Transcript Ch. 16 PPT File - Northwest ISD Moodle

Chapter 16:Chapter XX:
Chapter Title
Nutrition and Wellness
Learning Outcomes
 Cognitive Domain
Note: AAMA/CAAHEP 2015 Standards are italicized.
 1. Spell and define the key terms
 2. Identify body systems
 3. List major organs in each body system
 4. Identify the anatomical location of major organs in each body
system
 5. Describe the normal function of the digestive system
 6. Analyze health care results as reported in graphs and/or tables
(BMI)
 7. Describe dietary nutrients including carbohydrates, fats,
proteins, minerals, electrolytes, vitamins, fiber, and water. Discuss
the body’s basal metabolic rate and its importance in weight
management.
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Learning Outcomes
 8. Explain how to use the food pyramid and MyPlate guides to
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promote healthy food choices
9. Read and explain the information on food labels
10. Identify the special dietary needs for weight control,
cardiovascular disease, and hypertension
11. Define the function of dietary supplements
12. List the components of physical fitness
13. Discuss suggestions for a healthy lifestyle
14. Explain the importance of disease prevention
15. List and describe the effects of the substances most
commonly abused
16. Recognize the dangers of substance abuse
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Learning Outcomes (cont'd.)
 Psychomotor Domain
Note: AAMA/CAAHEP 2015 Standards are italicized.
 1. Teach a patient how to read food labels (Procedure 16-1)
 2. Document patient care accurately in the medical record
 3. Develop a meal plan utilizing the basic principles of
nutrition (Procedure 16-2)
 4. Instruct a patient according to the patient’s special dietary
needs (Procedure 16-2)
 5. Coach patients appropriately considering a. cultural
diversity, b. developmental life stage, and c. communication
barriers
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Learning Outcomes (cont'd.)
 Affective Domain
Note: AAMA/CAAHEP 2015 Standards are italicized.
 1. Incorporate critical thinking skills when performing patient
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assessment
2. Incorporate critical thinking skills when performing patient
care
3. Show awareness of a patient’s concerns regarding dietary
changes
4. Protect the integrity of the medical record
5. Demonstrate a. empathy, b. active listening, and c.
nonverbal communication
6. Demonstrate the principles of self-boundaries
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Learning Outcomes (cont'd.)
 7. Demonstrate respect for individual diversity, including a.
gender, b. race, c. religion, d. age, e. economic status and f.
appearance
 8. Explain to a patient the rationale for performance of a
procedure
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Learning Outcomes (cont'd.)
 ABHES Competencies
 1. Comprehend and explain to the patient the importance of
diet and nutrition
 2. Effectively convey and educate patients regarding the
proper diet and nutrition guidelines
 3. Identify categories of patients that require special diets or
diet modifications
 4. Document accurately
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Introduction
As a medical assistant, you should consider yourself a role
model for your patients. Throughout your career, you will
have many opportunities to teach patients the essentials of
good health and disease prevention by knowing how
behaviors affect short-term and long-term health.
Together, diet and exercise offer important benefits for overall health
maintenance and disease prevention for people of all ages.
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Digestion and Metabolism
 Digestion begins in mouth as enzymes in
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saliva start to break down chewed food
Partly digested food passes through
digestive tract, where enzymes continue
to break down food
In small intestines, process of absorption
nutrients into bloodstream
Nutrients taken to liver to be further
broken down and filtered to every cell in
the body
Any nutrients not needed are eliminated
from the body or stored as fat for future
energy use
metabolism: sum of
chemical processes
that result in growth,
energy production,
elimination of waste,
and body functions
performed as
digested nutrients
are distributed;
conversion of oxygen
and calories to
energy
Digestion consists of both the physical and chemical breakdown of complex
food into simpler substances that the body can use for energy.
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Digestion and Metabolism (cont’d.)
 Catabolism creates energy
Measured in calories
o Needed for cell growth
o Needed for heat production
o Example = glycogen  pyruvic
acid
 Nutrients reassembling to produce
substances required by body =
anabolism
o Example = amino acid  protein
o
catabolism: the
destructive phase of
metabolism in which
larger molecules are
converted into
smaller molecules
anabolism: the
constructive phase of
metabolism, when
smaller molecules
are converted to
large ones
The speed of these metabolic processes is particular to each individual, which
explains why some people seem to be able to eat more and maintain a healthy
weight, whereas others consume the same amount of food and gain weight.
