Upload
desrene-denton
View
223
Download
0
Embed Size (px)
Citation preview
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
1/43
Adelaida L. Mayeta-Peart
Dr. Feleta Wilson
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
2/43
Understand the term chronic non-
communicable Discuss characteristics of chronic non-
communicable diseases
Review some communicable diseases
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
3/43
Non-communicable diseases are a serious
threat to global well-being, They present a growing economic and social
challenge for many developed and developing
countries.
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
4/43
Diseases of long duration and generally slow
progression.
By far the leading cause of mortality in the world,
representing 60 % of all deaths.
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
5/43
Not infectious
May result from genetic or lifestyle factors Illness caused by something other than a
pathogen
It might result from hereditary factors, improper
diet, smoking, or other factors
Those resulting from lifestyle factors are
sometimes called diseases of affluence
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
6/43
No single necessary agent
Seldom agent-disease specificity
Intervention often based on risk factors as causes areunknown
Long latency period
May require multiple exposure to same or multiple agents
Most often produces chronic diseases Acquired immunity unlikely
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
7/43
Hypertension
Diabetes
Cardiovascular disease
Physical inactivity & unhealthy diets
Cancer Mental health problems
Asthma
Cerebrovascular accident (CVA)
Atherosclerosis
Allergy
osteoarthritis
osteoarthritis , etc
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
8/43
Unhealthy diets (especially those which have a
high content in fats, free sugars and salt)
Physical inactivity
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
9/43
Physical inactivity and unhealthy diets are majorcontributors to overweight (Body Mass Index: 25
29.9) and obesity (BMI greater than 30). Extra body weight increases the risk of serious
health consequences such as:
- Cardiovascular disease (mainly heart disease and
stroke)- Diabetes
- Breast, colon and endometrial cancers
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
10/43
Children are also affected. It is estimated that, in
2005, at least 20 million children under the age of5 years were overweight.
Childhood obesity is associated with a higher
chance of premature death and disability in
adulthood.
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
11/43
Tobacco use
Physical inactivity Unhealthy diet
Over 80% of cardiovascular disease deaths take
place in low-and middle-income countries and
occur almost equally in men and women.
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
12/43
Coronary heart disease (heart attacks)
Cerebrovascular disease Raised blood pressure (hypertension)
Peripheral artery disease
Rheumatic heart disease Congenital heart disease
Heart failure
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
13/43
Cardiovascular diseases affect many people in
middle age, very often severely limiting theincome and savings of affected individuals and
their families.
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
14/43
Interruption of the blood supply to a part of the
brain and the development neurological deficits Prevention-To prevent stroke causes must be
identified:
- Hypertension
- Atherosclerosis(narrowing of the arteries by fattydeposits)
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
15/43
A stroke cannot be controlled; but some of the
causes can be prevented or controlled e.g.- Obesity
- Hypertension
- Diabetes
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
16/43
Chronic disease that occurs when the pancreas
does not produce enough insulin (a hormone thatregulates blood sugar/ carbohydrate
metabolism) or alternatively, when the body
cannot effectively use the insulin it produces
Characterized by hyperglycemia and glycosuriaresulting from inadequate production or
utilization of insulin
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
17/43
Heterogeneous group of disorders of
carbohydrates, fat and protein metabolism,characterized by chronic hyperglycemia,
degenerative vascular changes and neuropathy
It accelerates degenerative changes throughout
the body by widespread vascular changes in thelarge and small blood vessels
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
18/43
Cannot be cured however hyperglycemic agents
can be used to lower the blood glucose, therebyeffecting acceptable levels of blood glucose and
therefore, control
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
19/43
In order to prevent a condition, the cause must
be identified. In Diabetes mellitus the possiblecauses are:
- Destruction of Beta cells
- Retarded release of insulin
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
20/43
Correcting hyperglycemia & glycosuria
Maintaining normal weight Encouraging appropriate activity (exercises)
Encouraging healthy eating habits
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
21/43
Trained nurse (PHN/nurse educator) Engage educate and empower patient to
manage diabetes and impact of disease on
patient and family
Based on trust and partnership between publichealth centre (PHN/ health care team), patient
and family
Patient determine agreed targets
Continuity and access
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
22/43
Case study
Mr. R. is 45 yrs old and self employed. He hasbeen diagnosed with Diabetes mellitus, however
he does not understand why he must make so
many new changes to his lifestyle as he is really
comfortable with his life now. He does notexercise and he hates vegetables. However his
family is concerned as he is constantly in and out
of hospital and he is the breadwinner for the
family
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
23/43
Use the nursing process addressing issues
a) Assessb) Diagnose
c) Plan strategies to address problem
d) Implement plane) Evaluate such plan
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
24/43
Sickle-cell anemia: life-long blood disordercharacterized by red blood cells that assume an
abnormal, rigid, sickle shape
The sickle shape occurs because of a mutation in
the hemoglobin gene
Life expectancy is shortened, an average lifeexpectancy of 42 and 48 years for males and
females, respectively.
