HEALTH-EDUCATION-act-twenty-semifinals.pptx

this is a health related ppt

1. HEALTH EDUCATION SEMI FINAL

2. LITERACY Defined by National Assessment of Adult literacy as using printed and written information to function is society, to achieve one's goals and to develop one's knowledge and potential.

3. 3 LITERACY DOMAIN: Prose Literacy-refers to understanding information from texts such as books and newspapers. Document Literacy-skills needed to understand and use information in applications, maps,schedules and so on 3. Quantitative Literacy - the ability to understand numbers in printed materials or having the skills to do arithmetic.

4. Printed Educational Materials (PEMS) Educational pamphlets or booklets Brochures Hospital instruction booklets Instruction sheets: A. For taking medications B. Carrying out treatments

5. Factors that contribute to reading difficulty: Long sentence and polysyllabic words Complex sentence and paragraph structure Use of technical terminology and abstract concepts Mechanical factors

6. ASSESSING LITERACY CUES THAT CLIENT HAVE READING OR COMPREHENSIVE PROBLEM Claiming eyeglasses were left home Stating that they can't read something because they are too tired or don't feel well Avoiding discussion of written material or asking no question about it Mouthing words as they try to read

7. TESTS TO MEASURE LITERACY LEVELS: REALM-Rapid Estimate of Adult Literacy in Medicine WRAT-Wide Range Achievement Test both tests measure the basic reading skill of decoding words (recognizing letters that form words and then pronouncing the words correctly) do not measure reading comprehension only 2 to 3 minutes are needed to administer the tests hospitals and clinics use these tests routinely to assess reading ability of patients and they record the results in the patient's chart

8. REALM (Rapid Estimate of Adult Literacy in Medicine) A reading test that requires patients to pronounce common medical and anatomical words Contains 66 words arranged in three columns in ascending order of number of syllables and increasing difficulty. To administer the test 1. Ask the patient to read the words aloud, starting at the top of the first line and continuing through all three lists 2. Allow the patient 5 seconds to pronounce each word. 3. If the patient gets stuck on a portion of the list, ask him to look down each list to see if he can pronounce any additional words. 4. Score the test by adding up the total number of words pronounced correctly.

9. WRAT The most recent version of the Wide Range Achievement Test is WRAT 5. In the reading portion of this test, patients read aloud from a list of 42 words of increasing difficulty The examiner instructs the patient to pronounce each word and checks off each word pronounced incorrectly. When 10 consecutive words are mispronounced, the test is stopped. The administration manual shows how to convert the raw score to grade level

10. Teaching Patients with Low Literacy Assess reading ability Plan an approach to teaching that wil best meet the needs of individuals in this group Focus on basic essential skills that must be achieved Start from what the person already knows about the topics as well as what he still needs to learn Avoid information overload Teach limited amounts of material during each session Keep instruction simple by breaking them down into smaller units If possible, use more than one teaching method to reinforce learning Many with low literacy skills also have trouble understanding verbal instruction. Reinforce with printed educational material Make use of audiovisual presentation or simple computer tutorial

11. Use examples and analogies to which the person can relate Use familiar illustrations and pictures that are culturally relevant Use repetition at appropriate times At each steps, evaluation should take place so you know the person has learned

12. Health Teaching Evaluation Be creative in the way you evaluate Verbal quizzes may not work well with low literate people Ask them to repeat what you have said in their own words and ask for return demonstrations If you give them PEMs, you may ask them to underline important Info.

13. Guidelines to Developing Printed Educational Materials Organizational Factors Linguistic Factors Appearance Factors

14. Organizational Factors 1. Include a short but descriptive title 2. Use brief headings and subheadings 3. Incorporate only one idea per paragraph, and be sure the first sentence is the topic sentence 4. Divide complex instructions into small steps 5. Consider using a question/answer format 6. Address no more than three or four main points 7. Reinforce main points with a summary at the end

15. Linguistic Factors 1. Keep the reading level at grade 5 or 6 to make the material understandable to most low literate persons. 3. Use a personal and conversational style. Ex. "You should weigh yourself everyday." Is preferable to "The person with congestive heart failure should measure body weight everyday." 2. Use mostly one or two syllable words and short sentences 4. Define technical terms if they must be used. 5. Use words consistently throughout the text. For example, stay with the word pill rather than switching between pill and medicine. 6. Avoid the use of idioms that might mean different things to different people. For example, the term junk food may not be clear to all people. 7. Use graphics and language that are culturally and age relevant for the intended audience. 8. Use active rather than passive voice; for example, "Take one pill every morning" rather than "A pill should be taken every morning." 9. Incorporate examples and simple analogies to illustrate concepts.

