By G. Nerusul. Columbus State University.
The term “deﬁcit” refers Nursing to a particular relationship between self-care agency and self-care demand that is said to exist when capabilities for engaging in self-care are less Theory than the demand for self-care buy generic doxycycline 200 mg. Isenberg The comprehensive development of the self-care concepts enhances the usefulness of the Self-Care Deﬁcit Nursing Theory as a guide to nursing prac- tice situations involving individuals across the life span who are experiencing health or illness purchase doxycycline master card, and to Research nurse-client situations aimed at health promotion order doxycycline with amex, health restoration, or health maintenance. Practice According to this theory, nurses use their spe- cialized capabilities to create a helping system in Summary Nurses use their specialized capabilities to References create a helping system in situations where persons are deemed to have an existent or potential self-care deﬁcit. According to Orem (2001), it is the special focus on human beings that distinguishes or differenti- situations where persons are deemed to have an ex- ates nursing from other human services. When the answer is the nurse, a wholly tions of the Self-Care Deﬁcit Nursing Theory pro- compensatory system of helping is appropriate. The aspect situations, the goal of nursing is to empower of the Self-Care Deﬁcit Nursing Theory that has the person to meet their self-care requirements by generated the most research of this type is the doing for (wholly compensatory system), doing relationship posited between basic conditioning with (partly compensatory system), or developing factors and self-care agency. Dorothy Johnson (1959), in the Self-Care Deﬁcit Nursing Theory states that in- her treatise on nursing theory development, viewed dividuals’ abilities to engage in self-care (self-care this attribute of a theory as its value for the profes- agency) are conditioned by age, developmental sion, its social utility. This proposition offers direction to nurses Research interested in engaging in theory-based research. Basic conditioning factors are deﬁned as “condi- Dorothea Orem’s theory is offering clear direction tions or events in a time-place matrix that affect the to nurses in the advancement of nursing science in value of person’s abilities to care for themselves” this millennium. It is important to note that the inﬂuence of tical science that is comprised of both theoretical the basic conditioning factors on self-care agency is and practical knowledge, a point of view that is not assumed to be operative at all times. There the basic conditioning factors assumed to be oper- are parallels between Orem’s description of nursing ative at all times. Because the inﬂuence of these fac- as a practical science and Donaldson and Crowley’s tors occurs within a time-place matrix, research is discussion of nursing as a professional discipline. Both perspectives address the between the basic conditioning factors and the sub- need for nurses to develop both theoretical and stantive structure of self-care agency can then be practical knowledge. Scholarly work of this type is vital to kinds of knowledge about persons with existent or the advancement of the theoretical knowledge of potential health-related self-care deﬁcits. The theory is the result singularly and in combination, on individuals’ self- of Stage 1. Several studies (1981) studied the inﬂuence of family as a social designed to determine the nature of the inﬂuence of support system on the self-care agency of adults variations in health state on self-care abilities are re- with diabetes mellitus. Research suggests inﬂuence of basic conditioning factors on the self- that this relationship is particularly salient in prac- care agency of persons enrolled in a weight-loss tice situations in which persons are experiencing program. The work of selected in- of family variables and caregiver variables on the vestigators is presented here to exemplify this line of self-care abilities of the spouses of patients with a inquiry. Baker (1991) explored the predic- the self-care abilities of persons with coronary tive effect of basic conditioning factors on the self- artery disease has been studied with both American care agency and self-care in adolescents with cystic and Dutch adult patient populations (Isenberg, ﬁbrosis. Across these ence of basic conditioning factors on the self-care studies, changes in health state were found to be capabilities of unmarried women at risk for sexu- critical determinants of the quality of the self-care ally transmitted disease. As the health tualized personality as a basic conditioning factor state of patients improved, so did their capabili- and tested the model with a healthy population