MISAMIS OCCIDENTAL TECHNOLOGICAL INSTITUTE

OROQUIETA CITY

CAREGIVING NC II

MODULE TITLE: BASIC KNOWLEDGE

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 Basic Knowledge

Anatomy, Physiology, Pathophysiology

Anatomy - is the study of the structure and relationship between body parts.

Physiology - is the study of the function of body parts and the body as a whole.

Pathophysiology - (“Patho” means abnormal) the study of the essential nature of diseases especially of the structural
and functional changes and abnormalities produced by them.

Organizations of Living Systems

Atom
At the chemical level, atoms, molecules (combinations of atoms), and the chemical bonds between atoms
provide the framework upon which all living activity is based.

Cell
The cell is the smallest unit of life. Cells themselves may be specialized. Thus, there are nerve cells, bone cells,
and muscle cells.

Tissue
A tissue is a group of similar cells performing a common function. Muscle tissue, for example, consists of
muscle cells.

Organ
An organ is a group of different kinds of tissues working together to perform a particular activity. The heart is
an organ composed of muscle, nervous, connective, and epithelial tissues.

System
An organ system is two or more organs working together to accomplish a particular task. The digestive system,
for example, involves the coordinated activities of many organs, including the mouth, stomach, small and large
intestines, pancreas, and liver.

Organism
An organism is a system possessing the characteristics of living things—the ability to obtain and process
energy, the ability to respond to environmental changes, and the ability to reproduce.

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 Body Orientation and Direction

 Anterior (or ventral) Describes the front or direction toward the front of the body. The toes are anterior to the foot.
 Posterior (or dorsal) Describes the back or direction toward the back of the body.
 Superior (or cranial) describes a position above or higher than another part of the body.
 Inferior (or caudal) describes a position below or lower than another part of the body; near or toward the tail (in
humans, the coccyx, or lowest part of the spinal column). The pelvis is inferior to the abdomen.
 Lateral describes the side or direction toward the side of the body.
 Medial describes the middle or direction toward the middle of the body.
 Proximal describes a position in a limb (hands or legs) that is nearer to the point of attachment or the trunk of the
body. Shoulder is proximal to the center of the body than the fingers.
 Distal describes a position in a limb (hands or legs) that is farther from the point of attachment or the trunk of the
body. Fingers are distal to the center of the body than the shoulder.
 Superficial describes a position closer to the surface of the body. The skin is superficial to the bones.
 Deep describes a position farther from the surface of the body. The brain is deep to the skull.

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Body Cavities

A body cavity is any hollow space or compartment that accommodate organs and other structures. These cavities
contain and protect delicate internal organs.
The dorsal (posterior) cavity and the ventral (anterior) cavity are the largest body compartments.

1. Anterior (Ventral) Cavities

The anterior (ventral) cavity allows for significant changes in the size and shape of the organs as they perform their
functions. The lungs, heart, stomach, and intestines, for example, can expand and contract without distorting other
tissues or disrupting the activity of nearby organs.

A. Thoracic Cavity
- is the more superior subdivision of the anterior cavity, and it is enclosed by the rib cage.
- The thoracic cavity contains the lungs and the heart, which is located in the mediastinum.
- The diaphragm forms the floor of the thoracic cavity and separates it from the more inferior
abdominopelvic cavity.

B. Abdominal Cavity
- is the largest cavity in the body, the division that houses the digestive and urinary organs such as
the kidneys, ureters, stomach, intestines, liver, gallbladder, and pancreas.

C. Pelvic Cavity
- enclosed by the pelvis and contains bladder, anus and reproductive organs.

2. Posterior (dorsal) Cavity

Together the cranial cavity and spinal (or vertebral) cavity can be referred to as the dorsal body cavity.

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 Just as the brain and spinal cord make up a continuous, uninterrupted structure, the cranial and spinal cavities
that house them are also continuous. The brain and spinal cord are protected by the bones of the skull and
vertebral column and by cerebrospinal fluid, a colorless fluid produced by the brain, which cushions the brain and
spinal cord within the posterior (dorsal) cavity.

A. Cranial Cavity
- The cranial cavity is a large, bean-shaped cavity filling most of the upper skull where the brain is located.

B. Spinal Cavity or Vertebral Cavity

- The spinal cavity is a very narrow, thread-like cavity running from the cranial cavity down the entire length
of the spinal cord.

Abdominopelvic Quadrants

By dividing the abdomen into four imaginary quadrants the caregiver can refer to assessment findings and record them
in relation to each quadrant. Landmarks helps in mapping out the abdominal region. For example, you may determine
that the client is experiencing discomfort over the left lower quadrant (LLQ).

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Cancer

Cancer refers to any one of a large number of diseases characterized by the development of abnormal cells that divide
uncontrollably and have the ability to infiltrate and destroy normal body tissue. Cancer often has the ability to spread
throughout your body. Cancer cells are commonly characterized by abnormal increase in number and size.

