Homeostasis 2: nurses as external agents of homeostatic control

Homeostasis 5: nurses as external agents of control in breast cancer

Breast cancer is caused by a homeostatic imbalance of cell division. Healthcare practitioners need to understand cellular activities to appreciate the physiological basis of health (homeostasis), the pathophysiological basis of illness and the physiological rationale of healthcare. Cells are the 'basic unit of life' (Clancy and McVicar, 2011a). This article describes normal cell division and the anatomy and physiology of the breast and, using a case study, will show how breast cancer is a homeostatic imbalance of cell division. There are analogies between the components of homeostasis and the components of the nursing (healthcare) process (Clancy and McVicar, 2011b) in the condition of breast cancer. After reading this article, nurses should be able to: understand that breast cancer is a cellular hence chemical imbalance that causes uncontrollable mitotic division of breast cells; understand how the cell cycle of cancer cells differs from that of normal cells; identify nature-nurture interactions involved in the aetiology of breast cancer; understand that when caring for people with breast cancer, health professionals including oncology nurses are acting as external agents of homeostatic control as the patient 'recovers' from breast cancer, and also to some extent when reducing signs and symptoms, hence quality of life, by providing palliative care.

Homeostasis 6: nurses as external control agents in rheumatoid arthritis

All disorders involve a disturbance of cellular and hence chemical function in the body. Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory disease that usually attacks synovial joints and surrounding ligaments, muscles and their tendons and blood vessels. This article applies the concept of health professionals operating as external agents of homeostatic control (Clancy and McVicar, 20011a; 2011b) to RA and to the care of affected patients, using a case scenario to illustrate attempts to minimize homeostatic imbalances. After reading the article, nurses should be able to understand: how the principles of homeostatic theory apply to skeletomuscular function, in particular to synovial joint function; the skeletomuscular homeostatic role in movement; and that homeostatic failure of reduced mobility, as in RA, is a result of nature-nurture interaction; that illness arises from a cellular, hence chemical, homeostatic imbalance(s) (Clancy and McVicar, 2011a; 2011b; 2011c; 2011d; 2011e). RA is considered a cellular (B-lymphocyte) hence chemical (autoantibody) imbalance that causes the homeostatic imbalances (inflammatory pain, reduced mobility, reduced activities of daily living) associated with the condition. Health professionals are able at act as external agents of homeostatic control to only a limited extent when caring for people with RA because, as with any progressive disorder, they will only be managing signs and symptoms to improve patients' quality of life.

Homeostasis 3: nurses as external agents of control in hypothyroidism

The role of healthcare practitioners in reversing homeostatic imbalances essentially makes them external agents of homeostatic control-they are replacing the usual assessment, controlling and effector aspects that operate intrinsically in health (homeostasis) but have failed in ill-health (homeostatic imbalances). This article examines the homeostatic imbalance of hypothyroidism, using a case study to draw analogies between the components of homeostatic theory and those of the nursing process. After reading this article, nurses should be able to explain: how the components of homeostasis are associated with health, and how failure of one or more of these components of homeostasis is associated with illness; that illness arises from a cellular, and therefore chemical, homeostatic imbalance; that hypothyroidism is a cellular imbalance of low levels of thyroid hormone, which is identified by signs and symptoms (i.e. other homeostatic imbalances) related to these low levels; and understand how primary care nurses looking after people with hypothyroidism are acting as external agents of homeostatic control.

Homeostasis 4: nurses as agents of control in myocardial infarction

The role of health practitioners in attempting to reverse homeostatic imbalances essentially makes them external agents of homeostatic control-they are replacing the assessment, controlling and effector mechanisms that operate during health (homeostasis), but have failed in ill-health (homeostatic imbalances). Myocardial infarction (MI) is the homeostatic imbalance examined in this article, which aims to apply the analogy between the components of homeostatic theory and the components of the nursing process (Clancy and McVicar, 2011b) to the condition. After reading the article, nurses should be able to understand that: the components of homeostasis are associated with health, and the failure of one or more of these components results in illness; illness arises from a cellular, hence chemical, homeostatic imbalance(s); MI results from a cellular imbalance leading to a restriction in blood flow to the myocardium, and is identified by signs and symptoms (i.e. other homeostatic imbalances) related to the ischaemia; when caring for people with MI, coronary care nurses are acting as external agents of homeostatic control.