Chapter 9 Concepts
What is Dorthea Orem's Self-Care Model
**What deficits does this patient have in providing his or her own self-care?* In Orem's model, appropriate care for the patient is developed through a series of three operations: diagnostic, prescriptive, and regulatory. To determine the patient's ability to* provide effective self-care,* the nurse initiates a diagnostic operation that begins with the establishment of the nurse-patient relationship.*
What is Ida Orlando's Nursing Process Theory
*How can I best figure out what my patient needs through my interaction with him or her?* The goal of the nurse is to determine and meet patients' immediate needs and to improve their situation by relieving distress or discomfor
What is Jean Watson's philosophy
*How can I create an environment of trust, understanding, and openness so that the patient and I can work together in meeting his or her needs?* *She focused on the relationship of the nurse and the patient, drawing on philosophical sources for a new approach that emphasized how the nurse and patient change together through *transpersonal caring* *Watson's 10 Caritas Processes™* 1. Embrace altruistic values and practice loving kindness with self and others. 2. Instill faith and hope and honor in others. 3. Be sensitive to self and others by nurturing individual beliefs and practices. 4. Develop helping-trusting-caring relationships. 5. Promote and accept positive and negative feelings as you authentically listen to another's story. 6. Use creative scientific problem-solving methods for caring decision making. 7. Share teaching and learning that addresses the individual needs and comprehension styles. 8. Create a healing environment for the physical and spiritual self which respects human dignity. 9. Assist with basic physical, emotional, and spiritual human needs. 10. Open to mystery and allow miracles to enter.
What is Callista Roy Adaptation MOdel?
*How can I modify this patient's environment to facilitate his or her adaptation?** *focuses on the adaptation of the patient and on the environment.* Adaptation, specifically patients' adaptation behavior and stimuli in the internal and external environments, is assessed and facilitated. Based on these assessments, the nurse develops nursing diagnoses to guide goal setting and interventions aimed at promoting adaptation. Simply stated, the nurse modifies the environment to facilitate patient adaptation
What is Leininger's Theory of Culture Care Diversity and Universality
*What are the best ways to provide care to my patient that are culturally congruent?* The goal of transcultural nursing involves more than simply being aware of different cultures. It involves planning nursing care based on knowledge that is culturally defined, classified, and tested—and then used to provide care that is culturally congruent
What is Virginia Henderson's Philosphy
*What can I help this patient do that he would do for himself if he could?* Henderson's philosophy linked her definition of nursing that emphasized the functions of the nurse with a list of basic patient needs that are the focus of nursing care. *14 Basic needs* 1. Breathe normally. 2. Eat and drink adequately. 3. Eliminate body wastes. 4. Move and maintain desirable position. 5. Sleep and rest. 6. Select suitable clothes—dress and undress. 7. Maintain body temperature within normal range by adjusting clothing and modifying the environment. 8. Keep the body clean and well groomed and protect the integument (skin). 9. Avoid dangers in the environment and avoid injuring others. 10. Communicate with others in expressing emotions, needs, fears, or opinions. 11. Worship according to one's faith. 12. Work in such a way that there is a sense of accomplishment. 13. Play or participate in various forms of recreation. 14. Learn, discover, or satisfy the curiosity that leads to normal development and health and use the available health facilities.
What is King's Interacting Systems Framework and Theory of Goal Attainment
*What goals can we set together to restore the patient to health?* nurses focus on goal attainment for and by the patient. *Steps occur simultaneously as the nurse and patient work to identify goals and the best means to attain those goals.*
What was Nightingale's Philosophy?
*What needs to be adjusted in this environment to protect the patient?* Nightingale believed that the *health of patients was related to their environment*. She recognized the *importance of clean air and water and of adequate ventilation and sunlight and encouraged the arrangement of patients' beds so that they were in direct sunlight. In her writing, she described both the necessity of a balanced diet and the nurse's responsibility to observe and record what was eaten*. Cleanliness of the patient, the bed linens, and the room itself were essential.
