30 minutes
Online
ASSESS BASELINE
• Have the class complete the Pretest. Collect their
work and use the results to guide how you teach the
class.
DISCUSS
• Discuss what the health-illness continuum is and why
health and illness are relative terms.
• Discuss some of the factors that affect a person’s
perception of health and illness.
• As a class, discuss the relative nature of the health–
illness continuum. Ask students to explain what it
condition have relative illness?
ASSESS BASELINE
• Post the Pretest and the Background
Assessment online and have your class
complete them. Use the results to guide how
you teach the class.
DISCUSS
• Discuss the differences and similarities between
traditional views of health and illness and current
views.
• Discuss how psychosocial and spiritual values and
beliefs can influence a person’s perception of his or
her health state.
• As a class, discuss how the current view of health
and illness differs from the traditional view. Next,
POST AND COMMENT
• Post the following discussion topic online
and have students comment. Compare and
contrast traditional and current views of
health care. Feel free to present this in chart
form if you feel it will help.
DISCUSS
• Discuss the order in which needs must be met
according to Maslow’s hierarchy of needs.
• Discuss and name the five levels of human needs in
Maslow’s hierarchy of human needs.
• Discuss: Is there ever a time when emotional needs
might have to be met before physical needs? If so,
give an example.
• Divide the class into five groups. Have each group
POST AND COMMENT
• Post the following discussion topic online
and have students comment. Briefly outline
Maslow’s hierarchy of needs. What does
Maslow indicate are the most important
needs for the patient to meet (or have met
for them)?
20 Chapter 8 Health and Illness _______________________________________________________________
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 8.1
DISCUSS
• Discuss the four levels of adaptability to stress.
• Discuss the three stages of the general adaptation
syndrome. How is it different from the local adaptation
syndrome?
• Discuss the effects of the alarm reaction on the
sympathetic nervous system. Which hormones play a
role and what effects do they have?
• Discuss the signs and symptoms of depression that
may develop if a person is unable to respond to
stress.
POST AND COMMENT
• Post the following discussion topic online
and have students comment. Outline in what
order you would care for the patients listed
below. Describe coping mechanisms that
might be employed by each person.
• A housewife begins to drink heavily after
she finds out her husband of 30 years is
divorcing her.
• A housewife signs up for job training
classes after her husband of 30 years
DISCUSS
• Discuss Healthy People 2020 and the leading health
indicators that are used to determine achievement of
goals.
• Discuss the activities that are thought to promote
on these areas can contribute to improved health.
POST AND COMMENT
• Post the following discussion topic online
and have students comment. List five
activities to promote health.
• Post the following discussion topic online
DISCUSS
• Explain the difference between acute and chronic
illness. Give examples of each. Can a chronic
POST AND COMMENT
• Post the following discussion topic online
and have students comment. Pick a chronic
CREATE
• Create an outline of ways an illness could affect
family processes.
POST AND COMMENT
• Post the following discussion topic online
and have students comment. Describe three
specific illness behaviors and appropriate
reactions to those behaviors.
_______________________________________________________________ Chapter 8 Health and Illness 21
Introduction to Medical-Surgical Nursing, 6th ed.
LESSON 8.1
DISCUSS
• Discuss the nurse’s role in caring for the ill patient.
POST AND COMMENT
• Post the following discussion topic online
and have students comment. List specific
DISCUSS
• What are some complementary therapies that you
have seen patients use? What effect could this have
on them or their treatment regimen?
POST AND COMMENT
• Post the following discussion topic online
and have students comment. Perform an
Internet search of alternative therapies sold
Critical Thinking Question
A 75-year-old woman who has never been sick is in the hospital with a new diagnosis of stomach
cancer. The woman has been married for 52 years and has four adult children. When the nurse
enters her room in the late evening, the patient is crying. The nurse asks if she’s uncomfortable or in
pain, but she denies both. According to Maslow, what could be the problem with this patient? What
nursing interventions would be appropriate in this case?
Discussion Guidelines: The patient is probably experiencing fear. Since she has been married for 52
years, it is possible that she has rarely been away overnight without her husband. This could raise an issue
Instructor Notes/Student Feedback
22 Chapter 8 Health and Illness _______________________________________________________________
Introduction to Medical-Surgical Nursing, 6th ed.
8
Assessments for
Health and Illness
CHAPTER OBJECTIVES
Lesson 8.1:
2. Discuss traditional and current views of health and illness.
4. Explain how the body attempts to adapt to stressors.
6. Differentiate acute and chronic illness.
8. Describe nursing measures for health promotion, health maintenance, and illness.
9. Describe complementary and alternative therapies and the nurse’s role in relation to both.
Assessments by Lesson & Objective
Lesson 8.1
1
Study Guide
• Part IB: 1 (p. 36)
Evolve Instructor Resources
• Test Bank: 1
Evolve Student Resources
• NCLEX Review:
2
Evolve Instructor Resources
• Test Bank: 3, 4
3
Study Guide
• Part IA: 1-11 (p. 36)
• Part IID: 13 (p. 37)
Evolve Instructor Resources
• Test Bank: 5, 6, 8
Evolve Student Resources
4
• Prioritization: 4
Study Guide
• Part IID: 1-8, 12, 14 (pp. 36-37)
• Part IIIE: 1, 3-10 (pp. 37-38)
_______________________________________________________________ Chapter 8 Health and Illness 23
Introduction to Medical-Surgical Nursing, 6th ed.
Assessments by Lesson & Objective
5
Study Guide
• Part IID: 11 (p. 37)
Evolve Instructor Resources
• Test Bank: 2, 18, 19, 27
6
Study Guide
• Part IB: 3-10 (p. 36)
• Part IIIE: 2 (p. 37)
Evolve Instructor Resources
• Test Bank: 15, 20
7
Study Guide
• Part IB: 2 (p. 36)
Evolve Instructor Resources
• Test Bank: 24
8
Evolve Instructor Resources
9
Study Guide
• Part IC: 1, 2 (p. 36)
• Part IID: 9 (p. 37)
Evolve Instructor Resources
• Test Bank: 21, 25, 28, 29
Evolve Student Resources
• Multiple Response: 1
Instructor’s Notes/Student Feedback