Cells have many different mechanisms to restrict cell division, repair DNA damage, and prevent the development of
cancer. Because of this, it’s thought that cancer develops in a multi-step process, in which multiple mechanisms must
fail before a critical mass is reached and cells become cancerous.

Specifically, most cancers arise as cells acquire a series of mutations (change in DNA) that make them divide more
quickly, escape internal and external controls on division, and avoid programmed cell death.

Hypothetical example, a cell might first lose activity of a cell cycle inhibitor, an event that would make the cell’s
daughter cells divide a little more rapidly. It’s unlikely that they would be cancerous, but they might form a benign
tumor, a mass cells that divide too much but don’t have the potential to invade other tissues. Over time, a mutation
might take place in one of the daughter cells, causing increased activity of a positive cell cycle regulator. The mutation
might not cause cancer by itself, but the offspring of this cell would divide even faster, creating a larger pool of cells in
which a third mutation could take place. Eventually, one cell might gain enough mutations to take on the characteristics
of a cancer cell and give rise to a malignant tumor, a group of cells that divide excessively and can invade other tissues.

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The Skin (Integumentary System)

1. The skin is the largest organ of the body.

2. The primary function of the skin is to act as a barrier. The skin provides protection from: mechanical impacts
and pressure, variations in temperature, micro-organisms, radiation and chemicals.

Sweat gland

Epidermis
- makes new skin cells, gives skin its color, protects the body.
- The color of our skin is produced by a pigment called melanin, which is produced by melanocytes; these
are found in the epidermis and protect the skin from UV rays.

Dermis
- makes sweat (sweat gland) and oil (sebaceous gland), provides sensations and blood to the skin, grows
hair.

Hypodermis
- The deepest layer is called subcutaneous tissue mostly made of fat; it is not technically part of the skin but
helps attach the skin to underlying bone and muscle.
- The high levels of fat help insulate the body and prevent us from losing too much heat. The fat layer also
acts as protection, padding our bones and muscles.

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Pressure Ulcer

Bedsores — also called pressure ulcers and decubitus ulcers — are injuries to skin and underlying tissue resulting from
prolonged pressure on the skin. Bedsores most often develop on skin that covers bony areas of the body, such as the
heels, ankles, hips and tailbone.

People most at risk of bedsores are those with a medical condition that limits their ability to change positions or those
who spend most of their time in a bed or chair.

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Musculoskeletal System

The human musculoskeletal system is an organ system that gives humans the ability to move using their muscular and
skeletal systems. The musculoskeletal system provides form, support, stability, and movement to the body.

The Skeleton

It protects the internal organs, supports and gives shape

to the body and allows for movement. It also is the site
of blood cell production, which occurs in the marrow of
some bones.

The axial skeleton consists of:

the skull

 the vertebral column (spine)

 the thoracic (rib cage)

The appendicular skeleton consists of:

 the pectoral girdle (shoulders):

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  upper and lower limbs (arms and legs)

 the pelvic girdle (hip bones)

The Muscles

The body contains three types of muscle tissue: skeletal muscle, smooth muscle, and cardiac muscle.

 Skeletal muscle is voluntary. These are the muscles that attach to bones and control conscious movement.

 Smooth muscle is involuntary. These muscles continue to function without conscious knowing or control of the
person. It is found in the hollow organs of the body, such as the stomach, intestines, and around blood
vessels.

 Cardiac muscle is involuntary. It is found only in the heart and is specialized to help pump blood throughout
the body.

Joints, Ligaments, and Tendons

Joints

The point at which two or more bones connect, can be fixed, slightly movable, or freely movable.

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Types of Joints:

Immovable (Fibrous/ fiber) Joints

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 - Immovable or fibrous joints are those that do not allow movement (or allow for only very slight movement) at
joint locations. Bones at these joints have no joint cavity and are held together structurally by thick fibrous
connective tissue, usually collagen. These joints are important for stability and protection.
- Fibrous joints connect bones of the skull, holds a tooth in place in its socket in the upper and lower jaw.

Slightly Movable (Cartilage) Joints

- Slightly movable joints permit some movement but provide less stability than immovable joints. Found
between certain bones of the rib cage and intervertebral discs located between spinal vertebrae.

Freely Movable (Synovial fluid) Joints

- Freely movable joints are classified structurally as synovial joints. Unlike fibrous and cartilaginous joints,
synovial joints have a joint cavity (space filled with synovial fluid) between connecting bones. Synovial joints
allow for greater mobility but are less stable than fibrous and cartilaginous joints.
- Examples of synovial joints include joints in the wrist, elbow, knees, shoulders, and hip.

Ligaments

Help stabilize the joint, keeping it from moving outside of its intended range of motion. Ligament attaches bone to
another bone.

Tendon

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Connect the skeletal system to the muscular system by attaching muscle to bone. When muscle contracts, the tendon
acts on the bone, causing movement.

