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Sorrentino: Mosby’s Essentials for Nursing Assistants, 3rd Edition
Instructor’s Resource Manual
Chapter 24: Caring For Persons With Common Health Problems
Instructor’s Preparation
I. Read Chapter 24 in the textbook.
II. Review chapter objectives, key terms, and review questions for Chapter 24 in the textbook.
III. Read the outline and classroom activities in Chapter 24 of this Instructor’s Resource Manual.
IV. Review the student assignment and the quiz in Chapter 24 of this Instructor’s Resource Manual.
V. Review the PowerPoint slides for Chapter 24.
VI. If you are using the accompanying Student Workbook, review the activities for Chapter 24.
VII. Collect all necessary supplies and equipment for the classroom activities and student
assignments.
A. Collect PowerPoint slides.
B. Prepare the correct number of handouts.
C. Prepare appropriate flip charts.
D. Collect correct TAs.
E. Collect colored markers.
F. Collect any other items that will be needed for classroom activities.
G. Assemble items in the order they will be used.
VIII.
Make sure that the necessary equipment is available and in good working order.
IX. Contact each guest speaker to confirm the day, date, time, and location that he or she is expected.
A. Ask each speaker if he or she requires any special equipment or supplies. Make sure these are
available.
Objectives
 Define the key terms listed in this chapter
 Describe how cancer is treated
 Describe musculoskeletal disorders and the care required
 Describe nervous system disorders and the care required
 Describe hearing loss and the care required
 Describe eye disorders and the care required
 Describe respiratory disorders and the care required
 Describe cardiovascular disorders and the care required
 Describe urinary system disorders and the care required
 Describe digestive disorders and the care required
 Describe diabetes and the care required
 Describe communicable diseases and the care required
 Describe mental health disorders and the care required
Key Terms
anxiety
aphasia
arthroplasty
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benign tumor
fracture
hemiplegia
malignant tumor
metastasis
paraplegia
quadriplegia
tumor
Outline and Classroom Activities
I. INTRODUCTION
A. Understanding common health problems gives meaning to the required care.
B. Refer to Chapter 6 while you study this chapter.
II. CANCER

Write the following on a flip chart using a variety of colored markers. Use the flip chart to
present information and ask for input from students. Leave space after each item to add
information.
 Cancer
 Definition
 Contributing factors
 Treatment
 Special needs of persons with cancer
 Call on students to provide information about each topic.
A. A tumor is a new growth of abnormal cells.
1. Tumors are benign or malignant.




Refer students to Figures 24-1 and 24-2 on pp. 405-406 in the textbook.
Display TA 44.
Write the following terms on the chalk board:
 Malignant tumor
 Benign tumor
 Metastasis
 Call on students to define each term. Write the correct answers on the chalk board.
Arrange for a representative from the American Cancer Society to visit the class. Ask the
person to bring educational materials and handouts describing the role of the organization
and the services provided.
 Allow time for questions and discussion.
a. A benign tumor:
(1) Grows slowly and within a local area
(2) Does not spread to other body parts
b. A malignant tumor (cancer):
(1) Grows fast
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Instructor’s Resource Manual
B.
C.
D.
E.
F.


(2) Invades other tissues
(a) Metastasis is the spread of cancer to other body parts.
Common cancer sites are the skin, lungs, colon, rectum, breast, prostate, uterus, and urinary
tract.
Cancer is the second leading cause of death in the United States.
1. It occurs in all ages.
Exact causes are unknown.
The National Cancer Institute cites these risk factors:
1. Tobacco
2. Exposure to radiation
3. Alcohol
4. Diet
a. High-fat diet
b. Being seriously overweight
5. Chemicals and other substances
6. Hormone replacement therapy (HRT)
7. Diethylstilbestrol
a. A synthetic form of estrogen
8. Close relatives with certain types of cancer
If detected early, cancer can be treated and controlled.
1. See Box 24-1 on p. 406 in the textbook for some signs and symptoms of cancer.
Use a round-table discussion format. Ask students to discuss the cancer risk factors. Then
ask them to:
 Identify any personal risk factors.
 Discuss what life style changes they can make to reduce their personal risk factors.
Review the contents of Box 24-1 on p. 406 in the textbook with students.
 Allow time for questions and discussion.
G. Common cancer treatments include:
1. Surgery is done to:
a. Remove tumors to cure or control cancer
b. Relieve pain from advanced cancer
2. Radiation therapy
a. X-ray beams are aimed at the tumor.
(1) Cancer cells and normal cells are destroyed.
b. Side effects include:
(1) Burns, skin breakdown, and hair loss at the treatment site
(2) Discomfort
(3) Nausea and vomiting
(4) Diarrhea
(5) Loss of appetite (anorexia)
3. Chemotherapy
a. Drugs are given that kill cancer cells and normal cells.
b. Side effects can be severe and include:
(1) Nausea, vomiting, and diarrhea
(2) Stomatitis (an inflammation of the mouth)
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(3) Hair loss (alopecia)
(4) Bleeding and infection
H. The needs of persons with cancer include:
1. Pain relief or control
2. Rest and exercise
3. Fluids and nutrition
4. Preventing skin breakdown
5. Preventing bowel problems
6. Dealing with treatment side effects
7. Psychological, social, and spiritual needs
a. Anger, fear, and depression are common.
b. Some surgeries are disfiguring.
(1) The person may feel unwhole, unattractive, or unclean.
c. You need to:
(1) Provide needed support.
(2) Listen and use touch to show that you care.
d. A spiritual leader may provide comfort.
III. MUSCULOSKELETAL DISORDERS
A. Musculoskeletal disorders affect movement.
B. Arthritis

Arrange for a representative from the Arthritis Foundation to visit the class. Ask the
person to bring educational materials and handouts describing the role of the organization
and the services provided.
 Allow time for questions and discussion.
1. Arthritis means joint inflammation.
a. Pain and decreased mobility occur in the affected joints.
2. Osteoarthritis (degenerative joint disease) occurs with aging, joint injury, and obesity.
a. The hips, knees, spine, fingers, and thumbs are commonly affected.
b. Joint stiffness occurs with rest and lack of motion.
c. Pain occurs with weight-bearing and joint motion.
(1) Severe pain affects rest, sleep, and mobility.
d. Cold weather and dampness seem to increase symptoms.
e. Treatment involves:
(1) Measures to relieve pain and stiffness
(a) Drugs and heat or cold applications
(b) Exercise to decrease pain, increase flexibility, and improve blood flow
(c) Regular rest
(d) Canes and walkers provide support
(e) Weight loss for persons who are obese
(2) Falls are prevented.
(3) Help is given with activities of daily living (ADL) as needed.
(4) Some people need joint replacement surgery.
3. Rheumatoid arthritis (RA) is a chronic inflammatory disease.
a. RA causes joint pain, swelling, and stiffness.
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Instructor’s Resource Manual
b. It is most common in women.
c. It can occur at any age.
d. It occurs on both sides of the body.

