Nursing Blog

The 4 Metaparadigms in Nursing as defined by Patricia Benner: Nursing Patricia Benner described nursing as an “enabling condition of connection and concern” (Marriner-Tomey, 1989, p192) which shows a high level of emotional involvement in the nurse-client relationship. She viewed nursing practice as the care and study of the lived experience of health, illness, and disease and the relationships among these three elements. Person Benner stated that a “self-interpreting being, that is, the person does not come into the world predefined but gets defined in the course of living a life. A person also has… an effortless and non-reflective understanding of the self in the world. The person is viewed as a participant in common meanings.” (Tomey, 2002 p173) Benner believed that there are significant aspects that make up a person. She had conceptualized the major aspects of understanding that the person must deal as: The role of the situation The role of the body. The role of personal concerns.

Dorothy Johnson believes that each individual has a focusing and repeating ways of acting which covers a behavioral system distinct to that individual. These actions or behaviors form outstanding thoughts- out and included functional unit that determines and defines the relations between the person and his environment and establishes the bond of the person to the object,events, and circumstances in his environment. These behaviors are logical, fixed, predicatable and adequately secure and persistent to be satisfying to depiction and clarification. Johnsons identifies seven subsystems within the Behavioral System Model. These subsystems were originally in Johnson’s 1968 paper presented at Vanderbilt University. The seven subsystems are considered to be interrelated, thus changes in one subsystem affect all the subsystem. Seven Behavioral Subsystems The Attachment or Affiliative Subsystem is well-known as the earliest response system to expand in the individual. The most favorable functi

Dorothy Johnson biography: Life story of the nursing theorist of Behavioral System Model Dorothy Johnson was born in Savannah, Georgia, in 1919. She was the youngest in a family of seven. She obtained her Bachelor of Science in Nursing degree from Vanderbilt University, Nashville, Tennessee, and her Masters in Public Health from Harvard University in Boston, Massachusetts. She began publishing her ideas about nursing soon after graduation from Vanderbilt. Most of her education career was in Pediatric Nursing at the University of California, Los Angeles. She withdrew from the academe as a Professor Emeritus at January 1, 1978. Dorothy Johnson has influenced nursing through her publications since the 1950′s. Through her career, Johnson has made her cause on the importance of Research-Based Knowledge about the effect of nursing care on clients. She was an early advocate of Nursing as a Science as well as an Art. She also assumed that nursing had a body of Knowledge reflecting both the sci

Virginia Henderson’s Need Theory Henderson’s Theory Background Henderson’s concept of nursing was derived form her practice and education therefore, her work is inductive. She called her definition of nursing her “concept” (Henderson1991) Although her major clinical experiences were in medical-surgical hospitals, she worked as a visiting nurse in New York City. This experience enlarges Henderson’s view to recognize the importance of increasing the patient’s independence so that progress after hospitalization would not be delayed (Henderson,1991) Virginia Henderson defined nursing as “assisting individuals to gain independence in relation to the performance of activities contributing to health or its recovery” (Henderson, 1966, p. 15). She was one of the first nurses to point out that nursing does not consist of merely following physician’s orders. She categorized nursing activities into 14 components, based on human needs. She described the nurse’s role as substitutive (doing for the p

1897-1996 Army School of Nursing, Washington, D.C., 1921 First full-time nursing instructor in Virginia Recipient of the Virginia Historical Nurse Leader Award Member of the American Nurses Association Hall of Fame Fellow of the American Academy of Nursing Authored one of the most widely used definitions of nursing Proposed plan to create districts within the Graduate Nurses Association of Virginia (now Virginia Nurses Association) Virginia Avenel Henderson's national and international achievements made her the quintessential nurse of the twentieth century. Her professional career was launched in Virginia where she served as the first full-time nursing instructor at Norfolk Protestant School of Nursing and took an active role in the state nurses association. A pioneer nurse educator, Henderson was instrumental in pushing for the inclusion of psychiatric nursing in educational programs in Virginia. "Henderson through her efforts as an author, researcher,

