Introduction To Medical Surgical Nursing

Introduction to Medical Surgical
Nursing
By: Shegaw Zeleke (Lecturer)
5/18/2018 By Shegaw Z(MSCc in AHN) 1

Objectives
• Define Medical-surgical nursing.
• Describe the major roles of nurses.
• Discuss expanded nursing roles.
• Describe nursing care delivery models.

Definition of Medical Surgical Nursing
• Medical-surgical nursing is a nursing care that is given

to patients/clients with medical and surgical problems.
• Medical-surgical nursing enables nurses to develop

knowledge and skills that are necessary to give care for
individuals with medical as well as surgical problems.

The Patient’s Basic Needs
• Certain needs are basic to all people and require satisfaction
accordingly.
• Such needs are addressed on the basis of priority, meaning that

some needs are more pressing than others.
• Once an essential need is met, the person experiences a need on a

higher level.
• Approaching needs according to priority reflects Maslow’s

hierarchy of needs (see figure below).

Maslow’s Hierarchy Needs
• Maslow ranked human needs as follows:
– physiologic needs;
– safety and security;
– belongingness and affection;
– esteem and self-respect; and
– self-actualization, which include self-
fulfillment, desire to know and understand, and
aesthetic needs.
cont’d
• Lower-level needs always remain, but a person’s ability to
pursue higher-level needs indicates that he or she is moving
toward psychological health and well-being.
• Such a hierarchy of needs is a useful organizational

framework that can be applied to the various nursing models
for assessment of a patient’s strengths, limitations, and need
for nursing interventions.

•
cont’d
Understanding the needs of health care consumers and the
health care delivery system is a foundation for the delivery of
nursing care.
• Patients’ needs vary depending on their problem, associated

circumstances, and past experiences.
• One of the nurse’s important functions in health care delivery is

to identify the patient’s immediate needs and take measures to
address them.
• General Observation of Patients conditions are used to

identify patient’s immediate
5/18/2018 needs
By Shegaw Z(MSCc in AHN) 8
General Observation of Patients
1. Posture and Stature
 The posture that a person assumes often provides valuable
information about the illness.
 Eg. Patients who have breathing difficulties (dyspnea)

secondary to cardiac disease prefer to sit
 Those pts with abdominal pain due to peritonitis prefer to lie

perfectly still and guarding their abdomen

cont’d
2. Body Movements
• Abnormalities of body movement may be of two general kinds:
– generalized disruption of voluntary or involuntary movement
eg. Park sons disease, ARF
– asymmetry of movement
e.g. stroke

cont’d
3. Nutrition
• Obesity may be generalized as a result of excessive intake of

calories or if it is localized to the trunk with endocrine disorders
(Cushing’s disease)
• Loss of weight may be generalized as a result of inadequate

caloric intake or with disorders that affect protein synthesis.

cont’d
4. Speech Pattern
• Speech may be slurred because of

• CNS disease or
• Damage to cranial nerves
– E.g. Recurrent damage to the laryngeal nerve will

produce hoarseness

cont’d
5. Emotional Status
• Recognize the patient’s emotional state and assist
the patient to explore his or her feelings.
6. Vital Signs

The Nursing Profession

NURSING DEFINED
• The American Nurses Association (ANA), defined

nursing as “the diagnosis and treatment of human
responses to health and illness”.

FLORENCE NIGHTINGALE
(The lady with the lamp)
5/18/2018 (12 May 1820 – By

13Shegaw
Aug Z(MSCc
1910)in AHN) 16
Definitions of nursing….
 Florence Nightingale who is the founder of modern
nursing defined nursing as:
 “utilizing the environment of the patient to assist him/her in
his/her recovery.” or
 ‘is to put patient in the best possible condition for nature to act
upon him.’

Florence Nightingale
• 1st Nursing Theorist
• Nursing is separate and distinct from medicine
• All women are natural nurses
• Emphasized importance of environment: fresh air, cleanliness,

nutrition
• Maintained accurate records, 1st Nursing Researcher

Florence Nightingale favorite dictum/ motto
• “Do the Patient no harm”

Definitions of nursing….
• World health origination (WHO) defined nursing: “the art
and science based on knowledge, skill and attitude aimed
at assisting the individual and community in health and
illness to maintain health , to prevent illness, to alleviate
physical, biological and psychological pain, to avoid
complication and to fulfill self-reliance in meeting daily,
health needs.