Refer students to Figure 24-3 on p. 407 in the textbook.
e. Treatment goals are to:
(1) Relieve pain
(2) Reduce inflammation
(3) Slow down or stop joint damage
f. The care plan may include:
(1) Rest balanced with exercise
(2) Good alignment
(a) The person is turned and repositioned at least every 2 hours.
(3) Eight to 10 hours of sleep each night
(a) Morning and afternoon rest periods
(4) An exercise program
(5) Walking aids, self-help devices, and splints as needed
(6) Safety measures to prevent falls
(7) Measures to relieve pain and reduce inflammation
(a) Drugs
(b) Heat or cold applications
(c) Joint replacement surgery
(8) Emotional support
(a) A good outlook and being active are important.
(i) Give encouragement and praise.
(ii) Listen when the person needs to talk.
4. Total joint replacement
a. Arthroplasty is the surgical replacement of a joint.
b. The diseased joint is removed and replaced with a prosthesis.
C. Osteoporosis
1. With osteoporosis, the bone becomes porous and brittle.
a. Bones are fragile and break easily.
2. Risk factors
a. Age
(1) Older persons are at risk.
b. Women after menopause
(1) The lack of estrogen after menopause causes bone changes.
c. Low levels of dietary calcium
d. Tobacco use
e. Alcoholism
f. Lack of exercise
g. Bedrest
h. Immobility
(1) Exercise and activity are needed for bone strength.
3. Back pain, gradual loss of height, and stooped posture occur.
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4. Fractures are a major threat.
5. Prevention measures include:
a. Calcium and vitamin supplements
b. Estrogen is ordered for some women.
c. Weight-bearing exercise
d. Strength training
e. Avoiding smoking and alcohol
6. Some people:
a. Wear back braces or corsets for good posture
b. Need walking aids
7. You need to:
a. Protect the person from falls and accidents (Chapter 8).
b. Turn and reposition the person gently.
D. Fractures
1. A fracture is a broken bone.
a. A closed fracture (simple fracture) means the bone is broken, but the skin is intact.
b. In an open fracture (compound fracture), the broken bone has come through the skin.

Refer students to Figure 24-4 on p. 408 in the textbook.
2. Causes include falls, accidents, cancer, and osteoporosis.
3. Signs and symptoms include pain, swelling, limited movement, loss of function, bruising,
and bleeding.
4. For healing, bone ends are brought into normal position (reduction).
a. Closed reduction involves moving the bone back into place.
(1) The skin is not opened.
b. Open reduction involves surgery.
5. After reduction, movement of the bone ends is prevented with a cast or traction.
a. Plastic and fiberglass casts are used.
(1) You can assist with care.
(a) See Box 24-2 on p. 408 in the textbook.

Review the contents of Box 24-2 on p. 408 in the textbook with students.
 Allow time for questions and discussion.
b. With traction:
(1) A steady pull from two directions keeps the bone in place.
(2) Weights, ropes, and pulleys are used.
(a) You may assist with the person’s care.
(i) See Box 24-3 on p. 410 in the textbook.


Refer students to Figure 24-7 on p. 409 in the textbook.
Review the contents of Box 24-3 on p. 410 in the textbook with students.
 Allow time for questions and discussion.
6. Hip fractures
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a. Surgery is done to fix the fracture in position with a pin, nail, plate, screw, or
prosthesis.

Refer students to Figure 24-8 on p. 410 in the textbook.
b. Rehabilitation is needed after surgery.
(1) These postoperative problems present life-threatening risks:
(a) Pneumonia
(b) Urinary tract infections
(c) Thrombi in the leg veins
(2) Pressure ulcers, constipation, and confusion are other risks.
c. Box 24-4 on p. 410 in the textbook describes the care required.


Review the contents of Box 24-4 on p. 410 in the textbook with students.
 Allow time for questions and discussion.
Invite a physical therapist to visit the class. Ask the therapist to demonstrate positioning
and transfer techniques used for persons with hip fractures.
 Allow time for questions and discussion.
IV. NERVOUS SYSTEM DISORDERS
A. Nervous system disorders can affect mental and physical functions.
B. Stroke (cerebrovascular accident [CVA])
1. Stroke is a disease affecting the blood vessels that supply blood to the brain.
a. The main causes are:
(1) A ruptured blood vessel
(a) Bleeding occurs in the brain.
(2) Blood clots
(a) A blood clot blocks blood flow to the brain.
b. Brain cells in the area affected do not get oxygen and nutrients.
(1) Brain damage occurs.
2. Stroke is:
a. The third leading cause of death in the United States
b. The leading cause of disability in adults
3. See Box 24-5 on p. 411 in the textbook for warning signs.

Review the contents of Box 24-5 on p. 411 in the textbook with students.
 Allow time for questions and discussion.
4. The person needs emergency care.
5. Stroke can occur suddenly.
6. Warning signs may occur.
a. See Box 24-5 on p. 411 in the textbook
b. The following may occur:
(1) Nausea and vomiting
(2) Memory loss
(3) Unconsciousness
(4) Noisy breathing, high blood pressure, and slow pulse
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(5)
(6)
(7)
(8)
(9)
Redness of the face
Seizures
Paralysis on one side of the body (hemiplegia)
Loss of bowel and bladder control
Loss of the ability to speak
(a) Aphasia is the inability to speak.
7. If the person survives, some brain damage is likely.
a. Functions lost depend on the area of brain damage.

Refer students to Figure 24-10 on p. 412 in the textbook with students.
8. The effects of a stroke include:
a. Loss of face, hand, arm, leg, or body control
b. Hemiplegia
c. Changing emotions
d. Difficulty swallowing (dysphagia)
e. Aphasia or slow or slurred speech
f. Changes in sight, touch, movement, and thought
g. Impaired memory
h. Urinary frequency, urgency, or incontinence
i. Depression and frustration
9. Rehabilitation starts at once.
a. The health team helps the person regain the highest possible level of function.
(1) See Box 24-6 on p. 412 in the textbook.

Review the contents of Box 24-6 on p. 412 in the textbook with students.
 Allow time for questions and discussion.
 Ask a representative from a stroke support group in your community to visit the class. Ask
the person to:
 Provide educational materials and handouts.
 Discuss their role and the services they provide.
 Allow time for questions and discussion.
10. Aphasia
a. Expressive aphasia is difficulty expressing or sending out thoughts.
(1) There are problems speaking, spelling, counting, gesturing, or writing.
(2) The person thinks one thing but says another.
(3) Sometimes only sounds, not words, are uttered.
(4) The person may cry or swear for no reason.
b. Receptive aphasia relates to difficulty receiving information.
(1) The person has trouble understanding what is said or read.
(2) People and common objects are not recognized.
c. Some people have expressive and receptive aphasia.
(1) This is called expressive-receptive aphasia.
C. Parkinson’s disease
1. Parkinson’s disease is a slow, progressive disorder with no cure.
a. Degeneration of a part of the brain occurs.
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2. Persons over 50 years old are at risk.
3. Some signs and symptoms are shown in Figure 24-11 on p. 413 in the textbook.


Refer students to Figure 24-11 on p. 413 in the textbook.
Arrange for a representative from the American Parkinson’s Disease Association to visit
the class. Ask the person to bring educational materials and handouts describing the role
of the organization and the services provided.
 Allow time for questions and discussion.
a. Pill-rolling movements
b. A mask-like expression
c. A fixed stare
4. Other signs and symptoms develop over time.
a. Swallowing and chewing problems
b. Constipation and bladder problems
c. Sleep problems
d. Depression
e. Memory loss, slow thinking, and emotional changes
f. Speech changes include slurred, monotone, and soft speech.
5. Treatment includes:
a. Drugs for Parkinson’s disease
b. Exercise and physical therapy to improve strength, posture, balance, and mobility
c. Therapy for speech and swallowing problems
d. Help with eating and self-care as needed
e. Measures to meet normal elimination needs
f. Safety measures to prevent injury
D. Multiple sclerosis

Arrange for a representative from the National Multiple Sclerosis Society to visit the class.
Ask the person to bring educational materials and handouts describing the role of the
organization and the services provided.
 Allow time for questions and discussion.
1. Multiple sclerosis (MS) is a chronic disease.
a. The myelin (which covers nerve fibers) in the brain and spinal cord are destroyed.
b. Nerve impulses are not sent to and from the brain in a normal manner.
2. There is no cure.
3. Symptoms usually start between the ages of 20 and 40.
4. Progression of the disease varies.
5. Symptoms depend on the damaged area.
a. The following may occur:
(1) Vision problems
(2) Muscle weakness and balance problems
(3) Paralysis
(4) Tremors, numbness, and tingling
(5) Loss of feeling
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(6) Speech problems
(7) Dizziness and poor coordination
(8) Problems with concentration, attention, memory, judgment, and behavior
(9) Bowel, bladder, and sexual function problems
(10) Respiratory muscle weakness
(11) Anger and depression
6. Persons with MS are kept active as long as possible.
a. The care plan reflects the person’s changing needs.
b. These measures are needed:
(1) Skin care
(2) Hygiene
(3) Range-of-motion exercises
(4) Turning and positioning
(5) Coughing and deep breathing
(6) Promoting normal bowel and bladder elimination
(7) Preventing injuries
(8) Preventing complications from bedrest
E. Spinal cord injuries
1. Spinal cord injuries can permanently damage the nervous system.
2. Common causes are stab or bullet wounds, accidents, falls, and sports injuries.
3. Cervical traction is often needed to keep the spine straight.
4. The higher the level of injury, the more functions lost.

