Transcript Ch 4 Body Systems and Related Conditions Study

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Body Systems and Related Conditions
Define the following terms:
Homeostasis
the condition in which all of the body’s systems are working their
best.
Metabolism
physical and chemical processes by which substances are produced
or broken down into energy or products for use by the body.
Dilate
to widen.
Constrict
to narrow.
4 Body Systems and Related Conditions
Transparency 4-1: The Integumentary System
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Body Systems and Related Conditions
1. Describe the integumentary system
Remember the following points about the integumentary system:
• Largest organ and system
• Natural protective covering
• Prevents excessive loss of water and injury to internal organs
• Skin made of tissue and glands
• Skin is a sense organ
• Regulates body temperature (Dilates if hot, which allows more
blood to surface for sweat/evaporation. Constricts if cold to
keep in body heat.)
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Body Systems and Related Conditions
1. Describe the integumentary system
Normal changes of aging include the following:
• Skin gets thinner and more fragile.
• Skin is drier and less elastic.
• Protective fatty tissue gets thinner and person may feel
colder.
• Hair thins and turns gray.
• Wrinkles and brown spots appear.
• Fingernails and toenails thicken and become more brittle.
• Reduced circulation can cause skin dryness, itching, and
irritation.
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Body Systems and Related Conditions
1. Describe the integumentary system
Think about this question:
How can you help residents with the normal changes of aging to
the integumentary system?
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Body Systems and Related Conditions
1. Describe the integumentary system
Observe and report the following regarding the integumentary
system:
• Pale, white, reddened, or purple areas, blisters or bruises
• Dry or flaking skin
• Rashes or discoloration
• Cuts, boils, sores, wounds, abrasions
• Fluid or blood draining from skin
• Changes in moisture level
• Swelling
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Body Systems and Related Conditions
1. Describe the integumentary system
Observe and report, integumentary system (cont’d.):
• Blisters
• Changes in wound or ulcer
• Redness or broken skin between toes or around toenails
• Scalp or hair changes
• Skin that appears different from normal
• In ebony complexions, also look for change in the feel of the
tissue (e.g. “orange peel” look)
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Body Systems and Related Conditions
1. Describe the integumentary system
Common disorders of this system include the following:
• Pressure sores (also called decubitus ulcers) occur where
blood has poor circulation and bone is close to skin. Skin
receives less oxygen and nutrients, cells die, and tissue
breaks down.
• More information on pressure sores is found in chapter 6.
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Body Systems and Related Conditions
Define the following terms:
Atrophy
the wasting away, decreasing in size, and weakening of
muscles from lack of use.
Contractures
the permanent and often painful stiffening of a joint and
muscle.
4 Body Systems and Related Conditions
Transparency 4-2: The musculoskeletal system and related conditions
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Body Systems and Related Conditions
2. Describe the musculoskeletal system and related conditions
Remember the following points about the musculoskeletal
system:
• Human body has 206 bones.
• Two bones meet at a joint (for movement). Joints make
movement possible either in all directions or in one direction
only.
• Muscles provide movement and produce body heat.
• Physical activity/exercise increases circulation, increasing
blood flow to organs and tissues.
• Inactivity can cause depression, pneumonia, constipation,
UTIs, loss of self- esteem, and blood clots.
• Muscles develop atrophy or contractures from inactivity.
• ROM exercises help prevent atrophy or contractures.
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Body Systems and Related Conditions
2. Describe the musculoskeletal system and related conditions
Normal changes of aging to the musculoskeletal system include
the following:
• Muscles weaken and lose tone.
• Body movement slows.
• Bones lose density and become more brittle.
• Joints can stiffen/become painful.
• Height is gradually lost.
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Body Systems and Related Conditions
2. Describe the musculoskeletal system and related conditions
Think about this question:
How can you help residents with the normal changes of aging to
the musculoskeletal system?
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Body Systems and Related Conditions
2. Describe the musculoskeletal system and related conditions
Observe and report the following regarding the musculoskeletal
system:
• Changes in movement and activity
• Changes in ability to do ROMs
• Pain during movement
• New or increased swelling of joints
• White, shiny, red, or warm joints
• Bruising
• Aches and pains reported by resident
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Body Systems and Related Conditions
2. Describe the musculoskeletal system and related conditions
Common disorders of this system include the following:
• Arthritis
• Osteoporosis
• Fractures
• Hip replacement
• Knee replacement
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Body Systems and Related Conditions
Define the following terms:
Inflammation
swelling.
Autoimmune illness
an illness in which the body’s immune system attacks normal
tissue in the body.
Osteoarthritis
a type of arthritis that usually affects hips and knees and
joints of the fingers, thumbs, and spine.
Rheumatoid arthritis
a type of arthritis in which joints become red, swollen, and
very painful, and movement is restricted.
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Body Systems and Related Conditions
2. Describe the musculoskeletal system and related conditions
Remember these facts about arthritis:
• Arthritis is inflammation of the joints causing stiffness and
pain, and decreased mobility.
• Arthritis may be caused by aging, injury, or autoimmune
illness.
• Two types are osteoarthritis and rheumatoid arthritis.
• Pain and stiffness increase in cold or damp weather.
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Body Systems and Related Conditions
2. Describe the musculoskeletal system and related conditions
Arthritis may be treated in these ways:
• Anti-inflammatory medications (aspirin or ibuprofen)
• Local applications of heat
• ROMs
• Exercise
• Diet
4 Body Systems and Related Conditions
Transparency 4-3: Care Guidelines for Arthritis
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Watch for stomach irritation or heartburn.
Encourage activity.
Adapt ADLs to allow independence.
Choose clothing that is easy to put on and fasten.
Use special utensils if needed.
Treat each resident as an individual.
Help self-esteem by encouraging self-care.
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Body Systems and Related Conditions
Define the following terms:
Osteoporosis
a condition in which the bones become brittle and weak; may be
due to age, lack of hormones, not enough calcium in bones, alcohol,
or lack of exercise.
Menopause
the stopping of menstrual periods.
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Body Systems and Related Conditions
2. Describe the musculoskeletal system and related conditions
Remember these facts about osteoporosis:
• Causes bones to become brittle
• May be due to age, lack of hormones, lack of calcium, alcohol
consumption, or lack of exercise
• Occurs more commonly in women after menopause
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Body Systems and Related Conditions
2. Describe the musculoskeletal system and related conditions
Remember these signs and symptoms of osteoporosis:
• Low back pain
• Loss of height
• Stooped posture
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Body Systems and Related Conditions
2. Describe the musculoskeletal system and related conditions
The following can be done to prevent or slow osteoporosis:
• Encourage residents to walk and do other light exercise as
ordered.
• Move residents with osteoporosis very carefully.
• Follow care plan regarding medication, calcium, and fluoride
supplements, which might be used to treat osteoporosis.
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Body Systems and Related Conditions
Define the following terms:
Partial weight bearing (PWB)
able to support some weight on one or both legs.
Non-weight bearing (NWB)
unable to support any weight on one or both legs
Full weight bearing (FWB)
able to bear 100 percent of the body weight on one or both
legs on a step.
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Body Systems and Related Conditions
2. Describe the musculoskeletal system and related conditions
REMEMBER:
Fall prevention is the key to avoiding fractures.
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Body Systems and Related Conditions
2. Describe the musculoskeletal system and related conditions
Follow these guidelines when caring for a new cast:
• Do not cover until dry.
• Do not place on hard surface.
• Elevate extremity in cast.
• Observe for skin discoloration, tightness, swelling, sores, skin
temperature, burning, numbness or tingling, drainage,
bleeding, or odor.
• Protect residentís skin from edges of cast.
• Keep cast dry.
• Do not insert anything into cast.
• Tell the nurse if pain medication is needed.
• Use bed cradles as needed.
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Body Systems and Related Conditions
2. Describe the musculoskeletal system and related conditions
Remember these facts about hip fractures:
• Cause may be a fall or weakened bones
• Elderly bones heal slowly
The following are common reasons for hip replacements:
• Fracture does not heal properly
• Weakened hip due to aging
• Painful and disabled hip
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Body Systems and Related Conditions
2. Describe the musculoskeletal system and related conditions
Remember these facts about hip fractures:
• Cause may be a fall or weakened bones
• Elderly bones heal slowly
The following are common reasons for hip replacements:
• Fracture does not heal properly
• Weakened hip due to aging
• Painful and disabled hip
4 Body Systems and Related Conditions
Transparency 4-4: Care Guidelines for Hip Replacement
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Keep often-used items within reach.
Dress affected side first.
