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NURSING CARE FOR SPECIAL GROUPS:CHILDREN,ADOLESCENTS,ADULT,WOMAN AND ELDERLY INTRODUCTION The period of growth and development extends throughout the life cycle.the scope of community health is very extensive,and community health services have different aspects. Providing community health services to every class or group of the community is the chief aim of community health nursing.community health nurse provided their services at different stages of life that are as follow:- ADULT NURSING C
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  NURSING CARE FOR SPECIAL GROUPS:CHILDREN,ADOLESCENTS,ADULT,WOMAN AND ELDERLY INTRODUCTION The period of growth and development extends throughout the life cycle.the scope of community health is very extensive,and community health services have different aspects. Providing community health services to every class or group of the community is the chief aim of community health nursing.community health nurse provided their services at different stages of life that are as follow:-  ADULT NURSING CARE The young middle adulthood is a period of challenges,reward and crises. The population in adult primary care practice includes adolescents and young, middle, and older adults. 1.HEALTH PROMOTION, HEALTH PROTECTION, DISEASE PREVENTION, AND TREATMENT A. Assessment of Health Status:-  The adult nurse practitioner employs evidence-based clinical practice guidelines to guide   screening activities, identifies health promotion needs, and provides anticipatory guidance and   counseling addressing environmental, lifestyle, and developmental issues. 1. Obtains and accurately documents a relevant health history for adolescents and adults. 2. perform and accurately documents complete, system, or symptom-specific physical examinations on adults (including developmental evaluations, physical system evaluations, and behavioral evaluations. 3. Assesses the impact of family, community, environment, home, economic, work environments on an individual’s health status.  4. Performs screening evaluations for mental health, substance abuse, and violence. 5. Distinguishes between normal and abnormal change with aging 6. Assesses adolescents and adults throughout the stages of chronic illness. 7. Assesses for common occupational, home, and recreational exposures that affect health. 8. Assesses the effect of illness and/or injury on the individual: a. Functional status. b. Ability to work or return to work/school. c. Physical and mental status. d. Social relationships. 9. Assesses the changing impact and reciprocal effects of acute illness and known chronic health problems in adults. 10. Analyzes the multiple effects of pharmacologic agents, including over-the-counter (OTC) preparations and folk remedies, in adolescents and adults with multiple health problems.  11. Assesses the impact of family transitions, such as death, divorce, marriage, employment and retirement, on the health issues of adolescents and adults 12. Distinguishes ethnic and gender differences in presentation and progression of common acute and chronic health problems in adolescents and adults 13. Assesses for psychological manifestations of health problems in adolescents and adults. B. Diagnosis of Health Status:- The adult nurse practitioner is engaged in the diagnosis of health status. This diagnostic process   includes critical thinking, differential diagnosis, and the integration and interpretation of various forms   of data. 1. Discriminates among multiple potential mechanisms causing signs and symptoms of health problems commonly diagnoses in adults and adolescents. 2. Identifies both typical and atypical presentations of commonly occurring health problems in adolescents and adults. 3. Differentiates between signs and symptoms indicating exacerbation and/or remission of a chronic health problem and signs and symptoms of a new problem . 4. Diagnoses commonly occurring complications of chronic health problems, including psychological/mental health manifestations. 5. Diagnoses commonly occurring acute and chronic health problems in adolescents and adults with an emphasis on multi-system health problems 6. Diagnoses common mental health and substance abuse problems such as anxiety, depression, obesity, alcohol, and drug abuse. C. Plan of Care and Implementation of Treatment 1. Participates in the development and implementation of health promotion programs for adolescents and adults 2. Designs health maintenance and disease prevention interventions for adolescents and adults. 3. Provides age-relevant health promotion that reflects understanding of gender differences in adolescents and adults. 4. Incorporates prevention for work-related risks and exposures in the plan of care. 5. Provides secondary and tertiary preventive interventions to adolescents and adults with multiple and/or chronic health problems. 6. Provides anticipatory guidance and counseling to adolescents and adults and assists them to cope with the competing concerns of multigenerational family members. 7. Manages commonly-occurring acute and chronic physical and mental health problems in adolescents and adults to promote health, function, and quality of life and reduce disability and complications. 8. Plans for long-term management of common health problems in adolescents and adults. 9. Treats common complications of chronic and/or multi-system health problems in adults and adolescents. 10. Promotes self-care by adolescents and adults within the constellation of the family and/or support system and facilitates their participation in care when appropriate. 11. Evaluates the response of both the individual and the family to the health care provided. 12. Advocates for the patient’s/family’s rights regarding decision making as appropriate regarding durable power of attorney, advance directives, and other related issues. 