16. Appearance Factors 1. Avoid cluttered appearance by including enough white space. 2. Include simple diagrams or graphics that are well labeled. 3. Use upper-and lowercase letters. All capitals are difficult for everyone to read. 4. Use 10 to 14 point type in plain font (serif is preferred) sample starts at the beginning of a paragraph. 5. Place emphasized words in bold or 3. underline them, but do not use capitals because they are difficult to read. Count the number of words in each sentence in the sample, figuring numbers, contractions, and hyphenated words as one word each. 6. Use lists when appropriate. 7. Try to limit line length to no more than 50 or 60 characters.

17. Readability Formulas Flesch Fog SMOG Use the measurement of number of syllables and sentence length as the basic variables that are entered into mathematical equations or plotted on a graph.

18. Flesch Reading Ease Formula Was developed by Rudolph Flesch (1948) Assumes that about 50 percent of people who are at a grade level can comprehend the material written at that grade level. Can be applied to materials that fall between the 5th and 12th grade reading levels. The formula are as follows: 1. For short writings, take 3 or 4 samples of approximately 100 words each. For a book, take 25 to 30 samples. Each 4. Calculate overage sentence length (SL) by counting the number of words in each sample, figuring numbers, contractions and hyphenated words as one word each. Ex. 22, don't, seventy- two, long-term 5. Count the number of syllables in your 100 word samples. Reading aloud will help you determine the syllables, especially in numbers. For example, 1915 would have four syllables. 6. Calculate average word length (WL) by dividing the number of syllables by the number of words in your sample and multiplying by 100. 7 . Insert your SL number and WL number into this Reading Ease formula:

19. Fog Index Was developed by Gunning in the 1970’s It can be used to determine readability from 4th Grade to College Assumes that 75 percent of people reading at the grade level should be able to read the tested material Steps: 1. For short writings, take a sample of 100 words. For long pieces, take several samples and average the results. 2. Figure the number of sentences (S) in the sample. If the 100-word count falls more than halfway through a sentence, count this sentence in the sample and add up the number of words (W). 3. Count the number of words containing three or more syllables (A). Do not count verbs ending in "ed" or "es" if they make the word have three syllables, and do not count capitalized words or combinations of simple words like wallpaper. 4. Insert your (S), (W), and (A) numbers into this Grade level formula: GL= (W/S+A) x 0.4 This formula is easy to interpret because the results are already expressed as a grade level

20. SMOG Formula Named after the smog found in London, the author's birthplace Was developed by McLaughlin (1969) to simplify the process of measuring readability Is quick and simple if you are not intimidated by estimating a square root Based on the assumption that 100 percent of the people reading at that grade level will comprehend the material, compared to the other formulas that are based on perfect comprehension by only 50 and 75 percent of people at the grade level. Are usually about two grades higher than the grades calculated by other formula Steps: 1. Count 10 consecutive sentences at the beginning, middle and end of a passage, for a total of 30 sentences. Sentences are considered to be Independent units of thought that end with a period, question mark or exclamation point. 2. In these sentences, count every word that has three or more syllables. Include numbers in the way they are sounded out. For example, 1915 would have four syllables. 3. Estimate the square root of the number of polysyllabic words in the count. This can be done by calculator, or estimated by taking the square root of the nearest perfect square. 4. If a word count falls about midpoint between two perfect squares, choose the lower number. 5. Add 3 to the estimated square root to get the SMOG grade. The SMOG grade is the grade reading level.

21. Word processing software- usually has built in readability formulas: A. Flesch Reading Ease B. Flesch Kincaid Microsoft word -click on the Tools button then click Options then follow a path of options that leads to readability statistics Corel Word Perfect -click on Grammatik instead of Options

22. Variables that affect readability: Word length Sentence length Number of words containing polysyllables Conceptual nature of the words The number of times difficult words are repeated Layout of the printed material Motivation of the learner

23. TEACHING STRATEGIES Lecturing Teaching strategy from which learning is passive. Purposes of Lecturing An efficient means of introducing learners to new topics. Can be used to stimulate students“ interest in a subject. Can be used to inspire people Used to integrate and synthesize a large body of knowledge from several fields or sources Used to clarify difficult concepts Lecture is valuable where knowledge is advancing rapidly and up to date textbooks are not available

24. Advantages of the Lecture Method Economical-greatest advantage over other methods Economical in terms of student time-lecturing can sift through the textbook info and pull out what is most important as well as Include info from other sources that a student could take hours locate and read Helps students develop their listening abilities-discipline selves to listen, remember, track arguments, decide what to take notes on and relate what is being said to the assigned reading

25. Disadvantages of the Lecture Method Places learners to the passive role By nature it lends itself to the teaching of facts while placing little emphasis on problem solving, decision making. analytical thinking or transfer of learning Lectures result in "surface learning" with students memorizing info and failing to truly comprehend or tie new info to existing cognitive schemata Not conducive to meeting students' individual learning needs

26. Disadvantages of the Lecture Method cont … The lecture works best for auditory, linguistic learners and disadvantage those with other learning styles may Lecturing brings with it the problem of limited attention span on the part of learners

27. Organizing the Lecture Plan ahead of time Outline your lecture (Organizing of content) Make structure clear to learners-2 approach: Explain verbally at the start of the class Show outline on transparency slide or handout Make use of advance organizers- a statement that forms a bridge between concepts already discussed and to those to come. At the end of the lecture, structure and main points should be summarized.