Refer students to Figure 24-12 on p. 414 in the textbook.
a. Paraplegia is paralysis from the waist down.
b. Quadriplegia is paralysis from the neck down.
5. If the person survives, rehabilitation is necessary.
a. Care measures are listed in Box 24-7 on p. 414 in the textbook.


Review the contents of Box 24-7 on p. 414 in the textbook with students.
 Allow time for questions and discussion.
Arrange for a representative from a spinal cord injury rehabilitation facility to visit the
class. Ask the person to bring educational materials and handouts describing their role and
the services they provide.
 Allow time for questions and discussion.
V. HEARING LOSS
A. Hearing losses range from mild to severe.
1. Deafness is hearing loss in which it is impossible for the person to understand speech
through hearing alone.
B. A person may not notice gradual hearing loss.
C. Symptoms of hearing loss include:
1. Speaking too loudly
2. Leaning forward to hear
3. Turning and cupping the better ear toward the speaker
4. Answering questions or responding inappropriately
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5. Asking for words to be repeated
D. Hearing-impaired persons:
1. May wear hearing aids or read lips
2. Watch facial expressions, gestures, and body language
a. Follow the measures in Box 24-8 on p. 415 in the textbook to help the person hear or
lip-read (speech-read).
3. Some learn sign language.





Review the contents of Box 24-8 on p. 415 in the textbook with students.
 Allow time for questions and discussion.
Refer students to Figure 24-13 on p. 416 in the textbook.
Make arrangements for a person who uses sign language to visit the class. If any students
know how to use sign language, ask them to demonstrate.
Invite a professional who works with hearing impaired persons to speak to the class. Ask
the person to:
 Bring educational materials and handouts to enhance the learning experience.
 Share communication techniques.
 Discuss safety issues related to hearing impairment.
 Allow time for questions and discussion.
Provide disposable ear plugs for students. Ask them to place the plugs in their ears.
Conduct the class for 5 minutes while students have the ear plugs in place.
 Ask them to discuss the experience.
4. Some have hearing assistance dogs (hearing guide dogs).
E. Hearing aids
1. A hearing aid makes sounds louder.
a. It does not correct or cure the hearing problem.
2. The measures in Box 24-8 on p. 415 in the textbook apply.




Refer students to Figure 24-14 on p. 416 in the textbook.
Review the contents of Box 24-8 on p. 415 in the textbook with students.
Make arrangements for an audiologist to visit the class. Ask the audiologist to discuss:
 Types of hearing loss
 Care of hearing aides
Have various types of hearing aides available for students to see and handle.
 Ask them to practice:
 Putting in and removing a battery
 Turning the hearing aide on and off
 Adjusting the volume
3. When a hearing aide does not seem to work properly, try these simple measures:
a. Check if the hearing aid is on.
b. Check the battery position.
c. Insert a new battery if needed.
d. Clean the earmold if necessary.
4. Hearing aids are costly.
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a. Handle and care for them properly.
b. Report lost or damaged hearing aids to the nurse at once.
c. Check with the nurse before washing a hearing aid.
(1) Follow the manufacturer’s instructions.
d. Remove the battery at night.
e. When not in use, turn the hearing aid off.
VI. EYE DISORDERS
A. Vision loss:
1. Occurs at all ages
2. Is sudden or gradual in onset
3. Affects one or both eyes


Display TA 10 showing the structures of the eye. Use this to help students visualize which
structures are involved in each of the eye disorders.
Divide students into two groups. Provide each group with a flip chart and colored markers.
 Ask one group to provide the following information about glaucoma and the other
group to provide the information about cataracts.
 Definition
 Signs and symptoms
 Persons at risk
 Causes
 Treatment
 Allow 10 minutes. Then call on one student from each group to report to the class.
 Allow time for questions and discussion.
B. Glaucoma
1. Fluid pressure within the eye increases.
a. This damages the optic nerve.
b. Vision loss with eventual blindness occurs.
2. Onset is gradual or sudden.
3. Peripheral vision is lost.
a. The person:
(1) Sees through a tunnel

Refer students to Figure 24-15 on p. 417 in the textbook.
(2) Has blurred vision
(3) Sees halos around lights
4. With sudden onset, the person has severe eye pain, nausea, and vomiting.
5. Persons at risk include:
a. Those over age 40 years
b. African-Americans and Asian-Americans
6. Treatment involves drug therapy and possibly surgery.
a. The goal is to prevent further damage to the optic nerve.
(1) Prior damage cannot be reversed.
C. Cataract
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1. The lens of the eye becomes cloudy.
a. Light cannot enter the eye.

Refer students to Figure 24-16 on p. 417 in the textbook.
(1) Vision blurs and dims.
b. The person is sensitive to light and glares.
2. Aging is the most common cause.
3. Surgery is the only treatment.
a. The lens is removed and a plastic lens is put in the eye.
b. After surgery, protect the eye from injury:
(1) Keep the eye shield in place as directed.
(2) Follow measures for the blind person when an eye shield is worn.
(a) See pp. 418-419 in the textbook.
(3) Remind the person not to rub or press the affected eye.
(4) Do not bump the eye.
(5) Do not shower or shampoo the person without a doctor’s order.
(6) Report eye drainage or complaints of pain at once.

Simulate various types of vision impairment.
 Provide several pairs of eyeglasses for students to use. Put petroleum jelly on the lenses.
Have students wear the eyeglasses.
 Have students cover one eye with an eye patch.
 Have students cover both eyes with eye patches.
 Poke a small hole in the center of two eye patches. Have students cover both eyes with
the eye patches.
 Have students wear the eyeglasses and the eye patches for 5 minutes while
participating in class.
 Ask them to discuss the experience.
 Did they feel frustrated, angry, or left out?
 Did they have difficulty concentrating?
D. Corrective lenses
1. Eyeglasses and contact lenses can correct many vision problems.
2. Protect glasses from breakage or other damage.
a. When not worn, put them in the eyeglass case.
b. Put the case in the drawer of the bedside stand or overbed table.
3. To prevent loss, nursing centers label eyeglasses with the person’s name.
4. Clean glasses daily and as needed.
a. Use warm water for glass lenses.
b. Dry them with soft tissue.
c. Use special cleaning solutions, tissues, and cloths for plastic lenses.
5. Contact lenses fit on the eye.
a. To remove and clean them, follow the manufacturer’s instructions and agency
procedures.
E. Blindness
1. Causes include:
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a. Birth defects, accidents, and eye diseases
b. A complication of some diseases
2. The level of blindness varies.
3. Loss of sight is serious.
a. Adjustments are hard and long.
4. Braille is a writing system that uses raised dots.
a. Braille is read with the fingers.

Refer students to Figure 24-18 on p. 418 in the textbook.
5. Blind persons learn to move about using a white cane with a red tip or a guide dog.
a. Both are used worldwide.
6. Treat the blind person with respect and dignity.
a. Follow the practices in Box 24-9 on p. 419 in the textbook


Review the contents of Box 24-9 on p. 419 in the textbook with students.
 Allow time for questions and discussion.
Invite a professional who works with blind persons to speak to the class.
 Ask the person to:
 Bring educational materials and handouts to enhance the learning experience.
 Share communication techniques.
 Discuss safety issues related to blindness.
 Provide assistive devices used by blind persons.
 Provide braille reading material.
 Allow time for questions and discussion.
VII. RESPIRATORY DISORDERS
A. The respiratory system brings oxygen (O2) into the lungs and removes carbon dioxide (CO2)
from the body.
1. Respiratory disorders interfere with this function.