What is Peplau's Theory of Interpersonal Relations in Nursing?
*Within the relationship with my patient, how can I best help him or her understand his or her health problems and develop new, healthier behaviors?* based on the premise that the relationship between patient and nurse is the focus of attention, rather than the patient only as the unit of attention first is the survival of the patient; second is the patient's understanding of his or her health problems and learning from these problems as he or she develops new behavior patterns.
The nurse professor is giving a lecture on Dorothy Orem. Which statement by one of the nursing students indicates that teaching has been effective? A) "An underlying assumption of Orem's model is that patients want to be in control of their lives." B.) "Orem's work focuses on goal attainment, for and by the patient." C.) "Orem focused on the patient as a biopsychosocial adaptive system." D.) "Orem believed that unless attention was paid to the patient's concerns, mutual goal setting was unlikely."
A) "An underlying assumption of Orem's model is that patients want to be in control of their lives." Over the years, *Orem formalized three interrelated theories: theory of self-care, theory of self-care deficit, and theory of nursing system. Her model focuses on the patient's self-care capacities and the process of designing nursing actions to meet the patient's self-care needs. *An underlying assumption of Orem's model is that patients want to be in control of their lives. Imogene King's work focused on goal attainment for and by the patient. King believed that unless attention was paid to the patient's concerns, mutual goal setting was unlikely. Sister Calista Roy focused on the patient as a biopsychosocial adaptive process.
Which statement by the nursing student on theory-based nursing practice indicates a need for further teaching? A.) "Theory-based nursing practice inhibits autonomy." B.) "Nursing theory develops analytical skills." C.) "Theory provides the language to explain what nurses do." D.) "Theory provides a nursing-based guide for practice."
A.) "Theory-based nursing practice inhibits autonomy." Nursing theory provides a language for the nurse to explain what nurses do, as well as provide a nursing-based guide for practice.* Use of nursing theory develops analytical skills, as well as contributes to professional autonomy.*
The nurse is interested in improving nursing practice by providing culturally competent care. What action by the nurse indicates a need for further education? A.) Be aware of other cultures. B.) Show respect for the culture of each patient. C.) Recognize and incorporate health beliefs and folk practices of the patient's culture into care. D.) Question the patient regarding cultural practices
A.) Be aware of other cultures. *Leininger specified caring as the essence of nursing, and nurses who use Leininger's theory of cultural care in their practices view patients in the context of their cultures*. In order to provide culturally competent care, it is important that the nurse first question the patient to determine if there are any cultural practices that can be incorporated into care. The nurse should show respect for the culture of each patient, and incorporate health beliefs and folk practices into care whenever possible. The nurse should spend time becoming educated, and feeling comfortable to provide culturally competent care.
The nurse has decided to incorporate Imogene King's model into practice. Which action by the nurse indicates that further teaching is needed? A.) Create a plan of care for the patient after receiving report. B.) Determine what factors influence the patient's decision-making. C.) Develop and maintain a rapport with the patient. D.) Determine what the patient's goals are.
A.) Create a plan of care for the patient after receiving report. When using *King's work, nurses focus on goal attainment for and by the patient. It is important that the nurse include the patient in decision making regarding care.* The nurse should sit down with the patient and determine what factors influence the patient's decision-making, and what the patient's goals are. Developing and maintaining rapport with the patient allows the nurse to understand the patient on a deeper level and gain trust.
The nurse is listening to a lecture on Virginia Henderson. Which statement by the nurse indicates that further teaching is necessary? A.) "Henderson identified 14 basic needs as a general focus for patient care." B.) "Henderson believed that exposure to sunlight was necessary for good health." C.) "Henderson described the role of the nurse as a substitute or helper for the patient." D.) "Henderson believed that the nurse's role changed day-to-day."
B.) "Henderson believed that exposure to sunlight was necessary for good health." *Virginia Henderson identified 14 basic needs as a general focus for patient care. She described the role of the nurse as a substitute or helper for the patient, and believed that the nurse's role changed day-to-day.* Florence Nightingale believed that exposure to sunlight was necessary for good health.