28. Outline of Lecture Hierarchical or Classical lecture - the most commonly used form, especially in Nursing. a. info is grouped, divided and subdivided in typical outline form. b. the simplest lecture structure and is very easy for learners to follow, especially if the outline is visually presented on slides or transparencies c. most appropriate for teaching of facts and introducing difficult material

29. Research Design 1. Why we need different research designs 2. Research Designs A. Experimental (Clinical Trials) 1. Quasi-experimental 2. Pre-experimental B. Correlational 1. Ex Past Facto (Comparative) 2. Retrospective and Prospective 3. Cross-Sectional and Longitudinal C. Descriptive

30. D. Qualitative 1. Ethnographic 2. Phenomenological 3. Grounded Theory Validity and Reliability of Designs • Problem-centered format also popular also problem is posed and various hypothesis and solutions are developed. Ex. Problem : Fever Hypotheses: Infection , Inflammation, Dehydration Solutions: Antibiotics, fluids, Heat application, Fluids and electrolytes Comparative structure-when the objective is to differentiate between two entities. the chart-type format may be actually presented to the learners to help them visualize the comparison

31. Thesis Format this involves the lecture taking a position on an Issue or a particular viewpoint on a subject and then supporting or justifying that viewpoint or position with evidence or logic .

32. Characteristics of Disorganized Lectures 1. Structure or outline is not obvious to the listener. 2. No mention of the objective or desired learning outcomes of the lecture 3. Lecture mentions the same topic at different times for no apparent purpose other than falling to complete a thought at one time 4. No advance organizers before new concepts are introduced 5. No transition between sections of the lecture 6. No summary or tying thoughts together at the end.

33. Delivering the Lecture Plan your delivery Rehearse Consciously think about your technique of delivery

34. Techniques to Consider in Delivering Lecture Controlling Anxiety - make use of imaging, an effective control mechanism. With imaging, you visualize yourself as you want to appear to your audience the preferred image can increase yourself concept and confidence Spontaneity -do not write lecture out in full sentences. notes are important lifesavers

35. Voice quality -loud enough to be heard beware of lecturing in a Monotone vary the pitch and volume of your voice as you speak enthusiasm will help to overcome any tendency to a monotone voice Body language -reflects self confidence your movements add dramatic quality of your Lecturing be aware of your borty language common annoying mannerisms are distracting maintain eye contact with the class Speed of Delivery -pacing of a lecture affects learner’s comprehension and enjoyment of the material

36. Getting off on the right foot- the way you begin a lecture sets the tone for all that follows give an opening "attention getter"

37. Clarifying during the lecture- give examples and analogies rather than repetition Facilitating Retrieval from memory -simple repetition of Important Ideas elaboration in which repeated words are fleshed out in more detail when mentioned the second time in the lecture imagery by which info can be lodged in memory for later retrieval. The brain encodes info in the form of either words or mental pictures

38. Types of Lecture 1. Traditional Oral Essay-the teacher is an orator and is the only speaker resulting in passive and sometimes bored learners some teachers use this solely to be able to cover all the material 2. Participatory lecture-begins with learners brainstorming ideas on the lecture based on what they have read in preparation The lecture with uncompleted handouts-somewhat traditional oral essay format the handouts help learners focus attention on important points

39. 3. The feedback lecture-consists of mini lectures interspersed with 10-minute small group discussions structured around questions related to the lecture content 4. The mediated lecture-the use of media such as films, slides or Web based images along with traditional lecture.

40. Additional Teaching Strategies in Conjunction with Lecture Discussion Questioning Using Audiovisuals

41. Types of Class Discussion Formal-topic is announced in advance and the class is asked to prepare to take part in the discussion Informal-may take place spontaneously at any point during the class including at the end of a lecture when the teacher asks," Are there any questions?"

