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Nursing care plan

Nursing Care Plan The Orem’s self-care model of Nursing incorporates 3 subtheories: self-care deficit, self-care and nursing systems (Comley, 1994). According to the self-care deficit subtheory, ” individuals may experience self-care limitations related to their health state and may benefit from nursing provision of this care or augmentation of their own self-care efforts” (Comley, 1994) The theory considers care of one-self and that of dependents as a type of learned behavior which causes regulation of the structural integrity, development and functioning of the humans. The nursing system ensues at that point of time when the nurse intervenes with the patient either to prescribe medication or to provide care that is intended to take care of self-care deficit and regulate his or her own capabilities of self-care (Orem, 1985; cited in Comley, 1994). Dorothea Orem considered all human beings as basically biopsychosocial beings with capabilities and willingness to take care of themselves and also be dependent on others. It is through these capabilities that human beings live and maintain health (Clark, 1986). The ultimate aim of these capabilities is to meet 3 groups of needs, which are known as ‘self-care requisites’ and they are universal, developmental and health deviation (Orem, 1985; cited in Comley, 1994 ). The requisite for Mr. C at this current juncture is health deviation. Mr. C is in congestive heart failure, has anemia and also deep vein thrombosis. He also has hypothyroidism. He is on lasix and metoprolol for heart failure and coumadin for deeep vein thrombosis. He is very pale because of low hemoglobin and also congestive heart failure. His laboratory tests are suggestive of renal impairment. In view of congestive heart failure, he is dyspneic and his saturations are low. Mr. C needs to feel comfortable at breathing. He is dysneic and his saturations are low. The nursing goals with regard to this requisite would be to decrease dysnea and improve oxygen saturation. The nursing interventions provided are head end elevation and oxygen administration through mask. Head end elevation prevents accumulation of fluid in the lungs and administration of oxygen through mask improves saturations and diaphoresis. Administration of lasix improves fluid removal through kidneys (Nettina, 2006). The next requisite is diaphoresis and pallor as a result of low hemoglobin. The nursing interventions are to send for blood cross matching and grouping. The rationale behind the intervention is that it helps the lab technician to keep blood to be ready (Nettina, 2006). Other requisites include universal requisites and developmental requisites. The universal requisites of M C, like any other individual would be those needs which are necessary for physiological and functional aspects of a human being and include maintenance of food, shelter, air, water, rest, solitude, activity, rest, interaction in a social perspective, prevention of hazards and facilitate various functions of the human being (Comley, 1994 ). Besides these, Mr. C also needs some one to remember his medicines and health problems and take him to check-ups regularly. The developmental requisite for Mr. C would be companionship. Mr. C’s wife passed away and his daughter-in-law who is no longer married to his son is taking care of him presently. This can be addressed by asking his daughter-in-law to be with him for some time or ask his son to visit him and take care of him. Actions intended to meet various self-care requisites are known as ” therapeutic self care demands” and when these exceed the basic capacity of an individual, deficits in self-care ensue. It is during such deficits that legitimization of nursing intervention occurs (Orem, 1985, cited in Comley, 1994). Thus, Mr. C, is not able to take care of himself because of the his age and nature of illness. References Clark, M. D. (1986). Application of Orem’s Theory of Self-Care: A Case Study. Journal of Community Health Nursing, 3(3), 127- 135. Comley, A. L. (1994). A comparative analysis of Orem’s self-care model and Peplau’s interpersonal theory. Journal of Advanced Nursing, 20, 755- 760. Nettina, S. M. (2006). Manual of Nursing. Lippincott: Singapore.

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