Isabel Adams Hampton Robb (1860–1910) was one of the founders of modern American nursing theory and one of the most important leaders in the history of nursing. She graduated from the Bellevue Hospital Training School for Nurses in 1883. After gaining experience working as a nurse in Rome she traveled back to the United States to take a position as superintendent of nursing at the Cook County Hospital nursing school in Chicago. In her time as head of the nursing program there she implemented an array of reforms that set standards for nursing education. Most of these standards are still followed today. One of her most notable contributions to the system of nursing education was the implementation of a grading policy for nursing students. Students would need to prove their competency in order to receive qualifications. In 1889 she was appointed head of the new Johns Hopkins School of Nursing, where she continued to suggest reforms, participated in teaching, and published the text Nursing

Product Description The painless way to master medical-surgical nursing Need to learn the complexities of medical-surgical nursing but find yourself looking for some anesthesia after perusing thick textbooks? Here's your remedy! This easy-to-follow guide delivers the material with surgical precision. Medical-Surgical Nursing Demystified features a full chapter for each system--cardiovascular, respiratory, immune, hematologic, nervous, musculoskeletal, gastrointestinal, endocrine, genitourinary, and integumentary. You'll find a description of how the system functions, signs and symptoms of diseases and conditions, diagnostic tests, and treatment options. Perioperative preparation and pain management are also covered. Filled with key terms to help you to remember important concepts, and complete with end-of-chapter NCLEX-style quizzes to test your knowledge, this book will teach you the fundamentals of medical-surgical nursing in no time at all. This fast and easy guide offers: L

From Publishers Weekly In this useful home healthcare guide, Carroll offers the insight of a nurse to help readers understand and treat common medical conditions such as skin rashes and joint pains. Rather than following the general practice of organizing a self-care guide around specific diagnoses-which, she argues, makes such guides "hard to use unless you can diagnose yourself correctly first"-she lists the topics by symptoms, starting with the most common medical complaint: headaches. She then works through topics like eye irritation, toothaches, constipation and dizziness. In each section, she explains what the symptoms look and feel like, answers FAQs and decisively informs readers when the symptoms might be serious enough to warrant a call to a healthcare pro or a trip to the emergency room. The book also includes information on dealing with injuries like sprains and cuts, choosing and using medications, fighting through the difficulties of the healthcare system and ha

Review “Tilda Shalof’s A Nurse’s Story is the first time the work of nurses has been documented in print in Canada in such an honest, no-holds-barred account. . . . Shalof has seen it all, and writes about it, too.” –The Calgary Herald “But her book isn’t a doom-and-gloom account of overworked nurses. Interspersed with tales of tragedy are accounts of the funny, often bizarre events that transpire on an ICU.” Canadian Press “A compelling book laced with humour.” –Times & Transcript “There are genuinely heart-rending, disturbing and thought-provoking stories to be found in the pages of A Nurse’s Story. If this book doesn’t give you pause, you’re made of stone.” –Edmonton Journal “In a post-SARS world where nurses are finally being recognized for the heroes they always were, A Nurse’s Story is the best-seller no one can put down.” –Montreal Gazette “This is a difficult book. Its content is difficult. Its tone is difficult. But it is also difficult to put down, so compelling and beaut

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ECG : shows the pattern of ischemic injury and conduction disturbances. Stating the type / source of dysrhythmia and effect of electrolyte imbalance and cardiac medications. Holter Monitor : Overview of ECG (24 hours) may be required to determine where the dysrhythmia caused by a particular symptom when the patient is active (at home / work). It can also be used to evaluate the function of a pacemaker / drug effects of anti-dysrhythmia. Chest photo : It can show enlarged heart shadow with respect to ventricular dysfunction or valve Scan myocardial imaging : it can show areas of ischemic / myocardial damage that could affect or disrupt the normal conduction wall motion and pump capacity. Exercise stress tests : demonstrating the exercises can be done separately which causes dysrhythmias. Electrolytes : An increase or decrease in potassium, calcium and magnesium can cause dysrhythmias. Examination of drugs : cardiac drug toxicity can be expressed, the presence of street drugs or digitali

Shock Symptoms Shock is defined as abnormal metabolism at the cellular level. Since it is not easy to directly measure cellular problems, the symptoms of shock are indirect measurements of cellular function. Shock is the end stage of all diseases, and symptoms will often be dependant on the underlying cause. Vital signs As the patient goes through the various stages of shock, vital signs change. In the early stages, the body tries to compensate by moving fluids around from within cells to the blood stream with an attempt to maintain blood pressure in a normal range. However, there may be a slight rise in the heart rate (tachycardia = tachy or fast + cardia or heart). Think of donating blood. A unit of blood (or about 10% of your blood volume) is removed, yet the body compensates well, except for a little lightheadedness, which is often resolved by drinking fluids. Another example is exercising and forgetting to drink enough fluids and feeling a little tired at the end of the day. As th

