Nursing Theory Plan of Care - Research Paper Example

?Nursing Theory Plan of Care Nursing Theory Plan of Care Introduction Nursing theories are vital concepts that nursing mustbe introduced to in order to broaden their definition of different schools of thought on nursing practices. The learning of nursing theories enables the nursing practitioners to learn about the numerous nursing models that have been proposed towards caring for patients. Therefore, proper understanding of the nursing theory will enable nursing student to able to formulate their own nursing models and theories towards helping and caring for patients Orem, Renpenning, and Taylor, 2003). Various nursing models that have been provided for by Nursing Theories provide a frame of reference in all the healthcare institutions. There are numerous nursing models or theories with each having its essential but integral parts. Thus, each theory or model is applied differently and distinctively (Roussel and Swansburg, 2009). A valid nursing model must contain assessment procedure towards determining the individual needs of patients, as well as medication implementation procedures and measurement methods in healthcare provision. Most of the nursing models are capable of producing effective care plans towards documenting the patient’s treatment so that all other healthcare workers and professional who encounter such a patient will know the patient’s condition (Roussel and Swansburg, 2009). However, the care plan should be to allow daily evaluation and changes as the needs and ability of the patient may change. Notably, the care plans are often shaped by the nursing model or theories upon which the car plan was formulated. Thus, the nursing theories have a significant impact on the significant of the clinical practices. Dorothea Orem’s general theory is among the nursing theories that provide a fundamental framework that define nursing care practices that should be offered to patients (Meleis, 2011). The Orem’s general theory is often defined by three highly defined theories including the self-care theory. The self-care theory defines the activities that a patient needs to achieve a complete or achieve optimum health Orem, Renpenning, and Taylor, 2003). Additionally, Orem’s theory is defined by self-care deficit that specifies when the nursing care in appropriate for the patient who can meet his or her self-care needs. Finally, the Orem’s general theory is defined by the nursing systems theory that describes how the nurse, patient, or both working together will meet the underlined self-care needs. The Orem’s theory ensures that a nurse properly identifies the self-care deficits of the patient’s ability. A nurse can achieve this through acting or guiding the patients or other parties involve in her or his care in supporting the patient (Roussel and Swansburg, 2009). Moreover, the nurse should provide a friendly environment that encourages the patient thereby developing self-care abilities. Such environment can be achieved through teaching the patient and others persons involve in his care on how to meet the environmental self-care needs of the patient. Therefore, the main aim of the Orem’s self-care model is enable patients and their family or caregivers to maintain or take care of their health (Meleis, 2011). Orem’s Model Health Care Plan There are numerous health care plans that are proposed by Orem’s model of practice and Mr. Issler must consider undertaking all of them. 1. Universal self-care requisites I will advise Mr. Issler to maintain human integrity in order to allow proper functioning of his body structures. In providing health care for Mr. Issler, the following requisites shall be to consider Maintain sufficient air, water, and food intake Provision of health care assoc through elimination process Mr. Issler to be advised to balance between chores and rest and between solitude and social interaction He is to avoid hazardous life like getting to congested and overcrowded places 2. Developmental self-care requisites This is a developmental process conditions or events in the life of the patient and the case of Mr. Issler, I shall consider asking her to Change his mode of transportation Adjust on his body changes since he is in his old age 3. Health deviation self-care These are Orem’s requirements in illness, disease, or injury conditions Mr. Issler will be diagnosed regularly over his health condition to analyze his improvement in order to secure appropriate medical assistance. Analyzing the medical condition and understanding their effects on Mr. Issler From the analysis effective medical prescription measures to be offered to Mr. Issler Modifying the concept of Mr. Issler that he suffers from congestive heart failure (CHF) and deep vein thrombosis (DVT) Finally, persuading Mr. Issler to accept