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Nursing Theory Graphic Organizer

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by

Nora Sy

on 19 March 2013

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Transcript of Nursing Theory Graphic Organizer

Dorothy Orem has three principal theories Patricia Benner Major concept essential to theory
•Actual research based, derived from practice situations
•Benner’s domains of Nursing Practice
•The helping role
•The teaching –coaching function
•Effective management of rapidly changing situations
•The diagnostic and patient-monitoring funtion
•Administering and monitoring therapeutic interventions and reimens
•Monitoring and ensuring the quality of healthcare practices
•Organizational and work-role competencies

How theory approaches patient care
•Ontological, hermeneutic, holistc, and qualitative approaches
•She believed in interpretive phenomenological study used a situational approach to the study of the knowledge and meaning embedded in the everyday proactive of nurses. Which identifies competencies from actual practice situations rather than having experts generate competencies from models or hypothetical situations

Specific examples to illustrate approach to patient care
•Talking with the patient learning their habits, likes and dislikes as well as their needs, value system and such helps to give unique care creates learning through involvement. Perhaps a patient asks a question pertaining to their care or maybe they express concern over their situation; this is a teaching coaching opportunity. Anticipation of blood glucose monitoring, completing a course of antibiotics, stoma or catheter care, and lab work for blood thinners are examples of diagnostic monitoring. Having good communication with a team of healthcare providers increases potential for quality as well. Nursing Theory
Graphic Organizer by
Kurt Johnson,
Nicole Gama,
Nora Sy, and
Ruth Witthauer

March 18, 2012

Athena Brummett, MSN, FNP-C Sr. Calista Roy’s adaptation model Major concept essential to theory
Per Roy’s model, a person is an adaptive system that responds to stimuli from the environment which either hinders or improves the person’s ability to adapt. Health is viewed as a becoming whole or integrated with the environment and is viewed as a health-wellness continuum. The nurse’s goal is to promote adaptation in each mode.

How theory approaches patient care
Roy’s theory includes four modes of adaptation: physiological, interdependence, self-concept, and role function and two phases of assessment, behavior and stimuli, followed by diagnosis, goal setting, intervention, and evaluation. The behavior assessment is collecting subjective and objective data, and the stimuli assessment would be identifying contributing factors. Once this data is collected the nurse identifies the nursing diagnosis and works with the patient to set goals. With goals in place the nurse can intervene as needed and then evaluate effectiveness of those interventions. (Alligood)

Specific examples to illustrate approach to patient care
Physiological mode assessment: Patient is admitted with exacerbation of CHF. On physical assessment peripheral edema is noted to hands and feet. Rhonchi noted throughout bilateral lung fields and patient reports shortness of breath with very little activity and anxiety. In the second phase of the assessment the nurse would probe causative factors for CHF and finds that patient has been non-compliant with medications because he does not like having to urinate so frequently. Patient is educated on importance of compliance to treatment plan and consequences of non-compliance. They make a goal that the patient will take his diuretic as ordered and monitor weight and symptoms daily until next cardiology appointment which is in 1 week. To meet this goal patient has agreed to take his diuretic as soon as he wakes up and again no later than 4pm, so voiding will not interrupt his sleep. He will log his daily weight when he takes his morning dose and symptoms at bedtime. At the time of cardiology appointment member has lost a significant amount of fluid and is asymptomatic. Cardiologist is able to decrease the dose of patient’s diuretic. Patient has adapted to life with CHF and will continue with current plan of care. Imogene King’s Theory of Goal Attainment Major concept essential to theory
King's major concepts were organized
around individuals as personal systems
small groups (nurse-patient) as interpersonal systems
larger groups (multi-disciplinary treatment team) as social systems
The Transaction process in King's Theory of Goal Attainment provides a process in which a nurse and a patient communicate information to each other to mutually set goals that lead to outcomes. Then, healthcare providers can be introduced to the use of this process in a multidisciplinary team approach to delivery of health care. Nurses and healthcare professionals bring their special knowledge, skills, and values to each patient situation. The team's use of the transaction process results in goal attainment (Killeen, 2007).

How theory approaches patient care
The nurse meets the patient and communicates and interacts with him or her. Assessment will be done by gathering data about the patient based on relevant concepts (perception, self, growth and development, body image, learning, time, personal space, and coping)
Identifying goals and planning to achieve those goals
Transaction are being made which is a result of perceiving the other person(s) and the situation, making judgements about those perceptions and taking some actions in response. Reaction to action(s) leads to interaction between the nurse and patient. This reflects implementation in the traditional nursing process
Goal attainment or failure to attain the goal This is comparable to evaluation of the traditional nursing process. Goals can only be achieved if the patient, nurse and other members of the Treatment team share their perceptions, feelings, values, and conclusions.

Specific examples to illustrate approach to patient care
When a patient is admitted in a mental health locked facility, during the admission/intake process, the nurse will communicate and interact with the patient to gather information as stated above. The nurse will also explain things about the unit and activities and expectations from the patient to attain goals like safe detox from alcohol or drugs, stabilization of medication or removal or minimization of psych sings and symptoms. Then, patient will meet with the rest of the treatment team composed of psychiatrist, psychologist, interns, pharmacist and social worker. Transactions are made based from the interaction, data and care plans made to attain goals. References:

Alligood, M. R. (2010). Nursing theory: Utilization & application (4th ed.). Maryland Heights, MO: Mosby Elsevier. 1. Theory of self-care- Is to initiate activities on your own in order to maintain health and well-being.
2. Theory of self-care deficit- Is when the services of a professional such as a nurse are needed. Their service allows them to act, guide, teach and support.
3. Theory of nursing system- Is how the patient’s self-care needs will be met by the nurse.

How theory approaches patient care
Theory of self-care: 1. Maintain a balance between activity and rest.
Theory of self-care deficit: 2. Establishing nurse patient relationship and discussing current and potential therapeutic self-care demand.
Theory of nursing system: 3. General and specific roles of nurses and patients are define.

Specific examples to illustrate approach to patient care
Miss Jones is a 25 year old female who is managing and maintaining her health. She examines her breast once a month while in the shower. She starts from her collar bone, to the armpit. She examines one side at a time in a mini circular motion to the breast. She makes an appointment to see her doctor once a year for a physical that includes a pap smear.
Theory of self-care deficit: Joshua is an 8 year old boy who is status post appendix removal. Nurse Bennett introduces herself to her patient/parent. Nurse Bennett tells the patient and family that she knows he will be uncomfortable for the next 48 hours. She states I am here to help you through it. Before you start to get to the sad face on Wong’s faces, please let me know, so that I can give you pain medicine. When you are comfortable with no pain, I will teach you how to breathe in deep, cough and will help get you out of the bed. I will support/hold you by your arm and walk slowly with you to continue the healing process.
Theory of nursing system: Post operatively after the 48 hours, Joshua is able to get out of bed by himself and walk up and down the hall of the pediatric floor, taking deep breath/coughing periodically. He rests when he feels tired and asks for pain medicine when he feels pain. Major concept essential to theory
Killeen, M. B. (2007, October-Decembr). Erratum:: Viewpoint:Use of King's Conceptual System, Nursing Informatics, and
Nursing Classification Systems for Global Communication. International Journal of Nursing Terminologies and Classifications, 18(4), 156.

SE, A. (n.d.). nih.gov/Self-care requirements for activity and rest: an Orem nursing focus.
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