Never rush the resident. Use praise and encouragement.
Ask for pain medication if needed.
Have the resident sit to do tasks.
Follow the care plan.
Do not perform ROM exercises on a leg on hip replacement
side.
• Hip cannot be at less than 90 degree angle. It cannot be
turned inward or outward.
• Transfer resident carefully, with stron side leading in
standing, pivoting and sitting.
• With chair or toilet transfers, operative leg/knee should be
straightened. Strong leg should stand first.
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Body Systems and Related Conditions
2. Describe the musculoskeletal system and related conditions
Observe and report the following about hip replacement:
• Red, draining, bleeding, or warm incision
• Increase in pain
• Numbness or tingling
• Abnormal vital signs
• Inability to use equipment properly and safely
• Resident not following doctor’s orders for activity and exercise
• Problems with appetite
• Increasing strength and improving ability to walk
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Body Systems and Related Conditions
2. Describe the musculoskeletal system and related conditions
The following are common reasons for knee replacement:
• Relieve severe pain
• Restore motion to damaged knee
• Help stabilize a knee that buckles or gives out
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Body Systems and Related Conditions
2. Describe the musculoskeletal system and related conditions
REMEMBER:
Recovery time for knee replacement is generally shorter than for
a hip replacement.
4 Body Systems and Related Conditions
Transparency 4-5: Care Guidelines for Knee Replacement
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Apply special stockings as ordered.
Perform ankle pumps as ordered.
Encourage fluids.
Assist with deep breathing exercises.
Ask for pain medication if needed.
Report to nurse if you notice redness, swelling, heat or
deep tenderness in one or both calves.
4 Body Systems and Related Conditions
Transparency 4-6: The Nervous System
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Body Systems and Related Conditions
3. Describe the nervous system and related conditions
Remember the following points about the nervous system:
• Control and message center of body
• Controls and coordinates all body functions
• Interprets information from outside the body
• Two main parts: central nervous system (brain) and
peripheral nervous system
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Body Systems and Related Conditions
3. Describe the nervous system and related conditions
Normal changes of aging to the nervous system include the
following:
• Slower responses and reflexes
• Decrease in sensitivity of nerve endings in skin
• Some memory loss, more often with short-term memory
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Body Systems and Related Conditions
3. Describe the nervous system and related conditions
Think about this question:
How can you help residents with the normal changes of aging to
the nervous system?
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Body Systems and Related Conditions
3. Describe the nervous system and related conditions
Observe and report the following regarding the nervous system:
• Fatigue or pain with movement
• Shaking or trembling
• Inability to speak clearly
• Inability to move one side of body
• Disturbance in vision or hearing
• Changes in eating or fluid intake
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Body Systems and Related Conditions
3. Describe the nervous system and related conditions
Observe and report the following (cont’d.):
• Difficulty swallowing
• Bowel or bladder changes
• Depression or mood changes
• Memory loss or confusion
• Violent behavior
• Unusual change in behavior
• Decreased ability to perform ADLs
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Body Systems and Related Conditions
3. Describe the nervous system and related conditions
Common disorders of this system include the following:
• Dementia (covered in detail in Chapter 5)
• Alzheimer’s disease (covered in detail in Chapter5)
• CVA/Stroke
• Parkinson’s disease
• Multiple Sclerosis
• Head and spinal cord injuries
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Body Systems and Related Conditions
Define the following terms:
Hemiplegia
paralysis on one side of the body.
Hemiparesis
weakness on one side of the body.
Expressive aphasia
inability to speak or speak clearly.
Receptive aphasia
inability to understand spoken or written words.
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Body Systems and Related Conditions
Define the following terms:
Emotional lability
laughing or crying without any reason, or when it is
inappropriate.
Dysphagia
difficulty swallowing.
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Body Systems and Related Conditions
3. Describe the nervous system and related conditions
Remember these facts about CVA/Stroke:
• Caused when blood supply to brain is cut off by a clot or
ruptured vessel.
• Results in lack of oxygen to tissue, causing cells to die.
• Swelling, leaking blood, and clots affect surrounding healthy
brain tissue.
• Weakness occurs opposite affected side of brain.
• Mild stroke may result in few, if any, complications.
4 Body Systems and Related Conditions
Transparency 4-7: Care Guidelines for Stroke
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Assist with exercises as ordered, keeping safety in mind.
Use terms “weaker” or “involved,” not “bad.”
Assist with speech therapy as needed.
Use verbal and nonverbal communication to express
positive attitude.
Residents may experience confusion, memory loss, and
emotions. Be patient and understanding.
Encourage independence and self-esteem.
Always check on resident’s body alignment.
Pay special attention to skin care.
If residents have lost sense of touch or sensation, be aware
of potentially harmful situations such as closeness to heat
and sharp objects.
Adapt procedures when caring for residents with one-sided
paralysis or weakness.
4 Body Systems and Related Conditions
Transparency 4-7: Care Guidelines for Stroke (cont’d.)
For transfers:
• Always use gait belt.
• Stand on and support weaker side.
• Lead with stronger side.
For assisting with dressing:
• Dress weaker side first. Undress stronger side first.
• Use assistive equipment to help resident dress himself.
4 Body Systems and Related Conditions
Transparency 4-7: Care Guidelines for Stroke (cont’d.)
For assisting with communication:
• Keep questions and directions simple.
• Phrase questions so they can be answered with a “yes” or
“no.”
• Agree on signals, such as shaking or nodding the head or
raising a hand or finger for “yes” or “no.”
• Give residents time to respond. Listen attentively.
• Use a pencil and paper if the resident can write.
• Use verbal and nonverbal communication to express your
positive attitude.
• Use pictures, gestures, or pointing. Use communication
boards or special cards to aid communication.
• Keep the call signal within reach of residents.
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Body Systems and Related Conditions
Define the following terms:
Gait
manner of walking.
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Body Systems and Related Conditions
3. Describe the nervous system and related conditions
Remember these facts about Parkinson’s disease:
• Progressive, degenerative disease
• Causes stiff muscles, stooped posture, shuffling gait, pillrolling, tremors, and mask-like facial expression
• Tremors can make ADLs difficult
4 Body Systems and Related Conditions
Transparency 4-8: Care Guidelines for Parkinson’s Disease
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Protect residents from falls.
Help with ADLs as needed.
Assist with ROM exercises as ordered.
Encourage self-care and be patient.
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Body Systems and Related Conditions
3. Describe the nervous system and related conditions
Remember these facts about Multiple Sclerosis (MS):
• MS is a progressive disease affecting the central nervous
system.
• Protective sheath breaks down over time and nerves cannot
send messages properly.
• Residents will have varying abilities.
• Symptoms can include blurred vision, fatigue, tremors, poor
balance, trouble walking, weakness, numbness, tingling,
incontinence, and behavior changes.
• MS can cause blindness, contractures, and loss of function in
arms and legs.
4 Body Systems and Related Conditions
Transparency 4-9: Care Guidelines for Multiple Sclerosis
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Help with ADLs.
Be patient with self-care and movement.
Allow time for tasks. Offer rest periods.
Give resident time to communicate.
Prevent falls.
Help avoid stressful situations. Listen to residents.
Encourage proper diet.
Give regular skin care.
Assist with ROM exercises.
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Body Systems and Related Conditions
Define the following terms:
Paraplegia
loss of function of lower body and legs.
Quadriplegia
loss of function of legs, trunk, and arms.
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Body Systems and Related Conditions
3. Describe the nervous system and related conditions
Remember these facts about head and spinal cord injuries:
• May result from diving, sports injuries, falls, car and
motorcycle accidents, industrial accidents, war, and criminal
violence.
• Can cause permanent brain damage, mental retardation,
personality changes, trouble breathing, seizures, coma,
memory loss, loss of consciousness, paresis, paralysis.
• Effects of spinal cord injuries depend on force of impact and
where spine is injured.
• May cause paraplegia or quadriplegia.
• Rehabilitation is needed.
• Emotional support is important.
4 Body Systems and Related Conditions
Transparency 4-10: Care Guidelines for Head and Spinal Cord Injuries
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Give emotional, as well as physical, support.
Be patient.
Prevent falls and burns.
Be patient with self-care.
Give good skin care.
Assist with position changes at least every two hours.
Perform passive range of motion exercises.
Encourage fluids and proper diet to prevent constipation.
Give extra catheter care as needed.
Offer rest periods as needed.
Use special stockings as ordered.
Encourage deep breathing exercises as ordered.
Provide for privacy if involuntary erections occur.
Assist with bowel and bladder training.