and ties for self-care. Conversely, self-care capabilities a comparative clinical population with chronic tended to decline as patients experienced recur- renal disease. The ﬁndings re- ence of basic conditioning factors on the self-care vealed a positive relationship between health state abilities of a healthy and clinical adult population and self-care agency in patients with cardiac disease. In addition to the study of variation in health Baiardi (1997) explored the inﬂuence of health state due to pathophysiology, the conditioning in- state and caregiving factors on the self-care agency ﬂuence of health state on self-care agency has also of the caregivers of cognitively impaired elders. West ined the inﬂuence of personal and environmental (1993) investigated the inﬂuence of clinical varia- factors on the self-care behaviors among patients tions in the level of depression, conceptualized as a with congestive heart failure. In a study with Dutch psychiatric patients, Deﬁcit Nursing Theory have been greatly enhanced Brouns (1991) also reported that variations in men- by the measurement work with self-care concepts tal health state signiﬁcantly inﬂuenced patients’ that has transpired over the past 20 years. In both studies a positive rela- portant to note that the theory-testing studies cited tionship between health state and self-care agency above were made possible by the development and was revealed. Higher levels of mental health were psychometric testing of instruments to measure the correlated with higher self-care agency scores. Instruments are currently These ﬁndings veriﬁed the conditioning inﬂuence available to measure the self-care agency of adoles- of health state on the self-care agency of patients’ cent populations (Denyes, 1982), adult populations experience variations in physical and mental health. The availability The conditioning inﬂuence of other basic fac- of valid and reliable measures of self-care agency tors on the self-care abilities of clinical and non- has been vital to the advancement of the theoretical clinical populations has been the focus of inquiry component of self-care nursing science. Intervention studies therapeutic self-care demand, self-care agency, and designed to enhance self-care performance are also the self-care actions of individuals with chronic ob- under way. Health state was found to gram of research focused on the self-care of cancer offer signiﬁcant explanation of variations in the patients who were receiving chemotherapy or radi- self-care actions of this population. Her early descriptive studies clariﬁed universal, developmental, and health deviation self- the health-deviation self-care requisites of this pop- care requisites, Riley (1996) developed a tool to ulation and documented the therapeutic self-care measure the performance and frequency of the self- demand (Dodd, 1982, 1984). More recent work de- care actions of patients with chronic obstructive scribed speciﬁc self-care behaviors initiated by pa- lung disease. This tool has the potential to be useful tients receiving these therapies and led to the as an outcome measure in future intervention stud- identiﬁcation of a patient proﬁle of self-care that ies designed to enhance the self-care abilities of this can be used in practice to target speciﬁc patient population. Dodd’s intervention studies Nursing Theory as the basis for her program of re- demonstrated that with targeted information, search with children. She has developed the Child patients can learn more about their treatment and and Adolescent Self-Care Practice questionnaire, can perform more effective self-care behaviors which can be used to assess the self-care perfor- (Dodd, 1997). Children with higher Through her 20-year program of descriptive, pre- self-concept scores were found to perform more dictive, and intervention studies based on self-care self-care activities than children with low self- theory, Dodd’s research has demonstrated how to concept scores (Mosher & Moore, 1998). Investigators have used Orem’s theory to iden- The utility of the Self-Care Deﬁcit Nursing Theory tify the self-care requisites and self-care capabilities beyond our national borders can be explained in of patients across a broad range of health devia- tions. Based on the theory, Utz and Ramos (1993) The utility of the Self-Care Deﬁcit Nursing have conducted a sequence of studies to explore Theory beyond our national borders can and describe the self-care needs of people with be explained in part by the fact that symptomatic mitral valve prolapse. The self-care Orem’s intention was to develop a general capabilities and the self-care needs (requisites) of theory of nursing that would be useful in persons with rheumatoid arthritis have also been describing and explaining universal nursing