Nursing Care Plan for Neonatal Sepsis Neonatal sepsis Neonatal sepsis is any infection involving an infant During the first 28 days of life. Neonatal sepsis is also known as "neonatal sepsis." The infection may involve the infant globally or may be limited to just one organ (Such as the lungs with pneumonia). It may be acquired prior to birth (intrauterine sepsis) or after birth (extrauterine sepsis). Viral (Such as herpes, rubella [German measles]), bacterial (Such as group B strep) and more rarely fungal (Such as Candida) Causes may be implicated. Nursing Assessment Nursing Care Plan for Neonatal Sepsis Early signs: Lethargy, especially after the first 24 hours, poor sucking, anorexia Regurgitation of food, sensitive excitatory, pallor, hypotonia, hiporefleksia Weight loss, jaundice, hypothermia, nervousness Another sign: Hyperthermia, snoring, bradipnea, apnea, tremors, convulsions, vomiting Abdominal distension, dehydration, cold and moist skin, pallor, diarrhea Hyp

by: Evan Langsted If you are a caregiver for someone with mesothelioma, you already know, or are learning quickly, how drastically your routines must change. Fortunately, there are seemingly endless sources of support for you as the caregiver, as well as for your loved one with this diagnosis. Start with an Internet search to learn about mesothelioma (the disease, causes, treatments, care giving, support, options–everything you can find) and print out as much as you can. You won’t be able to remember it all. Make a file and organize it into categories so that you can easily find what you need when you need to know it. Then devise a plan to investigate each aspect of your care giving in an orderly manner. If you jump around from topic to topic, you’ll surely get confused, forget things and become overwhelmed. Make notes and file them with your topics. Also, be aware that there are many sites that offer unreliable or biased information, so consider your sources carefully. One place to st

by: Wendy Moyer Mesothelioma victims can experience a substantial amount of pain. However, there are medications that can make them more comfortable. Experiencing a physical pain in one's chest or abdomen may be the first sign of mesothelioma. And, if the disease has spread, people may also feel pain in other parts of their body. As the disease spreads and the mesothelioma tumor grows other symptoms may appear. What is the Cause of Mesothelioma Pain? One of the most common symptoms of mesothelioma is a buildup of fluids. As a mesothelioma tumor gets larger it produces a fluid in the patient's abdomen or chest. If the fluid is in a person's chest it will compress the lung and can cause severe pain. As the fluid increases it will slowly crush vital organs. When that happens a person usually loses his appetite and often finds it very difficult to sleep. It can be challenging to completely eliminate the pain but there are a number of proven ways to reduce any discomfort. This s

by: Wendy Moyer Mesothelioma is a relatively rare malignancy that is usually comes about as the result of a person's being exposed to asbestos. This form of cancer arises most frequently in the pleura - the cells that line the chest - or in the peritoneum - the cells that line the abdomen. The most common form of this disease is pleural mesothelioma and its symptoms often present themselves in the chest area. What are the Symptoms of Mesothelioma? Peritoneal mesothelioma is considerably rarer than pleural mesothelioma. If a person has peritoneal mesothelioma the organs in the abdomen are affected and the symptoms may include abdominal swelling, vomiting, nausea, and bowel obstruction. The rarest type of this disease, pericardial mesothelioma, involves the sac that surrounds the heart. Most of the people who have mesothelioma complain of a shortness of breath. Their difficulty breathing is sometimes accompanied by chest pains. What may come as a surprise is that the chest pain is n

The normal temperature varies by person, age, time of day, and where on the body the temperature was taken. The average normal body temperature is 98.6°F (37°C). Your body temperature is usually highest in the evening. It can be raised by physical activity, strong emotion, eating, heavy clothing, medications, high room temperature, and high humidity. Daily variations change as children get older: In children younger than 6 months of age, the daily variation is small. In children 6 months to 2 years old, the daily variation is about 1 degree. By age 6, daily variations gradually increase to 2 degrees per day. Body temperature varies less in adults. However, a woman's menstrual cycle can raise temperature by one degree or more. For information on when to call a doctor due to specific temperatures and ages, see the article on fever.