Display TA 13 showing the respiratory system. Use this to help students visualize the
structures involved in each of the respiratory disorders.
Ask students to identify the structures of the respiratory system affected by:
 Chronic bronchitis
 Emphysema
 Asthma
 Ask them to define the terms listed above. Write the correct answers on the chalk
board.
B. Chronic obstructive pulmonary disease (COPD)
1. Chronic bronchitis occurs after repeated episodes of bronchitis.
a. Bronchitis means inflammation of the bronchi.
b. Smoking is the major cause.
c. Symptoms
(1) Smoker’s cough in the morning is often the first symptom.
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

(a) At first the cough is dry.
(b) Over time the person coughs up mucus.
(2) Mucus may contain pus.
(3) The person has difficulty breathing and tires easily.
(a) Mucus and inflamed breathing passages obstruct airflow into the lungs.
d. Treatment involves:
(1) The person must stop smoking.
(2) Oxygen therapy and breathing exercises are often ordered.
(3) Respiratory tract infections are prevented.
(a) If one occurs, prompt treatment is needed.
2. Emphysema
a. In emphysema, the alveoli enlarge.
(1) They become less elastic.
(2) They do not expand and shrink normally with breathing in and out.
(a) Some air is trapped in the alveoli when exhaling.
(i) Over time, more alveoli are involved.
(ii) As more air is trapped in the lungs, the person develops a barrel chest.
Refer students to Figure 24-20 on p. 420 in the textbook.
Display TA 45 showing chest.
b. Breathing is easier when the person sits upright and slightly forward (Chapter 22).
c. Smoking is the most common cause.
d. Signs and symptoms include:
(1) Shortness of breath and a cough
(2) Sputum that may contain pus
e. Treatment involves:
(1) The person must stop smoking.
(2) Respiratory therapy, breathing exercises, and oxygen
(3) Drug therapy
3. Asthma
a. The airway narrows with asthma.
(1) Dyspnea results.
b. Allergies and emotional stress are common causes.
c. Symptoms are mild to severe.
(1) Wheezing and coughing are common.
d. Sudden attacks (asthma attacks) can occur.
e. Asthma is treated with drugs.
C. Pneumonia
1. Pneumonia is an inflammation and infection of lung tissue.
2. Bacteria, viruses, aspiration, and immobility are causes.
3. The person is very ill.
a. Fever, chills, painful cough, chest pain on breathing, and rapid pulse occur.
b. Cyanosis may be present.
c. Sputum is thick and green, yellowish, or rust colored.
4. Treatment measures involve:
a. Drugs for infection and pain
b. Increased fluid intake
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(1) To help reduce fever and to thin secretions
c. IV fluids and oxygen may be needed.
d. Semi-Fowler’s position eases breathing.
e. Standard Precautions are followed
f. Isolation Precautions depend on the cause.
D. Tuberculosis (TB)
1. TB is a bacterial infection in the lung.
2. TB is spread by airborne droplets with coughing, sneezing, speaking, and singing
(Chapter 10).
3. Risk factors include:
a. Living in close, crowded areas
b. Age
c. Poor nutrition
d. HIV infection
4. An active infection may not occur for many years.
a. Chest x-ray and TB testing can detect the disease.
5. Signs and symptoms are:
a. Tiredness
b. Loss of appetite and weight loss
c. Fever
d. Night sweats
e. Cough and sputum production
f. Chest pain
6. Treatment measures include:
a. Drugs for TB
b. Covering the mouth and nose with tissues when coughing or sneezing.
(1) Tissues are:
(a) Flushed down the toilet
(b) Or they are placed in a paper bag and burned
(c) Placed in a biohazard bag
(i) In health care agencies
c. Hand washing after contact with sputum
d. Standard Precautions and Isolation Precautions
VIII. CARDIOVASCULAR DISORDERS
A. Cardiovascular disorders are the leading causes of death in the United States.
1. Problems occur in the heart or blood vessels.


Display TA 12 showing the heart. Use this to help students visualize the structures involved
in each of the cardiovascular disorders.
Divide students into three groups. Provide each group with a flip chart and colored
markers. Assign one of the following cardiovascular disorders to each group:
Hypertension, coronary artery disease, and heart failure.
 Ask each group to provide the following information about the disorder assigned to
them.
 Definition
 Persons at risk
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




Causes
Signs and symptoms
Treatment
Care needs
 Allow 10 minutes. Then ask one person from each group to report to the class.
Arrange for a representative from the American Heart Association to visit the class. Ask
the person to bring educational materials and handouts describing the role of the
organization and the services provided.
 Allow time for questions and discussion.
B. Hypertension (high blood pressure)
1. With hypertension, the resting blood pressure is too high.
a. The systolic pressure is 140 mm Hg or higher.
b. Or the diastolic pressure is 90 mm Hg or higher.
2. Prehypertension is when:
a. The systolic pressure is between 120 and 139 mm Hg.
b. Or the diastolic pressure is between 80 and 89 mm Hg.
3. See Box 24-10 on p. 421 in the textbook for risk factors.


Review the contents of Box 24-10 on p. 421 in the textbook with students.
 Allow time for questions and discussion.
Ask students to discuss their individual risk factors.
 Ask them which risk factors they can control.
4. Causes include:
h. Narrowed blood vessels
i. Kidney disorders
j. Head injuries
k. Some pregnancy problems
l. Adrenal gland tumors
5. Signs and symptoms develop over time and include:
b. Headache
c. Blurred vision
d. Dizziness
e. Nose bleeds
6. Hypertension can lead to stroke, heart attack, heart failure, kidney failure, and blindness.
7. Treatment involves:
a. Drugs to lower blood pressure
b. A diet low in fat and salt
c. A healthy weight
d. Regular exercise
e. No smoking
f. Limiting alcohol and caffeine
g. Managing stress and sleeping well
C. Coronary artery disease (CAD)
1. The coronary arteries supply the heart with blood.
a. In CAD, one or all of the coronary arteries narrow.
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(1) The heart muscle gets less blood.
2. The most common cause is atherosclerosis.
a. The narrowed arteries block blood flow.

Refer students to Figure 24-21 on p. 421 in the textbook.
3. CAD is the leading cause of death in the United States.
4. Risk factors include:
a. Gender
(1) It is more common in men.
b. Age
(1) Older persons are at risk.
c. A family history of CAD
d. Smoking
e. Obesity
f. Lack of exercise
g. Hypertension
h. High cholesterol
i. Diabetes
5. Treatment involves reducing risk factors.
6. Major complications of CAD are angina pectoris and myocardial infarction.
7. Angina pectoris means chest pain.
a. The chest pain is from reduced blood flow to a part of the heart muscle.
(1) It occurs when the heart needs more oxygen.
b. Chest pain is described as a tightness or pressure.
c. Other symptoms may include:
(1) Discomfort in the chest
(2) Pain in the jaw, neck, and down one or both arms
(3) Pallor
(4) Feeling faint
(5) Perspiring
(6) Dyspnea
d. Rest and nitroglycerin often relieve symptoms in 3 to 15 minutes.
(1) A nitroglycerin tablet is placed under the tongue when an attack occurs.
(a) Tablets are kept with the person at all times.
e. Things that cause angina are avoided.
f. Doctor supervised exercise programs are helpful.
g. Surgery can open or bypass the diseased part of the artery.

Refer students to Figure 24-23 on p. 422 in the textbook.
(1) Increased blood flow to the heart is the goal.
h. Angina pectoris often leads to heart attack.
(1) Chest pain not relieved by rest and nitroglycerin may signal a heart attack.
(a) The person needs emergency care.
8. Myocardial infarction (MI)
a. With MI, part of the heart muscle dies.
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(1) Blood flow to the heart muscle is suddenly blocked.
(2) Sudden cardiac death (cardiac arrest) can occur (Chapter 26).
b. Signs and symptoms are listed in Box 24-11 on p. 422 in the textbook.