4 Body Systems and Related Conditions
Transparency 4-11: Parts of the Eye
4 Body Systems and Related Conditions
Transparency 4-12: The Ear
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Body Systems and Related Conditions
3. Describe the nervous system and related conditions
Think about this question:
What are the other sense organs in the human body?
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Body Systems and Related Conditions
3. Describe the nervous system and related conditions
Normal changes of aging to the sense organs include the
following:
• Reduced vision and hearing (sense of balance may be
affected)
• Decreased senses of taste, touch and smell
• Decreased sensitivity to heat and cold
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Body Systems and Related Conditions
3. Describe the nervous system and related conditions
Think about this question:
How can you help residents with the normal changes of aging to
the sense organs?
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Body Systems and Related Conditions
3. Describe the nervous system and related conditions
Observe and report the following regarding the sense organs:
• Changes in vision or hearing
• Signs of infection
• Dizziness
• Complaints of pain in eyes or ears
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Body Systems and Related Conditions
3. Describe the nervous system and related conditions
Remember these facts about vision impairment:
• Vision impairment can affect people of all ages.
• Some residents may wear eyeglasses or contacts.
• People over 40 are at risk for developing cataracts, glaucoma,
and blindness.
• Cataracts may be corrected surgically.
• Glaucoma can occur suddenly or gradually, and is treated with
medication and sometimes surgery.
• Residents who are visually impaired may enjoy books on tape,
large-print books, or Braille books (if they are trained to read
Braille).
4 Body Systems and Related Conditions
Transparency 4-13: The Circulatory System
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Body Systems and Related Conditions
4. Describe the circulatory system and related conditions
Remember the following points about the circulatory system:
• Made up of heart, blood vessels, and blood
• Blood carries food, oxygen, and essential substances.
• Major functions are to:
• Supply food, oxygen, and hormones to cells
• Produce and supply antibodies
• Remove waste products from cells
• Control body temperature
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Body Systems and Related Conditions
4. Describe the circulatory system and related conditions
The circulatory system (cont’d.):
• Heart has four chambers (two atria/upper chambers and two
ventricles/lower chambers)
• Heart functions in two phases:
• Resting phase, or diastole (chambers fill with blood)
• Contracting phase, or systole (ventricles pump blood)
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Body Systems and Related Conditions
4. Describe the circulatory system and related conditions
The following are normal changes of aging to the circulatory
system:
• Heart pumps less efficiently
• Decreased blood flow
• Narrowed blood vessels
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Body Systems and Related Conditions
4. Describe the circulatory system and related conditions
Think about this question:
How can you help residents with the normal changes of aging to
the circulatory system?
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Body Systems and Related Conditions
4. Describe the circulatory system and related conditions
Observe and report the following regarding the circulatory
system:
• Changes in pulse rate
• Weakness or fatigue
• Loss of ability to perform ADLs
• Swelling of hands and feet
• Pale or blue hands, feet, or lips
• Chest pain
• Weight gain
• Shortness of breath
• Severe headache
• Inactivity, which can lead to circulatory problems
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Body Systems and Related Conditions
4. Describe the circulatory system and related conditions
Common disorders of the circulatory system include the
following:
• Hypertension (HTN) or high blood pressure
• Coronary artery disease
• Myocardial infarction (MI) or heart attack
• Congestive heart failure (CHF)
• Peripheral vascular disease (PVD)
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Body Systems and Related Conditions
Define the following terms:
Hypertension
high blood pressure.
Diuretics
medications that reduce fluid volume in the body.
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Body Systems and Related Conditions
4. Describe the circulatory system and related conditions
Remember these facts about hypertension:
Causes:
• Hardening and narrowing of blood vessels (atherosclerosis)
• Kidney disease
• Adrenal tumors
• Pregnancy
Symptoms:
• Headache
• Blurred vision
• Dizziness
• Sometimes there are no noticeable symptoms
4 Body Systems and Related Conditions
Transparency 4-14: Care Guidelines for High Blood Pressure
• Treatment to control it is vital.
• Encourage residents to follow their diet and exercise
programs.
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Body Systems and Related Conditions
Define the following terms:
Angina pectoris
the medical term for chest pain, pressure, or discomfort due
to coronary artery disease.
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Body Systems and Related Conditions
4. Describe the circulatory system and related conditions
Remember these facts about coronary artery disease (CAD):
• Cause: vessels in coronary arteries narrow, reducing blood to
heart
• Symptoms: angina pectoris
4 Body Systems and Related Conditions
Transparency 4-15: Care Guidelines for Angina Pectoris
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Encourage rest.
Nitroglycerin should be close by.
Tell the nurse if a nitroglycerin patch comes off.
Residents may need to avoid heavy meals, overeating,
intense exercise, and extreme weather exposures.
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Body Systems and Related Conditions
4. Describe the circulatory system and related conditions
Remember these facts about myocardial infarction (MI) or heart
attack:
• Caused by complete block of blood flow to heart muscle,
which results in tissue death
• Area of dead tissue may be large or small
• Can result in serious heart damage or death
• Chapter 2 covers warning signs
4 Body Systems and Related Conditions
Transparency 4-16: Care Guidelines for Heart Attack
• Residents may be placed on exercise program.
• Residents may be on low-fat/low-sodium diet.
• Medications may be used to regulate heart rate and blood
pressure.
• Quitting smoking is encouraged.
• Stress management program may be started.
• Residents may need to avoid cold temperatures.
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Body Systems and Related Conditions
4. Describe the circulatory system and related conditions
Remember these facts about congestive heart failure (CHF):
• Cause: failure of heart muscle to pump effectively due to
damage
• Symptoms:
• Trouble breathing
• Coughing or gurgling with breathing
• Dizziness
• Confusion
• Fainting
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Body Systems and Related Conditions
4. Describe the circulatory system and related conditions
Symptoms of congestive heart failure (cont’d.):
• Pale or blue skin
• Low blood pressure
• Swelling of feet and ankles
• Bulging neck veins
• Weight gain
4 Body Systems and Related Conditions
Transparency 4-17: Care Guidelines for Congestive Heart Failure
• Medications can help control CHF.
• Medications mean more trips to bathroom. Answer call
lights promptly.
• Low-sodium diet or fluid restriction may be prescribed.
• Limited activity or bedrest may be prescribed.
• I&O may need to be measured.
• Residents may need to be weighed daily.
• Elastic leg stockings help reduce swelling.
• ROM exercises improve muscle tone.
• Extra pillows may help breathing.
• Help with personal care and ADLs as needed.
• High-potassium foods can help with dizziness.
• Report symptoms to the nurse.
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Body Systems and Related Conditions
4. Describe the circulatory system and related conditions
Remember these facts about peripheral vascular disease (PVD):
• Cause: fatty deposits in the blood vessels that harden
• Symptoms:
• Cool arms and legs
• Swelling in hands and feet
• Pale or bluish hands or feet
• Bluish nail beds
• Ulcers of legs and feet
• Pain may be severe when walking but can decrease with rest
• Anti-embolic stockings can help prevent swelling and blood
clots and aid circulation
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Body Systems and Related Conditions
Define the following terms:
Respiration
the process of breathing air into the lungs and exhaling air
out of the lungs.
Inspiration
breathing air into the lungs.
Expiration
exhaling air out of the lungs.
4 Body Systems and Related Conditions
Transparency 4-18: The Respiratory System
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Body Systems and Related Conditions
5. Describe the respiratory system and related conditions
Remember the following points about the respiratory system:
• Has two functions:
• To bring oxygen into body
• To eliminate carbon dioxide produced by the body
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Body Systems and Related Conditions
5. Describe the respiratory system and related conditions
Normal changes of aging to the respiratory system include the
following:
• Loss of lung strength
• Decreased lung capacity
• Decreased oxygen in the blood
• Weakened voice
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Body Systems and Related Conditions
5. Describe the respiratory system and related conditions
Think about this question:
How can you help residents with the normal changes of aging to
the respiratory system?
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Body Systems and Related Conditions
5. Describe the respiratory system and related conditions
Observe and report the following regarding the respiratory
system:
• Changes in respiratory rate
• Shallow breathing or breathing through pursed lips
• Coughing or wheezing
• Nasal congestion or discharge
• Sore throat, difficulty swallowing
• Need to sit after mild exertion
• Pale or bluish lips or extremities
• Pain in chest
• Yellow, green, gray, or bloody sputum
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Body Systems and Related Conditions
5. Describe the respiratory system and related conditions
Remember these facts about chronic obstructive pulmonary
disease (COPD), a common disorder of the respiratory system:
• It is a chronic condition.