Nurses have a responsibility to carry out their role, to
comply with the nurse practice act of the state where they
practice, and to comply with the code for nurses as
spelled out by the International Council of Nurses and
the ANA.

THE PATIENT/CLIENT: CONSUMER OF
NURSING AND HEALTH CARE
• The central figure in health care services is patient.
• The term patient, which is derived from a Latin verb meaning “to
suffer,” has traditionally been used to describe those who are
recipients of care.
• The connotation commonly attached to the word is one of

dependence.
• For this reason, many nurses prefer to use the term client, which is
derived from a Latin verb meaning “to lean,” connoting alliance
and interdependence.
“A Biblical Fable on Our
Origin”
• In the beginning, God created Nursing.
• He said, “I will take a solid, significant system of
nursing education and
• An adequate, applicable base of clinical nursing
research, and
• On these rocks will I build My greatest gift to
mankind = Nursing Practice.”
• On the 7th day He threw up his hands. And has left
it up to us.
ROLES OF THE NURSE
• The professional nurse in institutional, community-based
and home care settings has three major roles:
– The practitioner role, which includes teaching and

collaborating;
– The leadership role and
– The research role.

• These roles are designed to meet the immediate and future health
care and nursing needs of consumers
Practitioner Role
• The practitioner role of the nurse involves;
– meeting the health care and nursing needs of individual patients,
their families, and significant others.
– It is a role that can be achieved only through use of the

nursing process, the basis for all nursing practice
• This role is the dominant role of nurses in primary,

secondary, and tertiary health care settings and in home
care and community nursing.

Leadership Role
Nursing leadership is a process involving four
components:
–Decision making,
–Relating,
–Influencing, and
–Facilitating.
Each of these components promotes change and
the ultimate outcome of goal achievement.

Research Role
• The research role of the nurse was traditionally viewed as
one carried out only by academicians, nurse scientists,
and graduate nursing students.
• Today, participation in the research process is also

considered to be a responsibility of nurses in clinical
practice.
• The primary task of nursing research is to contribute to

the scientific base of nursing practice/Evidence-based
nursing practice
Expanded Nursing Roles
 Nurses may receive advanced education in such specialties
as:
– Family,
– Critical care,
– Coronary care,
– Respiratory care,
– Oncologic care,
– Maternal and child health care,
– Neonatal intensive care,
– Pediatric nursing,
– Trauma,
– Psychiatry nursing
– Rural health, and
– Gerontologic nursing, to name just a few.
COLLABORATIVE PRACTICE
• The collaborative model, should be a primary

goal for nursing—a venture that promotes shared
participation, responsibility, and accountability
in a health care environment that is striving to
meet the complex health care needs of the public.

Figure: Collaborative practice model

Ethical Dilemma
• Situation that requires an individual to make a choice
between two equally unfavorable alternatives.
• Conflict between one individual’s rights and those of

another, or between one individuals obligation and the
rights of another, usually form the basis of the dilemma.

Ethical Decision Making
• Steps in Ethical Decision making are:
1. Assess the ethical/moral situations of the
problem
2. Collect information.
3. List the alternatives. Compare alternatives
with applicable ethical principles and
professional code of ethics
4. Decide and evaluate the decision.

HEALTH, ILLNESS AND WELLNESS

Class Activity
• Define Health, Illness and Wellness

Health, Illness, and Wellness
• Illness is the inability of an individual’s
adaptive responses to maintain physical and
emotional balance that subsequently results in an
impairment of functional abilities.
• Wellness is the condition in which an individual

functions at optimal levels.
• Health is a global term because it refers to every aspect
of a person’s life, including:
– Physical status
– Emotional well-being
– Social relationships
– Intellectual functioning
– Spiritual condition
• The American Holistic Nurses’ Association describes
health as a maintenance of harmony and balance among
body, mind, and spirit.
• Balance refers to homeostasis, which is an equilibrium

among psychological, physiological, socio-cultural,
intellectual, and spiritual needs.
• The process by which a person adjusts to achieve

homeostasis is called adaptation.
• When people describe their health status,
basically three areas are considered:
– Presence or absence of symptoms (physical and

emotional)
– How they feel (emotionally and physically)
– What they are able to do (ability to function)

Health Continuum


Introduction To Medical Surgical Nursing

Enviado por

Dados do documento

Título original

Direitos autorais

Formatos disponíveis

Compartilhar este documento

Compartilhar ou incorporar documento

Opções de compartilhamento

Você considera este documento útil?