Bones and Spine Problems:

1. Osteoporosis - the bones become porous, weak and brittle that can develop compression fractures causing the
bones to collapse a bit.
2. Scoliosis - which always refers to the abnormal sideways curves of the spine.
3. Lordosis - refers to the abnormal inward curvatures of the spine.
4. Kyphosis - refers to the abnormal outward curvature of the spine.

Scoliosis Lordosis Kyphosis

Joint Problems:

1. Osteoarthritis

It's the "wear and tear" that happens when your joints are overused. It usually happens with age, but it can also
come from joint injuries or obesity, which puts extra stress on your joints. Cartilage, the slippery material that
covers the ends of bones, gradually breaks down. The damaged cartilage makes movement painful.

2. Rheumatoid Arthritis

RA is an autoimmune disease. That means the immune system attacks parts of the body, especially the joints. That
leads to inflammation, which can cause severe joint damage if you don't treat it.

3. Gout

Purines are a natural substance found in the body. They are also found in many foods such as liver, shellfish,
and alcohol. Some meats such as bacon, turkey, veal, liver, beef kidney, brain. When purines are broken
down to uric acid in the blood, the body gets rid of it when you urinate or have a bowel movement. But if your
body makes too much uric acid, or if your kidneys aren't working well, uric acid can build up in the blood. Uric

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 acid levels can also increase when you eat too many high-purine foods. Then crystals of uric acid can form and
collect in the joints. This causes painful inflammation. This condition is called gout.

Nervous System

The nervous system consists of the brain, spinal cord, sensory organs, and all of the nerve cells or neuron that connect
these organs with the rest of the body. Together, these organs are responsible for the control of the body and
communication among its parts.

The Nervous System Two Major Subdivisions:

a. the Central Nervous System (CNS)

b. the Peripheral Nervous System (PNS)

The CNS includes the brain and spinal cord. The brain is the body’s “control center.”

The PNS is a vast network of spinal and cranial nerves that are linked to the brain and the spinal cord. It contains
sensory receptors which help in processing changes in the internal and external environment. This information is sent
to the CNS via afferent sensory nerves. The PNS is then subdivided into the autonomic nervous system and the somatic
nervous system. The autonomic has involuntary control of internal organs, blood vessels, smooth and cardiac muscles.
The somatic has voluntary control of skin, bones, joints, and skeletal muscle. The two systems function together, by way
of nerves from the PNS entering and becoming part of the CNS, and vice versa.

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The Nervous System Three Main Functions:

a. Sensory Input
b. Integration/ Processing of Data
c. Motor Output/ Response

Sensory Input

Is when the body gathers information or data, by way of neurons, their communication with one another
determines their function. These nerves conduct impulses from sensory receptors to the brain and spinal
cord.

Integration/ Processing of Data

The data is then processed by way of integration of data, which occurs only in the brain.

Motor Output/ Response

After the brain has processed the information, impulses are then conducted from the brain and spinal
cord to muscles and glands, which is called motor output.

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Nervous Systems Problems:

1. Alzheimer's disease
Alzheimer's disease attacks brain cells and neurotransmitters (chemicals that carry messages between brain
cells), affecting the way your brain functions, your memory and the way you behave. It is also the most
common form of dementia.

Dementia is a collection of symptoms that are caused by disorders affecting the brain. It affects thinking,
behavior, and your ability to do normal tasks. About 7 in 10 people with dementia have Alzheimer’s disease.

2. Paralysis
Paralysis is the loss of muscle function in part of your body. It happens when something goes wrong with the
way messages pass between your brain and muscles. It can occur on one or both sides of your body. It can also
occur in just one area, or it can be widespread.

Types of Paralysis (Plegia):

- Spastic – tight and hard muscles (spasm)

- Flaccid – muscles shrink and flabby (weakness)

a. Monoplegia – affects only one arm or leg

b. Hemiplegia - affects one arm and one leg on the same side of your body
c. Diplegia – affects both of your arms
d. Paraplegia – affects both of your legs
e. Quadriplegia – affects both of arms and both your legs

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Respiratory System

- The human respiratory system is a series of organs responsible for taking in oxygen and expelling carbon
dioxide.

- Breathing starts when you inhale air into your nose or mouth. It travels down the back of your throat and into your
larynx and trachea, then into divided air passages called bronchial tubes.

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 - For your lungs to perform their best, these airways need to be open. They should be free from inflammation or
swelling and extra mucus.

- As the bronchial tubes pass through your lungs, they divide into smaller air passages called bronchioles. The
bronchioles end in tiny balloon-like air sacs called alveoli. Your body has about 600 million alveoli.
- The alveoli are surrounded by a mesh of tiny blood vessels called capillaries. Here, oxygen from inhaled air passes
into your blood.