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Essentials of Nutrition
 Making healthy food choices is best
way to maintain a state of wellness
including homeostasis
 Diet that includes all nutrients in
adequate amounts increases body’s
ability to maintain wellness
homeostasis:
maintaining a constant
internal environment
by balancing positive
and negative feedback
calories: a unit of heat
content or energy. The
amount of heat
necessary to raise 1 g
of water from 14.5 to
15.5˚C (small calorie)
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Essentials of Nutrition (cont’d.)
 Nutrients
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Essential elements found in food
include:
o Vitamins and minerals
o Carbohydrates
o Proteins
o Fiber
o Fat
o Micronutrients
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Essentials of Nutrition (cont’d.)
 Carbohydrates
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Provide energy:
o Found in grain, fruits, vegetables, legumes
and sugar
Complex carbohydrates
Simple carbohydrates
Refined sugars:
o High calories—no nutritious value
Carbohydrates are chemical substances that are broken down by the body into
simple sugars (glucose), which provide energy to all cells of the body.
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Essentials of Nutrition (cont’d.)
 Proteins
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Contain amino acids:
o Provide energy
o Build and repair tissue
o Assist with antibody production
80 found in nature:
o Human body needs 20
o Body produces 11
o Other 9 called essential amino acids
Some animal proteins provide all necessary
Essential
amino acids:
amino acids
nutritionally
required by an
organism and
that must be
supplied in its
diet
A combination of both types of proteins, complete and incomplete, will ensure a
proper amount of protein in the diet.
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Essentials of Nutrition (cont’d.)
 Complete proteins:
Milk
o Cheese
o Eggs
o Meat (includes fish and poultry)
 Incomplete proteins:
o Plants
o Beans
o Legumes
o Nuts and seeds
o
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Essentials of Nutrition (cont’d.)
 Fats
 Concentrated source of heat production and energy:
Provide essential fatty acids
o Heart, skeletal muscle and other tissues derive energy
o Composed of:
• Carbon
• Hydrogen
• Oxygen
 Fats have important functions:
o Cushion and protect organs
o Sustain temperature
o Proper cell functioning
o
Fats, also known as lipids, serve as a concentrated source of heat production
and energy and provide essential fatty acids.
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Essentials of Nutrition (cont’d.)
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Essentials of Nutrition (cont’d.)
 Vitamins
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Organic substances that enhance breakdown of proteins,
carbohydrates, and fats
Used in formation of blood cells and hormones
Production of vital neurochemicals
Fat-soluble vitamins:
o A, D, E, and K
o Absorbed with foods that contain fat
o Excess stored in body in liver, kidneys, and body fat
The consumption of additional fat-soluble vitamins should be avoided because
the body stores these vitamins, and an excess can result in serious illness.
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Essentials of Nutrition (cont’d.)
 Water soluble:
o
o
o
o
Vitamins C
B-complex
o Thiamin
o Folic acid
o Riboflavin
o Niacin
Should be consumed daily
Excess excreted by body daily
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Checkpoint Question
Based on what Jack Stone, the medical
assistant at Great Falls Medical Center,
knows about vitamins, why is it
important to follow the recommended
dosage of a fat-soluble vitamin?
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Checkpoint Answer
Fat-soluble vitamins are usually absorbed with
foods that contain fat and are stored in the
liver, kidneys, and body fat.
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Essentials of Nutrition (cont’d.)
 Minerals
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Body uses minerals in differing
amounts
Minerals required in small amounts =
trace minerals:
o Flourine
o Zinc
o Copper
o Cobalt
o Chromium
minerals: inorganic
substances (such as
sodium, potassium,
calcium, phosphorus,
magnesium, iron,
iodine, fluorine,
zinc, copper, cobalt,
and chromium) used
in the formation
of hard and soft body
tissue; necessary for
muscle contraction,
nerve conduction, and
blood clotting
Minerals are inorganic substances used in the formation of hard and soft body
tissue, muscle contraction, nerve conduction, and blood clotting.
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Essentials of Nutrition (cont’d.)