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
25/43
Stroke: result from a progressive vascularnarrowing of blood vessels, preventing oxygenfrom reaching the brain. Cerebral infarction
occurs in children, and cerebral hemorrhage inadults.
Cholelithiasis (gallstones) and cholecystitis,which may result from excessive bilirubinproduction and precipitation due to prolongedhaemolysis
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
26/43
Jaundice: May occur due to the inability of theliver to effectively remove bilirubin from the
filtering of damaged red blood cells out of the
blood supply as well as blocks in the organ's
blood supply
Avascular necrosis (aseptic bone necrosis) of thehip and other major joints, which may occur as a
result of ischemia.
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
27/43
Decreased immune reactions due tohyposplenism (malfunctioning of the spleen).
Priapism and infarction of the penis
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
28/43
Sickle-cell conditions are inherited from parentsin much the same way as blood type, hair color
and texture, eye color, and other physical traits.
The types of hemoglobin a person makes in the
red blood cells depend on what hemoglobin
genes are inherited from his parents.
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
29/43
If one parent has sickle-cell anemia (SS) and theother has sickle-cell trait (AS), there is a 50%
chance of a child's having sickle-cell disease (SS)
and a 50% chance of a child's having sickle-cell
trait (AS).
When both parents have sickle-cell trait (AS), achild has a 25% chance (1 of 4) of sickle-cell
disease (SS), as shown in the diagram.
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
30/43
Sickle-Cell Disease
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
31/43
Proliferation of cells whose unique trait- loss ofnormal controls results on unregulated growth,
lack of differentiation , local tissue invasion and
metastasis (spread from one organ to another
non-adjacent organ)
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
32/43
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
33/43
Advocate for reduction of salt consumption
Advocate for reduction of saturated fat
consumption
Advocate to limit intake of free sugars
Promote increase consumption of fruits andvegetables
Encourage achievement of a healthy weight
Encourage practice of adequate levels of physicalactivity.
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
34/43
Ensure that physical environments for walking,cycling and other forms of physical activity are
accessible to and safe for all
Introduce transport policies that promote active
and safe methods of traveling to schools andworkplaces, such as walking or cycling
Improve sports, recreation and leisure facilities
Increase the number of safe spaces available foractive play
For diet and physical activity interventions that
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
35/43
Monitor tobacco use and encourage tobacco-prevention policies
Protect people from tobacco smoke in publicplaces and workplaces
Offer help to people who want to stop usingtobacco
Warn people about the dangers of tobacco
Enforce bans on tobacco advertising, promotion
and sponsorship
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
36/43
Raise tobacco taxes and prices.
Promote and support exclusive breastfeeding forthe first six months of life and promote programs
to:
a) ensure optimal feeding for all infants and young
children;
b) develop a national policy and action plan on
food and nutrition, with an emphasis on national
nutrition priorities
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
37/43
Establish and implement food-based dietaryguidelines and support the healthier composition
of food by:
Promoting healthy diet
Reducing salt levels
Eliminating industrially produced trans-fatty
acids
Decreasing saturated fats
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
38/43
Ms . L. S, age 58, and Ms. R. W, age 67, are sisters
who live together in a small rural town.They are
both retired high school teachers. Ms. L. S has
retired early due to advanced osteoporosis. Ms.R. W has osteoarthritis.The two sisters have
requested information from the community
health center about managing their mobility
concerns and have expressed interest inincreasing their exercise.
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
39/43
They are both being seen by the family physicianand managed with a pharmacological treatment
plan.The physician has advised them to exercise
more and increase their flexibility through
weight training. Both sisters are optimistic andenthusiastic about gaining greater control in
their lives through self management.
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
40/43
What should the nurse keep in mind as he
develops a plan of care with these clients?
What aspects of chronic illness influence the
health goals of these clients?
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
41/43
Chronic disease is characterized by periods ofremissions and exacerbations, depleted or
inadequate coping mechanisms, and by fatigue,
factors which must be considered by the nurse in
planning their care.
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
42/43
Realistic goals can be set with the clients whenconsidering the long term progression of these
debilitating diseases.
Quality of life and control related to the
promotion of autonomy are important aspects to
promote health in these clients.
8/3/2019 Prevention Control of Chronic Non-Communicable Diseases
43/43
The community health nurse may intervene tofacilitate use of adaptive coping mechanisms and
incorporate social support into the sisters plan of
exercise.
Examples include seeking group exercise classes
designed for elder women with arthritis andspiritual support through their church groups.