42. Purposes and Advantages of Discussion 1. Give learners opportunity to apply principles, concepts and theories 2. Clarification of information and concepts-helps the teacher gauge learners' understanding as learning is taking place 3. Students learn the process of group problem solving 4. Attitudes can be changed through discussion 5. Many students like it and may even prefer it to other methods

43. Disadvantages of Discussion Method 1. Discussions take a lot of time 2. An Inefficient way to communicate information 3. An expensive strategy 4. One person or a few people monopolize the discussion 5. Valuable only if participants come prepared with the necessary background info

44. Discussion Techniques Make your expectations clear Set the ground rules Arrange the physical space Plan a discussion starter Facilitate, don't discuss Encourage quiet group members Don't allow monopolies Direct the discussion among group members Keep the discussion on track Clarify when confusions reigns Tolerate some silence Summarize when appropriate

45. Questioning Awareness of effectiveness. questioning as a teaching strategy seems to have begun with Socrates Socratic method of teaching-a teacher asks a series of questions that are designed to first make the students aware of their ignorance Emphasizes more as questioning as as means of teaching reasoning and critical thinking

46. Functions of Questioning 1. Places learners in the active role • 2. Used to assess baseline of knowledge 3. Used to review content 4. Can arouse learner's curiosity-a motivation to learn can increase as learner's hear questions 5. Guide learner's thought processes in a certain direction

47. Levels of Questions Can be classified as: Convergent Questions-require the learner to recall or integrate information they have learned . Requires fairly low-level cognitive activity Divergent Questions ask the learner to generate new ideas, draw implications or formulate a new perspective on a topic. Requires a higher level of cognitive activity There is no single correct answer

48. • Can be categorized as: Lower-order questions-those that require the learner to recall information they have read or memorized Higher-order questions-require more than recall to answer it, the leamer would have to be able to comprehend or think critically about the information

49. Question Classification Using Bloom's

50. Types of Questions: 1. Factual questions 2.Probing questions 3. Multiple-choice questions 4. Open-ended questions 5. Discussion-stimulating questions 6. Questions that guide problem solving 7. Rhetorical questions

51. Questioning Techniques Prepare some questions ahead of time State questions clearly and specifically Tolerate some silence Listen carefully to some responses Use the "beam, focus, build" technique Provide feedback Handle wrong answers carefully

52. Types of Traditional Audiovisuals Handouts Chalkboards or whiteboards Overheard transparencies Slides Videos

53. Change tactics every 20 minutes to recapture learner's interest at points and divide into the following: Lecture Informal discussion Question Video More lecturing combined with various audiovisuals

54. CLIENT TEACHING 1. The client's learning needs, abilities, preferences and readiness to ad 2. The assessment considers cultural and religious practices, emotional barriers, des and motivation to learn, physical and cognitive limitations, language barriers and the financial Implication of care choices 3. When called for by the age of the client and the length of stay, the hospital assesses and provides for client academic and educational needs 4. Clients are educated about the safe and effective use of medication according to law and their needs 5. Clients are educated about potential drug food interactions and are provided counting on nutrition and modified diets 6. Clients are educated about rehabilitation techniques to help them adapt or function m independently in their environment 7. Chants and informed about access to additional resources in the community 8. Clients are informed about when and how to obtain any further treatment they may need

55. Purpose of Client Teaching 1. Maintenance and promotion of health and illness prevention 2. Restoration of health 3. Coping with impaired functioning Domains of Learning involves Cognitive Learning acquiring and using knowledge Affective Learning occurs when a client changes unhealthy attitudes or feelings and values Psychomotor learning to complete a physical act

56. Factors that influence client teaching 1. Motivation 2. Health Beliefs 3. Psychosocial adaptation to illness 4. Active participation 5. Literacy level/educational level 6. Developmental level 7. Individual learning style

57. Motivation Motivation-desire to learn Important to learning is that the client recognizes the need to learn a new behavior Nurses can assist a client in identifying needs and in solving problems that may increase his desire to learn

58. Health Beliefs A client's health beliefs may or may not be congruent with the information being taught. Nurses need to assess a client's health care beliefs in order to develop beneficial teaching plans Nurses need to be cognizant (aware) that a client's healthcare beliefs may not change, despite concentrated efforts because of multiple psychological, cultural and environmental factors

59. Psychosocial adaptation to illness The nurse should assess how a client is adapting on a regular basis Successful adaptation depends on the client's emotional make up It is important for the nurse to understand that a client is unlikely to learn a new health related behavior when he is not ready or not motivated to learn experiencing problems unrelated to his health illness

60. Active participation in Active participation by the client the teaching/learning process makes learning more meaningful The nurse needs to assess a client's learning needs and to involve the client in the learning process to make this happen

61. Literacy level/ educational level Ability of the client to read materials provided and understand the spoken word

62. Developmental task Task that arises at or about a certain period in life

63. Individual learning Style Learning is enhanced when nurses use instructional methods that match client's preferred learning style

64. Basic Teaching Principles Set priorities Use appropriate timing Organizes materials Promote/ maintain learner attention and participation Build on existing knowledge Select appropriate teaching methods Use appropriate teaching aids Provide teaching related to developmental level

65. Teaching Methods in Client Discussion Question and Answer Role P lay discovery Computerized (Computer Instruction) instruction assisted

66. Teaching Aids: Visual aids Audiotapes (Compact discs) Films Videotapes (compact discs) Programmed instruction Games

67. Teaching related to Developmental Level Infant Toddler Preschool D. School age E. Adolescent F. Young/ middle aged adult G. Older adult