the effects of pathologic condition in his life Orem’s Theory of Self Care Deficit Data Collection from Mr. Issler Basic Conditioning Factors Age Not stated Gender Male Health status Disability due to pale and diaphoretic Development status Socialculture Orientation Not stated Health care system Institutional health care Family system Widowed Patterns of living At home with his daughter in law Environment To use his prescribed medication Resources Daughter in law Applying The Orem’s Theory of Self-Care Deficit, Nursing Care Plan for Mr. Issler Could Be Prepared As Follows: 1. Therapeutic Self Care Demand: Deficient Area: Food Adequacy of Self Care Agency: Adequate Nursing Diagnosis Mr. Issler is able to maintain ideal nutrition Outcomes and Plan a. Nursing Goals and objectives Goal: To ensure Mr. Issler illness is not pegged on poor nutrition Objectives: Mr. Issler will be eating healthy b. Design of the nursing system: education support c. Method of helping: Providing developmental environment Implementation Mutually planning the health care services for Mr. Issler to identify the objectives and understand his required behavior changes towards meeting requisites. Evaluation Mr. Issler understands the importance of healthy nutrition.   He is advised to avoid fatty foodstuffs.    The food self-care deficit will reduce illness induced by poor nutritional intake. The educative support system will help reduce Mr. Issler’s hyper and hypothyroidism 2. Support: Provide Mr. Issler with the necessary articles for self-care and ask her daughter in law to ensure she eats healthy. Assist Mr. to conduct passive exercises and to reduce fat content in the body Provide necessary assistance to Mr. Issler whenever needed for the self-care activities Encourage Mr. Issler on positive improvement in the activity level. Ensure Mr. Issler takes his medication effectively 3. Teaching: Teach Mr. Issler’s daughter in law how to take care of Mr. Issler toward quick recovery. 4. Promoting a developmental environment: Teach Mr. Issler’s daughter in law on how provide medical care to the patient according to the medication requirement. Implementation Mutually planned and identified the objectives are geared to make Mr. Issler to understand the need for his behavior changes in accordance the requisites. Evaluation and Implementation The patients Pulse was very low (58), BP 176/84, Respirations- 22, Pulse oximetry 88, and is over weight (weighs 147 pounds).   Mr. Issler seems comfortable with the care provide to him; thus, he is able to conduct self-care to himself.  Patient verbalized that he is capable of conducting activities as instructed through his ADL done. 5. Therapeutic Self Care Demand: Deficient Area: Prevention Of Hazards  Adequacy of Self Care Agency:  adequate Nursing Diagnosis The patient is in stable condition at the time of diagnosis. Outcomes and Plan a. Outcome: Patient answer most of the questions asked effectively and accurately b. Nursing Goals and objectives Goal: prevent further heart failures   Objectives: Mr. Issler will have effective and normal blood flow c. Design of the nursing system: supportive educative d. method of helping: educative Educate Mr. Issler on how to handle his ill health matters Evaluation and Implementation Conduct subsequent diagnosis to Mr. Issler on later days Analysis In Relation to the Case Study In the case, of Mr. Issler and his daughter in law shall be advised accordingly on the favorable environment for the patient. Applying Orem’s model, the patient’s diagnostic results provide a solid ground for providing medical and other health care measures to services as well as advising him and her daughter in law (Roussel and Swansburg, 2009). Furthermore, Mr. Issler’s condition calls for the application of self-care deficit since his medical condition is preventing him from reaching his optimal health. Mr. Issler condition makes Orem’s comparative system mode that require total provision of nursing care to the patient irrelevant. This model is only applicable when the patient cannot do anything by him or herself and depends wholly on the nurse for survival. However, Mr. Issler is still strong and can do most of things by himself. Secondly, the Orem’s systems or model allows partial compensatory services. In this case, the nurse is expected to assist in caring for the patient; however, the patient and the family may assist in providing the same care. For instance, patients who may have short breath may require the nurse to monitor some of their vital signs and symptoms including oxygen saturation and to assist in ambulation and ADL’s. After all these medical care services, the patient is expected to able to resume his or her own care after getting better Orem, Renpenning, and Taylor, 2003). Nonetheless, Orem’s model requires that the nurse to educate