 Cholesterol
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Produced by all animals
Contained in animal products:
o Meat
o Poultry
o Seafood
o Eggs
o Dairy
Necessary for body functioning
National Cholesterol Education Program (NCEP)
recommends adult daily consumption of <300 mg of dietary
cholesterol to avoid excess cholesterol in bloodstream
Any excess cholesterol in the blood can result in plaque buildup inside the blood
vessels, eventually causing occlusion or blockage of the blood vessel.
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Essentials of Nutrition (cont’d.)
 Lipoproteins
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Substances composed of lipids and proteins that transport
cholesterol between the liver and arterial walls
Found only in body—not food
Amounts and types are indicators of risk of heart disease
Two types of lipoproteins:
o Low-density lipoproteins (LDL):
• Transports cholesterol from liver to walls of large and
medium-sized arteries
• Excess LDL causes plaques
• Impairs circulation
• As LDL levels rise--risk of heart disease increases
• LDL or “bad” cholesterol (above 160 mg/dL= increased
risk; optimal < 100 mg/dL )
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Essentials of Nutrition (cont’d.)
o High-density lipoproteins (HDL):
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Carries cholesterol away from arterial walls to liver
Removes cholesterol from body
High levels of HDL
Reduction in risk of heart disease
Called “good” cholesterol
HDL level above 60 mg/dL lowers risk of heart disease;
<40 mg/dL major heart disease risk factor
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Checkpoint Question
A parent of one of the children seen at Great
Falls Medical Center ask Jack Stone,
CMA(AAMA), about complete proteins and
where are they found. How should he answer
this question?
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Checkpoint Answer
A complete protein is one that contains all nine
essential amino acids. Complete proteins are
found in milk, cheese, eggs, and meats.
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Essentials of Nutrition (cont’d.)
 Fiber
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Needed to help with elimination of waste
Vegetables, raw and cooked fruits, whole-grain foods
contain fiber
Some patients with chronic colitis, or ileitis may follow
low fiber diet
Also encouraged to avoid fatty foods, and eat lots of
whole grains
High fiber diet for constipation or to regulate bowel
movements
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Essentials of Nutrition (cont’d.)
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Essentials of Nutrition (cont’d.)
 Nutritional Guidelines
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Multiple government agencies involved in establishing
healthy diet guidelines:
o United States Department of Health and Human
Services (DHHS)
o United States Department of Agriculture (USDA)
o National Academy of Sciences
o Food and Nutrition Board
Web sites provide additional information
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Essentials of Nutrition (cont’d.)
 MyPyramid and MyPlate Guidelines
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USDA developed food guidance system—MyPyramid
Help people maintain healthy diets, exercise level
Developed in 2005
Includes five basic food groups plus “oils”:
o Grains
o Vegetables
o Fruits
o Milk
o Meat and beans
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Essentials of Nutrition (cont’d.)
Anatomy of MyPyramid.
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Essentials of Nutrition (cont’d.)
MyPyramid guide based on a 2,000-calorie diet.
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Essentials of Nutrition (cont’d.)
 Rolled out updated in 2011 — MyPlate:
o
o
o
o
o
o
o
Does not give specific information about serving sizes
Reminder to Americans to choose reduced portions at
meals
Include a plate of 50% fruits and vegetables
Drink fat-free or 1% milk
Eat whole grains
Decrease dietary sodium by comparing and choosing
those with low numbers
Drink water instead of sugary drinks
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Essentials of Nutrition (cont’d.)
MyPlate icon.
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Essentials of Nutrition (cont’d.)
 Grains
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USDA recommends whole grains for half of daily servings
Entire grain kernel that contains fiber, vitamins,
carbohydrates, proteins and antioxidants
When selecting food groups—look for:
o Whole wheat
o Bulgur
o Whole-grain corn
o Oatmeal
o Whole oats
o Wild rice at beginning of list
o Check for high percentage of daily fiber
Foods in the grain food group include bread, cereal, oatmeal, crackers, rice, and
pasta.
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Essentials of Nutrition (cont’d.)
 Substitute whole wheat flour when baking
 Choose whole-grain snacks — popcorn or baked tortilla chips
 Eat whole grain cereals — muesli or toasted oat
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Essentials of Nutrition (cont’d.)
 Vegetables
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Five categories:
o Dark green
o Orange
o Dry beans and peas
o Starchy
o Other
The key to choosing foods within this group is to select a variety of
vegetables from different categories.
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Essentials of Nutrition (cont’d.)
