nursing theory application
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Nursing Theory Application
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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
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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
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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
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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
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3.Theory of Nursing Systems
Wholly compensatory system
Partly compensatory system
Supportiveeducative system
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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
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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
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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
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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
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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.
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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
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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
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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