13. Applies research that contributes to positive change in the health of or health care delivered to adolescents and adults.  14. Promotes comprehensive care and continuity of care in both primary care and specialty practice. 15. Recognizes the importance of participation in community and professional organizations that influence the health of adolescents and adults and supports the role of the adult nurse practitioner. 16. Interprets the adult nurse practitioner role in primary and specialty health care to other health care providers and the public. 17. Serves as a resource in the design and development of adult community-based health services. C. MANAGING AND NEGOTIATING HEALTH CARE DELIVERY SYSTEMS 1. Works collaboratively with a variety of health professionals to promote restoration of health and safe optimal functioning of adolescents and adults. GERONTOLOGICAL NURSING CARE I. HEALTH PROMOTION, HEALTH PROTECTION, DISEASE PREVENTION, AND TREATMENT Within this the nurse synthesizes theoretical, scientific, and contemporary clinical knowledge for the assessment and management of both health and illness states. These competencies incorporate the health promotion, health protection, disease prevention, and treatment focus of gerontological practice. A. Assessment of Health Status These competencies describe the role in assessing all aspects of the patient’s health status, including for purposes of health promotion, health protection, and disease prevention. The gerontological nurse practitioner employs evidence-based clinical practice guidelines to guide screening activities, identifies health promotion needs, and provides anticipatory guidance and counseling addressing environmental, lifestyle, and developmental issues. 1. Analyzes the relationship between normal physiology and specific system alterations produced by aging and disease processes. 2. Assesses the developmental status regarding maintenance of self-identity through later and final stages of life. 3. Assesses the dynamic interaction between acute illness and known chronic health problems in older adults. 4. Assesses elders and caregivers for abuse and/or neglect. 5. Assesses for addictive behavior. 6. Assesses health/illness by conducting a complete health history in light of physiologic and psychosocial changes of aging. 7. Performs a comprehensive physical exam considering physiologic changes of aging. 8. Performs a comprehensive functional assessment, including mental status, social support, and nutrition. 9. Assesses special risks of institutionalized older adults for common patterns of illness and communicable disease. 10. Assesses sexual function and sexual well-being in older adults. B. Diagnosis of Health Status  1. Recognizes the commonly occurring conditions associated with aging, including differential diagnosis of delirium, dementia, and/or depression. 2. Implements screening using appropriate, age-specific instruments and guidelines and interprets results in light of expected changes associated with aging. 3. Applies knowledge of atypical presentations of disease seen with aging to the formulation of differential diagnoses. 4. Plans diagnostic strategies and orders, performs, and interprets results of laboratory tests, clinical procedures, and other tests used in diagnosis and management of older adults with specific organ system alterations. C. Plan of Care and Implementation of Treatment 1. Treats acute and chronic illness and geriatric syndromes frequently manifested in older adults such as incontinence, falls, constipation, loss of functional abilities, dehydration, dementia, depression,delirium, and malnutrition. 2. Adapts interventions to meet the complex needs of older adults and frail elders arising from normal changes of aging, multiple system problems, psychosocial, and financial issues. 3. Plans therapeutic interventions to restore or maintain optimal level of functioning and when appropriate plans for palliative care. 4. Prescribes medications with knowledge of pharmacodynamics and pharmacokinetic processes in older adults with high potential for adverse drug outcomes and polypharmacy. 5. Works with an interdisciplinary health care team to plan and deliver skilled gerontological care to older adults. 6. Prescribes and monitors ancillary therapies for older adults in various settings (e.g. physical therapy and nutritional therapy). 7. Formulates and implements a plan of care related to sexual health and functioning in older men and women. 8. Applies research that is older adult-centered and contributes to positive change in the health of or health care delivered to older adults. II. NURSE PRACTITIONER-PATIENT RELATIONSHIP 1. Facilitates informed and appropriate transition of older adults from one level of care to another. 2. Assesses the impact of congregate/institutional living upon health/wellness of the residents and family. 3. Assists older adults and their families dealing with grief and bereavement. 4.  Assists older adults, family members, and caregivers in maintaning the older adult’s sense of autonomy. III. TEACHING-COACHING SERVICES 1. Adapts teaching-learning approaches to physiological changes associated with aging. 2. Analyzes the impact of aging on the ability and readiness to learn and tailors approaches accordingly to avoid information overload. 3. Includes caregivers in teaching-learning activities when appropriate. 4. Creates an educational approach/learning environment for older adults, families, and caregivers with focus on optimal functioning. 5. Recognizes and utilizes the contributions of family and caregivers when eliciting information. 6. Demonstrates knowledge and skill in addressing sensitive topics with older adults such as sexuality,finances, mental health, substance abuse, and terminal illness.
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