nursing theory application

8/13/2019 Nursing Theory Application

1/16

Nursing Theory Application


2/16

Nursing theories which can be used in

medical surgical nursing

Dorothea Orem - Self-care theory

Betty Neuman - System model

Sister Calista Roy - Adaptation theory

Imogene King - Goal Attainment theory

Florence Nightingale - Environment theory

Virginia Henderson - Need Theory

Fay Abdella - Twenty One Nursing Problems

Lydia E. Hall - The Core, Care and Cure Ernestine Wiedenbach - The Helping Art of Clinical Nursing

Rosemarie Rizzo Parse - Human Becoming Theory

Dorothy Johnson - System model


3/16

Orem's theory

Orems general theory of nursing in three related parts:-

Theory of self care

Theory of self care deficit Theory of nursing system


4/16

1. Theory of self care

Self care

Self care agency

Self care requisites

-Universal self care requisites- air, water,food, activity,elimination, social interaction, prevention of hazard, healthpromotion

-Developmental self care requisites

-Health deviation self care requisites

Therapeutic self care demand


5/16

2. Theory of self care deficit

5 methods of helping:

Acting for and doing for others

Guiding others

Supporting another

Providing an environment promoting personal developmentin relation to meet future demands

Teaching another


6/16

3.Theory of Nursing Systems

Wholly compensatory system

Partly compensatory system

Supportiveeducative system


7/16

Application using nursing process

Self care,Agency,Requisite

Self caredeficit

Nursingsystem

Assessmentof self carerequisite

NursingdiagnosisTherapeuticself caredemand

Planning and Interventionincludeschoosing the nursing system and helping the

patients

Evaluation


8/16

Application

Areas Patient details

Name

Age

SexEducation

Occupation

Marital status

Religion

Diagnosis

Symptoms

Medical

Treatment

Mrs. X

56 years

FemaleNo formal education

House hold

Married

Hindu

K/C/O Congestive cardiac failure

Dyspnoea , oedema, fatigue,

palpitation , anorexia, nausea.

Digitalis, Indwelling catheter, fluid

restriction, diuretics, Bed rest


9/16

Assessment

Assess the level of self careNot adequate

Asses the self care agency- Not adequate

Assess the self care requisite-UniversalAir( Dyspnoea), water (oedema) ,

Fatigue ( Activity & rest), Food ( Anorexia)

-Developmentalrole change

-Health deviationPoor adherence, knowledge,Poor lifestyle adaptation to illness


10/16

Nursing diagnosis

Therapeutic self care demand

Common diagnosis

Impaired gas exchange Fluid volume overload

Activity intolerance

Altered nutrition less than body requirement

Impaired family process

Ineffective therapeutic regimen

Knowledge deficit


11/16

Planning and implementation

Choose the best system and method of helping tocombat the problem

Evaluation Ascertain the self care level and patient self care

agency adequacy.


12/16


13/16

Assessment Diagnosis Goal Planning Interventions Evaluation

Subjectivedata

Pts verbalizesdiscontinuationof medication forpast 1 week dueto side effects

Ineffectivetherapeutic

regimen r/tpoorknowledgeabout drugregimen

To improvecompliance

As appropriateNursing system

supportivesystemhelping teaching

As appropriate Ascertain thenormalcy of self

care deficit, selfcare agencyas evidence byclinicalparameters asappropriate

Objective dataPts serumdigitalisconcentration isinadequate

Therapeuticself caredemandPtsbe compliantwithmedication

Self care

deficit areahealth promotion

Self careagency

inadequate


14/16


15/16

Case study

Mr .x 63 years old male, a known case of CAD afterstrenuous exercise and smoking in home developedacute onset of substernal chest pain got admitted inICCU with diagnosis as MI


16/16

Nursing processAssessment Diagnosis Goal Planning Interventions Evaluation

Subjective dataPts verbalizescrushing nature

pain in chest,palpitation,profuse sweating,dyspnoea

Ineffectivetissue perfusionr/t

atherosclerosisPhysiologicalmodeaffected(oxygenation)

Short termgoal-To improve

perfusion ,oxygenation,(Focal stimuli)long term-goal preventiveeducation(Contextualstimuli)

As appropriate As appropriate Ascertain theadaptation tophysiological

mode bychecking theclinicalparameter

Objective dataPts ECG showsST segmentelevation,Elevated troponinlevel

Therapeuticself caredemandPtsnot able tomeet o2demand for hisequilibrium

Focal stimuliReduced o2 andbloodContextualstimuli Exercise,smoking, age,

CADResidual stimuli

nursing theory application

Documents