Review the contents of Box 24-11 on p. 422 in the textbook with students.
 Allow time for questions and discussion.
c. MI is an emergency.
(1) Life-threatening complications are prevented.
d. Cardiac rehabilitation is planned.
(1) The goal is to prevent another heart attack.
D. Heart failure
1. Heart failure or congestive heart failure (CHF) occurs when the heart cannot pump blood
normally.
a. Left-sided failure
(1) Blood backs up into the lungs.
(a) The person has dyspnea, increased sputum, and cough.
(2) The rest of the body does not get enough blood.
(a) Signs and symptoms occur from effects on the organs.
b. Right-sided failure
(1) Blood backs up into the venous system.
(a) Feet and ankles swell.
(b) Neck veins bulge.
(c) Liver congestion affects liver function.
(d) The abdomen becomes congested with fluid.
(2) The right side of the heart pumps less blood to the lungs.
(a) Normal blood flow does not occur from the lungs to the left side of the heart.
(b) The signs and symptoms described for left-sided failure occur.
2. Treatment involves:
a. Drugs to strengthen the heart
b. Drugs to reduce the amount of fluid in the body
c. A sodium-controlled diet
d. Fluid restrictions
e. Oxygen therapy
f. Semi-Fowler’s or Fowler’s position for breathing
g. Bedrest
h. Intake and output
i. Daily weight
j. Elastic stockings
k. Range-of-motion exercises
IX. URINARY SYSTEM DISORDERS
A. Urinary system disorders can occur in any of the major urinary system structures.


Display TA 15 showing the urinary system. Use this to help students visualize the
structures involved in each of the urinary system disorders.
Write the following terms on the chalk board:
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



20
Cystitis
Pyelonephritis
Renal calculi
Renal failure
 Call on students to write the definition after each term.
B. Urinary tract infections (UTI)
1. Microbes can enter the system through the urethra.
2. Catheters, poor perineal hygiene, immobility, and poor fluid intake are common causes.
3. Cystitis is a bladder infection.
a. Signs and symptoms include:
(1) Urinary frequency and urgency
(2) Pain or burning on urination
(3) Blood or pus in the urine
(4) Foul-smelling urine
(5) Fever
b. Treatment involves:
(1) Antibiotics
(2) Encourage fluids
c. If untreated, cystitis can lead to pyelonephritis.
4. Pyelonephritis is inflammation of the kidney pelvis.
a. Signs and symptoms include:
(1) Cloudy urine may contain pus, mucus, and blood.
(2) Chills and fever
(3) Back pain
(4) Nausea and vomiting
(5) Signs and symptoms of cystitis
b. Treatment involves antibiotics and fluids.
C. Renal calculi (kidney stones)
1. Risk factors include:
a. Bedrest
b. Immobility
c. Poor fluid intake
2. Signs and symptoms include:
a. Severe cramping pain in the back and side just below the ribs
b. Pain in the abdomen, thigh, and urethra
c. Nausea and vomiting
d. Fever and chills
e. Blood in the urine
f. Voiding is painful, frequent, and urgent
3. Treatment involves:
a. Drugs for pain relief
b. Intake of 2000 to 3000 ml of fluid a day
(1) Increased fluids help stones pass through the urine.
(a) All urine is strained.
c. Surgical removal of the stone may be necessary.
4. Some dietary changes can prevent stones.
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D. Renal failure
1. The kidneys do not function or are severely impaired.
a. Waste products are not removed from the blood.
b. The body retains fluid.
(1) Heart failure and hypertension easily result.
2. Renal failure may be acute or chronic.
X. THE ENDOCRINE SYSTEM
A. The endocrine system is made up of glands.
B. Diabetes is the most common endocrine disorder.
C. Diabetes



Write the following on a flip chart in outline form using a variety of colored markers.
Leave space to add information.
 Diabetes
 Definition
 Risk factors
 Types
 Signs and symptoms
 Complications
 Treatment
 Call on students to write in the information requested.
 Allow time for discussion.
Arrange for a representative from the American Diabetic Association to visit the class. Ask
the person to bring educational materials and handouts describing the role of the
organization and the services provided.
 Allow time for questions and discussion.
Arrange for a person with diabetes to visit the class. Ask the person to discuss:
 Daily routine
 Dietary issues
 Exercise program
 Impact of the disease on life-style
 Allow time for questions.
1. In this disorder the body cannot produce or use insulin properly causing sugar to build up
in the blood.
a. Insulin is needed for sugar use.
(1) The pancreas secretes insulin.
2. There are three types of diabetes:
a. Type 1 occurs most often in children and young adults.
(1) The pancreas produces little or no insulin.
(2) Onset is rapid.
(3) There is:
(a) Increased thirst and urination
(b) Constant hunger
(c) Weight loss
(d) Blurred vision
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Instructor’s Resource Manual
3.
4.
5.
6.
(e) Extreme fatigue
b. Type 2 occurs in adults.
(1) Risk factors are:
(a) Being over 40 years of age
(b) Obesity
(c) Hypertension
(2) The pancreas secretes insulin.
(a) The body cannot use it well.
(3) Onset is slow.
(4) The person has:
(a) Fatigue
(b) Nausea
(c) Frequent urination
(d) Increased thirst
(e) Weight loss
(f) Blurred vision
(g) Frequent infections
(h) Slow wound healing
c. Gestational diabetes develops during pregnancy.
(1) It usually goes away after the baby is born.
(a) The woman is at risk for type 2 diabetes later in life.
Complications include:
a. Blindness
b. Renal failure
c. Nerve damage
d. Hypertension
e. Circulatory disorders
(1) These can lead to stroke, heart attack, and slow healing.
(2) Foot and leg wounds are very serious.
(a) Infection and gangrene can occur.
Risk factors include:
a. A family history of the disease
b. For type 1, whites are at greater risk than nonwhites.
c. Type 2 is more common in older and overweight persons.
Treatment
a. Type 1 is treated with daily insulin therapy, healthy eating, and exercise.
b. Type 2 is treated with healthy eating and exercise.
(1) Many persons with type 2 take oral drugs.
(a) Some need insulin.
(2) Overweight persons need to lose weight.
c. Both types require:
(1) Blood glucose monitoring
(2) Good foot care
The person’s blood sugar level can fall too low or go too high.
a. Hypoglycemia means low sugar in the blood.
b. Hyperglycemia means high sugar in the blood.
c. See Box 24-12 on p. 424 in the textbook for their causes, signs, and symptoms.
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(1) Call for the nurse at once if signs or symptoms occur.

Review the contents of Box 24-12 on p. 424 in the textbook with students.
 Allow time for questions and discussion.
XI. DIGESTIVE DISORDERS
A. The digestive system breaks down food so the body can absorb it.
1. Solid wastes are eliminated.
B. Diverticular disease
1. Many people have small pouches in their colons.
 Refer students to Figure 24-24 on p. 424 in the textbook.
a. Each pouch is called a diverticulum.
(1) The condition of having these pouches is called diverticulosis.
b. When the pouches become infected or inflamed, this is called diverticulitis.
2. Risk factors are:
a. Age
(1) It is common in older persons.
b. A low-fiber diet
c. Constipation
3. When feces enter the pouches, they can become inflamed and infected.
a. The following can occur:
(1) Abdominal pain and tenderness in the lower left abdomen
(2) Fever
(3) Nausea and vomiting
(4) Chills
(5) Cramping
(6) Constipation
(7) Bloating
(8) Rectal bleeding
(9) Frequent urination and pain while voiding
4. Treatment measures include:
a. Dietary changes
b. Antibiotics
c. Surgery (for severe disease, obstruction, and ruptured pouches)
(1) Sometimes a colostomy is necessary (Chapter 16).
C. Vomiting
1. Vomiting means expelling stomach contents through the mouth.
a. It signals illness or injury.
b. Aspirated vomitus can obstruct the airway.
c. Vomiting large amounts of blood can lead to shock.
2. These measures are needed:
a. Follow Standard Precautions and the Bloodborne Pathogen Standard.
b. Turn the person’s head well to one side.
c. Place a kidney basin under the person’s chin.
d. Move vomitus away from the person.
e. Provide oral hygiene.
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f. Observe vomitus for color, odor, and undigested food.
(1) If it looks like coffee grounds, it contains digested blood.
(a) Report your observations.
g. Measure, report, and record the amount of vomitus.
(1) Note the amount on the I&O record.
h. Save a specimen for laboratory study.
i. Dispose of vomitus after the nurse observes it.
j. Provide for comfort.

