Questions and Answers
Which of the following are considered metaparadigms of nursing?
Florence Nightingale viewed nursing as the act of utilizing the environment to assist the patient in recovery.
True
What is the primary focus of Martha Rogers' nursing theory?
Unitary Human Being
Dorothea Orem's theory emphasizes the importance of self-care and self-care __________ theory.
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Match the following nursing theorists with their respective theories:
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What medical act included Sec.7 & 8 about nursing practice?
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Which model of health includes the epidemiological triad of agent, host, and environment?
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Travis' Illness-Wellness Continuum suggests that health is static and does not change over time.
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According to the General Adaptation Syndrome, a physiological response is a systemic response in the ___ stage.
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What are the 3 types of stressors mentioned in the content?
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According to the content, what are the primary, secondary, and tertiary levels of prevention?
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Who is known as the 'Patroness of nurses'?
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What is the role of oxytocin in the body?
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Who was the founder of the American Red Cross?
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What are the methods to decrease stress?
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Doctrine of trephining involved boring a hole into the skull to release evil spirits.
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Florence Nightingale is also known as the 'Mother of Modern Nursing' and the Lady with a Lamp, and is the first ___________.
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What is the inflammatory response?
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What is the vascular stage of inflammation?
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What are the types of exudate?
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What is the role of macrophages in the reparative stage?
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What is primary intention in wound healing?
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What is secondary intention in wound healing?
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What is the goal of diagnosis in nursing?
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What is knowledge deficit?
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What is koilonychia?
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What is paronychia?
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What type of breathing sound is described as continuous, low-pitched, gurgling, and harsh?
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Vesicular breath sounds are characterized by high pitch and loud harsh sounds.
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The ______ is a test used to determine the presence of sugar in urine.
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What is the purpose of orienting the client?
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What are the types of fever mentioned in the content?
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_______ is the temperature phase with absence of chills, feels warm, and up HR, RR, thirtst.
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Heat stroke is caused by the hypothalamus not regulating body temperature properly.
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What is the normal range for respiratory rate in adults?
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Which of the following is a factor affecting blood pressure?
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Hyperventilation leads to respiratory acidosis.
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_______ is the movement of gases from higher to lower concentration.
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Match the blood pressure Korotkoff sounds phases with their descriptions.
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What is the approximate oxygen percentage delivered by a nasal cannula at 2L/min?
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What does CBE stand for?
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What does SMART stand for in the context of planning?
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Documentation or charting should be done recklessly without any guidelines.
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What should be carefully compared during a physical examination?
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What sample should be taken 3 days before an occult blood sample to determine seizure disorders?
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What does CBC require for collection to avoid clotting?
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What must be withheld before conducting an Electromyogram (EMG) due to its invasive nature?
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Match the following medical imaging procedures with their corresponding special requirements:
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Study Notes
Theoretical Foundations of Nursing
- A theory is a set of concepts that explain a phenomenon.
- A paradigm is a pattern.
Metaparadigms of Nursing
- There are 4 metaparadigms of nursing: person, health, environment, and nursing.
- Person is the most important because knowing the client will make nursing care individualized, holistic, ethical, and humane.
Concepts of Man
- Man is a bio-psychosocial and spiritual being who is in constant contact with the environment.
- Man is an open system in constant interaction with a changing environment.
- Man is a unified whole composed of parts, which are interdependent and interrelated with each other.
- Man is composed of parts, which are greater than and different from the sum of all his parts.
- Man is composed of subsystems and suprasystems.
Nursing Theorists
- Florence Nightingale: Environment Theory, Environmental Sanitation.
- Hildegard Peplau: Psychodynamic Theory of Nursing, Interpersonal Process, Phases of Nurse-patient relationship.
- Virginia Henderson: 14 Fundamental needs of the person, Patient-centered approach.
- Faye Abdellah: Typology of 21 Nursing problems, Patient-centered approach.
- Sister Callista Roy: Adaptation Model, Individuals cope through biophysical social adaptation.