Este conteúdo é inapropriado?

Direitos autorais:

Formatos disponíveis

Introduction To Medical Surgical Nursing

Enviado por

Direitos autorais:

Formatos disponíveis

Introduction to Medical Surgical

By: Shegaw Zeleke (Lecturer)

5/18/2018 By Shegaw Z(MSCc in AHN) 1

• Describe the major roles of nurses.

• Discuss expanded nursing roles.

• Describe nursing care delivery models.

5/18/2018 By Shegaw Z(MSCc in AHN) 2

• Medical-surgical nursing is a nursing care that is given

• Medical-surgical nursing enables nurses to develop

5/18/2018 By Shegaw Z(MSCc in AHN) 3

• Such needs are addressed on the basis of priority, meaning that

• Once an essential need is met, the person experiences a need on a

• Approaching needs according to priority reflects Maslow’s

5/18/2018 By Shegaw Z(MSCc in AHN) 4

• Such a hierarchy of needs is a useful organizational

5/18/2018 By Shegaw Z(MSCc in AHN) 6

• Patients’ needs vary depending on their problem, associated

• One of the nurse’s important functions in health care delivery is

• General Observation of Patients conditions are used to

 Eg. Patients who have breathing difficulties (dyspnea)

 Those pts with abdominal pain due to peritonitis prefer to lie

5/18/2018 By Shegaw Z(MSCc in AHN) 9

– generalized disruption of voluntary or involuntary movement

eg. Park sons disease, ARF

5/18/2018 By Shegaw Z(MSCc in AHN) 10

• Obesity may be generalized as a result of excessive intake of

• Loss of weight may be generalized as a result of inadequate

5/18/2018 By Shegaw Z(MSCc in AHN) 11

• Speech may be slurred because of

• Damage to cranial nerves

– E.g. Recurrent damage to the laryngeal nerve will

5/18/2018 By Shegaw Z(MSCc in AHN) 12

5/18/2018 By Shegaw Z(MSCc in AHN) 13

5/18/2018 By Shegaw Z(MSCc in AHN) 14

• The American Nurses Association (ANA), defined

5/18/2018 By Shegaw Z(MSCc in AHN) 15

5/18/2018 (12 May 1820 – By

nursing defined nursing as:

 “utilizing the environment of the patient to assist him/her in

5/18/2018 By Shegaw Z(MSCc in AHN) 17

• Nursing is separate and distinct from medicine

• All women are natural nurses

• Emphasized importance of environment: fresh air, cleanliness,

• Maintained accurate records, 1st Nursing Researcher

5/18/2018 By Shegaw Z(MSCc in AHN) 18

5/18/2018 By Shegaw Z(MSCc in AHN) 19

5/18/2018 By Shegaw Z(MSCc in AHN) 20

5/18/2018 By Shegaw Z(MSCc in AHN) 23

• The connotation commonly attached to the word is one of

– The practitioner role, which includes teaching and

– The leadership role and

– The research role.

– It is a role that can be achieved only through use of the

• This role is the dominant role of nurses in primary,

5/18/2018 By Shegaw Z(MSCc in AHN) 27

5/18/2018 By Shegaw Z(MSCc in AHN) 28

• Today, participation in the research process is also

• The primary task of nursing research is to contribute to

• The collaborative model, should be a primary

5/18/2018 By Shegaw Z(MSCc in AHN) 31

5/18/2018 By Shegaw Z(MSCc in AHN) 32

• Conflict between one individual’s rights and those of

5/18/2018 By Shegaw Z(MSCc in AHN) 33