Refer students to the inside of the front book cover for comfort measures.
XII. COMMUNICABLE DISEASES
A. Communicable diseases are contagious or infectious diseases.

Arrange for a representative from the department of health to speak to the class. Ask the
person to cover the following topics: Hepatitis, AIDS, and sexually transmitted diseases.
 Mode of transmission and special precautions for each disease should be covered.
 Brochures and handouts about each disease can help reinforce the information
presented.
 Allow time for questions and discussion.
1. Standard Precautions and Isolation Precautions are followed.
2. Assist the person with hygiene and hand washing as needed.
B. Hepatitis
1. Hepatitis is an inflammation of the liver.
a. It can be mild or cause death.
2. Signs and symptoms are listed in Box 24-13 on p. 425 in the textbook.

Review the contents of Box 24-13 on p. 425 in the textbook with students.
 Allow time for questions and discussion.
3. Treatment involves rest, a healthy diet, fluids, and no alcohol.
a. Recovery takes about 8 weeks.
4. There are five major types of hepatitis:
a. Hepatitis A is spread by the fecal-oral route.
(1) Causes include:
(a) Poor sanitation
(b) Crowded living conditions
(c) Poor nutrition
(d) Poor hygiene
(e) Anal sex
(f) IV drug abuse
(2) These measures are needed:
(a) Handle bedpans, feces, and rectal thermometers carefully.
(b) Good hand washing is needed by everyone, including the person.
b. Hepatitis B is caused by the hepatitis B virus (HBV).
(1) It is present in the blood and body fluids of infected persons.
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(a) Saliva, semen, vaginal secretions
(2) It is spread by:
(a) Contaminated blood products
(b) IV drug use
(c) Sexual contact, especially anal sex
c. Hepatitis C is spread by blood contaminated with the virus.
(1) A person may have the virus but no symptoms.
(a) Even without symptoms, the person can transmit the disease.
(2) The virus is spread by:
(a) Contaminated blood products
(b) IV drug use; inhaling cocaine through contaminated straws
(c) Contaminated needles used for tattooing and body piercing
(d) High-risk sexual activity
d. Hepatitis D occurs in persons infected with the hepatitis B virus (HBV).
(1) It is spread the same way as HBV.
e. Hepatitis E occurs in countries with contaminated water supplies.
(1) It is spread by the fecal-oral route.
C. Acquired immunodeficiency syndrome (AIDS)
1. AIDS is caused by a virus.
a. The virus is called the human immunodeficiency virus (HIV).
(1) It attacks the immune system.
b. It is a life-threatening disease.
c. The virus is spread through:
(1) Body fluids
(a) Blood, semen, vaginal secretions, and breast milk
d. The virus is transmitted mainly by:
(1) Unprotected anal, vaginal, or oral sex with an infected person
(a) “Unprotected” is without a new latex or polyurethane condom.
(2) Needle and syringe sharing among IV drug users
(3) HIV-infected mothers before or during childbirth and through breast-feeding
2. Box 24-14 on p. 426 in the textbook lists the signs and symptoms of AIDS.

Review the contents of Box 24-14 on p. 426 in the textbook with students.
 Allow time for questions and discussion.
a. Persons infected with HIV may be symptom free for 8 to 10 years.
(1) They carry the virus and can spread it to others.
3. Persons with AIDS are at risk for:
a. Pneumonia, TB, and Kaposi’s sarcoma (a cancer)
b. Memory loss, loss of coordination, paralysis, mental health disorders, and dementia
4. You may care for persons with AIDS or those who are HIV carriers.
a. See Box 24-15 on p. 426 in the textbook.

Review the contents of Box 24-15 on p. 426 in the textbook with students.
 Allow time for questions and discussion.
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


26
Arrange for a representative from an AIDS support group to visit the class. Ask the person
to bring educational materials and handouts describing their role and the services they
provide.
 Allow time for questions and discussion.
Use a round-table discussion format. Ask students to:
 Discuss risk factors for AIDS.
 Discuss life style issues and ways to decrease risk.
 Discuss how they feel about caring for persons with AIDS.
 Discuss how they might handle these feelings.
Have information about AIDS available from the CDC (Centers for Disease Control and
Prevention).
 Provide handouts to students.
b. Follow Standard Precautions and the Bloodborne Pathogen Standard.
(1) In some persons, HIV or AIDS is not yet diagnosed.
(2) Persons age 50 years and older also get AIDS.
(a) They get and spread HIV through sexual contact and IV drug use.
(b) Aging and other diseases can mask the signs and symptoms of AIDS.
D. Sexually transmitted diseases (STDs)
1. STDs are spread by oral, vaginal, or anal sex.
2. People with STDs
a. May not have signs and symptoms
b. May not be aware of an infection
c. May know but do not seek treatment because of embarrassment
3. STDs occur in:
a. The genital and rectal areas
b. The ears, mouth, nipples, throat, tongue, eyes, and nose
4. Using condoms helps prevent the spread of STDs.
5. Some STDs are spread:
a. Through skin breaks
b. By contact with infected body fluids
c. By contaminated blood or needles
6. Standard Precautions and the Bloodborne Pathogen Standard are followed.
XIII. MENTAL HEALTH DISORDERS
A. Mental relates to the mind.
1. Mental health involves the mind.
B. Mental health and mental illness involve stress.
1. Stress is the response or change in the body caused by any emotional, physical, social, or
economic factor.
C. Mental health means that the person copes with and adjusts to everyday stresses in ways
accepted by society.
D. Mental illness is a disturbance in the ability to cope with or adjust to stress.
1. Behavior and function are impaired.
2. Causes include:
a. Inability to cope or adjust to stress
b. Chemical imbalances
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c. Genetics
d. Drug or substance abuse
e. Social and cultural factors
E. Anxiety disorders
1. Anxiety is a vague, uneasy feeling in response to stress.
a. The person acts to relieve the unpleasant feeling.
2. Often anxiety occurs when needs are not met.
3. Some anxiety is normal.
a. Persons with mental health problems have higher levels of anxiety.
4. Signs and symptoms depend on the degree of anxiety.
a. See Box 24-16 on p. 427 in the textbook.

Review the contents of Box 24-16 on p. 427 in the textbook with students.
 Ask students if they have ever experienced any of the signs or symptoms of anxiety
listed in the box. Discuss the situations and the coping and defense mechanisms used to
relieve anxiety.
5. Coping and defense mechanisms relieve anxiety.
a. Some are healthy; others are not.
6. Defense mechanisms are unconscious reactions that block unpleasant or threatening
feelings.
a. See Box 24-17 on p. 427 in the textbook.

Review the contents of Box 24-17 on p. 427 in the textbook with students.
 Ask students which defense mechanisms they might use to relieve anxiety.
b. Some use of defense mechanisms is normal.
c. With mental health problems, they are used poorly.
7. Some common anxiety disorders are:
a. Panic disorder
(1) Panic is an intense and sudden feeling of fear, anxiety, terror, or dread.
(a) Onset is sudden with no obvious reason.
(b) The person cannot function.
b. Phobias
(1) Phobia means fear, panic, or dread.
(a) The person has an intense fear of an object, situation, or activity.
c. Obsessive-compulsive disorder
(1) An obsession is a recurrent, unwanted thought or idea.
(2) Compulsion is repeating an act over and over again (a ritual).
(a) The person has much anxiety if the act is not done.
F. Schizophrenia
1. Schizophrenia means split mind.
a. It is a severe, chronic, disabling brain disease that involves:
(1) Psychosis
(a) This is a state of severe mental impairment.
(b) The person does not view the real or unreal correctly.
(2) Delusion
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b.
c.
d.
e.
f.
g.

