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Questions and Answers
Which of the following best describes Orlando’s view of the nurse-patient relationship?
Deliberative Nursing Actions are taken without assessing the patient's immediate needs.
False
List the five major interrelated concepts of Orlando's nursing theory.
Function of professional nursing, presenting behavior, distress, immediate reaction, nurse's action.
When a patient experiences a need they cannot resolve, they feel a sense of __________.
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What is the primary focus of the initial assessment in the Deliberative Nursing Process?
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Match the nursing action classifications with their descriptions:
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Presenting behavior reflects the patient’s need for help.
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What happens during the immediate reaction phase of the nursing process?
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Which stage of the Deliberative Nursing Process involves identifying a patient's need for help?
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In Lydia Hall's theory, care is the sole function of nurses.
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What is the primary focus of the Care Circle in Lydia Hall's model?
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In the Deliberative Nursing Process, the stage where the nurse evaluates the effectiveness of their intervention is called __________.
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Match the nursing process stage with its description:
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Which of the following represents the three aspects of a patient in Lydia Hall’s Core, Care, Cure theory?
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Which role involves providing specific answers to questions within a larger context?
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The Nurse functions equally across all three circles of Lydia Hall's theory.
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What is the significance of patient assessment in the nursing process?
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Mild anxiety is defined as the initial response to a psychic threat.
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What role serves as a substitute for another such as a parent or sibling?
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In Peplau's Theory, _____ anxiety involves feelings of dread and terror and inability to focus on tasks.
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Match the following levels of anxiety with their descriptions:
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Which of the following roles includes helping the client to learn formally or informally?
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Anxiety can only be classified as a negative experience.
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Name one function of a 'Technical Expert' in nursing.
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Study Notes
NCM 100: TFN
- Course name: NCM 100
- Topic: TFN
- Instructor: Hosanna Angeli D. Corpuz, MAN, RN
Hildegard Peplau's Theory of Interpersonal Relationship
- Peplau was the first published nursing theorist since Florence Nightingale
- Her achievements were recognized worldwide
- She was known as the "Mother of Psychiatric Nursing" and the "Nurse of the Century"
- Her theory emphasizes the nurse-client relationship as fundamental to nursing practice
- It emphasizes the give-and-take of nurse-client relationships
- Peplau created an interpersonal model, emphasizing a partnership between the nurse and client, instead of a passive client receiving treatment and a passive nurse following doctor's orders
- For Peplau, nursing is a "maturing force and an educative instrument" involving interaction between two or more individuals with a common goal that provides incentive for the therapeutic process
- Nurses and patients respect each other as individuals and mutually learn and grow from the interaction
The four components of the theory
- Person: a developing organism that attempts to reduce anxiety caused by needs
- Environment: existing forces outside the person, in the context of culture
- Health: a word symbol that implies a forward movement of personality
- Nursing: a significant therapeutic interpersonal process that cooperatively functions with another process to make health possible for individuals in communities
Therapeutic nurse-client relationship
- A professional and planned relationship between client and nurse focuses on the client's needs, feelings, problems, and ideas
- It involves interaction between two or more individuals with a common goal achieved through a sequential pattern of steps
Sequential phases in the interpersonal relationship
- Orientation
- Identification
- Exploitation
- Resolution
1. Orientation Phase - Initial Phase
- The nurse engages the client in treatment, provides explanations and information, and answers questions
- Problem-defining phase
- Begins when the client meets the nurse as a stranger
- Client seeks assistance, conveys needs, asks questions, and shares preconceptions and expectations of past experiences
- Nurse responds, explains roles to the client, identifies problems, and uses available resources to address them
Factors influencing orientation phase
- Nurse: Values, culture, race, beliefs, past experiences, expectations, preconceived ideas
- Patient: Values, culture, race, beliefs, past experiences, expectations
2. Identification Phase
- The client works interdependently with the nurse, expresses feelings, and begins to feel stronger
- Client starts to trust the nurse and feels comfortable sharing thoughts and feelings
- Nurses support and encourage clients to develop a sense of trust and security
3. Exploitation Phase
- The client makes full use of the services offered
- Use of professional assistance for problem-solving alternatives
- Nurses aid the client in exploiting resources for help, and progress is made towards improved health
4. Resolution Phase
- The client no longer needs professional services and gives up dependent behavior, leading to the termination of the relationship
- The patient's needs have been met through the collaborative effect of the patient and nurse
Roles of the Nurse (in interpersonal relationship)
- Stranger: offering the client the same acceptance and courtesy as any stranger
- Resource person: providing specific answers to questions
- Teacher: helping the client learn formally or informally.