Upper Respiratory Tract Infection

An upper respiratory tract infection (URTI) is an illness caused by an acute infection, which involves the upper
respiratory tract, including the nose, sinuses, pharynx, or larynx. This commonly includes nasal obstruction, sore
throat, tonsillitis, pharyngitis, laryngitis, sinusitis, and the common cold.

Lower Respiratory Tract Infection

Lower respiratory tract infections (LRTI) are any infections in the lungs or below the voice box/ larynx. These include
pneumonia, bronchitis, and tuberculosis. A lower respiratory tract infection can affect the airways, such as with
bronchitis, or the air sacs at the end of the airways, as in the case of pneumonia.

Circulatory System

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The circulatory system, also known as the cardiovascular system, is a network consisting of blood, blood vessels, and
the heart. Nutrients, oxygen and hormones are delivered to every cell and as these necessities are provided, waste
products such as carbon dioxide are removed.

I. The Blood

1. Formed Elements

A. Red Blood Cells (Erythrocytes)

- carry oxygen from the lungs to the tissues and to carry carbon dioxide, a waste product of metabolism, to the
lungs, where it is excreted. The mature human red blood cell is small, round, and biconcave. The cell is flexible
and assumes a bell shape as it passes through extremely small blood vessels.

B. White Blood Cells (Leukocytes)

- is capable of motility, and defends the body against infection and disease by ingesting foreign materials and
cellular debris, by destroying infectious agents and cancer cells, or by producing antibodies.
-
C. Platelets (Thrombocytes)
- Platelets are tiny blood cells that help your body form clots to stop bleeding. If one of your blood vessels gets
damaged, it sends out signals to the platelets. The platelets then rush to the site of damage. they form a plug
(clot) to fix the damage.

2. Plasma

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 It appears as a straw-colored fluid and is composed mainly of water, but also carries enzymes and salts.
Plasma is designed to carry nutrients, hormones, and proteins to the different parts of the body. It also carries
away the waste products of cell metabolism from various tissues to the organs responsible for detoxifying
and/or excreting them. In addition, plasma is the vehicle for the transport of the blood cells through the blood
vessels.

II. The Blood Vessels

Blood vessels (“ugat” in tagalog term) are key components of the systemic
and pulmonary circulatory systems that distribute blood throughout the
body. There are three major types of blood vessels:

Arteries

 Carry blood away from the heart, a part of it are red

blood cells with oxygen. They branch into smaller
arterioles throughout the body and eventually
forming the capillary network.

Veins

- Carry deoxygenated blood from the tissues back to the heart, a part of it are red blood cells with carbon
dioxide.

Capillaries

 Facilitate efficient chemical exchange between tissue and blood. Capillaries in turn merge into venules, then
into larger veins responsible for returning the blood to the heart.

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Vasodilation

 (vaso = blood vessel; dilation = relax)

 Vasodilation is the widening of your blood vessels. It happens when smooth muscles found in the walls of
arteries or large veins relax, allowing the blood vessels to become more open. This leads to an increase in
blood flow through your blood vessels as well as a decrease in blood pressure.

Vasoconstriction

 (vaso = blood vessel; constriction = tighten)

 Vasoconstriction is narrowing or constriction of the blood vessels. It happens when smooth muscles in blood
vessel walls tighten. This makes the blood vessel opening smaller. Vasoconstriction may also be called
vasospasm.

Atherosclerosis

 a condition where the arteries become narrowed and hardened due to a buildup of plaque made of
cholesterol and other substances from the blood around the artery wall.

Stroke

 the sudden death of brain cells due to lack of oxygen, caused by blockage of blood flow or rupture of
an artery to the brain. Sudden loss of speech, weakness, or paralysis of one side of the body can be
symptoms.

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III. The Heart

 The heart is a muscular organ about the size of a fist, located just behind and slightly left of the breastbone. The
heart pumps blood through the network of arteries and veins called the cardiovascular system.
 The coronary arteries run along the surface of the heart and provide oxygen-rich blood to the heart muscle. A web
of nerve tissue also runs through the heart, conducting the complex signals that govern contraction and relaxation.

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Chambers of the Heart

 The right atrium receives blood from the veins and pumps it to the right ventricle.
 The right ventricle receives blood from the right atrium and pumps it to the lungs, where it is loaded with oxygen.
 The left atrium receives oxygenated blood from the lungs and pumps it to the left ventricle.
 The left ventricle (the strongest chamber) pumps oxygen-rich blood to the rest of the body. The left ventricle’s
vigorous contractions create our blood pressure.

Circulatory Pathway

 The cardiac cycle for the right atrium and right ventricle also occurs simultaneously in the left side of the heart,
in the left atrium and left ventricle. Cardiac activity that is happening in the right atrium happens at the same
time with the left atrium, same as well with both ventricles. But for understanding, we elaborated the flow of
blood before and after it enters the heart and how the cycle is continuously repeated.