(a) A false belief
(3) Hallucination
(a) Seeing, hearing, or feeling something that is not real
(4) Paranoia
(a) A disorder of the mind
(b) The person has false beliefs (delusions).
(i) He or she is suspicious about a person or situation.
(5) Delusion of grandeur
(a) An exaggerated belief about one’s importance, wealth, power, or talents
(6) Delusion of persecution
(a) The false belief that one is being mistreated, abused, or harassed
Thinking and behavior are disturbed.
The person has delusions and hallucinations.
The person has problems relating to others.
He or she may be paranoid.
Communication is disturbed.
Some persons regress.
(1) See Box 24-17 on p. 427 in the textbook.
Refer students to Box 24-17 on p. 427 in the textbook.
G. Affective disorders
1. Affective disorders involve feelings, emotions, and moods.
2. Bipolar disorder (manic-depressive illness)
a. Bipolar means two poles or ends.
b. The person has severe extremes in mood, energy, and ability to function.
(1) There are emotional lows (depression) and emotional highs (mania).
c. The disorder tends to run in families.
3. Major depression
a. Depression involves the body, mood, and thoughts.
b. The person is very sad.
c. Body functions are depressed.
d. Depression is common in older persons.
(1) Causes include:
(a) Many losses
(b) Loneliness
(c) The side effects of some drugs
(2) See Box 24-18 on p. 428 in the textbook for the signs and symptoms of
depression in older persons.


Review the contents of Box 24-18 on p. 428 in the textbook with students.
Invite a psychologist to speak to the class about depression in older persons.
 Allow time for questions and discussion.
(3) Often the person is thought to have a cognitive disorder (Chapter 25).
(a) Depression often is untreated in older persons.
H. Personality disorders
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1. Personality disorders involve rigid and maladaptive behaviors.
a. To adapt means to change or adjust.
b. Maladaptive means to change or adjust in the wrong way.
2. Personality disorders include:
a. Abusive personality
(1) The person copes with anxiety by abusing others.
(a) Behavior may be violent.
b. Paranoid personality
(1) The person is very suspicious.
c. Antisocial personality
(1) The person has poor judgment.
(2) He or she lacks responsibility and is hostile.
(3) Morals and ethics are lacking.
(4) The person is often in trouble with the police.
I. Care and treatment
1. Treatment involves:
a. Having the person explore thoughts and feelings
(1) Psychotherapy, group, occupational, art, and family therapies are used.
b. Drugs
2. The RN uses the nursing process to meet the person’s needs.
a. Communication is important.
(1) Be alert to the person’s nonverbal communication and your own.
XIV. FOCUS ON THE PERSON
A. A person may have one or more health problems.
1. The care you give affects the person’s quality of life.
B. Focus on the person: caring for persons with common health problems
1. Providing comfort
a. Comfort needs depend on the disorder.
b. To provide comfort:
(1) Follow the care plan.
(2) Follow the measures listed on the inside of the front book cover.