• Residents with COPD have trouble breathing, especially
getting air out of the lungs.
• Two chronic lung diseases are grouped under COPD:
• chronic bronchitis
• emphysema.
• Residents with COPD are at high risk of contracting
pneumonia.
• All body systems are affected when the lungs and brain do not
get enough oxygen.
• Residents may be in constant fear of not being able to breathe
and might need to sit upright to improve lung expansion.
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Body Systems and Related Conditions
5. Describe the respiratory system and related conditions
Facts about COPD (cont’d.):
• Residents may have poor appetites and not sleep well, leading
to weakness and feelings of general poor health.
• COPD can result in these symptoms:
• Chronic cough or wheeze
• Trouble breathing
• Shortness of breath
• Pale, cyanotic, or reddish-purple skin
• Confusion
• General weakness
• Difficulty completing meals
• Fear and anxiety
4 Body Systems and Related Conditions
Transparency 4-19: Care Guidelines for COPD
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Observe and report symptoms getting worse.
Help resident sit upright.
Offer plenty of fluids and small, frequent meals.
Encourage a balanced diet.
Keep oxygen supply available as ordered.
Be calm and supportive.
Use good infection control.
Encourage independence with ADLs.
Remind residents to avoid exposure to colds and the flu.
Make sure residents always have help ready.
Encourage pursed-lip breathing.
Encourage residents to save energy. Encourage rest.
4 Body Systems and Related Conditions
Transparency 4-19: Care Guidelines for COPD (cont’d.)
Report any of these to the nurse:
• Temperature over 101˚F
• Changes in breathing patterns, including shortness of
breath
• Changes in color or consistency of lung secretions
• Changes in mental state or personality
• Refusal to take medications as ordered
• Excessive weight loss
• Increasing dependence upon caregivers and family
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Body Systems and Related Conditions
Define the following terms:
Urinary incontinence
the inability to control the bladder, which leads to an
involuntary loss of urine.
4 Body Systems and Related Conditions
Transparency 4-20: The Urinary System
4
Body Systems and Related Conditions
6. Describe the urinary system and related conditions
Remember the following points about the urinary system:
• Composed of two kidneys, two ureters, one urinary bladder,
and a single urethra
• Two functions are
• Eliminate waste products created by the cells
• Maintain water balance in the body
4
Body Systems and Related Conditions
6. Describe the urinary system and related conditions
Normal changes of aging to the urinary system include the
following:
• Ability of kidneys to filter blood decreases
• Bladder muscle tone weakens
• Bladder holds less urine, which causes more frequent
urination
• Bladder may not empty completely, causing greater chance of
infection
4
Body Systems and Related Conditions
6. Describe the urinary system and related conditions
Think about this question:
How can you help residents with the normal changes of aging to
the urinary system?
4
Body Systems and Related Conditions
6. Describe the urinary system and related conditions
Observe and report the following regarding the urinary system:
• Weight loss or gain
• Swelling in upper or lower extremities
• Pain or burning during urination
• Changes in urine (cloudiness, odor, color)
• Changes in frequency and amount of urination
• Swelling in abdominal/bladder area
• Complaints that bladder feels full or painful
• Urinary incontinence/dribbling
• Pain in kidney or back/flank region
• Inadequate fluid intake
4
Body Systems and Related Conditions
6. Describe the urinary system and related conditions
Common disorders of the urinary system include the following:
• Urinary incontinence
• Urinary tract infection (UTI)
4
Body Systems and Related Conditions
6. Describe the urinary system and related conditions
Remember these facts about urinary incontinence:
• Can occur in people who are confined to bed, ill, elderly,
paralyzed, or who have circulatory or nervous system
diseases or injuries
• Stress that incontinence is not a normal part of aging and
may signal an illness. It is a major risk factor for pressure
sores.
4 Body Systems and Related Conditions
Transparency 4-21: Care Guidelines for Urinary Incontinence
•
•
•
•
•
•
•
•
Offer to assist with toileting often.
Follow toileting schedules.
Answer call lights and requests for help promptly.
Document carefully and accurately any time a resident’s
skin or anything touching resident’s skin is wet from urine,
even if it is a small amount.
Wash urine off immediately and completely.
Incontinent residents who are bedbound should have
plastic, latex or disposable sheets under them to protect
the bed. Place a draw sheet over it to absorb moisture and
protect skin.
Use disposable incontinence pads or briefs as needed to
keep body wastes away from skin. Change wet briefs
promptly. Do not refer to them as “diapers.”
Be reassuring and understanding.
4
Body Systems and Related Conditions
6. Describe the urinary system and related conditions
Remember these facts about urinary tract infection (UTI):
• Being bedbound is a risk factor for increased incidence of
UTIs.
• Women are more likely than men to contract a UTI.
• Women should wipe the perineal area from front to back after
elimination.
4 Body Systems and Related Conditions
Transparency 4-22: Preventing Urinary Tract Infections
• Encourage residents to wipe front to back and do the same
when providing perineal care.
• Give careful perineal care when changing incontinent briefs.
• Encourage plenty of fluids.
• Offer to assist with toileting often. Answer call lights
promptly.
• Taking showers, rather than baths, helps prevent UTIs.
• Report cloudy, dark, or foul-smelling urine, or if resident
urinates often and in small amounts.
4
Body Systems and Related Conditions
Define the following terms:
Digestion
the process of preparing food physically and chemically so
that it can be absorbed into the cells.
Elimination
the process of expelling solid wastes made up of the waste
produts of food that are not absorbed into the cells.
Fecal/anal incontinence
the inability to control the bowels, leading to involuntary
passage of stool.
4 Body Systems and Related Conditions
Transparency 4-23: The Gastrointestinal System
4
Body Systems and Related Conditions
7. Describe the gastrointestinal system and related conditions
Remember the following points about the gastrointestinal
system:
• Digestion prepares food for absorption into cells.
• Elimination is expelling solid wastes.
4
Body Systems and Related Conditions
7. Describe the gastrointestinal system and related conditions
Normal changes of aging to the gastrointestinal system are as
follows:
• Decreased saliva production affects chewing/swallowing
• Absorption of vitamins/minerals decreases
• Digestion takes longer, is less efficient
• Body waste moves more slowly through intestines;
constipation more frequent
4
Body Systems and Related Conditions
7. Describe the gastrointestinal system and related conditions
Think about this question:
How can you help residents with the normal changes of aging to
the gastrointestinal system?
4
Body Systems and Related Conditions
7. Describe the gastrointestinal system and related conditions
Observe and report the following regarding the gastrointestinal
system:
• Difficulty swallowing or chewing
• Fecal/anal incontinence
• Weight gain or loss
• Loss of appetite (anorexia)
• Abdominal pain or cramping
• Diarrhea
• Nausea and vomiting (especially coffee grounds type)
4
Body Systems and Related Conditions
7. Describe the gastrointestinal system and related conditions
Observe and report (cont’d.):
• Constipation
• Flatulence
• Hiccups, belching
• Bloody, black, or hard stools
• Heartburn
• Poor nutritional intake
4
Body Systems and Related Conditions
7. Describe the gastrointestinal system and related conditions
Common disorders/conditions of the gastrointestinal system
include the following:
• Constipation
• Fecal impaction
• Hemorrhoids
• Diarrhea
• Gastroesophageal reflux disease (GERD)
• Ostomies
4
Body Systems and Related Conditions
Define the following terms:
Constipation
the inability to eliminate stool, or the difficult and painful
elimination of a hard, dry stool.
Enema
a specific amount of water, with or without an additive, that
is introduced into the colon to eliminate stool.
Suppository
a medication given rectally to cause a bowel movement.