 The cardiac cycle refers to all of the events that occur from the beginning of one heartbeat to the beginning of
the next and can be divided into two parts: a period of contraction known as systole and a period of relaxation
known as diastole.

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Process of Blood Circulation

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Process of Blood Circulation

1. (Diastolic Pressure) Blood with the red blood cells carrying carbon dioxide enters the heart through inferior
and superior vena cava into the right atrium.

2. During diastole, the build-up of blood in the right atrium creates pressure that forces the tricuspid valve to
open allowing for about 75% of this blood to pass into the right ventricle causing a ventricular diastolic
pressure. In late diastole, the contraction of the right atrium propels the remaining 25% of the blood into the
right ventricle, which produces a further increase in diastolic pressure. Blood flows passively to right ventricle,
while the right ventricle is relaxed and not contracting.

3. When the ventricles are full, the tricuspid valve closes. This prevents blood from flowing backward into the
right atrium when the right ventricle contracts (squeeze).

4. (Systolic Pressure) The right ventricle contracts which forces the opening of the semilunar valve pushing blood
into the lungs.

5. In the lungs, the red blood cells that carry carbon dioxide undergo chemical exchange through the tiny
capillary vessels in the lungs. It retains carbon dioxide in the alveoli and carry available oxygen. Carbon dioxide
leaves the body when you exhale.

6. (Diastolic Pressure) The blood present in the lungs where red blood cells carry oxygen travels to the left
atrium.

7. During diastole, the build-up of blood in the left atrium creates pressure that forces the mitral/ bicuspid valve
to open allowing for about 75% of this blood to pass into the left ventricle causing a ventricular diastolic
pressure. In late diastole, the contraction of the left atrium propels the remaining 25% of the blood into the
left ventricle, which produces a further increase in diastolic pressure. Blood flows passively to left ventricle,
while the left ventricle is relaxed and not contracting.

8. When the left ventricle is full, the mitral valve closes. This prevents blood from flowing backward into the left
atrium when the left ventricle contracts (squeeze).

9. (Systolic Pressure) The left ventricle contracts which forces the opening of the aortic valve pushing blood into
the aorta and into the systemic circulation or the rest of the body.

10. From the aorta connects the arteries where blood flows with red blood cells carrying oxygen. Capillaries
around tissue cells undergo chemical exchange, red blood cells give off oxygen to be used up by the cell and in
return carry the metabolic waste carbon dioxide.

11. Red blood cells carrying carbon dioxide pass through the veins and enter the heart through superior and
inferior vena cava and the cycle repeats and continues.

Systolic Pressure
The pressure of the blood as a result of contraction of the ventricles that is the pressure of the height of the
blood wave.

Diastolic Pressure
The pressure when the ventricles are at rest and relaxed receiving blood that passively flows from the atria.

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Heart Problems:

1. Myocardial Infarction (Heart Attack)

Over the years, cholesterol plaques can narrow the arteries supplying blood to the heart. The narrowed arteries are
at higher risk for complete blockage from a sudden blood clot (this blockage is called a heart attack). When a
coronary artery is suddenly blocked the surrounding cardiac muscle is starved of oxygen, this part of the heart
muscle dies.

2. Cardiac Arrest
A cardiac arrest is when a person's heart stops pumping blood around their body and causing loss of heart
function, sudden cardiac death.

3. Arrhythmia (Dysrhythmia)
An abnormal heart rhythm due to changes in the conduction of electrical impulses through the heart. Some
arrhythmias are benign, but others are life-threatening.

4. Congestive Heart Failure

The heart is either too weak or too stiff to effectively pump blood through the body. Shortness of breath and leg
swelling are common symptoms.

5. Heart Valve Disease

There are four heart valves, and each can develop problems. If severe, valve disease can cause congestive heart
failure.

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Digestive System

Your digestive system breaks nutrients into parts small enough for
your body to absorb and use for energy, growth, and cell repair.
Each part of your digestive system helps to move food and liquid
through your GI tract, break food and liquid into smaller parts, or
both. Once foods are broken into small enough parts, your body
can absorb and move the nutrients to where they are needed.

The GI tract is a series of hollow organs joined in a long, twisting

tube from the mouth to the anus. The hollow organs that make up
the GI tract are the mouth, esophagus, stomach, small intestine,
large intestine, and anus. The liver, pancreas, and gallbladder are
the solid organs of the digestive system.

Food moves through your GI tract by a process called peristalsis.

The large, hollow organs of your GI tract contain a layer of muscle
that enables their walls to move. The movement pushes food and
liquid through your GI tract and mixes the contents within each organ. The muscle behind the food contracts and
squeezes the food forward, while the muscle in front of the food relaxes to allow the food to move.

Gastrointestinal Tract:

Mouth - The digestive process starts in your mouth when you chew. Your salivary glands make saliva, a digestive juice,
which moistens food so it moves more easily through your esophagus into your stomach. Saliva also has an enzyme that
begins to break down starches in your food.