- Leader: offering direction to the client or a group
- Surrogate: serving as a substitute for another person/relatives
- Counselor: promoting health experiences, including the expression of feelings
- Technical Expert: providing physical care and operating equipment
Additional Roles of the Nurse
- Technical expert
- Consultant
- Health teacher
- Tutor
- Socializing agent
- Safety agent
- Manager of environment
- Mediator
- Administrator
- Recorder observer
- Researcher
Anxiety
- Anxiety is defined as the initial response to a psychic threat
- There are four levels of anxiety: mild, moderate, severe, and panic
Four Levels of Anxiety
- Mild: heightened awareness and sharper senses, allowing learning and problem-solving
- Moderate: decreased perceptual field(focus on immediate task); learning and problem-solving with assistance
- Severe: dread and terror, inability to focus; scattered details, physiological symptoms (tachycardia, diaphoresis, chest pain)
- Panic: loss of rational thought; delusions, hallucinations; complete physical immobility or muteness
Ida Jean Orlando's Theory of Deliberative Nursing Process
- An internationally known psychiatric health nurse, theorist, and researcher
- Her theory allows nurses to create an effective nursing care plan that can be easily adapted when complications arise
- Orlando's theory stresses the reciprocal relationship between patient and nurse
- The nurse's function is finding out and meeting the patient's immediate needs for help
- Nursing is seen as an organizing principle, meaning finding out and meeting immediate needs for help
Five Stages of Deliberative Nursing Process Theory
- Assessment
- Diagnosis
- Planning
- Implementation
- Evaluation
Lydia Hall's Core, Care, Cure
- Nursing is defined as participation in care, core and cure aspects of patient care.
- CARE is the sole function of nurses; CORE and CURE are shared with other healthcare team members
- The theory emphasizes the whole patient, focusing on all three components working together
- The patient comprises the core, care, and cure aspects
- Nurses play a vital role in all three aspects of nursing: core, care, and cure
Abdellah's Typology of 21 Nursing Problems
- Based on Henderson's 14 basic human needs and nursing research
- Nursing is an art and science that molds attitudes and competencies
- Guiding care in hospital and community health settings
Four categories of Patient's Needs
- Basic
- Sustenance care
- Remedial care
- Restorative care
Basic Needs
- Hygiene and comfort
- Optimal activity (exercise, rest, sleep)
- Safety (accident, injury prevention, infection control)
- Good body mechanics
- Deformity prevention or correction
Sustenance Care Needs
- Oxygen supply maintenance
- Nutrition maintenance
- Elimination
- Fluid and electrolyte balance
- Body response to disease
- Regulatory mechanisms maintenance
- Sensory function
Remedial Care Needs
- Accepting positive and negative expressions
- Interrelatedness of emotions and illness
- Effective communication
- Interpersonal relationships
- Personal spiritual goals
- Therapeutic environment
- Self awareness
Restorative Care Needs
- Optimal goals with limitations
- Community resources
- Role of social problems
Ten steps to identify the patient's problem
- Learn to know the patient
- Sort out relevant data
- Make generalizations about similar nursing problems
- identify therapeutic plan
- Test generalizations with the patient and generate additional ones
- Validate patient conclusions
- Observe/evaluate the patient over a period of time for attitudes and behavior
- Explore patient and family reactions
- Identify nurse feelings about the patient's problem
- Discuss and develop comprehensive care plan
The 11 nursing skills
- Observation of the health status
- Skills of communication
- Application of knowledge
- Teaching patients and families
- Planning and organization of work
- Use of resource materials
- Use of personnel resources
- Problem-solving
- Direction of work of others
- Therapeutic use of the self
- Nursing procedure
Conclusion
- Abdellah's typology of 21 nursing problems is a conceptual model that focuses on patient needs and nurses' role in problem identification through a problem-analysis approach.
- Patients have physical, emotional, and sociological needs.
- People are the reason why nursing exists.
Abraham Maslow's Hierarchy of Needs
- A motivational theory in psychology comprising a five-tier model of hierarchical human needs
- Physiological
- Security and safety
- Love and Belongingness
- Self-esteem
- Self-actualization
Physiological Needs
- Food
- Water
- Breathing/air
- Sleep
- Shelter
Security and Safety Needs
- Financial security
- Health and wellness
- Safety against accidents and injury
Love and Belongingness
- Friendships
- Romantic attachments
- Family relationships
- Social groups
- Community groups
- Churches and religious organizations
Self-Esteem
- Appreciation and respect
- Need to accomplish things and have efforts recognized
- Feeling valued by others
- Feeling a contribution to the world
Self-Actualization Needs
- Self-aware, concerned with personal growth, less concerned with other’s opinions, fulfills potential.
- Reaching full potential, living meaningfully, and feeling living their best lives
Appendix: Patient Examples
- Physiological, safety, love and belonging, esteem, and self-actualization needs of a homeless person (Mina)
- Expanded Hierarchy of Needs
- Cognitive, aesthetic, and transcendence needs
- Erik Erikson's Stages of Psychosocial Development
- Stages of Psychosocial Development
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Description
This quiz explores key concepts from Orlando's Deliberative Nursing Process and Lydia Hall's Care Circle model. Test your understanding of nurse-patient relationships, nursing actions, and care theories. Perfect for nursing students seeking to deepen their knowledge of nursing theory.