Refer students to the comfort measures on the inside of the front book cover.
2. Ethical behavior
a. Some disorders, accidents, and injuries result from life-style choices.
(1) Do not judge the person or the person’s actions.
(2) Always treat the person with dignity and respect.
3. Remaining independent
a. Many people require rehabilitation after illness, injury, or surgery.
(1) Follow the rehabilitation plan (Chapter 23).
4. Speaking up
a. Only the common health problems were presented in this chapter.
b. Only basic information was given.
c. If you want or need more information about a problem:
(1) Ask the nurse to explain the problem and the care required.
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(2) Look up the problem in a medical dictionary.
5. OBRA and other laws
a. Protecting the person’s privacy and confidentiality is required by OBRA and the
Health Insurance Portability and Accountability Act of 1996 (HIPAA).
(1) If you are not involved in a person’s care, you have no right to information about
that person.
(2) You cannot share information about patients or residents with family or friends.
6. Nursing teamwork
a. A person’s condition can change very quickly.
(1) Sudden changes in a person’s condition require the nurse’s attention.
(a) You need to help as the nurse directs.
(i) Always help willingly.
b. The entire nursing team may need to make that “extra effort” to meet patient and
resident needs.
Homework Assignment
Ask students to answer the questions at the end of Chapter 24 in the textbook. Tell them the date and
time this assignment must be completed and turned in.
If the accompanying Student Workbook is being used, assign the Chapter 24 workbook exercises.
Tell students the date and time this assignment must be completed and turned in.
Ask students to interview a person with one of the common health problems discussed in this
chapter. Tell them to ask about age of onset, risk factors, cost of health care, and how the disease
affects activities of daily living. Ask them to write a report about the interview. Tell them the date
and time this assignment must be completed and turned in.
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Chapter 24 Student Assignment
Name: _________________________________
Date: __________________________________
Caring For Persons With Common Health Problems
Matching
Match each terms with the correct definition.
A. Glaucoma
B. Cataract
C. Compensation
D. Conversion
E. Pneumonia
F. Denial
G. Compulsion
H. Hepatitis
I. Projection
J. Rationalization
K. Diverticulitis
L. Regression
M. Repression
N. Angina pectoris
1. _______ To give some acceptable reason or excuse for one’s behavior. The real reason is not
given.
2. _______ An eye disease in which fluid pressure within the eye increases
3. _______ To make up for or substitute a strength for a weakness
4. _______ Repeating an act over and over again
5. _______ An eye disease in which the lens of the eye becomes cloudy
6. _______ Refusing to accept or believe something that is true
7. _______ Blaming another person or object for one’s unacceptable behavior, emotions, ideas, or
wishes
8. _______ Keeping unpleasant or painful thoughts or experiences from the conscious mind
9. _______ An inflammation and infection of lung tissue
10. _______ Chest pain
11. _______ When an emotion is shown or changed into a physical symptom
12. _______ To retreat or move back to an earlier time or condition
13. _______ Pouches in the colon become infected or inflamed
14. _______ An inflammation of the liver
Fill in the Blanks
15. A new growth of abnormal cells is a ______________________________________ .
16. List three common cancer treatments.
A. _________________________ ______________________________________
B. ___________________________ __________________________ ___________
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C. ______________________________________ __________________________
17. Arthritis means
____________________________________________________________________.
18. ______________________________________ is a chronic inflammatory disease that causes
joint pain, swelling, and stiffness. It occurs on both sides of the body.
19. ______________________________________ is the surgical replacement of a joint.
20. With osteoporosis, the bone becomes ______________________________________.
21. Miss Lewis had an open reduction of her fractured right arm. This means _________
____________________________________________________________________.
22. With ____________________________________________________, a steady pull from two
directions keeps the bone in place.
23. _________________________________________________________________ is the leading
cause of disability in adults.
24. With ____________________________________________ aphasia, the person has trouble
understanding what was said.
25. Symptoms of multiple sclerosis usually start between the ages of ________________.
26. With spinal cord injuries, problems depend on the level of injury. Injuries at the thoracic level
cause ____________________________________________________.
27. A hearing aid helps the person hear better because ___________________________.
28. With glaucoma, fluid pressure in the eye increases. This damages the ____________
____________________________________________________________________.
29. The most common cause of cataract is _____________________________________.
30. The three disorders grouped under chronic obstructive pulmonary disease interfere with
_______________________________________________________________.
31. ________________________________ and ________________________________ are
common causes of asthma.
32. Tuberculosis is detected by ___________________ and ______________________ .
33. ______________________________________________ are the leading causes of death in the United
States.
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34. List seven risk factors for coronary artery disease (CAD) that the person can change.
A. ________________________________ ___________________________________
B. ________________________________ ___________________________________
C. ________________________________ ___________________________________
D. _______________________________________________________________
E. _______________________________________________________________
F. _______________________________________________________________
G. _______________________________________________________________
35. With right-sided heart failure, blood backs up into ___________________________.
36. _____________________________ is a bladder infection _____________________ .
37. ________________________, ______________________, and _________________ are risk
factors for renal calculi (kidney stones).
38. The endocrine system is made up of ______________________________________ .
39. _____________________________________________________ is a disorder in which the body
cannot produce or use insulin properly.
40. List five complications of uncontrolled diabetes.
A. ________________________________ ___________________________________
B. ________________________________ ___________________________________
C. ________________________________ ___________________________________
D. _______________________________________________________________
E. _______________________________________________________________
41. Many people have small pouches in their colons. This condition is called __________.
42. Vomiting signals ____________________________________________________________.
43. Treatment of hepatitis involves ______________________________________________
__________________________________________________________________________.
44. Hepatitis C is spread by:
A. ________________________________ ___________________________________
B. ________________________________ ___________________________________
C. ________________________________ ___________________________________
D. _______________________________________________________________
45. The virus that causes AIDS is called ___________________________________________.
46. HIV is spread through these body fluids:
A. ________________________________ ___________________________________
B. ________________________________ ___________________________________
C. ________________________________ ___________________________________
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D. _______________________________________________________________
47. Mental health and mental illness involve _______________________________________.
48. Anxiety often occurs when ___________________________________________________.
49. _________________________________ and __________________________________ are used to
relieve anxiety.
50. Define these terms:
A. Phobia _________________________________________________________________
B. Panic __________________________________________________________________
C. Delusion of grandeur _____________________________________________________
51. With ______________________________________, the person has emotional lows and emotional
highs.
52. Depression involves _________________________________________________________
__________________________________________________________________________
53. The person with a paranoid personality is _____________________________________.
54. Ms. Green is a patient at Eastside Hospital. A visitor asks you about Ms. Green’s condition. How
should you respond? _________________________________________
__________________________________________________________________________
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Chapter 24 QUIZ
Name: _________________________________
Date: __________________________________
Caring For Persons With Common Health Problems
True or False
Mark T for true or F for false.
1. ____________ A malignant tumor grows slowly and does not invade healthy tissue.
2. ____________ Radiation destroys cancer cells and normal cells.
3. ____________ Osteoporosis is common in young men.
4. ____________ A closed fracture means the bone is broken but the skin is intact.
5. ____________ Elevating a leg in a cast on a pillow reduces swelling.
6. ____________ Traction is removed to make the person’s bed.
7. ____________ Stroke is the leading cause of disability in adults.
8. ____________ A person may not notice gradual hearing loss.
9. ____________ Hearing loss may cause speech problems.
10. ____________ Check with the nurse before washing a hearing aid.
11. ____________ Speak in a very loud voice when communicating with the hearing-impaired person.
12. ____________ Surgery is the only treatment for cataracts.
13. ____________ Eyeglasses are kept on the overbed table at night.
14. ____________ A ruptured blood vessel is a common cause of stroke.
15. ____________ Multiple sclerosis is cured with drugs and diet.
16. ____________ Quadriplegia is paralysis from the neck down.
17. ____________ Smoking is the most common cause of emphysema.
18. ____________ Angina pectoris means chest pain.
19. ____________ The use of condoms helps prevent the spread of STDs.
20. ____________ Some anxiety is normal.
21. ____________ Affective disorders involve hallucinations and paranoia.
Multiple Choice
Circle the BEST answer.
22. Inflammation of the mouth is
A. Aphasia
B. Metastasis
C. Benign
D. Stomatitis
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23.These statements are about osteoarthritis. Which is false?
A. It occurs with aging.
B. Joint injury and obesity are causes.
C. Joint stiffness occurs with rest and lack of motion.
D. Fatigue and fever are common.
24. The surgical replacement of a joint is called
A. Metastasis
B. Arthroplasty
C. Osteoporosis
D. Open reduction
25.A plaster cast is applied to Mr. Adams’s leg. Which is false?
A. Cover the cast with a blanket.
B. Use pillows to support the entire length of the cast.
C. Keep the cast dry.
D. Turn Mr. Adams as directed by the nurse.
26.Which is incorrect when caring for a person with a hip fracture?
A. Give good skin care.
B. Prevent external rotation of the hip.
C. Perform range-of-motion exercises as directed.
D. Keep the operated leg adducted at all times.
27.A person has had a stroke. Which is incorrect?
A. Rehabilitation starts about 1 week after the stroke.
B. Give emotional support and encouragement.
C. Give good skin care.
D. Encourage coughing and deep breathing.
28.Which statement about multiple sclerosis is true?
A. The onset is sudden.
B. Symptoms usually start after age 60.
C. Symptoms always progress rapidly.
D. Vision problems may occur.
29. Which statement about hearing aids is true?
A. Hearing aids make sounds louder.
B. Hearing aids correct the hearing problem.
C. The entire hearing aid is washed daily in soapy water.
D. The battery is left in the hearing aid at night.
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30. Cataract is an eye disorder in which
A. The optic nerve is damaged.
B. Fluid pressure within the eye increases.
C. The lens becomes cloudy.
D. Severe eye pain is common.
31.When caring for the blind person, do all of the following except:
A. Face the person when speaking.
B. Use a normal tone of voice.
C. Avoid using the words “see,” “look,” or “read.”
D. Identify yourself when you enter the room.
32. To communicate with the hearing-impaired person:
A. Approach the person from behind.
B. Speak very loudly or shout to be heard.
C. Speak clearly, distinctly, and slowly.
D. Cover your mouth while talking.
33. A writing system that uses raised dots is:
A. Cerumen
B. Tinnitus
C. Vertigo
D. Braille
34. You are caring for a person with congestive heart failure. Which is not likely to be part of the
person’s care plan?
A. Measuring intake and output
B. Measuring daily weight
C. Encouraging fluids to 2500 ml per day
D. Applying elastic stockings
35.The following are risk factors for coronary artery disease. Which cannot be changed?
A. Family history
B. Being overweight
C. Smoking
D. Lack of exercise
36. An infection of the bladder is
A. Cystitis
B. Pyelonephritis
C. Renal calculi
D. Dialysis
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37.Which statement about Type 1 diabetes is false?
A. The amount of sugar in the diet is limited.
B. It is treated with diet and exercise only.
C. It requires blood glucose monitoring.
D. It occurs most often in children and young adults.
38. This type of hepatitis is spread by the fecal-oral route
A. Hepatitis B
B. Hepatitis D
C. Hepatitis C
D. Hepatitis A
39. The HIV virus is spread by:
A. Sneezing and coughing
B. Insects
C. Unprotected anal, vaginal, and oral sex
D. Holding hands and hugging
40.Which is not a sign or symptom of depression?
A. Feelings of hopelessness
B. Changes in the person’s sleep pattern
C. Thoughts of suicide
D. Increased energy
41. A vague, uneasy feeling that occurs in response to stress is
A. Obsession
B. Delusion
C. Anxiety
D. Mental disorder
42. The repeating of an act over and over is
A. Phobia
B. Paranoia
C. Delusion
D. Compulsion
43.Which statement about defense mechanisms is false?
A. They are used to relieve anxiety.
B. They are a symptom of mental illness.
C. They are used to block unpleasant feelings.
D. They are unconscious reactions.
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44. The person with this disorder has severe extremes in mood, energy, and ability to function.
A. Paranoia
B. Major depression
C. Bipolar disorder
D. Psychosis
45. Mr. Jansen is 75 years old. You notice that he lacks interest in his grooming, he complains of not
sleeping, and he is constipated. These are signs and symptoms of
A. Aging
B. A phobia
C. Abusive personality
D. Depression
46. The person with an antisocial personality
A. Mistrusts others
B. Abuses drugs and alcohol
C. Has an intense fear of an object, situation, or activity
D. Has poor judgment, lacks responsibility, and is hostile
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