Esophagus - After you swallow, peristalsis pushes the food down your esophagus into your stomach.

Stomach - Glands in your stomach lining make stomach acid and enzymes that break down food. Muscles of your
stomach mix the food with these digestive juices.

Pancreas - Your pancreas makes a digestive juice that has enzymes that break down carbohydrates, fats, and proteins.
The pancreas delivers the digestive juice to the small intestine through small tubes called ducts. It also secretes insulin
that is necessary to transport glucose present in the blood to the cells for cellular energy and function.

Liver - Your liver makes a digestive juice called bile that helps digest fats and some vitamins. Bile ducts carry bile from
your liver to your gallbladder for storage, or to the small intestine for use.

Gallbladder - Your gallbladder stores bile between meals. When you eat, your gallbladder squeezes bile through the
bile ducts into your small intestine.

Small intestine - Your small intestine makes digestive juice, which mixes with bile and pancreatic juice to complete the
breakdown of proteins, carbohydrates, and fats. Bacteria in your small intestine make some of the enzymes you need
to digest carbohydrates. Your small intestine moves water from your bloodstream into your GI tract to help break down
food. Your small intestine also absorbs water with other nutrients.

Large intestine - In your large intestine, more water moves from your GI tract into your bloodstream. Bacteria in your
large intestine help break down remaining nutrients. Waste products of digestion, including parts of food that are still
too large, become stool.

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Digestive Problems:

1. Gastroesophageal Reflux Disease (GERD)

If the lower esophageal sphincter relaxes abnormally or weakens, stomach acid can flow back up into your esophagus.
This constant backwash of acid irritates the lining of your esophagus, often causing it to become inflamed. Symptoms of
reflux, such as heartburn accompanied by a sour taste in the mouth may indicate a person has GERD.

2. Peptic Ulcer

By disrupting a protective layer of mucus, Helicobacter pylori, the bacterium causes ulcers, creates sores in the lining of
the stomach or first stretch of the small intestine. Left untreated, ulcers can cause internal bleeding and may eat a hole
in the small intestine or stomach wall, which can lead to serious infection.

3. Constipation

Constipation happens when food moves too slowly through the large intestines, more water is absorbed by the large
intestine from the digested food often resulting in hard stool that is difficult to pass.

Eating fiber-rich foods helps move the contents of the large intestine along more quickly. Fiber also absorbs water, softening
stools so that they pass more easily.

4. Diarrhea

Diarrhea occurs when undigested food moves too fast, before the intestines can absorb water, resulting in watery, loose
stools. Most cases of diarrhea are caused by an infection in the gastrointestinal tract. Mild cases of acute diarrhea may
resolve without treatment.

Fiber’s ability to absorb water helps make stools more solid. And by slowing transit time, fiber gives the large intestines a
chance to absorb additional water. Fiber also helps bulk up the contents of the large intestines, binding indigestible food
together.

Renal or Urinary System

Parts:

Kidneys (left and right)

Ureters (left and right)

Bladder

Urethra

Female Urinary System

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 Male Urinary System

The urinary system also known as the renal system produces, stores and eliminates urine. The system consists of the
kidneys, ureters, urinary bladder, and urethra. The kidneys make urine by filtering wastes and extra water from blood.
The ureters carry the urine away from kidneys to the urinary bladder, which is a temporary reservoir for the urine. The
urethra is a tubular structure that carries the urine from the urinary bladder outside the body. The urethra is visible in a
female genital area above the vagina and at the tip of penis for male.

Renal Problems:

1. Urinary Tract Infection

Bacteria that live the vagina, genital, and anal areas may enter the urethra, travel to the bladder, and cause an
infection. Anything that brings bacteria in contact with your urethra can cause UTI.

2. Kidney Stones
Hard deposits made of minerals and salts that form inside your kidneys. Kidney stones have many causes and
can affect any part of your urinary tract — from your kidneys to your bladder. Often, stones form when the
urine becomes concentrated, allowing minerals to crystallize and stick together.

3. Kidney Failure, Also Called End-Stage Renal Disease (ESRD)

The last stage of chronic kidney disease. When your kidneys fail, it means they have stopped working well
enough for you to survive without dialysis or a kidney transplant. In most cases, kidney failure is caused by
other health problems that have done permanent damage (harm) to your kidneys little by little, over time.

When your kidneys are damaged, they may not work as well as they should. If the damage to your kidneys
continues to get worse and your kidneys are less and less able to do their job, you have chronic kidney disease.
Kidney failure is the last (most severe) stage of chronic kidney disease. This is why kidney failure is also called
end-stage renal disease, or ESRD for short.

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Reproductive System

The Male Reproductive System

Consists of two major parts: the testes protected and

enveloped by testicles, where sperm are produced, and the
penis. The penis and urethra belong to both the urinary and
reproductive systems in males. The testes are carried in an
external pouch known as the scrotum, where they normally
remain slightly cooler than body temperature to facilitate
sperm production.