 Eat fresh, seasonal:
Processed foods contain sauces, seasoning adding sodium and
fat
Look for vegetables without added salt
Choose foods with high levels of potassium
Eat salad daily — minimal dressing
Prepare vegetable main dishes — soups or stews
o
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Essentials of Nutrition (cont’d.)
 Fruits
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Includes:
o Fresh
o Fruit juice
o Frozen, dried and canned fruit
Get majority of servings from whole fruit—not juice:
o Whole fruit contains fiber
Check labels for items that do not contain added sugar:
o Fruit stored in 100% juice or water—not syrup
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Essentials of Nutrition (cont’d.)
 Eat a wide variety of fruits for maximum nutritional benefit:
o
o
o
o
Add fresh fruit to cereal
Drink 100% orange or grapefruit juice
Snack on cut-up or dried fruit
Substitute applesauce for portion of oil in recipes
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Essentials of Nutrition (cont’d.)
 Milk
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Includes milk products that retain calcium content:
o Butter and cream cheese do not
Important to select low-fat or nonfat:
o Nonfat or low-snack choices:
• Pudding
• Yogurt
Lactose free options available
Also referred to as the “milk, yogurt, and cheese group,” this food group
includes all milk and milk products that retain their calcium content.
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Essentials of Nutrition (cont’d.)
 Meat and Beans
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High fat and cholesterol content make varying food
choices important
Select variety for greatest nutritional benefit:
o Example—sunflower seeds and almonds high in
vitamin E
o Salmon and trout contain omega-3 fatty acids
o Eggs, beef, poultry, pork—good sources of proteins
Vegetarians should alternate protein sources
The meat and beans group includes all foods made from meat, poultry, eggs,
dry beans, peas, nuts, and seeds.
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Essentials of Nutrition (cont’d.)
 Select lean cuts of beef:
Round steaks
o Roast
o Top loin sirloin
o Buy 90% or greater lean ground beef
o Skinless chicken or turkey
o Prepare without adding fat
 Prepare meatless main dishes
 Eat fish more often than meat or poultry
 Substitute nuts in dishes containing meat or poultry
o
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Essentials of Nutrition (cont’d.)
 Oils
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Fats that are liquid form at room temperatures:
o Vegetable oils
o Natural plant and fish sources
Recommended daily servings are small—several
teaspoons
Most important guideline in this category—avoid
exceeding recommended amounts
Most people consume enough oils in the foods they eat:
o Olives and fish
o Salad dressing
o Nuts
Fats that are solid at room temperature, such as butter, shortening, and beef or
chicken fat, are not considered oils.
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Checkpoint Question
Who publishes the MyPyramid and MyPlate
food guidance systems and why?
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Checkpoint Answer
The USDA developed MyPyramid food
guidance system in 1992. In 2011, they
provided a new, simplified visual reference
known as MyPlate. The goal is to help people
maintain a healthy diet and sufficient exercise
levels.
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Essentials of Nutrition (cont’d.)
 Understanding Food Labels
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Most manufacturers except meat and poultry
Required to list nutritional information on package
Food and Drug administration regulates mandatory
food labeling
Includes measurements of:
o Calories and fat content
o Cholesterol and sodium
o Carbohydrates and dietary fiber
o Protein and vitamins
o Calcium and other nutrients
The Nutritional Labeling and Education Act was passed in 1990 to help
consumers identify nutritional content in food products.
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Essentials of Nutrition (cont’d.)
 Food label gives amount in
one serving size:
o Percentage of total daily
intake listed on right
o A DV (daily value) of 0% is
listed for those things that
should be kept to minimum
Sample food label.
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Checkpoint Question
Jack Stone explains to a parent that food labels
contain nutritional information about the food
or product. What information is listed on the
right side of a food label?
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Checkpoint Answer
The right side of the food label gives the
percentage of the total daily intake
recommended that is contained in one serving.
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Essentials of Nutrition (cont’d.)
 Therapeutic Nutrition
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Each part of lifespan requires different nutritional needs
Patient’s medical condition or situation will require:
o Diet restrictions
o Special foods
Medical assistant will teach patient how to follow
physician ordered diet:
o Example — chronic conditions such as diabetes or
heart disease
Regardless of the reason for the therapeutic diet, the purposes include
facilitating the healing process, promoting healthy weight, assisting with chewing
and swallowing, and/or influencing the components found in blood, such as
cholesterol or blood glucose levels.