The nurse is listening to a lecture on Jean Watson. Which statement indicates that further teaching is necessary? A.) "Watson emphasized the caring aspects of nursing." B.) "Watson identified 14 basic needs as a general focus for patient care." C.) "Watson equated health with harmony." D.) "Watson encourages nurses to share their genuine selves with patients."
B.) "Watson identified 14 basic needs as a general focus for patient care." *Jean Watson's caring theory focuses on the nurse-patient relationship, and draws upon philosophical sources for a new approach that emphasized how the nurse and patient change together through transpersonal caring.* Watson equated health with harmony, and encouraged nurses to share their genuine selves with patients, in order to reach a deeper level of caring. *Watson introduced the 10 caritas processes*, while Virginia Henderson identified 14 basic needs of patient care.
Which action by the nurse shows the incorporation of Nightingale's philosophy of nursing into practice? A.) Allow visitors to bring fast food to the patient. B.) Arrange the patient's bed to avoid sun exposure. C.) Arrange for periods of rest throughout the day. D.) Schedule housekeeping to clean once a week.
C.) Arrange for periods of rest throughout the day. *Florence Nightingale believed that the health of the patient was related to their environment. Clean air, water, adequate ventilation, rest, sunlight and proper diet were all recognized in her philosophy of nursing. *The nurse incorporating Nightingale's philosophy of nursing would incorporate periods of rest throughout the day for the patient, as well as: healthy food choices, sun exposure and housekeeping once per day, or as needed.
Which action by the nurse incorporates Watson's Caritas Processes into practice? A.) Rounding on the patient every 3 to 4 hours. B.) Avoiding personal conversation with the patient. C.) Arranging for the patient to have a private church service with family. D.) Providing an overview of cancer treatment for the newly diagnosed patient.
C.) Arranging for the patient to have a private church service with family. *Watson's Caritas Processes focus on the nurse-patient relationship and acts by the nurse that promote caring and understanding on a deeper level.* In order for the nurse to establish this relationship, the nurse must be present. Rounding frequently, engaging in conversation with the patient, and personalizing nursing care and education allow this connection to happen. Taking the time to get to know the patient, understanding the needs of the patient and acting on them—such as arranging a private church service—put the caritas processes into action.
After listening to a lecture on Hildegard Peplau, which statement by the nurse indicates that further education is necessary? A.) "The nurse holds many roles including: leader, educator and counselor." B.) "Peplau recognized the importance of the work of nursing rather than continuing to define nursing." C.) "Peplau drew from developmental, interactionist and human needs theories in developing her work." D.) "Peplau focused on goal attainment."
D.) "Peplau focused on goal attainment." *Hildegard Peplau was one of the earliest nurse theorists to recognize the importance of the work of nursing, rather than continuing to define and delineate nursing.* Peplau created her nursing theory by drawing from developmental, interactionist and humanistic needs theories. Peplau believed that the nurse holds many roles including: counselor, resource, teacher, technical expert, surrogate, and leader. Imogene King's model focuses on goal attainment.
The nurse is caring for a terminally ill patient who is near the end of life. The patient has expressed her desire to not be alone when she dies. Which action by the nurse shows an incorporation of Watson's caring theory into practice? A.) Strictly following visiting hours. B.) Impose a time limit for each visitor. C.) Coordinate routine medication passes with visits. D.) Help the patient create a schedule of visitors for each day.
D.) Help the patient create a schedule of visitors for each day. Jean Watson's caring theory focuses on the nurse-patient relationship, and creating a deeper level of caring.* The patient has expressed a desire to be with others at the end of life. It is important that the nurse help the patient create a schedule of visitors each day, to fulfill the request. The nurse should not strictly follow visiting hours, impose a time limit on visitors or interrupt visits with routine medications. Rather, the nurse should coordinate medication passes around the patient's visits.