described. Duration of illness velop a general theory of nursing that would be (health state) and educational level were found to useful in describing and explaining universal nurs- be related to self-care agency (Ailinger & Dear, ing knowledge. Aish (1993) tested the effect of an Orem- Western civilizations may be further explained by based nursing intervention on the nutritional the inclusion of culture as a primary inﬂuence on self-care of myocardial infarction patients. Professor and the activities of self-care are learned according Georges Evers at the Catholic University of Leuven to the beliefs and practices that characterize the in Belgium has developed an extensive program of cultural way of life of the group to which the indi- research based on the theory. The individual ﬁrst descriptive and explanatory studies of the self-care learns about cultural standards within the family. The theory provides a means to study the types of Orem’s theory is also being applied by Jaarsma self-care needs identiﬁed by speciﬁc cultural groups and colleagues as a basis for an ongoing program of and the acceptable cultural self-care practices to research with cardiac patients in the Netherlands. With a population of patients promotion self-care within Orem’s Self-Care with advanced heart failure, Jaarsma, Halfens, Deﬁcit Nursing Theory and went on to explore Senten, Saad, and Dracup (1998) identiﬁed the through a descriptive study the self-care actions therapeutic self-care demand of this population performed by healthy middle-aged women to pro- and then developed a supportive-educative pro- mote well-being. The women studied were able to gram designed to enhance their self-care abilities. The jority of which were related to the universal self- book Nursing: Concepts of Practice (Orem, 1985) care requisites (Hartweg, 1993). The interview has been translated into Dutch, French, German, guide used with this American population has Italian, Spanish, and Japanese. Whetstone (1987) the Self-Care Deﬁcit Nursing Theory in nursing sit- and Whetstone and Hansson (1989) also con- uations in Australia, Belgium, Denmark, Finland, ducted cross-cultural comparative studies using Germany, the Netherlands, Norway, Portugal, self-care concepts. They compared the meanings Sweden, Switzerland, the United Kingdom, Hong of self-care among Americans, German, and Kong, Taiwan, Thailand, Turkey, Canada, Mexico, Swedish populations.
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Surgery is usually considered as a last resort for women with malignant cysts, those who have very large cysts that do not go away, and those with severe symptoms or infertility. Foods to avoid: • Meat and dairy products may contain saturated fat, hormones, and chemicals that can affect ovarian health and trigger inﬂammation. O Top Recommended Supplements There is limited research on supplements for the prevention and/or treatment of ovarian cysts. The supplements outlined here may play a role in minimizing symptoms and support- ing hormone balance and liver health. Calcium D-glucarate: Helps the liver detoxify and eliminate excess hormones, particularly estrogen. Chasteberry: Balances estrogen to progesterone ratio and may help normalize ovulation. Indole-3-carbinol: A compound found naturally in cruciferous vegetables that aids in de- toxiﬁcation of estrogen, protects liver function, and may protect against hormonal cancers. Complementary Supplements Evening primrose oil: Helps reduce pain and inﬂammation. Some are harmless and even beneﬁcial for health and others can cause illness and disease. A parasite is an organism that lives on or in a host organism and gets its food from or at the expense of its host. There are two main classes of parasites that can cause intestinal disease in humans: Helminths: Derived from the Greek word for “worms,” these large, multicellular organisms are generally visible to the naked eye. The three main groups of helminths that are human parasites are ﬂatworms (tapeworms), P thorny-headed worms, and roundworms (hookworms and pinworms). Protozoa: Microscopic, one-celled organisms that can be free-living or parasitic in nature. They can multiply in humans, which contributes to their survival and also permits serious infections to develop from just a single organism. When the organisms are swallowed, they move into the intestine, where they can reproduce and cause disease. You can also contract parasites from intimate contact (oral-anal) with someone who has them. In some people, intestinal parasites do not cause any symptoms or the symptoms may be mild. In others they can cause horrible gastrointestinal problems, weight loss, irritability, and more. There are also a variety of lifestyle measures that can reduce your risk of contracting parasites. Fecal testing (exami- nation of your stool) can identify both helminths and protozoa. It is important to do stool tests before taking any anti-diarrheal drugs or antibiotics. Natural products, while helpful, are not as effective and take longer to work compared to prescription drugs. Dietary Recommendations Foods to include: • Boost intake of ﬁbre, which helps improve elimination. Lifestyle Suggestions To reduce the risk of contracting parasites, consider these tips: • Wash your hands after using the toilet, changing diapers, handling animals, or before eat- ing or preparing food. Do not drink untreated stream water while camping as it is almost P invariably contaminated with giardia, even in North America. Take probiotic supple- ments while travelling to help maintain normal gastrointestinal ﬂora. Top Recommended Supplements Herbal products: Black walnut, wormwood, oil of oregano, and ginger have anti-parasitic properties. Probiotics: Beneﬁcial bacteria such as Lactobacillus and Biﬁdobacteria can help in the prevention and treatment of parasites by maintaining healthy gut ﬂora and reducing over- growth of parasites and other pathogens. Propolis: A resinous substance collected by bees from the leaf buds and bark of trees. It has antimicrobial properties and may help protect against parasitic intestinal infections. Prelimi- nary research found that propolis extract was helpful in eliminating giardiasis in adults and children. Complementary Supplements Berberine: A compound found in many plants, such as Oregon grape and goldenseal. Preliminary studies have shown that berberine can be used successfully to treat giardia infec- tions. Digestive enzymes: Aid digestion and make your intestinal tract less hospitable to parasites. See your doctor for proper diagnosis and discuss the beneﬁts and risks of drug therapy. Boost intake of ﬁbre, drink lots of puriﬁed water, and eat more raw garlic, pumpkin seeds, pomegranates, beets, and carrots. Wash your hands after using the toilet and before touching food, and practise safe sex to avoid spreading the parasites. The disease causes degenerative changes in an area of the brain called the substantia nigra. Nerve cells in this area are responsible for producing the neurotrans- mitter dopamine. As these nerve cells become damaged and die, there is insufﬁcient dopamine to relay messages between nerve and muscle cells, and it becomes pro- gressively more difﬁcult for the body to move smoothly. This causes characteristic tremors and shaking, which interfere with normal activities such as walking, sitting, and standing. In Canada, there are approximately 100,000 people or one out of every 100 adults P with Parkinson’s disease.
Active transport lets cells obtain nutrients that can’t pass through the mem- brane by other means buy 100mg doxycycline free shipping. In addition purchase doxycycline toronto, there are secondary active transport processes that are similar to diffusion but instead use imbalances in electrostatic forces to move molecules across the membrane generic doxycycline 200 mg. Fill in the blanks to complete the following sentences: The lipid bilayer structure of the cell membrane is made possible because phospholipid molecules contain two distinct regions: The 1. Because it has both polar and non- polar regions, a phospholipid is classified as a(n) 3. A solution having a greater concentration of water than exists in the cell is said to be a. Injecting a large quantity of distilled water into a human’s veins would cause many red blood cells to a. As containment for the cytoplasm Part I: Building Blocks of the Body 26 Aiming for the Nucleus The cell nucleus is the largest cellular organelle and the first to be discovered by scien- tists. On average, it accounts for about 10 percent of the total volume of the cell, and it holds a complete set of genes. The outermost part of this organelle is the nuclear envelope, which is composed of a double-membrane barrier, each membrane of which is made up of a phospholipid bilayer. Between the two membranes is a fluid-filled space called the perinuclear cis- terna. The two layers fuse to form a selectively permeable barrier, but large pores allow relatively free movement of molecules and ions, including large protein mole- cules. Intermediate filaments lining the surface of the nuclear envelope make up the nuclear lamina, which functions in the disassembly and reassembly of the nuclear membrane during mitosis and binds the membrane to the endoplasmic reticulum. The nucleus also contains nucleoplasm, a clear viscous material that forms the matrix in which the organelles of the nucleus are embedded. Because of the various materials in the cytoplasm, it’s a colloid, or mixture of phases, that alternates from a sol (a liquid colloid with solid suspended in it) to a gel (a colloid in which the dispersed phase combines with the medium to form a semisolid material). The fluid part of the cytoplasm, called the cytosol, has a dif- fering consistency based on changes in temperature, molecular concentrations, pH, pressure, and agitation. Within the cytoplasm lies a network of fibrous proteins collectively referred to as the cytoskeleton. It’s not rigid or permanent but changing and shifting according to the activity of the cell. The cytoskeleton maintains the cell’s shape, enables it to move, anchors its organelles, and directs the flow of the cytoplasm. The fibrous proteins that make up the cytoskeleton include the following: Microfilaments, rodlike structures about 5 to 8 nanometers wide that consist of a stacked protein called actin, the most abundant protein in eukaryotic cells. They provide structural support and have a role in cell and organelle movement as well as in cell division. They average about 10 nanometers wide and consist of interlocking proteins, including keratin, that chiefly are involved in maintaining cell integrity and resist- ing pulling forces on the cell. Hollow microtubules about 25 nanometers in diameter that are made of the pro- tein tubulin and grow with one end embedded in the centrosome near the cell’s nucleus. Like microfilaments, these components of cilia, flagella, and centrioles provide structural support and have a role in cell and organelle movement as well as in cell division. Organelles, literally translated as “little organs,” are nestled inside the cytoplasm (except for the two organelles that move, cilia and flagellum, which are found on the cell’s exterior). Each organelle has different responsibilities for producing materials used elsewhere in the cell or body. Here are the key organelles and what they do: Centrosome: Microtubules sprout from this structure, which is located next to the nucleus and is composed of two centrioles — arrays of microtubules — that function in separating genetic material during cell division. Cilia: These are short, hair-like cytoplasmic projections on the external surface of the cell. In multicellular animals, including humans, cilia move materials over the surface of the cell. Flagellum: This whip-like cytoplasmic projection lies on the cell’s exterior sur- face. Golgi apparatus (or body): This organelle consists of a stack of flattened sacs with membranes that connect with those of the endoplasmic reticulum. Located near the nucleus, it functions in the storage, modification, and packaging of pro- teins for secretion to various destinations within the cell. Lysosome: A tiny, membranous sac containing acids and digestive enzymes, the lysosome breaks down large food molecules such as proteins, carbohydrates, and nucleic acids into materials that the cell can use. It destroys foreign particles in the cell and helps to remove nonfunctioning structures from the cell. Mitochondrion: Called the powerhouse of the cell, this rod-shaped organelle consists of two membranes — a smooth outer membrane, and an invaginated (folded inward) inner membrane that divides the organelle into compartments. This energy is used to accelerate chemical reactions in the cell, which we cover in Chapter 1. Ribosomes: These roughly 25-nanometer structures may be found along the endoplasmic reticulum or floating free in the cytoplasm. Vacuoles: More commonly found in plant cells, these open spaces in the cyto- plasm sometimes carry materials to the cell membrane for discharge to the out- side of the cell. In animal cells, food vacuoles are membranous sacs formed when food masses are pinched-off from the cell membrane and passed into the cytoplasm of the cell. This process, called endocytosis (from the Greek words meaning “within the cell”), requires energy to move large masses of material into the cell. Vacuoles also help to remove structural debris, isolate harmful materi- als, and export unwanted substances from the cell. The very small organelle responsible for protein synthesis (making proteins) is the a. Use the terms that follow to identify the cell structures and organelles shown in Figure 2-1. Proteins are chains of amino acids (usually very long chains of at least 100 acids). Enzymes, used to catalyze reactions, also are chains of amino acids and therefore also are categorized as proteins. Polypeptides, or simply peptides, are shorter chains of amino acids used to bond larger protein molecules, but they also can be regarded as proteins. Both antibodies and hormones also are pro- teins, along with almost everything else in the body — hair, muscle, cartilage, and so on. Fill in the blanks to complete the following sentences: Protein synthesis begins in the cell’s 38. The human body produces new cells every day to replace those that are damaged or worn out.