4
Body Systems and Related Conditions
7. Describe the gastrointestinal system and related conditions
Remember these facts about constipation:
• Causes:
• Decreased fluid intake
• Poor diet
• Inactivity
• Medications
• Aging
• Disease
• Ignoring the urge to eliminate
4
Body Systems and Related Conditions
7. Describe the gastrointestinal system and related conditions
Facts about constipation (cont’d.):
• Symptoms:
• Abdominal swelling
• Gas
• Irritability
• No recent record of bowel movement
• Treatment:
• Increasing fiber and fluid intake
• Increasing activity level
• Possibly enema or suppository
4
Body Systems and Related Conditions
7. Describe the gastrointestinal system and related conditions
Remember these facts about fecal impaction:
• Cause: hard stool that is stuck in the rectum and cannot be
expelled; results from unrelieved constipation
• Symptoms:
• No stool for several days
• Oozing of liquid stool
• Cramping
• Abdominal swelling
• Rectal pain
4
Body Systems and Related Conditions
7. Describe the gastrointestinal system and related conditions
Facts about fecal impaction (cont’.d):
• Treatment: Nurse or doctor inserts one or two gloved fingers
into the rectum to break the mass into fragments so that it
can be passed
• Prevention:
• High-fiber diet
• Plenty of fluids
• Increase in activity level
• Possibly medication
4
Body Systems and Related Conditions
7. Describe the gastrointestinal system and related conditions
Remember these facts about hemorrhoids:
• Cause: enlarged veins in the rectum and/or outside the anus
resulting from an increase in pressure in the lower rectum due
to
• Straining during bowel movements
• Chronic constipation
• Obesity
• Pregnancy
• Sitting for long periods of time on the toilet
4
Body Systems and Related Conditions
7. Describe the gastrointestinal system and related conditions
Facts about hemorrhoids (cont’d.):
• Symptoms: rectal itching, burning, pain, and bleeding
• Treatment:
• Medications
• Compresses
• Sitz baths
• Surgery may be necessary
4
Body Systems and Related Conditions
7. Describe the gastrointestinal system and related conditions
REMEMBER:
When cleaning the anal area, be careful to avoid causing pain
and bleeding from hemorrhoids.
4
Body Systems and Related Conditions
7. Describe the gastrointestinal system and related conditions
Remember these facts about diarrhea:
• Cause: frequent elimination of liquid or semi-liquid feces
resulting from
• Infections
• Microorganisms
• Irritating foods
• Medications
4
Body Systems and Related Conditions
7. Describe the gastrointestinal system and related conditions
Facts about diarrhea (cont’d.):
• Symptoms:
• Abdominal cramps
• Urgency
• Nausea and vomiting can accompany diarrhea
• Treatment:
• Medication
• Change of diet - bananas, rice, apples, and tea/toast (BRAT
diet)
4
Body Systems and Related Conditions
7. Describe the gastrointestinal system and related conditions
Remember these facts about gastroesophageal reflux disease
(GERD):
• Chronic condition in which the liquid contents of the stomach
back up into the esophagus
• Liquid can inflame and damage the lining of the esophagus,
causing bleeding or ulcers
• Scars from tissue damage can narrow the esophagus and
make swallowing difficult
• Heartburn is the most common symptom of GERD
• Treatment is usually medications.
4
Body Systems and Related Conditions
7. Describe the gastrointestinal system and related conditions
Remember these care guidelines for GERD:
• Serve evening meal three to four hours before bedtime.
• Keep resident upright at least two to three hours after eating.
• Give residents an extra pillow so the body is more upright
during sleep.
• Serve the largest meal of the day at lunchtime and serve
several small meals throughout the day.
• Reduce fast foods, fatty foods, and spicy foods.
• Stopping smoking, not drinking alcohol, and wearing loosefitting clothes may also help.
4
Body Systems and Related Conditions
Define the following terms:
Ostomy
a surgically-created opening from an area inside the body to
the outside.
Stoma
an artificial opening in the body.
4
Body Systems and Related Conditions
7. Describe the gastrointestinal system and related conditions
Remember these facts about ostomies:
• May be necessary due to bowel disease, cancer, or trauma
• The terms “colostomy” and “ileostomy” tell what part of the
intestine was removed and the type of stool that will be
eliminated.
• In a colostomy, stool will generally be semi-solid.
• With an ileostomy, stool may be liquid.
• Disposable bag fits over the stoma to collect the feces and is
attached to the skin by adhesive. A belt may also be used to
secure it.
4
Body Systems and Related Conditions
7. Describe the gastrointestinal system and related conditions
Remember these guidelines for ostomy care:
• Make sure resident receives good skin care and hygiene.
Ostomy bag should be emptied and cleaned or replaced
whenever stool is eliminated.
• Always wear gloves and wash hands carefully.
• Teach proper handwashing techniques to residents with
ostomies.
• Be sensitive and supportive when working with residents with
ostomies. Always provide privacy for ostomy care.
Caring for an ostomy
Equipment: disposable bed
protector, bath blanket, clean
ostomy bag and
belt/appliance, toilet paper or
gauze squares, basin of warm
water, soap or cleanser,
washcloth, skin cream as
ordered, 2 towels, plastic
disposable bag, gloves
1. Wash hands. Provides for
infection control.
Caring for an ostomy (cont’d.)
2. Identify yourself to
resident by name.
Address resident by
name. Resident has right
to know identity of his or
her caregiver. Identifying
resident by name shows
respect and establishes
correct identification.
3. Explain procedure to
resident, speaking clearly,
slowly, and directly,
maintaining face-to-face
contact whenever
possible. Promotes
understanding and
independence.
Caring for an ostomy (cont’d.)
4. Provide for resident’s
privacy during procedure
with curtain, screen, or
door. Maintains resident’s
right to privacy and
dignity.
5. Adjust bed to a safe
working level, usually
waist high. Lock bed
wheels. Raise head of
bed. Prevents injury to
you and to resident.
Caring for an ostomy (cont’d.)
6. Place bed protector under
resident. Cover resident
with a bath blanket. Pull
down the top sheet and
blankets. Only expose
ostomy site. Offer
resident a towel to keep
clothing dry. Maintains
resident’s right to privacy
and dignity.
7. Put on gloves. Provides
for infection control.
Caring for an ostomy (cont’d.)
8. Remove ostomy bag
carefully. Place it in plastic
bag. Note the color, odor,
consistency, and amount
of stool in the bag.
Changes in stool can
indicate a problem.
9. Wipe area around stoma
with toilet paper or gauze
squares. Discard the
paper/gauze in plastic
bag.
Caring for an ostomy (cont’d.)
10. Using a washcloth and
warm soapy water, wash
the area in one direction,
away from the stoma. Pat
dry with another towel.
Apply cream as ordered.
Keeping skin clean and
dry prevents skin
breakdown.
11. Place the clean ostomy
appliance on resident.
Make sure the bottom of
the bag is clamped.
Caring for an ostomy (cont’d.)
12. Remove disposable bed
protector and discard.
Place soiled linens in
proper container.
13. Remove bag. Discard the
bag in the proper
container.
14. Remove and discard
gloves.
15. Wash hands. Provides for
infection control.
Caring for an ostomy (cont’d.)
16. Return bed to lowest
position. Remove privacy
measures. Lowering the
bed provides for safety.
17. Place call light within
resident’s reach. Signaling
device allows resident to
communicate with staff as
necessary.
Caring for an ostomy (cont’d.)
18. Report any changes in
resident to the nurse.
Report if stoma is very
red or blue, or if swelling
or bleeding is present.
Provides nurse with
information to assess
resident.
19. Document procedure
according to facility
guidelines. What you
write is a legal record of
what you did. If you don’t
document it, legally it
didn’t happen.
4
Body Systems and Related Conditions
Define the following terms:
Glands
structures that produce substances in the body.
Hormones
chemical substances created by the body that control
numerous body functions.
4 Body Systems and Related Conditions
Transparency 4-24: The Endocrine System
4
Body Systems and Related Conditions
8. Describe the endocrine system and related conditions
Remember the following points about the endocrine system:
• Glands are structures that produce substances.
• Hormones are chemical substances created by the body that
regulate essential body processes.
• Hormones are carried by the blood to organs in order to
• Maintain homeostasis
• Influence growth and development
• Regulate blood sugar levels
• Regulate calcium levels in bones
• Regulate the body’s ability to reproduce
• Determine how fast cells burn food for energy
4
Body Systems and Related Conditions
8. Describe the endocrine system and related conditions
Normal changes of aging to the endocrine system include the
following:
• Decrease in levels of hormones, such as estrogen and
progesterone
• Less production of insulin
• Less able to handle stress
4
Body Systems and Related Conditions
8. Describe the endocrine system and related conditions
Think about this question:
How can you help residents with the normal changes of aging to
the endocrine system?
4
Body Systems and Related Conditions
8. Describe the endocrine system and related conditions
Observe and report the following regarding the endocrine
system:
• Headache*
• Weakness*
• Blurred vision*
• Dizziness*
• Hunger*
• Irritability*
• Sweating*
• Change in behavior*
• Change in mobility*
4
Body Systems and Related Conditions
8. Describe the endocrine system and related conditions
Observe and report (cont’d.):
• Change in sensation*
• Numbness or tingling in arms or legs*
• Weight gain/loss
• Loss of appetite/increase in appetite
• Increased thirst
• Frequent urination
• Dry skin
• Skin breakdown
• Sweet or fruity breath
• Sluggishness or fatigue
• Hyperactivity
*Report these immediately
4
Body Systems and Related Conditions
8. Describe the endocrine system and related conditions
Common disorders of the endocrine system include:
• Thyroid disorders include hyperthyroidism (too much thyroid
hormone) and hypothyroidism (too little).