Nanda Ineffective Airway Clearance Definition: Inability to clear secretions or obstructions from the respiratory tract to maintaina clear airway RELATED FACTORS Environmental Smoking; secondhand smoke; smoke inhalation Obstructed airway Retained secretions; secretions in the bronchi; exudate in the alveoli; excessive mucus; airway spasm; foreign body in airway; presence of artificial airway Physiological Chronic obstructive pulmonary disease (COPD); asthma; allergic airways; hyperplasia of the bronchial walls Neuromuscular dysfunction Infection DEFINING CHARACTERISTICS Subjective Dyspnea Objective Diminished/adventitious breath sounds [rales, crackles, rhonchi, wheezes] Cough, ineffective/absent; excessive sputum Changes in respiratory rate and rhythm Difficulty vocalizing Wide-eyed; restlessness Orthopnea Cyanosis Sample Clinical Applications: COPD, pneumonia, influenza, acute respiratory distress syndrome (ARDS), cancer of lung/head and neck, congestive heart failure (CHF), cystic f

Actions/Interventions NURSING PRIORITY NO. 1. To identify causative/contributing factors: Review daily dietary regimen. Note oral/dental health that can impact intake. Determine fluid intake, to note deficits. Evaluate medication/drug usage and note interactions or side effects (e.g., narcotics, antacids, chemotherapy, iron, contrast media such as barium, steroids). Note energy/activity level and exercise pattern. Identify areas of stress (e.g., personal relationships, occupational factors, financial problems). Determine access to bathroom, privacy, and ability to perform self-care activities. Investigate reports of pain with defecation. Inspect perianal area for hemorrhoids, fissures, skin breakdown, or other abnormal findings. Discuss laxative/enema use. Note signs/reports of laxative abuse. Review medical/surgical history (e.g., metabolic or endocrine disorders, pregnancy, prior surgery, megacolon). Palpate abdomen for presence of distention, masses. Check for presence of fecal impa

Standard Precautions - Infection Control Standard precautions were developed by the Centers for Disease Control and Prevention (CDC) to provide the widest possible protection against the transmission of infection. CDC officials recommend that health care workers handle all blood, body fluids (including secretions, excretions, and drainage), tissues, and contact with mucous membranes and broken skin as if they contain infectious agents, regardless of the patient's diagnosis. Standard precautions encompass much of the isolation precautions previously recommended by the CDC for patients with known or suspected blood-borne pathogens as well as the precautions previously known as body substance isolation. They are to be used in conjunction with other transmission-based precautions: airborne, droplet, and contact precautions. Standard precautions recommend wearing gloves for any known or anticipated contact with blood, body fluids, tissue, mucous membrane, and nonintact skin. (See Choosi

Nurses are assigned jobs that tackle any issues in patient care, ranging from surgery assistance to basic health care, to managing and maintaining charts and lab work. Despite all the responsibilities they are saddled with, they still must make time to develop their nursing care plans for many of their regular patients, especially in hospital settings. Nursing care plans serve a vital function in most hospitals and several clinics because they indicate to other nurses and doctors what type of diet patients are on, as well as any specific medical needs that the patient requires. Without such communication to night nurses or doctors, patients run the risk of being given medicine or food they are allergic to, or even missing a meal. Nursing care plans are relatively easy to create once you know the background of the patient. Spending some time with the patient additionally helps add to the nursing care plan; for example, if your patient is a particularly finicky eater, you can include thi

This phase of care begins when the patient arrives in the postanesthesia care unit (PACU) and continues as he moves on to the short procedure unit, medical-surgical unit, or intensive care unit. Postoperative care aims to minimize postoperative complications by early detection and prompt treatment. After anesthesia a patient may experience pain, inadequate oxygenation, or adverse physiologic effects of sudden movement. Recovery from general anesthesia takes longer than induction because the anesthetic is retained in fat and muscle. P.106 Fat has a meager blood supply; thus, it releases the anesthetic slowly, providing enough anesthesia to maintain adequate blood and brain levels during surgery. The patient's recovery time varies with his amount of body fat, his overall condition, his premedication regimen, and the type, dosage, and duration of anesthesia. Equipment Thermometer • watch with second hand • stethoscope • sphygmomanometer • postoperative flowchart or other docum