The main job of the prostate and seminal vesicles is to make

fluid to bathe semen. During ejaculation, sperm is made in
the testicles, and then moves to the urethra. At the same
time, fluid from the prostate and the seminal vesicles also
moves into the urethra. This mixture of semen and fluid from
the prostate and seminal vesicles forms the ejaculate that
passes through the urethra and out of the penis.

Female Reproductive System

The external structures of the female reproductive system

include the clitoris, labia minora, labia majora. The major
internal organs of the female reproductive system include
the vagina and uterus — which act as the receptacle for
semen — and the ovaries, which produce the female's ova.
The vagina is attached to the uterus through the cervix,
while the fallopian tubes connect the uterus to the ovaries.
In response to hormonal changes, one ovum, or egg — or
more in the case of multiple births — is released and sent
down the fallopian tube during ovulation. If not fertilized,
this egg is eliminated during menstruation.

Fertilization occurs if a sperm enters the fallopian tube and

burrows into the egg. While the fertilization usually occurs in the oviducts, it can also happen in the uterus itself. The
egg then becomes implanted in the lining of the uterus, where it begins the processes of embryogenesis (in which the
embryo forms) and morphogenesis (in which the fetus begins to take shape). When the fetus is mature enough to
survive outside of the womb, the cervix dilates, and contractions of the uterus propel it through the birth canal.

Reproductive Problems:

Male

1. Erectile Dysfunction

Erectile dysfunction (ED) is defined as persistent difficulty achieving and maintaining an erection sufficient to have
sex. Causes are usually medical but can also be psychological. Organic causes are usually the result of an underlying
medical condition affecting the blood vessels or nerves supplying the penis.

2. Prostate Cancer

No one knows why or how prostate cancer starts. Autopsy studies show 1 in 3 men over the age of 50 have some
cancer cells in the prostate. Eight out of ten "autopsy cancers" found are small, with tumors that are not harmful.

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Female

1. Polycystic Ovary Syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age. Women
with PCOS may have infrequent or prolonged menstrual periods or excess male hormone (androgen) levels. The
ovaries may develop numerous small collections of fluid (follicles) and fail to regularly release eggs. Some women
with PCOS have cysts on their ovaries. That’s why it’s called “polycystic.” But the name is misleading because many
women with PCOS don’t have cysts.

2. Ectopic Pregnancy

An ectopic pregnancy occurs when a fertilized egg implants and grows outside the main cavity of the uterus. An
ectopic pregnancy most often occurs in a fallopian tube. Sometimes, an ectopic pregnancy occurs in other areas of
the body, such as the ovary, abdominal cavity or cervix. An ectopic pregnancy can't proceed normally. The
fertilized egg can't survive, and the growing tissue may cause life-threatening bleeding, if left untreated.

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 Nursing / Treatment Process

1. Assessment
2. Diagnosis
3. Planning
4. Intervention
5. Evaluation

Assessment

Gathering information about a patient’s physiological, psychological, sociological, and spiritual status to
identify current health status and future patient care needs.

The patient is instructed or assisted to undergo non – invasive procedures (not introducing any instrument or
device inside the patient’s body) and invasive procedures (requires the need to use instruments like needles or
tubes to be inserted inside the patient’s body).

Example procedures:

Non – invasive Procedures Invasive Procedure

- Vital Signs - Blood examination
- Urine Analysis - (Complete Blood Count, Fasting blood sugar,
- Stool Exam Cholesterol, etc.)
- Sputum Exam - Coloscopy, Endoscopy
- X-ray - Vaginal exam
- CT scan/ MRI - Surgical biopsy
- History taking/ Interview
- Observation
- DNA test (swab, hair sample)

Sample Scenario:

An elderly person is complaining of chest pain and headache for 3 days. He visited the hospital for checkup and
the doctor conducted initial assessment to know the reasons for the complaints of the patient. The patient’s
blood pressure, temperature, pulse rate and respiration were checked. The doctor interviewed the patient for
his activities in the past 3 days. Blood sample for analysis was taken to see if there are any problems and chest
X – ray to evaluate the patient’s heart functions.

Diagnosis

The physician provides the actual health problem of the patient based on the results of the assessments
conducted. Examples are all possible names of diseases and their stages and severity.

Sample Scenario:

The patient has Hypertension Stage 2 based after his blood pressure was checked. No fever and signs of
infection. Chest x-ray result is normal but his blood analysis confirms high level of cholesterol and fats in the
blood.

Planning

Treatment plan provides direction on the type of nursing care the individual/ family may need. Nursing care
plans provide continuity of care, safety, quality care and compliance. The treatment plan for the patient is
based on the diagnosis of the physician and creates doctor’s orders for the healthcare team to implement.
Examples are medications, diet, surgery, therapy, etc.