68. 0-12 infant Guidelines for health promotion teaching for this age group include Infant safety Rest/sleep patterns Sensory stimulation Immunizations Choose to complete the client teaching when the infant is calm and happy to minimize the parent's distraction

69. 1-3 TODDLER Guidelines health for promotion teaching for this age group include: Accident prevention B. Toilet training Dental hygiene Appropriate play activities Toddlers fear pain and separation from parents Parent teaching for a hospitalized toddler includes participation in the care the child receives, purpose of care plan and developmental regression that can occur as a result of hospitalization

70. 3-5 PRE -SCHOOLER Health promotion teaching for a preschooler. A. Accident prevention B. Dental health C. Nutrition D. Cognitive stimulation E. Sleep patterns The nurse can assist the hospitalized preschooler by using visual, tactile, and auditory presentations to decrease fear of procedures Utilization of therapeutic play; using dolls or puppets to demonstrate prior to the procedure is also helpful to the child

71. *RACE PASS R-Rescue A- Alarm C-Confine E - Extinguish P-Pull the pin A- Aim the base of the fire S-Squeeze handle S-Sweep side to side

72. 6-12 SCHOOL AGE Health promotion teaching for the school age child includes: Dental hygiene Safety measures C. Promotion fitness of physical D. Hygiene measures to prevent the spread of infection Nurses can assist the hospitalized school age by providing concrete examples and explanations procedures to help the child understand care. Encourage the child to identify his own learning needs; forms of play may assist the child to learn as well

73. 13-19 ADOLESCENT Health promotion teaching for this age group includes information about the effects of A. Drugs and alcohol B. Sexually transmitted diseases C. Reducing risk of injury (motor vehicle accidents, sports) D. Nutrition information Actively involved the adolescent in learning to help him assimilate the information provided Peer education also promote learning

74. Young/middle-aged adult Health promotion teaching for this age group may include: Importance of routine health tests and screening Sun protection measures C. Importance of nutrition (especially adequate protein and calcium intake) D. Exercise to maintain health It is important that the nurse evaluates learning the client's needs and determines learning needs that the client believes are important to maintain his health

75. OLDER ADULT Heath promotion teaching for this age group includes: A. Fall prevention information B. Nutritional information (include caloric and fluid requirements and maintenance medicine) C. Importance of exercise in maintaining joint mobility The nurse should ensure there is adequate lighting and should use large print if necessary for the client who is visually impaired. If the client is hearing impaired, the nurse should use written teaching materials and it may be necessary to utilize visual aids

76. Client teaching Postpartum Demonstrate newborn care skills as necessary Provide the opportunity for the client to bathe the newborn infant Instruct in feeding technique Instruct the client to avoid heavy lifting for at least 3 weeks Instruct the client to plan at least one rest period Instruct the client to use general hygiene and wash the breast once daily. Do not use soap for the breasts because it tends to remove natural oils, which increases the chance of cracked nipples. Instruct the client to increase calorie intake by 200-500 cal / day and the diet should include additional fluids: prenatal vitamins should be taken as prescribed Instruct the client that contraception should begin after delivery or with the initiation of intercourse (intercourse should be postponed at least until lochia ceases) Instruct the client in the importance of follow-up, which should be scheduled at 4- 6 weeks Instruct the client to report any signs of hill, fever, increased in lochia ог depressed feelings to the physician immediately

77. Signs and symptoms of Postpartum Depression Anxiety Appetite changes Crying, Sadness Difficulty concentrating or making decisions Fatigue Unable to sleep Feelings of guilt Irritability and agitation Lack of energy Less responsive to the infant Loss of pleasure in normal activities Suicide thoughts

78. Breastfeeding procedure for the Mother Wash hands and assume comfortable position Start with the breast with which last feeding was ended Brush the newborn infant’s lower lip with nipple Tickle the lips to have open the mouth wide Guide the nipple and surrounding areola into the infant's mouth Encourage the infant to nurse on each breast for 15 to 20 minutes After the infant has nursed, release suction by depressing the infant's chin or inserting a clean finger into the infant's mouth Burp the infant after the first breast Repeat the procedure on the second breast until the infant stops nursing Burp the infant again Listen for inaudible sucking or swallowing

79. Client Education for Thrombophlebitis Never massage the legs Avoid crossing the legs Avoid prolonged sitting Avoid constrictive clothing Avoid pressure behind the knees Know how to apply elastic stockings (support hose) if prescribed Understand the importance of anticoagulant prescribed therapy if prescribed Understand the importance of follow-up with the health care provider

80. Infant skilLs 2 to 3 months Smiles Turns head side to side Cries Follows objects Holds head in midline 4 to 5 months Switch objects from hands Rolls over for the first time Enjoys social interaction Begins to show memory Aware surroundings