• Diabetes occurs when the body does not produce enough or
properly use insulin. Two major types are:
• Type I (juvenile, appears in childhood)
• Type II (most common, develops slowly after age 35)
4
Body Systems and Related Conditions
Define the following terms:
Diabetes
a condition in which the pancreas does not produce enough or
does not properly use insulin.
Insulin
a hormone that converts glucose into energy for the body.
Glucose
natural sugar.
4
Body Systems and Related Conditions
Define the following terms:
Pre-diabetes
a condition in which a person’s blood glucose levels are above
normal but not high enough for a diagnosis of type 2
diabetes.
Gestational diabetes
type of diabetes that appears in pregnant women who have
never had diabetes before but who have high glucose levels
during pregnancy.
4
Body Systems and Related Conditions
8. Describe the endocrine system and related conditions
Remember these facts about diabetes:
• Pancreas does not produce enough insulin.
• Glucose collects in blood causing circulatory problems.
• Two types are type 1 (diagnosed in children and young adults,
will continue throughout a person’s life) and type 2 (adultonset and milder).
• Pre-diabetes describes blood glucose levels above normal but
not high enough for a diagnosis of type 2 diabetes.
4
Body Systems and Related Conditions
8. Describe the endocrine system and related conditions
These are possible signs of diabetes:
• Excessive thirst
• Extreme hunger
• Frequent urination
• Weight loss
• High levels of blood sugar
• Sugar in urine
• Sudden vision changes
• Tingling or numbness in hands or feet
• Feeling very tired
• Very dry skin
• Sores that are slow to heal
• More infections than usual
4
Body Systems and Related Conditions
8. Describe the endocrine system and related conditions
Complications of diabetes include the following:
• Changes in the circulatory system can cause heart attack,
stroke, poor extremity circulation, poor wound healing, and
kidney and nerve damage.
• Damage to eyes can cause vision loss and blindness.
• Diabetes can lead to leg and foot ulcers, infected wounds, and
gangrene due to poor circulation and impaired wound healing.
• Insulin reaction and diabetic ketoacidosis are serious
complications (see Chapter 2).
4 Body Systems and Related Conditions
Transparency 4-25: Care Guidelines for Diabetes
•
•
•
•
•
•
Follow diet instructions exactly.
Encourage exercise.
Observe residentís management of insulin doses.
Perform urine and blood tests as directed.
Give foot care as directed.
Encourage comfortable, leather footwear and cotton socks.
4
Body Systems and Related Conditions
Define the following terms:
Reproduce
to create new life.
Gonads
sex glands.
4 Body Systems and Related Conditions
Transparency 4-26: The Reproductive System
4
Body Systems and Related Conditions
9. Describe the reproductive system and related conditions
Note the following about the reproductive system:
• Reproductive organs are different in males (testes, scrotum,
testosterone) and females (ovaries, fallopian tubes, estrogen).
4
Body Systems and Related Conditions
9. Describe the reproductive system and related conditions
Normal changes of aging to the reproductive system include the
following:
• Female:
• Menstruation ends.
• Decrease in estrogen leads to loss of calcium, causing
brittle bones.
• Drying and thinning of vaginal walls occurs.
• Male:
• Sperm production decreases.
• Enlargement of the prostate gland occurs.
4
Body Systems and Related Conditions
9. Describe the reproductive system and related conditions
Think about this question:
How can you help residents with the normal changes of aging to
the reproductive system?
4
Body Systems and Related Conditions
9. Describe the reproductive system and related conditions
Observe and report the following regarding the reproductive
system:
• Discomfort or difficulty with urination
• Discharge
• Swelling of genitals
• Blood in urine or stool
• Breast changes, lumps, or discharge
• Sores on genitals
• Reports of impotence
• Reports of painful intercourse
4
Body Systems and Related Conditions
9. Describe the reproductive system and related conditions
Common disorders of the reproductive system include
• Vaginitis
• Benign prostatic hypertrophy
4
Body Systems and Related Conditions
9. Describe the reproductive system and related conditions
Remember these facts about vaginitis:
• Causes:
• Bacteria
• Protozoa
• Fungus
• Hormonal changes after menopause
• Symptoms:
• White vaginal discharge
• Itching and/or burning
• Treatment
• Oral medication
• Vaginal gels or creams
4
Body Systems and Related Conditions
9. Describe the reproductive system and related conditions
Remember these facts about benign prostatic hypertrophy:
• Occurs in men as they age
• Causes:
• Enlarged prostate causes pressure on the urethra, which
leads to problems urinating and emptying the bladder
• Treatment
• Medications
• Surgery
4
Body Systems and Related Conditions
9. Describe the reproductive system and related conditions
REMEMBER:
• Men are also at increased risk for prostate cancer as they age.
• Prostate cancer is usually slow-growing and responsive to
treatment, so early detection is important.
4 Body Systems and Related Conditions
Handout 4-1: Sexually Transmitted Diseases and Infections
Sexually transmitted diseases (STDs), also called venereal
diseases, are diseases passed through sexual contact with an
infected person. This contact includes sexual intercourse, contact
of the mouth with the genitals or anus, and contact of the hands
to the genitals. A person may be infected, and may potentially
infect others, without showing signs of the disease. This is called
a sexually transmitted infection (STI).
Using latex condoms during sexual contact can reduce the
chances of being infected with or passing on some STDs and
STIs. The human immunodeficiency virus (HIV), acquired
immune deficiency syndrome (AIDS), and some kinds of hepatitis
can be sexually transmitted. STDs are very common. They can
cause serious health problems. Residents may be unaware of or
embarrassed by symptoms of an STD. Be professional when
dealing with STDs and STIs. This can help put residents at ease.
4 Body Systems and Related Conditions
Handout 4-1: Sexually Transmitted Diseases and Infections (cont’d.)
Chlamydia infection is caused by organisms in the mucous
membranes of the reproductive tract. Chlamydia can cause
serious infection, including pelvic inflammatory disease (PID) in
women. PID can cause sterility. Signs of chlamydia infection are
yellow or white discharge from the penis or vagina and burning
with urination. It is treated with antibiotics.
Syphilis can be treated effectively in the early stages, but if left
untreated, it can cause brain damage, mental illness, and even
death. Babies born to mothers with syphilis may be born blind or
with other serious birth defects. Syphilis is easier to detect in
men than in women. This is due to open sores called chancres
that form on the penis soon after infection.
4 Body Systems and Related Conditions
Handout 4-1: Sexually Transmitted Diseases and Infections (cont’d.)
The chancres are painless and can go unnoticed. If untreated, the
infection spreads to the heart, brain, and other vital organs.
Common symptoms at this stage include rash, sore throat, or
fever. When detected, syphilis can be treated with penicillin or
other antibiotics. The sooner it is treated, the better the chances
of preventing long-term damage and avoiding infection of others.
Gonorrhea, like syphilis, can be treated with antibiotics and is
easier to detect in men than in women. If untreated, gonorrhea
can cause sterility in both men and women. Most women with
gonorrhea show no early symptoms. This makes it easy for
women to spread the disease. Men with gonorrhea will often
show a greenish or yellowish discharge from the penis within a
week after infection. Burning with urination is another common
symptom in men.
4 Body Systems and Related Conditions
Handout 4-1: Sexually Transmitted Diseases and Infections (cont’d.)
Herpes simplex 2, unlike the other STDs discussed here, is
caused by a virus. It cannot be treated with antibiotics. Once
infected with the herpes virus, a person cannot be cured. The
person may have repeated outbreaks of the disease for the rest
of his or her life. A herpes outbreak includes burning, painful, red
sores on the genitals. These heal in about two weeks. The sores
are infectious, but a person with herpes virus can also spread the
infection when sores are not present.
Some people infected with herpes never have repeated
outbreaks. The later episodes may not be as painful as the first
outbreak. Antiviral drugs can help people stay symptom-free
longer. Babies born to women infected with herpes simplex 2 can
be infected during birth. Pregnant women experiencing a herpes
outbreak are usually delivered by cesarean section, or C-section.
4
Body Systems and Related Conditions
Define the following term:
Lymph
A clear yellowish fluid that carries disease-fighting cells called
lymphocytes.