Sample Scenario:

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 As part of the treatment plan, the doctor ordered medications the patient needs to take to manage his blood
pressure and cholesterol levels. Dietician was instructed to provide meal plan that has low salt, low
cholesterol, low fat diet. The patient was also advised to adapt individualized exercise routines to help regulate
blood pressure and cholesterol levels. Patient’s response to medications and diet plan should be monitored
and blood pressure should be regularly checked during the course of hospital stay.

Implementation

The health care team that includes nurses, technicians, dieticians, therapists and other members of the team
should implement the treatment plan ordered by the physician. During implementation the care plan is tested
for effectiveness.

Sample Scenario:

The nurses recorded the blood pressure in the patient’s record sheets that was checked regularly. Medications
for blood pressure and cholesterol are given accordingly to the patient following doctor’s order in terms of
time schedule and dosage. Meals provided are prepared following the diet plan.

Evaluation

The judgment of the effectiveness of nursing care. The patient’s responses are compared to predetermined
outcome criteria. The results of evaluation procedures can also be used as assessment data for the next
possible treatment process.

Sample Scenario:

After a given time depending on doctor’s discretion, he will evaluate the effectiveness of the treatment plan
given to the patient. The effectiveness of the medications given and diet plan can be evaluated through
improvements in the blood pressure recorded in the data sheets and blood sample can be taken from the
patient again to see if levels of fats and cholesterol have improved. Results taken from different evaluation
tools and methods are used as bases for the next set of assessment to indicate status of improvement. Right
then after, the doctor can establish another current diagnosis, whether the patient still has hypertension and
high level of cholesterol or greatly improved because of the treatment. Treatment plan will be established
again depending on the current diagnosis, if the patient needs to change the medications, dosage or whatever
the doctor decides unnecessary. The treatment process is repeated and continuous applied until the patient is
discharged from care of facility or hospital.

Application:

Caregivers are considered members of the healthcare team. When a caregiver is assigned to take care of a
patient at home, in a nursing facility or rendering supportive services in a hospital, he should understand the treatment
process given to his patient and his role in implementing it to achieve the proper care for the patient.

A caregiver’s tasks are primarily focused in supporting the patient in a personal, one-on-one basis. A caregiver
can provide essential data for assessment like daily lifestyle routines of the patient such as sleeping patten, eating
habits, recreational activities, unhealthy vices like smoking or drinking. The caregiver also knows the past and recent
maintenance medications of the patient. Since the caregiver take care of the patient at home, he is one of the
responsible person to continue and implement the treatment plan of the doctor for the patient like diet plan and meal
preparation, daily exercise, promotion of rest and relaxation, proper hygiene and prevention of infection especially if
the patient is bed ridden or needs assistance for bathroom privileges. Any improvement or deterioration of the patient
observed by the caregiver is a relevant information that the doctor can use for the evaluation of the patient’s treatment
plan.

Standard Guidelines in Performing Procedures (SOP):

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1. Check the Doctor’s Order
In a hospital setting, every patient has their own specific treatment regimen ordered by the doctor. It is very
important to confirm the order first before giving any treatment or conducting any procedure to the patient to
make sure that you are not putting the patient at harm because of performing procedures or giving treatment
that are contraindicated or that may cause harmful effects.

2. Identify the Patient

In case where the caregiver is rendering service to more than one patient, it is very important to identify the
right patient before starting any treatment or procedure. Check the name tag, ask the patient himself for
identification or verification from any watcher if person has memory problem or unable to talk. Treatment or
procedure given to the wrong patient is a serious offense of negligence in the performance of duty.

3. Introduce Self to the Patient

Upon entering the patient’s room, introduce yourself to the patient as good practice of common courtesy in
dealing with your patients.

4. Explain the Procedure to the Patient

Give time to explain the procedure to the patient before starting to enhance understanding and cooperation of
the patient during the procedure.

5. Provide a Comfortable Position and Environment to the Patient

Good quality care includes prioritizing comfort of the patient at all times, provide best position during
procedures that is comfortable and will not cause pain to the patient. Provide an environment that protects
the patient’s privacy like drawing curtains, closing doors or covering the patient’s body with blanket during
procedure especially if the patient is not alone in the room.

6. Gather All Necessary Materials and Equipment

To maximize time and energy, prepare everything before the start of any procedure. This will also create a
smooth flow of execution of the procedure and limit discomfort to the patient.

7. Handwashing
Whenever a caregiver is in close contact with the patient, practice handwashing at all times to prevent transfer
of microorganism from one person to another. After the caregiver took care of one person, all the possible
microorganisms can be carried by the hands and without handwashing, these microorganisms can be
transferred by the caregiver to the next person. At the same time, proper handwashing also protects the
caregiver from getting sick after being in contact with patients.

8. Wear Protective Gloves if Necessary

The caregiver should wear protective gloves if a certain procedure will require him to handle body secretions
like feces and urine or wastes.

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