81. 6 to 7 months Starts to crawl (creeps) Sits with support Imitates Exhibits fear of strangers Hold arms out Waves "bye-bye" 8 to 9 months : Sits steadily unsupported Crawls May stand while holding on Begins to stand with help 10 to 11 months Can change from prone to sitting position Walks while holding on the furniture (cruising) Stands securely Entertains self for periods of time

82. 12 to 13 months Walks with one hand held Can take a few steps without falling Can drink from a cup 14 to 15 months Walks alone Can crawl up stairs Shows emotions such as anger and affection Will explore away from mother in a familiar surrounding

83. Signs of readiness for toilet training Child is able to stay dry for 2 hours Child is waking up dry from a nap Child is able to sit, squat, and walk Child is able to remove clothing Child recognizes the urge to defecate or urinate Child expresses willingness to please a parent Child is able to sit on the toilet for 5 to 10 minutes without fussing or getting off

84. Basic safety rules to teach toddlers Eager to explore the world around them, they need to be supervised at play to ensure safety

85. Basic safety rules to teach Preschooler Never to play with matches or lighters Teach what to do in the event of fire or if clothes catch fire, fire drills should be practiced with the preschooler Teach his or her full name, address, parent's names and telephone number Teach how to dial 911 in an emergency situation Keep the Poison Control number available an area Teach to leave immediately if a gun is visible and to tell an adult. Teach to never point a gun at another person

86. Basic Safety rules to Teach s School-aged child Teach water safety rules Instruct the child to avoid teasing or playing roughly with animals Teach the child to never play with matches or lighter Teach what to do in the event of fire or in clothes catch fire, fire drills should be practiced with the child Teach the child traffic safety rules Teach how to dial 911 in an emergency situation Keep the Poison Contact Number available Teach how to leave an area immediately if a gun is visible and to tell an adult Teach to never point a gun at another person Teach the preschooler and school aged child that if another person touches his or her body in an inappropriate way, an adult should be told Also teach the child to avoid speaking to strangers And never to accept a ride, toys or gifts from a stranger

87. Client teaching to Adolescent Reinforce instructions about the dangers related to cigarette smoking, caffeine ingestion, alcohol, and drugs. Help adolescents recognize that they have choices when difficult potentially dangerous or situations arise Instruct in the consequences of injuries that motor vehicle accidents can cause Instruct in water safety and emphasize that they should enter the water feet first as opposed to diving, especially when the depth of the water is unknown Instruct about the dangers associated with guns, violence, and gangs Instruct about the complications associated with body piercing tattooing and sun tanning Discuss issues such as date rape, sexual relationships, and transmission of sexually transmitted infections with the adolescent. Also discuss the dangers of the internet related communicating and setting up meetings (dates) with unknown persons

88. Teaching early Adulthood client Teach that lifestyle habits such as smoking stress, lack of exercise, poor personal hygiene and family history disease increase the risk of future illness

89. Client teaching in Physical Assessment of the Adult Integumentary System Client teaching Provide information about factors that can be harmful to the skin, such as sun exposure ➤ Encourage performing self- examination of the skin monthly

90. HEAD, NECK AND LYMPH NODES Client Teaching Instruct the client to notify the HCP if persistent head-ache, dizziness, or neck pain occurs Instruct the client to notify HCP if swelling or lumps are noted in the head and neck region, or if neck or head injury occurs Neck movements are never performed if the client has sustained a neck injury nor a neck injury is suspected

91. eyes Instruct the client to notify the HCP if alteration in vision occur or any redness, swelling or drainage from the eye is noted Inform the client of the importance of regular eye examinations . Adults between the ages of 18- 39 without risk every 2 years Those with risk factors need to have eyes checked every year or as recommend by the eye doctor Adults between ages 40 and 64 who are without risk can undergo eye exam every 2 years

92. ears Instruct the client to notify the HCP if alteration in hearing or ear pain or ringing in the ears occurs, redness, swelling or drainage from the ear is note. Instruct the client in the proper method of cleaning the ear canal The client should cleanse the ear canal with the corner of a moistened washcloth and should never insert sharp objects or cotton tipped applicators into

93. NOSE, MOUTH AND THROAT Client Teaching Emphasize the importance of hygiene and tooth care as well as regular examinations and the use of fluoridated water or fluoride supplements Visit your dentist at least once, but ideally twice a year to get teeth checked. Every dental check up has two parts: check up and cleaning or oral prophylaxis Encourage the client to avoid at risk behaviors Stress the importance of reporting pain or abnormal occurrence (nodules, lesions, signs of infection)

94. LUNGS Client Teaching Encourage the client to avoid exposure environmental hazards, including smoking Client should undergo periodic examinations as prescribed Encourage the client to obtain pneumonia and influenza immunization HCP should be noticed if client experiences persistent cough, shortness of breath or other respiratory symptoms

95. BASIC CONSIDERATIONS FOR BASIC NURSING PROCEDURES Coughing Deep Breathing Pursed lip Breathing Chest Physiotherapy Suctioning