- Martha Rogers: Science of Unitary Human Being, Unitary man is an energy field in constant interaction with the environment.
- Dorothea Orem: Self-care and Self-care Deficit Theory, Universal self-care requirement, Developmental self-care requirement, Health care deviation self-care requirement.
- Dorothy Johnson: Behavioral Systems Theory, Man is composed of subsystems and these systems exist in dynamic stability.
- Imogene King: Goal Attainment Theory, Interacting systems framework.
- Betty Neuman: Total Person Model, 3 types of stressors: intra-personal, extra personal, interpersonal, Primary, secondary, tertiary levels of prevention.
Historical Development of Nursing
- Prehistoric: Intuitive nursing, nursing was untaught, rendered by mothers.
- Ancient Civilizations: Egyptians - art of embalming, anatomy and physiology, Moses - Father of Sanitation, asepsis, art of circumcision.
- Romans: Fabiola - a rich matron who contributed her home to serve as first hospital.
- History of Nursing Education:
- Apprentice: Known as the “on the job training” period, under the supervision of a more experienced person, but yet there is no formal education.
- Educated: Florence Nightingale School of Nursing, first theory author, first nurse-researcher.
- Development of Nursing Curriculum:
- 1946: UST, Managerial, teaching and supervision position.
- 1960s: 5-year curriculum.
- 1976: 4-year curriculum; GN program was phased out.
- 1980: Overlapping of 4 and 5 year curriculum graduates.
- 1992: RA 7164 - IV training for nurses by ANSAP.### History of Nursing in the Philippines
- First hospital in the Philippines: Hospital de Real de Manila (1577)
- San Lazaro Hospital (1578) - for leprosy and mental illness
- Hospital de San Gabriel - Chinese General Hospital
- Aliping sagigilid and aliping namamahay - first volunteer nurses in the Philippines
- Escuela de Practicantes (1878) - first school for nursing in the Philippines
- Iloilo Mission Hospital School for Nursing (1906) - 6 months training, no board exam
- Act 2493 (1915) - Medical act that included nursing practice, registration, and examination
- Act 2808 (1919) - further development of nursing practice in the Philippines
Nursing Practice
- Correlating theory and practice, updates, continuing education, research, and self-supporting nursing school
- Professionalized nursing practice
- Notes of Nursing: What it is, What it is not, Notes on Hospitals
- Modern nursing practice includes grand lady of Philippine nursing, Anastacia Giron-Tupas
- Loreto Tupas - Florence Nightingale of Iloilo, founded PNA
- Melchora Aquino - Tandang Sora, developed Red Cross
Health, Disease, and Illness
- Health: absence or presence of disease or infirmity, or a state of complete physical, mental, and social well-being
- Disease: malfunctioning of the body system
- Illness: a state where the person's physical, emotional, and social well-being is diminishing, felt by the patient
- Acute illness: sudden onset, short duration, may or may not require immediate intervention
- Chronic illness: gradual/slow onset, long duration, lessen complications or debilitating effects of the condition
Models of Health
- Clinical Model: absence of signs and symptoms of a disease
- Role Performance Model: able to perform job despite infirmity
- Adaptive Model: capable of adjusting to changes in the environment
- Eudemonistic Model: achieving the apex of Maslow's Hierarchy of needs
- Ecologic Model: epidemiological triad - agent, host, environment
- Multiple Causation Theory of Disease: health affected by different factors in the environment
- Rosenstoch-Becker's Health Belief Model: individual perception affects modifying factors influencing action
Stress and Adaptation
- Stress: organism reacts as a unified whole, non-specific response to any demand
- Response Based Model (Selye): non-specific response of the body to any demand
- Transaction-based Model: individual perceptual response rooted in psychological and cognitive process
- Adaptation Model: anxiety-provoking stimulus, people experience anxiety and increased stress when unprepared to cope
- Lazarus' Stress Response Theory: a physiological response is a systemic response
- General Adaptation Syndrome (GAS): alarm, resistance, exhaustion
- Local Adaptation Syndrome (LAS): only a part of the body responds to stress
Crisis
- Crisis: disequilibrium, not merely psychological but physiologic as well
- Crisis stages: spontaneous resolution (6 weeks), grieving process (4 years)
- Stressor: internal/intrinsic, external/extrinsic, developmental/maturational, situational
- Eustress: helpful stress
Nursing Process
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Assessment: data collection, primary/secondary, objective/subjective
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Data collection methods: interview, observation, physical examination
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Steps in assessment: data collection, validation, organization, categorizing, making influences or impressions of data
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Diagnosis, Planning, Implementation, Evaluation: overlapping process, cyclic
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Types of assessment: initial, problem-focused, emergency, time-lapsed### Phagocytosis and Wound Healing
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Phagocytosis is the ingestion of foreign substances by macrophages that develop from monocytes.
