Chapter 19 – Pathophysiology – Importance in Home Health

The three Ps of nursing education – Pathophysiology, Pharmacology, and Physical Assessment – are all incredibly important aspects of nursing. This section explains how each P affects students’ ability to perform physical examinations. By providing a hands-on approach, the nurse integrates the three Ps into a holistic approach that helps them develop a deeper understanding of their profession.

The Importance of Pathophysiology for Nurses

Understanding pathophysiology is essential for nursing. You better understand abnormal changes in the body and what treatments can be used to correct them. Knowing the pathophysiology of a disease will help you better communicate with doctors and patients, helping you to provide the best care possible for every patient.

Knowing the pathophysiology of a disease or disorder helps nurses identify their primary responsibilities. For example, nurses must understand how to recognize heart failure and what they can do to prevent the patient from suffering from worse outcomes. Pathophysiology is an important part of nursing and every nurse should master this subject.

As another example, you may need to monitor a patient with Bell’s palsy, a sudden weakness of facial muscles that prevents the patient from drinking through a straw. Understanding pathophysiology also helps you set more effective nursing priorities and provide better care. Nursing schools emphasize critical thinking skills, which is important for a nurse’s role in a medical setting.

Experienced nurses are likely to have a vast amount of experience in dealing with specific patient populations. This knowledge enables them to create comparisons and distinctions. It creates a “matrix” of background expectations and detective work for the patient. As a result, the clinician’s focus shifts as predictable changes in a patient’s condition occur. The clinician will be prepared for a variety of situations.

Here is list of just some disease topics the home health nurse should review:

• CARDIAC:
• Atherosclerosis
• Coronary Artery Disease (CAD)
• Endocarditis
• Heart Failure (CHF)
• Hypertension (HTN)
• Peripheral Arterial Disorder (PAD)
• Peripheral Venous Disorder (PVD)
• Deep Venous Thrombosis (DVT)
• Arrhythmias
• Atrial fibrillation
• DERMATOLOGY:
• Cellulitis
• Melanoma
• Dermatitis
• Eczema
• Psoriasis
• Candidiasis
• Stevens-Johnson Syndrome (SJS)
• Diabetic foot
• Pressure Ulcers/Pressure Injuries (and staging)
• Lice
• Scabies
• EARS, EYES, NOSE, THROAT (EENT):
• Otorrhea
• Tinnitus
• Hearing loss
• Dizziness and vertigo
• Otitis
• Glaucoma
• Retinopathy (i.e. diabetic retinopathy)
• Cataracts
• Epistaxis
• Nystagmus
• Laryngitis
• Nasal infections
• Rhinitis
• Sinusitis
• ENDOCRINE AND METABOLIC:
• Acid-Base Disorders
• Cushing Syndrome
• Addison Disease
• Pheochromocytoma
• Aldosteronism
• Diabetes Mellitus (type I and type II)
• Diabetic Ketoacidosis (DKA)
• Hyperglycemia and hypoglycemia
• Electrolyte disorders (hypo/hypernatremia, hypo/hyperkalemia, hypo/hypercalcemia, etc.)
• Volume overload
• Dyslipidemia
• Hyperlipidemia (HLD)
• Hypothyroidism
• GASTROINTESTINAL:
• Hemorrhoids
• Gastroesophageal reflux disease (GERD)
• Diverticulitis
• Dysphagia
• Gastritis
• Peptic ulcer
• Gastroenteritis
• GI bleed
• Inflammatory bowel disease (IBD)
• Irritable bowel syndrome (IBS)
• Celiac disease
• Pancreatitis
• Bowel incontinence
• Obesity
• GENITOURINARY:
• Acute kidney injury (AKI)
• Benign Prostatic Hyperplasia (BPH)
• Chronic Kidney Disease (CKD)
• Diabetic nephropathy
• Urinary calculi
• Urinary tract infection (UTI)
• Pyelonephritis
• Neurogenic bladder
• Urinary retention
• Urinary incontinence
• COMMON IN GERIATRICS:
• Elder abuse
• Falls in older people
• Gait disorders
• Polypharmacy
• Isolation
• Frailty
• Self-neglect
• End-of-life care
• HEMATOLOGY AND ONCOLOGY:
• Cancers
• Anemias
• Coagulation disorders
• Eosinophilia
• Leukemia
• Lymphomas
• Splenomegaly
• Thrombocytopenia
• HEPATIC AND BILIARY:
• Liver injury
• Cirrhosis
• Cholecystitis
• Cholelithiasis
• Hepatitis
• Hepatic cysts
• MUSCULOSKELETAL:
• Sjögren Syndrome
• Systemic Lupus Erythematosus (SLE)
• Multiple Sclerosis (MS)
• Bursitis
• Fibromyalgia
• Tendonitis
• Gout
• Plantar fasciitis
• Carpal tunnel syndrome
• Osteoarthritis
• Osteomyelitis
• Rheumatoid arthritis
• Sciatica
• Lumbar spinal stenosis
• Osteoporosis
• Total hip replacement (total hip arthroplasty)
• Total knee replacements (total knee arthroplasty or TKA)
• NEUROLOGIC:
• Encephalitis
• Delirium
• Dementia
• Alzheimer’s
• Multiple sclerosis
• Aphasia
• Migraine
• Meningitis
• Parkinson disease
• Trigeminal neuralgia
• Acute pain
• Chronic pain
• Neuropathic pain
• Guillain-Barré Syndrome (GBS)
• Amyotrophic Lateral Sclerosis (ALS)
• Myasthenia Gravis
• Seizures
• Insomnia
• Narcolepsy
• Acute cerebrovascular accident (stroke or CVA)
• Ischemic stroke
• Transient ischemic attack (TIA)
• Subarachnoid hemorrhage
• PSYCHIATRIC:
• Anxiety (acute)
• Generalized anxiety disorder (GAD)
• Post-traumatic stress disorder (PTSD)
• Eating disorders (Anorexia and bulimia)
• Bipolar disorders
• Depression
• Major depressive disorder
• Obsessive compulsive disorder (OCD)
• Schizophrenia
• PULMONARY:
• Acute bronchitis
• Asthma
• Bronchiectasis and Atelectasis
• Chronic Obstructive Pulmonary Disease (COPD)
• Pneumonia
• Tuberculosis (TB)
• Pulmonary Embolism (PE)
• Pulmonary hypertension
• Obstructive Sleep Apnea (OSA)
• COVID-19

This list is not exhaustive, and nurses should keep on the lookout to building on top of their current knowledge of pathophysiology. It is best to review the diseases system by system. Tip: Use the free resource MerckManuals.com to as a good database for review of pathophysiology topics.

Understanding disease and its pathophysiology is essential for nurses. The knowledge of the causes of disease, its symptoms, and treatment methods will help them provide effective care for patients. Nursing practitioners benefit from critical thinking skills, which help them implement timely preventive measures. The use of critical thinking skills is essential in pathophysiology. Communication skills are key for a nursing career. However, it is important to be sensitive to cultural differences. Developing empathy and compassion are key to being a good nurse.