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Essentials of Nutrition (cont’d.)
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Checkpoint Question
List four possible reasons for a patient’s need
for a special therapeutic diet.
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Checkpoint Question
The purposes of therapeutic diets are to:
1. Facilitate the healing process
2. Promote healthy weight
3. Assist with chewing and swallowing
4. Influence the components found in blood
such as cholesterol
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Wellness
 Physical Fitness
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Healthy and balanced diet and regular
exercise required to maintain physical fitness
Physical movement helps:
o Maintain healthy musculoskeletal system
o Normal weight
o Positive mental attitude
o Improves immune system
o Causes production of endorphins
o That tend to produce euphoria
Endorphins:
chemical that are
often called the
body’s ” natural
painkillers” that
tend to produce a
euphoria or
“good feeling.”
release often
caused by
physical
movement or
exercise
euphoria: a
feeling of wellbeing
Physical fitness is characterized by endurance, flexibility, and strength.
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Wellness (cont’d.)
 Components of Physical Fitness
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Cardiovascular health and endurance — aerobic
activities
Flexibility — stretching exercise
Bone and muscle strength:
o Exercise for strong bones
o Weight lifting and resistance training increase
muscle strength and endurance
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Checkpoint Question
What types of physical activities promote
cardiovascular health and endurance?
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Checkpoint Answer
Aerobic activities, such as running, bike riding, rowing, and
swimming, can improve cardiovascular system functioning
and endurance.
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Wellness (cont’d.)
 Weight Management

Rate of obesity in U.S. has doubled in past 20 years:
o 1/3 adult population obese
o 17% children and adolescents
o Obesity rate doubled in children
o Tripled in adolescents
Excess body fat can result in a higher risk of certain health conditions, such as
hypertension, heart disease, type 2 diabetes, gallbladder disease, respiratory
disorders, and certain kinds of cancers.
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Wellness (cont’d.)
 When helping overweight children and adolescents:
Goal is to slow unhealthy weight gain
o Maintain normal growth and development
o Eating more nutritious, lower-calorie foods
o Increasing physical activity
 Even small amount of weight loss beneficial
o
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Wellness (cont’d.)
 Physiologic Issues
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Reduce and maintain healthy
weight—move more, eat less
Three ways body expends energy:
o Basal metabolic rate
o Physical activity
o Thermic effect of food
Reducing and maintaining a healthy weight depends on a familiar formula––
increased physical activity + taking in fewer calories = reduction in body weight.
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Wellness (cont’d.)
 Basal Metabolic Rate

Approximately 60% to 70% of the
body’s energy is expended through
BMR basic activities:
o Respiration
o Heartbeat
o Maintaining body temperature
basal metabolic rate
(BMR): the amount of
energy used in a unit
of time to maintain
vital functions by a
fasting, resting subject
An individual’s BMR refers to the amount of energy used in a unit of time to
maintain vital functions by a fasting, resting subject.
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Wellness (cont’d.)
 Level of Physical Activity
20% to 30% of body’s total energy
expenditure
 Calories
 “Thermic effect” = amount of energy
needed to digest food
 Four caloric sources include:
o Carbohydrates
o Fats
o Proteins
o Alcohol

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Wellness (cont’d.)
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Determine daily caloric requirement
Take in fewer calories than need = lose weight
Take in more calories than need = gain weight
To calculate needs:
• Not physically active: weight (lbs) x 14 = estimated
calories/day
• Moderately active: weight (lbs) x 17 = estimated
calories/day
• Active individuals: weight (lbs) x 20 = estimated
calories/day
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Wellness (cont’d.)
 Body Mass Index
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
Adults over age 20 years —condition of
being overweight or obese based on
their BMI level only
For children, it is age, gender and BMI
Limitations:
o Can overestimate body fat in
muscular person
o Underestimate body fat in person
with decreased muscle mass
Growth charts available to track BMI
body mass index
(BMI): a
measurement of an
individual’s ratio of fat
to lean body mass. It
is calculated by using
the following formula:
[weight (pounds) ÷
height (inches)2] ×
703. A BMI over 30 is
considered obese
With the increased incidence of obesity, physicians are turning to BMI for
assessing patients’ risk for obesity.