4 Body Systems and Related Conditions
Transparency 4-27: The Lymphatic System
4
Body Systems and Related Conditions
10. Describe the immune and lymphatic systems and related
conditions
Remember the following points about the lymphatic system:
• Function of system is to remove excess fluids and waste
products as well as to help the immune system to fight
infections.
• It is closely related to the circulatory system because lymph
fluid, after being purified in the lymph nodes, flows into the
bloodstream.
• It has no pump, but is circulated by muscle activity, massage,
and breathing.
• Nonspecific immunity protects the body from disease in
general. Specific immunity protects against a particular
disease that is invading the body at a given time.
4
Body Systems and Related Conditions
10. Describe the immune and lymphatic systems and related
conditions
Normal changes of aging to the immune and lymphatic systems
include the following:
• Increased risk of infections due to weaker immune system
• Decreased response to vaccines
4
Body Systems and Related Conditions
10. Describe the immune and lymphatic systems and related
conditions
Think about this question:
How can you help residents with the normal changes of aging to
the lymphatic and immune systems?
4
Body Systems and Related Conditions
10. Describe the immune and lymphatic systems and related
conditions
Observe and report the following regarding the immune and
lymphatic systems:
• Recurrent infections
• Swelling of lymph nodes
• Increased fatigue
4
Body Systems and Related Conditions
10. Describe the immune and lymphatic systems and related
conditions
HIV/AIDS affects the immune and lymphatic systems:
• Acquired immunodeficiency syndrome (AIDS) is caused by
HIV (human immunodeficiency virus).
• HIV attacks the immune system and disables it.
• HIV is transmitted by sexual contact, blood, infected needles,
or from mother to fetus.
• Symptoms at transmission are like flu.
• Later symptoms include infections, tumors, and central
nervous system symptoms.
• Late stage is AIDS dementia complex.
4
Body Systems and Related Conditions
10. Describe the immune and lymphatic systems and related
conditions
Signs and symptoms of HIV/AIDS include the following:
• Appetite loss
• Involuntary weight loss
• Flu-like symptoms
• Night sweats
• Swollen lymph nodes
• Severe diarrhea
• Dry cough
• Skin rashes
4
Body Systems and Related Conditions
10. Describe the immune and lymphatic systems and related
conditions
Signs and symptoms of HIV/AIDS (cont’d.):
• Painful white spots in mouth
• Cold sores
• Warts on the skin and in mouth
• Inflamed and bleeding gums
• Low resistance to infection
• Bruising that does not go away
• Kaposiís sarcoma
• AIDS dementia complex
4
Body Systems and Related Conditions
10. Describe the immune and lymphatic systems and related
conditions
REMEMBER:
• Opportunistic infections invade the weakened body of a
resident with AIDS.
• Treatment is medication.
• Drugs slow the progress but there is no cure for the disease.
4 Body Systems and Related Conditions
Handout 4-2: Myths About HIV and AIDS
Myth: If I am HIV positive, that means I have AIDS.
Fact: HIV positive means that your body was exposed to the
virus. Since your body was exposed, there is a good chance that
you are infected with the virus. But it does not mean that you
have AIDS. AIDS develops over time.
Myth: HIV is the same as AIDS.
Fact: HIV is the virus that causes AIDS. AIDS is a group of
symptoms that develop during the last stage of HIV infection.
4 Body Systems and Related Conditions
Handout 4-2: Myths About HIV and AIDS
Myth: I can get HIV from an infected person by shaking hands,
hugging, or kissing.
Fact: HIV is not spread through casual contact. There is a slight
possibility that you could become HIV infected through kissing if
you and the infected person both have open bleeding sores in
your mouths and the infected person’s blood gets into yours. If
you are really worried about this, do an oral exam on your
partner before kissing him or her.
Myth: I can get HIV from telephones.
Fact: The HIV virus can't live outside of the body. You cannot
become infected through saliva.
Myth: I can get HIV from doorknobs, tables, chairs, or
push buttons.
Fact: The HIV virus can't live outside of the body.
4 Body Systems and Related Conditions
Handout 4-2: Myths About HIV and AIDS (cont’d.)
Myth: I can get HIV from eating food that was prepared by an
infected person.
Fact: Once again, HIV dies very quickly outside the body. Even if
the food prep person cut his finger and then attractively arranged
your food on your plate, you would not become infected from
eating this food. Once any body fluid is dry, you can be
absolutely sure that the virus is dead. Just about the only way
you could become infected this way is if the food prep person
cuts off a finger, and as he is bleeding in your food, you are
eating it at that exact moment. This scenario is rather extreme.
4 Body Systems and Related Conditions
Handout 4-2: Myths About HIV and AIDS (cont’d.)
Myth: I can get HIV from toilets.
Fact: Toilets have been blamed for just about everything, from
getting you pregnant to giving you sexually transmitted diseases
(STD). The only way you might possibly become HIV infected
from a toilet seat is to have unprotected sex while sitting on it!
Myth: I can get HIV from mosquitoes.
Fact: Although it sounds very possible, you cannot become HIV
infected through mosquitoes, fleas, ticks, or lice. For this to
happen, the HIV would have to survive in the insect saliva and
salivary glands. HIV is a human virus and cannot survive outside
of the human body. As a result, HIV will not and does not survive
in mosquitoes, fleas, ticks, or lice. If this were a route of
transmission, we would all have been infected a very long time
ago.
4 Body Systems and Related Conditions
Handout 4-2: Myths About HIV and AIDS (cont’d.)
Myth: I can get HIV from breathing the same air as an infected
person.
Fact: HIV does not spread through the air. You cannot get HIV by
being in the same room with someone who is infected with the
virus.
4 Body Systems and Related Conditions
Transparency 4-28: Care Guidelines for HIV/AIDS
• Wash hands often. Follow Standard Precautions, and keep
everything clean.
• High-protein, high-calorie, high-nutrient meals can help
maintain healthy weight.
• Help make mealtimes pleasant and relaxing. Know
residents’ favorite foods. Notify nurse of appetite
loss/difficulty eating.
• If residents have infections in the mouth they may need
food that is low in acid/spice and neither cold nor hot. Good
mouth care is vital.
• Small, frequent meals can help with nausea. Help ensure
adequate fluid intake.
4 Body Systems and Related Conditions
Transparency 4-28: Care Guidelines for HIV/AIDS (cont’d.)
• If diarrhea is severe, doctor may order “BRAT” diet
(bananas, rice, apples, toast). This is helpful short-term.
• Good rehydration fluids include water, juice, soda and
broth. Avoid caffeinated beverages.
• Numbness, tingling, and pain in the feet and legs is usually
treated with medications. Going barefoot or wearing loose,
soft slippers may help. Bed cradle may be used.
• Treat residents with respect and provide emotional support.
• Provide safe environment and close supervision in ADLs.
4
Body Systems and Related Conditions
10. Describe the immune and lymphatic systems and related
conditions
Think about these questions:
• Why might a resident with AIDS be under extra emotional
stress?
• Why might be some of the special challenges of caring for
residents with AIDS?
4
Body Systems and Related Conditions
10. Describe the immune and lymphatic systems and related
conditions
REMEMBER:
• Results of HIV testing (whether of residents or staff) are
confidential and cannot be discussed with anyone.
• Serious violations apply under HIPAA if confidentiality is
breached.
4
Body Systems and Related Conditions
Define the following term:
Tumor
a group of abnormally growing cells.
4
Body Systems and Related Conditions
10. Describe the immune and lymphatic systems and related
conditions
Cancer is a disorder of the immune and lymphatic systems:
• General term meaning many types of malignant tumors.
• Tumors can be benign (non-cancerous, usually grow slowly)
or malignant (cancerous, grow rapidly).
• There is no cure.
• It may spread to other areas of the body, affecting other body
systems.
• Cancer often first appears in breast, colon, rectum, uterus,
prostate, lungs or skin
4
Body Systems and Related Conditions
10. Describe the immune and lymphatic systems and related
conditions
The following are risk factors for cancer:
• Tobacco use
• Exposure to sunlight
• Excessive alcohol use
• Some food additives
• Exposure to some chemicals and industrial agents
• Radiation
• Poor nutrition
• Lack of physical activity
4
Body Systems and Related Conditions
10. Describe the immune and lymphatic systems and related
conditions
The American Cancer Society has identified warning signs of
cancer:
• Unexplained weight loss
• Fever
• Fatigue
• Pain
• Skin changes
• Change in bowel or bladder habits
4
Body Systems and Related Conditions
10. Describe the immune and lymphatic systems and related
conditions
Warning signs of cancer (cont’d.):
• Sores that do not heal
• Unusual bleeding or discharge
• Thickening or lump in breast or other part of body
• Indigestion or difficulty swallowing
• Recent change in wart or mole
• Nagging cough or hoarseness
4
Body Systems and Related Conditions
10. Describe the immune and lymphatic systems and related
conditions
Treatments for cancer include
• Surgery
• Chemotherapy
• Radiation
4 Body Systems and Related Conditions
Transparency 4-29: Care Guidelines Cancer
• Each case is different. Do not make assumptions.