and assist this patient at this time of need. Mr. Issler’s condition places him under Orem’s second type of care provision where his medical condition is expected to stabilize after some time. Despite being admitted in the emergency room, Mr. Issler’s condition is expected to stabilize since his condition might have been triggered fight (Meleis, 2011). The old man’s state is a case of high blood pressure; therefore, it would be the responsibility to the nurse to follow his pressure until it stabilizes. After stabilization, Mr. Issler care may be subjected to self-care of to the care of his daughter in law. Additionally, since the patient has the history of heart failure, it will be vital for the nurse to follow Mr. Issler’s medical condition through a series of medical examination so that proper medical care can be provided be advised to him (Roussel and Swansburg, 2009). Mr. Issler is providing to medical problems including history of deep vein thrombosis (DVT) and congestive heart failure (CHF). It is only through a series of medical checkups that may ascertain what he suffered. After the patient has fully regained his strength, the Orem’s third model or system theory requires the nurse to take the patient through educative development. At this state, the Orem’s general nursing theory expects the patient to capable to take full control over their health (Meleis, 2011). Therefore, the nurse is only obligated to providing educational services towards promoting the health practices provided to the patient. Some education development often targets diet, exercise, and medication improvement. In this case, the nurse is expected teach the patient on how to maintain healthy practices. Applying this case to Mr. Issler, he shall be required to follow his medication adequately. In addition, Mr. Issler should check his weight by consuming healthy diet and indulging in exercise adequately (Orem, Renpenning, and Taylor, 2003). Excessive fat in the body often narrows the blood streams there by altering the blood flow into and out of the heart. Alteration of the normal functions any body system often leads to that organs failure or interferes with its normal function. Increased blood pressure into and out of the heart often leads to heart failure. Therefore, Mr. Issler revert his history of congestive heart failure (CHF) by embarking on exercise that might not be instantaneously vigorous but may be continually vigorous. Current Influences and Utilization of Orem’s Theory in Nursing Practice Dorothea Orem’s self-care model aims at restoring, promoting, and maintaining the patient’s health system. This model looks at the patient as an entity and how their interaction with the environment (Roussel and Swansburg, 2009). However, self-care is a continuously changing process through the continuum of life; thus, it requires constant reassessment. Hence, the main importance of the Orem’s Self-care theory is that it established a comprehensive assessment to be applied in the planning nursing care. The model has analyzed every aspect of patients’ well-being including their social situations, character traits, environment, behavioral characteristics, and medical history in line with their physical self-care requisites assessment (Roussel and Swansburg, 2009). The Orem’s theory focuses on patient care and the need of nursing care that promotes patient self-care deficits that are revealed during the assessment process. Finally, Orem down scales the actual requirements of nursing care for patients and separates them from other healthcare providers thereby creating autonomy for the nursing profession. These practices are highly deployed in the health care centers to increase care provision to patients. Conclusion Despite the Orem’s theory concentration on the well-being of patients and its intent to improve the health of the patient, it is a time consuming nursing process. The staffing ratio in most health care institutions cannot allow such intensive initial nursing care plans. In ideal medical situations, nurses often receive quite a number of patients a day; thus, if they opt to scrutinize and follow Orem’s self-care systems, they might not attend to all patients. Orem’s theorem requires days only on one patient, but since nurses never dictate time and the number of patients flowing into the hospital; thus, this theorem seems to be unrealistic especially due to its complexity. References Meleis, A. I. (2011). Theoretical nursing: Development and progress. Philadelphia: Lippincott Williams and Wilkins. Orem, D. E., Renpenning, K. M. L., & Taylor, S. G. (2003). Self-care theory in nursing: Selected papers of Dorothea Orem. New York: Springer. Roussel, L., & Swansburg, R. C. (2009). Management and leadership for nurse administrators. Sudbury, Mass: Jones and Bartlett Publishers. Read More