96. CHEST PHYSIOTHERAPY To help clear excessive bronchial secretions from airways by shaking mucus from the walls of the airways and draining from the lungs Percussion -produce mechanical wave of energy strike the chest rhythmically with cupped hands that is transmitted through the chest wall

97. Vibration with the use of hand placed on client's chest with rapid and vigorous vibrations as client exhale Postural drainage use of gravity to assist in the movement of secretion (mucus-filled segment of lungs should be higher to allow movement out lungs)

98. suctioning Suctioning Using negative pressure, suctioning excessive mucous secretion to maintain patent airway and to collect specimen for diagnostic testing Use appropriate catheter size Fr 5-8 infants; Fr 12-18 for adult Position client in fowlers (for those with intact gag reflex); side lying (for unconscious) to prevent aspiration Preoxygenate client (hyper inflate with manual resuscitation bag or by asking client to take several deep breaths prior or by adjusting 02 flow to higher rate) Lubricate catheter tip by immersing in a cup of saline solution Retract catheter by 1 cm before exerting suction Exert suction by closing the open port, withdrawing catheter in rotating motion within 5 to 10 seconds ONLY! Hyperoxygenate for a full minute between subsequent suctioning. Encourage deep breathing Listen to breath sounds Document the procedure, client response and effectiveness.

99. OXYGEN THERAPY To reverse hypoxemia, hence to improve tissue oxygenation; decrease work of breathing in dyspneic clients, decrease myocardial workload Carbon dioxide is the major stimuli for respirations Low concentration of 02 given to clients with COPD (dependent of hypoxic drive) Position fowler's Insert flow meter with humidifier and regulate in the prescribed flow rate (LPM) Assess the vital signs, oxygen saturation, color, breathing pattern and orientation Place "NO SMOKING" sign. Don't use grease and oil that may spark

100. Nasal cannula 24-45% Simple 02 Mask 40-60% Venturi Mask 24-50% Partial Rebreather Mask 50-70% Non rebreather Mask 80-90% Oxygen Toxicity mild tracheobronchitis (sub sternal soreness, nasal congestion and increased coughing) that can lead to atelectasis and fibrosis of the lungs Retrolental Fibroplasia- retinal damage leading to irreversible blindness due to exposure to 100% oxygen in adults and to high oxygen flow rate (40% or more) in neonate especially premature. ( retinopathy in prematurity )

101. Heart and Peripheral Vascular System Client Teaching Advise client to modify lifestyle for risk factors associated with heart and vascular disease. ➤ "Hypertriglyceridemia- excessive triglyceride, emia - is in the blood. Explanation: ➤ Triglyceride-should be less than 150 mg per decilitre Sources is Cholesterol- it should be no more than 200 mg per Decilitre ➤ Hyperlipidemia (Cholesterol and triglyceride in the blood)- Increase cholesterol and Triglyceride in the blood." ➤ FOOD SOURCES: Saturated (solid and room temperature) like oil that you pour on the sink, when you pour so much the oil will become solid and get clogged (plaque). Client Teaching Advise client to modify lifestyle for risk factors associated with heart and vascular disease. ➤ "Hypertriglyceridemia- excessive triglyceride, emia - is in the blood. Explanation: ➤ Triglyceride-should be less than 150 mg per decilitre Sources is Cholesterol- it should be no more than 200 mg per Decilitre ➤ Hyperlipidemia (Cholesterol and triglyceride in the blood)- Increase cholesterol and Triglyceride in the blood." ➤ FOOD SOURCES: Saturated (solid and room temperature) like oil that you pour on the sink, when you pour so much the oil will become solid and get clogged (plaque).

102. GOOD CHOLESTEROL: (Example is Omega 3 Omega 6): - Food that has Omega 3 that the patient with heart problem can eat (Salmon, Sardines, Mackerel, Crab, Shrimp, Oysters). Other than those other sea foods contain saturated fats. Except the above sea foods that said.

103. OTHER FOODS CONTAINS HIGH LEVELS OF CHOLESTEROL LOW DENSITY LIPOPROTEIN OR BAD CHOLESTEROL (HIGH SATURATED FATS) Lard, Butter, Margarine, whole milk, Ice cream, Cake, Bacon, Cheese, Ham, Beef, Lamb, any Cake that has delicious consistency, Pies, Cookies, Puddings they contain high saturated fatty acids that can elevate the cholesterol which is a major risk factor for a cardio vascular disease.