• Respect residents’ needs and be sensitive. Have a positive
attitude.
• Try plastic utensils for residents receiving chemotherapy.
Encourage a variety of food.
• Watch for signs of pain and report them to the nurse.
• Give back rubs for comfort. Reposition residents.
• Use lotion on dry skin. Do not remove markings. Give back
rubs.
• Assist with oral care often. Use a soft-bristled toothbrush
and baking soda rinse.
• Provide help with grooming.
• Encourage visitors. Suggest good times of the day for
visits. Get to know residents’ interests.
• Be alert to needs not being met or stresses.
4
Body Systems and Related Conditions
10. Describe the immune and lymphatic systems and related
conditions
Report the following signs and symptoms and cancer:
• Increased weakness or fatigue
• Weight loss
• Nausea, vomiting, diarrhea
• Changes in appetite
• Fainting
• Signs of depression
4
Body Systems and Related Conditions
10. Describe the immune and lymphatic systems and related
conditions
Signs and symptoms of cancer to report (cont’d.):
• Confusion
• Blood in stool or urine
• Change in mental status
• Changes in skin
• New lumps, sores, rashes
• Increase in pain or unrelieved pain
4
Body Systems and Related Conditions
Chapter Exam
Multiple Choice.
1. Which of the following statements is true of the skin?
(A) It feels heat, cold, pain, touch, and
pressure.
(B) It becomes more elastic as a person ages.
(C) It is the chemical substance that is created by the body and
controls body functions.
(D) It becomes thicker as a person ages.
2. A resident with a head or spinal cord injury should be repositioned at
least every ___hours.
(A) 2
(B) 3
(C) 4
(D) 5
4
Body Systems and Related Conditions
Chapter Exam (cont’d.)
3. One way a nursing assistant can help with normal changes of aging
related to the integumentary system is to
(A) Withhold fluids so a resident will not go to the bathroom often.
(B) Clip toenails frequently.
(C) Keep sheets wrinkle-free.
(D) Rub lotion into red or irritated spots on the resident’s skin.
4. When atrophy occurs,
(A) The muscle slowly becomes stronger
(B) The muscle increases in size
(C) The muscle stays about the same
(D) The muscle decreases in size
4
Body Systems and Related Conditions
Chapter Exam (cont’d.)
5.When a hip has been replaced
(A) Dress the unaffected, or stronger, side first
(B) Place items far away from the resident to force him to walk
(C) The hip cannot be bent or flexed more than 90 degrees
(D) Perform range of motion exercises on the side that has the hip
replacement
6.Arthritis can be the result of an autoimmune illness. With an
autoimmune illness the body’s ______system attacks normal tissue.
(A) Immune
(B) Lymphatic
(C) Circulatory
(D) Endocrine
4
Body Systems and Related Conditions
Chapter Exam (cont’d.)
7.Which of the following is a function of the nervous system?
(A) Gives the body shape and structure
(B) Provides a natural protective covering to the body
(C) Produces and supplies antibodies and other infection-fighting
blood cells
(D) Senses and interprets information from outside the body
8.The eye and ear are part of
(A) The body’s sense organs
(B) The integumentary system
(C) The dermis
(D) The circulatory system
4
Body Systems and Related Conditions
Chapter Exam (cont’d.)
9.Which of the following is helpful when providing skin care for a
resident with cancer?
(A) Do not use lotion on dry, delicate skin.
(B) Do not offer backrubs.
(C) Avoid applying lotion to areas receiving radiation therapy.
(D) Avoid moving the resident at all.
10. Which of the following statements is true of assisting a resident with
one-sided weakness after a stroke?
(A) Lead with the weaker side.
(B) Stand on the weaker side.
(C) Use the terms “bad” or “messed up” to refer to weaker side.
(D) A gait belt is not helpful during transfers.
4
Body Systems and Related Conditions
Chapter Exam (cont’d.)
11. Guidelines for caring for a resident with multiple sclerosis include
(A) Rushing resident through tasks
(B) Administering medications
(C) Preventing falls
(D) Encouraging the resident to speak faster
12. Osteoporosis causes
(A) Menopause
(B) Stooped posture
(C) Supplements
(D) Lack of hormones
4
Body Systems and Related Conditions
Chapter Exam (cont’d.)
13. Residents with COPD have trouble with
(A) Breathing
(B) Urination
(C) Losing weight
(D) Vision
14. How should a resident with COPD be positioned?
(A) Flat on his back
(B) Sitting upright
(C) Lying on his stomach
(D) Lying on his side
4
Body Systems and Related Conditions
Chapter Exam (cont’d.)
15. Which of the following is one of the functions that the circulatory
system performs?
(A) Senses and interprets information from the environment
(B) Cushions the brain and spinal cord
(C) Allows humans to reproduce
(D) Supplies food, oxygen, and hormones to cells
16. Which of the following is helpful for numbness, tingling, and pain in
the feet for a resident who has AIDS?
(A) Wrapping the feet tightly in elastic bandages
(B) Wearing snug, firm slippers
(C) Wearing rigid, high-topped shoes
(D) Going barefoot
4
Body Systems and Related Conditions
Chapter Exam (cont’d.)
17. Respiration consists of
(A) Narrowing of blood vessels
(B) Inspiration and expiration
(C) Circulating blood in the heart
(D) Urinary elimination
18. The respiratory system is made up of
(A) Arteries, veins, capillaries
(B) Brain, spinal cord, nerves
(C) Trachea, bronchi, lungs
(D) Atria, ventricles, aorta
4
Body Systems and Related Conditions
Chapter Exam (cont’d.)
19. High blood pressure
(A) Can be detected just by looking at a person
(B) Cannot be treated with medication
(C) Is never a serious condition
(D) Is a measurement of 140/90 or higher
20. Which of the following is helpful for a resident who has had a heart
attack?
(A) Smoking
(B) High-fat diet
(C) Regular exercise
(D) Cold temperatures
4
Body Systems and Related Conditions
Chapter Exam (cont’d.)
21. Residents with congestive heart failure may
(A) Be on a high-sodium diet
(B) Take medications that cause them to urinate less often
(C) Have a “force fluids” order
(D) Use elastic stockings to reduce swelling in feet and ankles
22. What is one good way a nursing assistant can assist residents with
normal changes of aging related to the urinary system?
(A) Offer frequent trips to the bathroom.
(B) Withhold fluids.
(C) Scold residents who are incontinent.
(D) Make sure every resident wears incontinence briefs.
4
Body Systems and Related Conditions
Chapter Exam (cont’d.)
23. Why are females more likely to have urinary tract infections than
males?
(A) Due to the different location of the meatus
(B) Due to having a shorter urethra
(C) Due to not filtering blood properly in the kidneys
(D) Due to incontinence
24. Normal changes of aging for the female reproductive system
include:
(A) Menstruation continues
(B) Increased moisture of vaginal walls
(C) Voice weakens
(D) Loss of calcium
4
Body Systems and Related Conditions
Chapter Exam (cont’d.)
25. The yellowish fluid that carries disease-fighting cells is called
(A) Sperm
(B) Lymph
(C) Urine
(D) Blood
26. How does the immune system protect the body from disease?
(A) Through nonspecific and specific immunity
(B) Through hormones
(C) Through digestion and elimination
(D) Through changes in pulse rate
4
Body Systems and Related Conditions
Chapter Exam (cont’d.)
27. A diabetic resident should
(A) Skip meals
(B) Go barefoot
(C) Receive careful foot care
(D) Avoid exercise
28. What can a nursing assistant do to help prevent urinary tract
infections (UTIs)?
(A) Restrict fluids
(B) Encourage baths, rather than showers
(C) Wipe from front to back when giving perineal care
(D) Ask the resident not to drink cranberry or blueberry juice
4
Body Systems and Related Conditions
Chapter Exam (cont’d.)
29. What can be done to help a resident who has gastroesophageal
reflux disease (GERD)?
(A) Serve spicy foods.
(B) Ask the resident not to lie down for at least two to three hours
after eating.
(C) Serve the largest meal of the day at dinner.
(D) Assist the resident to eat in a reclined position.