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Wellness (cont’d.)
Body Mass Index (BMI) Table.
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Checkpoint Question
A patient asks Jack Stone what is meant by
BMR and how is this different from the BMI.
How should Jack answer this question?
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Checkpoint Answer
The BMR is the basal metabolic rate and refers
to the rate at which the body performs the
basic functions such as heart beat, respiration,
and maintaining body temperature. The BMI is
a measurement of an individual’s ratio of fat to
lean body mass.
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Wellness (cont’d.)
 Sociologic and Psychological Issues
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Food has become social entertainment
Emotional eating
To stop the growing epidemic of obesity:
o Make lifestyle changes
o Make better food choices
o Be more active
Starts with changing bad habits
Be an example for patients
Learn why people eat and how food plays a part in our
social and psychological well-being
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Checkpoint Question
What are the ill effects of excess body fat?
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Checkpoint Answer
Excess body fat can result in a higher risk of
certain health conditions, such as
hypertension, heart disease, type 2 diabetes,
gallbladder disease, respiratory disorders, and
certain kinds of cancers.
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Wellness (cont’d.)
 Staying Well
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Maintain proper body weight and nutrition
Necessary for good health
o Difficult to follow rigid diet
o Confining exercise regimen
Subtle changes can improve health
Eating more slowly, sleeping more, and taking the stairs instead of an elevator
are just a few of the things that you can do every day to make you feel
better.
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Wellness (cont’d.)
 Stress
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Certain amount needed to function
Too much harmful
High stress levels cause:
o Headaches
o Leg cramps
Keeps list of suggestions in patient education area
Talk to patients about stress levels
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Wellness (cont’d.)
 Stress reduction techniques:
Positive thinking
o 30 minutes daily doing activity that is enjoyable
o Calm thought when angry
o Know limits
o Get a good night’s sleep
 High levels of stress can contribute to health
problems in predisposed individuals
 Stress-reducing techniques include:
o Relaxation exercises
o Guided imagery
o Medication
o
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predisposed:
genetically
programmed
guided
imagery: selfrelaxation
technique,
sitting
comfortably
while imagining
a quiet,
peaceful place
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Wellness (cont’d.)
 Pollution
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Can negatively affect health
Respiratory problems, general discomfort
Damage to ozone layer:
o Increased instances of skin cancer, eye
damage
o To minimize harmful effects:
• Avoid secondhand smoke
• Heavy traffic
The Clean Air Act of 1990 is a federal law that limits the amounts of certain
pollutants that may be released into the air in the United States.
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Wellness (cont’d.)
 Seat Belt Use and Airbags
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22,000 died in 2012 as a result of motor vehicle
accidents
Proper seatbelt use can prevent up to half:
o Prevent “2nd crash”
o Should fit properly
o Lap + shoulder restraint greatest protection
Air bags help with frontal impact crashes
o Are NOT seat belt substitute
o Air bags + lap belts and shoulder restraints
greatly reduce risk of head injury
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Wellness (cont’d.)
 More than 3,000 were killed in U.S. in 2012
 Distraction includes:
Visual — taking eyes off of the road
o Manual — taking hands off steering wheel
o Cognitive — taking mind off task of driving
Sending text messages = one of most dangerous activities
because it involves all three types of distractions
Talking on cell phones
Eating or drinking
Using PDA or GPS
Watching video
Changing radio station, CD, or MP3 player
o
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Checkpoint Question
What human health effects are thought to be
caused by air pollution?
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Checkpoint Answer
Air pollution can result in several health
problems including respiratory problems,
burning eyes or irritated throats, birth defects,
certain cancers, and brain damage.
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Wellness (cont’d.)
 Dental Health
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Important part of person’s overall health
Flossing important
Keeping teeth in good repair promotes
better health
Unattended cavities have a profound effect on the gums as well as on the sinuses
and the throat.
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Wellness (cont’d.)
 Positive Mental Outlook
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Cannot control certain events—can control
reactions to them
Look at bright side of things
Many instances of terminally ill patient who fare
better due to positive outlook
Pay attention to positive—downplay negative
Having a positive mental outlook can benefit your health and well-being and
possibly even prolong life.
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Wellness (cont’d.)