104. BAD CHOLESTEROL 1. LDL (LOW DENSITY LIPOPROTEIN) 2. SATURATED which sources of Bad cholesterol and triglyceride are: meat (red meat, poultry. mutton also known as sheep meat ENCOURAGE THE CLIENT TO WEEKLY HEALTH EXAMINATION

105. IMMOBILITY, EMBOLISM, STROKE IMMOBILITY can contribute to cardiovascular disease. The Supine or flat position, the thrombus or clot will get dislodged. Once it dislodged it is called Embolism . The Embolism will get clogged to the lungs, Pulmonary Embolism will happen which is "Life Threatening" And when the Embolism will clog through the Brain, the client has risk for STROKE- "Cerebrovascular accident" or Heart Attack. Because when there has clot the Oxygenated blood can't pass through so that's will happen

106. In general, Healthy people should get physical exam every 2 to 3 years in their 20s, every either year in their 30s to 40s and annually starting around age 50 Client should seek medical assistance for signs of heart or vascular disease: Chest pain, chest tightness, chest pressure and other discomfort (ANGINA) Shortness of breath (DYSPNEA) Pain, numbness (PARESTHESIA) or tingling sensation, weakness or coldness in your legs or arms if the blood vessels in those parts of your body are narrowed. Pain in the neck, jaw, throat, upper abdomen or back

107. BREAST Encourage and teach the client to perform Breast Self- Examination (BSE) BSE should be perform 7 days after the menses, postmenopausal clients or clients who have had a hysterectomy should select a specific day of the month and perform BSE monthly on that day Regular physical examinations and mammograms should be obtained as prescribed Women ages 40-44 should have the choice to start annual breast cancer screening with mammograms if they wish to do so. Women ages 45-54 should get mammograms every year. Women 55 and older should switch to mammograms every year. Women 55 and older should switch to mammograms every 2 years, or can continue yearly screening Clients should report lumps or masses to the HCP immediately.

108. BSE client Instructions: While in the shower or bath, when the skin is slippery with soap and water. Use the pads of your second, third and fourth fingers to press every part of the breast firmly. Use your right hand to examine your left breast using small circular motions in a spiral or up-down motion so that the entire breast area is examined Repeat the pattern of palpation under the arm Check for any lump, hard knot or thickening issue Look at your breast in a mirror Stand with your arms at your side. . Raise your arm overhead and check for any changes in the shape of your breasts, dimpling of the skin or nay changes in the nipple. Next place your hand on your hips and press down firmly. tightening the pectoral muscles. Observe for asymmetry or changes, keeping in mind that your breasts probably do not match exactly. While laying down, feel your breasts as described in step When examining your right breast, place a folded towel under your right shoulder and put your right hand behind your head. Repeat the procedure while examining your left breast Mark your calendar that you have completed your BSE, note any changes or unique characteristics you want to check with your HCP

109. abdomen Encourage client to consume a balanced diet. Substances that can cause gastric irritation should be avoided. Lifestyle behaviors that can cause gastric irritation (smoking, spicy foods) should be modified). Regular physical examinations are important The client report Gl to the HCP. Presence of dark urine Jaundice Abdominal pain, distention, (bloated) Altered bowel pattern Nausea, vomiting Steatorrhea

110. musculoskeletal Should consume a balance sheet diet, including foods high in calcium and vitamin D Activities that cause muscle strain or stress to the joints should be avoided Participation in regular exercise program is beneficial Encourage the client to maintain a normal weight Client should contact HCP if joint or muscle pain or problems occur or if limitations in range of motion or muscle strength develop

111. NEUROLOGICAL Client should avoid exposure to environmental hazards (insecticides, lead) High risk behaviors that can result in head and spinal cord injuries should be avoided Protective devices (helmet, body pads) should be worn when participating high-risk behaviors

112. FEMALE GENITALIA AND REPRODUCTIVE TRACT Stress the importance of personal hygiene Explain the purpose and recommended frequency of Papanicolaou (Pap smear Test) Women should start Pap Smear screening at age 21-29 women whose pap smears are normal only need it repeated every 3 years. Women ages 30 and over should have testing for human papilloma virus (HPV) with Pap smear. Pap smears up to age of 65 Both girls and boys should get vaccinated with HPV vaccine at age 12 Explain the signs of sexually transmitted infections Inform the client with a sexually transmitted infection that she must inform her sexual partner of the need for an examination

113. MALE GENITALIA Stress the importance of personal hygiene Teach the client how to perform testicular self-Examination (TSE); begin at age 15 and continue to age 40 A day of the month is selected and the exam is performed on the same day each month after a shower or bath when the hands are warm and soapy and the scrotum is warm Explain the signs of sexually transmitted infections Educate the client on measures to prevent sexually transmitted infections Inform the client with a sexually transmitted infection that he must inform his partner of the need for an examination

114. TSE CLIENT Gently lift each testicle. Each one should feel like an egg, firm but not hard and smooth with no lumps, swelling or mass If you notice any changes from one month to the next, notify your HCP.

115. Rectum and anus Diet should include high fiber, low fat foods and plenty of liquids The client should obtain regular digital examinations Identify the symptoms of colorectal cancer

116. End of semi final BY: SIR MARTIN B.BELEN