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Chemotaxis is the movement of substances in response to a chemical signal.
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Wound healing methods:
- Cold compress for the first few hours, then warm compress afterwards.
- Nutrition and fluid intake are essential.
Types of Wound Healing
- Primary Intention: Wound edges are well approximated (closed), with minimal tissue damage (e.g., surgically created wound).
- Secondary Intention: Wound edges are not well approximated, with moderate to extensive tissue damage (e.g., decubitus ulcer).
Nursing Diagnosis
- Types of Nursing Diagnosis:
- Actual
- Risk for/Potential for
- Wellness – readiness and enhancement/achieve higher level of functioning
- Syndrome – “syndrome”
- Prioritization of Nursing Diagnosis:
- Airway, breathing, circulation
Planning
- Planning must be SMART (Specific, Measurable, Attainable, Realistic, Time-bound).
- Classify planning as dependent, interdependent, and collaborative.
Implementation
- Reassess if the patient still needs intervention.
- Determine if assistance is needed.
- Carry out intervention, ensuring background information is available.
- Document the process.
Evaluation
- Purposes of evaluation:
- Determine client's progress or lack of progress.
- Evaluate overall quality of care provided.
- Promote nursing accountability.
- Guidelines for evaluation:
- Systemic process.
- Ongoing basis.
- Involve the client, significant others, and other members of the health team.
Documentation or Charting
- Types of documentation:
- STAT – now.
- Ad lib – as desired.
- PRN – as required.
- OD – right eye/once a day.
- OS – left eye.
- OU – both.
- AD – right ear.
- AS – left ear.
- AU – both ears.
- Ss – half.
- Types of documentation methods:
- Source Oriented Recording (narrative account by nurse).
- Problem Oriented Recording (POR) – problems ranked according to priority by the healthcare team.
- Computer Assisted Recording.
- Flow Chart.
Physical Examination
- Cephalo-caudal approach:
- Inspection, palpation, percussion, and auscultation.
- Inspection, auscultation, percussion, and palpation sequence on the abdomen to prevent stimulation of peristalsis.
- Bruit – normal if with AV fistula, abnormal in other cases since it may signify arterial occlusion.
- Auscultate the scrotum in inguinal hernia since it may have bowel sounds.
- Compare each body part to the other.
Positioning
- Sitting.
- High Fowlers (90%).
- Orthopneic position (leaning on a table, hands extended).
- Supine, Back Lying, Dorsal, Horizontal Recumbent.
- Flat on Bed – no pillow.
- Dorsal Recumbent – legs flexed to relax abdominal muscles, abdominal palpation/exam – followed by diagonal draping.
Physical Examination – Abdomen and Chest
- Pectus excavatum – funnel chest (congenital); compression of heart and breathing.
- Pectus carinatum – pigeon chest – deformity for rickets (Vit D deficiency); AP diameter decreased.
Skin
- Capillary refill test = 1-2 seconds.
- Icteric sclera.
- Cyanosis – late sign of oxygen deprivation.
- Vitiligo.
- Erythema.
- Pallor.
Nail Beds
- Clubbing - Beyond 180 degree due to dec.
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Description
A quiz on the theoretical frameworks of nursing, part of the fundamentals of nursing course at the University of Cebu.