 Genetics
Good genes can be negated by bad health habits
 Infectious Disease Prevention
 Body protects a healthy person from most germs or
pathogens
 Can control how many germs enter body — use following
precautions:
o Wearing PPE when handling body fluids
o Use safe practices in kitchen and bathroom
 Preventing spread of infection takes care and attention
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Studies have shown that genetics play a large role in what diseases a person
contracts, but patients should not use this as an excuse to ignore risk factors.
Proper handwashing is known to be the best defense against illness.
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Wellness (cont’d.)
 Substance Abuse
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Excessive use of and dependency on drugs
Some are legal:
o Alcohol
o Nicotine
Others illegal:
o Marijuana
o Cocaine
Should seek help from trained specialist or counselors
Information available from various national organizations
Because substance abuse can be highly detrimental to your patients’ health, it is
important that you have information available about substance abuse available for
patients who may have a substance abuse problem.
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Wellness (cont’d.)
 Alcohol
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Most commonly abused legal substances
Overconsumption can lead to health problems:
o High blood pressure
o Cardiomyopathy
o Fetal alcohol syndrome
o Liver damage
Some can drink in moderation, others prone to
addiction
Considered mind-altering substance—depressant
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Wellness (cont’d.)
 Effects:
Lack of coordination
o Slurred speech
o Blurred vision
 Long term effects include:
o Cirrhosis of liver
o Certain cancers
o Increased risk of stroke
o Nutritional deficiencies
o
The effects of alcohol intoxication include a lack of coordination, slurred speech,
blurred vision, and impaired brain function.
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Wellness (cont’d.)
 Drugs
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Marijuana and hashish:
o Impair short-term memory and comprehension
o Increase heart rate and appetite
o Long-term used develop psychological
dependence
o Inhaled as unfiltered smoke-users take in cancer
causing agents
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Wellness (cont’d.)
 Drugs
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Cocaine and crack:
o Extremely addictive
o Stimulate central nervous system
o Psychological and physical dependency
o Can cause sudden death by disrupting brain’s
control of the heart and respiration
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Wellness (cont’d.)
o Side effects:
•
•
•
•
•
•
•
Dilated pupils
Increase pulse rate
Elevated blood pressure
Insomnia
Loss of appetite
Paranoia
Seizures
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Wellness (cont’d.)

Stimulants and amphetamines
• Same effect as cocaine
• Increased heart rate and blood pressure
• Symptoms
 Dizziness
 Sleeplessness
 Anxiety
 Psychosis
 Hallucinations
 Paranoia
 Physical collapse
• Long term effects
 Hypertension, heart disease, stroke, renal and liver
failure
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Wellness (cont’d.)
 Depressants and barbiturates
o
o
o
o
o
Physical and psychologic dependency
Can lead to respiratory depression, coma and death—
particularly with alcohol
Withdrawal can lead to restlessness, insomnia,
convulsions and death
Hallucinogens all interrupt brain message that control
intellect and instincts
Large doses can produce:
• Seizures and coma
• Heart and lung failure
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Wellness (cont’d.)
 Hallucinogens
o
o
o
o
LSD, PCP or “angel dust”, mescaline, peyote
Interrupt brain messages that control the intellect and
keep instincts in check
Large doses can produce:
• Seizures
• Coma
• Heart and lung failure
Chronic users complain of:
• Persistent memory problems
• Speech difficulties
• Lack of pain sensors may result in severe selfinflicted injuries
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Wellness (cont’d.)
 Narcotics are addictive
Heroin, cocaine, morphine, opium
o Produce euphoria, drowsiness and blood pressure and
pulse fluctuations
o Overdose can lead to seizures, coma, cardiac arrest,
death
 Any of these substances can impair a fetus’s health:
o Fetal alcohol syndrome
o “Crack baby”
 Provide positive reinforcement and offer services to patients
for cessation programs
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The most important role of the medical assistant in educating patients
about any type of substance abuse is to be supportive and have a list of
community resources available to assist patients who need them.
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Wellness (cont’d.)
 Smoking Cessation
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Health risks well documented:
o Nicotine reaches the brain in six seconds
o Damages the blood vessels
o Decreases heart strength
o Associated with many cancers
Withdrawal symptoms include:
o Anxiety
o Progressive restlessness
o Irritability and sleep disturbances
Nicotine is highly addictive whether ingested by inhaling or chewing.
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Wellness
(cont’d.)
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