NMIH103 Art and Science of Nursing Proof Reading Service

NMIH103 Art and Science of Nursing Proof Reading Service

Part 1

Information on personal cleaning and dressing:

Following are the requirement which should be met when the nurse is collecting the information on personal cleaning and dressing during the assessment of nursing:

1. Allergies

The nurse has to find out if the patient has any kind of allergy with any of the medicine or food. For example one patient has an allergy from a particular salt then s/he must not be given that medicine.

2. Eating habit

The nurse must also gather the information about the eating habits of the person through which the doctor can find out the reason behind the problem of the patient. For example the person is taking sugar in high quantity then the doctor comes to know that the patient problem can be diabetes and a sugar test is done through the blood sample of the patient. (Morton, P.G., Fontaine, D., Hudak, C.M. and Gallo, B.M., 2005)

3. Consumption of alcohol

If the person is having a problem in his/her liver then the patient has to share the information that s/he’s consumption of alcohol is there or not. For example the patient’s liver is fatty then it indicates that s/he is consuming alcohol in high quantity.

4. Pain in any part

The nurse has to check whether the patient is suffering from any kind of pain in any body part and if the patient is taking any kind of pills or treatment for the pain management.

5. Regular medication

The nurse has to check whether the patient is taking any kind of medicine on regular basis like anti depressive pills, Blood pressure pills or sugar pills. This information plays a very important role in knowing the disease of the patient.(Leininger, M.M. and McFarland, M.R., 2002)

6. Chronic illness

The nurse must find out whether the patient is suffering from any kind of chronic diseases like heart problem , kidney problem etc.

7. Physical examination

The nurse must also do a physical examination of the patient which includes the pulse rate, Blood pressure, respiratory rate, temperature and heart rate of the patient.

8. Cleanliness

The nurse must check whether the patient or person is clean this includes clean and tidy clothes, clean drinking water which is consumed by the person.

9. Sanitation

The nurse can also check the sanitation of the house of the patient to find out any sort of problem which can result in any kind of disease.

10. Exercise

The nurse must check whether a patient or person is devoting time for the exercise suggested by the doctor.(Virginia Henderson, 1997)

Ways or Methods of assessment

Following are the ways of collecting information of the patient by a nurse:

1. Observation

This is one of the most important step in the nursing assessment. In this step the nurse checks the following things:

Overall appearance of the patient- it includes checking the color of the patient (pale, white or reddish)

Respiratory rate-Whether the breathing is slow , fast or normal

Nasal flaring

Shape of chest

Sound from the nose or mouth

Oxygen saturation

2. Inspection

Another way of assessment is inspection. It includes wounds on the body, high risk  areas of the patient, moles( its size, irregular border line, and color), rashes on the body etc.(Watson, R., Stimpson, A., Topping, A. and Porock, D., 2002)

3. Palpation

This process includes the following things

chest expansion

condition of skin( temperature and moisture)

fremitus

subcutaneous emphysema

4. Percussion

It basically means to tap on something to find out about the inner structure and is generally used to find out the condition of the abdomen of the patient. It can be done in two ways

a. Directly by one or two fingers

b. Indirectly by using middle or flexor finger

This technique was first introduced by Dr.Leopold Auenbrugger and was first used by Avicenna approximately before 1000 years.

5. Ausculation

It includes the breathing sounds like is it fast or slow or normal. It also involves the noises like wheeze or crackles.(Yanhua, C. and Watson, R., 2011)

 Roper-Logan-Tierney model of Nursing

This model of nursing was firstly published in 1980 and then its various versions were formed. The authors involved were Nancy roper, Winifred w. Logan and Alisen J Tierney. This model is based on the activities of living. The main motive of making this assessment was for providing help in patients care or we can say that for increasing the quality of care given to the patient. This model examines the result or consequences of the illness on the patient’s life.

For example a person is suffering from a liver disease then the disease is having a direct effect on the diet of the person because the diet has to be very light for a person suffering from a liver disease.(Alligood, M.R., 2014)

This is also popularly known as the “green “ model because it considers the impact of our daily activities on the environment.

For example- The hospital is having a lot of waste medicines, cotton, chemical which they  are throwing but what  is the result of that waste on the environment is counted by the Roper-Logan-Tierney model of nursing.

This model of nursing is based on the activities of living which are as follows:

Eating habits-In this model the eating habits of the patient are also examined whether the patient is taking enough proteins, minerals required for improving from a particular disease.

Drinking water-whether the patient is drinking clean water or not

Sanitation-it also check whether the patients is having all the facilities related to sanitation or not. Sometimes a patient suffering from mental illness is not able to maintain the basic hygiene then a special help is given to  the patient

Communication- whether the patient is moving from one place or another or in other words we can say that the mobilization of the person is checked.

Physical environment –This model also considers the physical environment near the patients plus it also checks the consequences of the illness on the environment.

Sleeping habits-Whether is patient is getting enough sleep or s/he is in stress. In some cases the doctors prescribe sleeping pills to the patient for getting a sound sleep.

Dressing-The patience cloths are also important( whether the patient is wearing clean and tidy clothes or the clothes are smelly and dirty)

Physical activities -whether the patient is moving, playing or doing exercise or not.

Unable to perform certain task-sometimes the patient is not able to perform some task then a solution is found out. For example a person cannot comb her/his hair because the arms don’t go up, may be the person is suffering from a bone injury.(Timmins, F. and O'Shea, J., 2004)

Five Factors that influence the activities of living

Below are the five factors that affect or influence the activities of living:

1. Politico economic factor

It includes things like state of war, national economy, government policies of the country in which the person lives, violence in the city or country etc.

For example –Suppose a person is not able to  buy a house in the country and s/he has the money for buying  house but cannot do  the same because the government of the country does not allow the person of the another country to buy a property there. This can affect the activity of living of the person. This can make the person frustrated or disheartened.

2. Physical environment 

It means the surrounding of the person’s house. Like a hospital near the house, a banquet near the house.

For example – There is a dumping site near the house of a person, then it may affect the health of the person like she or he can get respiratory problems because of the smell and dust from the dump thrown in the dumping site near the house. The smell of the dump can also affect the air near the house by  making the air polluted which can result in headache, dizziness etc.(Wimpenny, P., 2002)

3. Socio- cultural factor

The socio cultural factor includes the personal experience of the society in which he or she is living. It also includes the culture of the person which consists of religion, beliefs and customs of the person. It also includes the personal ability of the person to perform the daily activities of the living.

For example – when one has to take care of a child born in the new age then the parent has to take care of him in way the modern society is doing. The parent tends to provide all the facilities to the child which they have not used or got.

4. Psychological factor

It includes the cognition, personal emotions, and spiritual beliefs. It basically includes the personal feelings of the person.

For example-When one person is not having enough education or we can say  that  there is lack of literacy in him or her then he or she will think differently from the educated person and the thinking and thoughts of the uneducated person will be different from the educated people.

The uneducated person also does not try much to understand the problem related to health and the treatment which has to be followed. They generally don’t cooperate with the nurse and the doctor.(Healy, P. and Timmins, F., 2003)

5. Biological factors

The biological factor of the model includes the overall health of the person which consists of the current illness or the injury of the person. It also takes care of the effect of the injury or illness on the person who is suffering from that.

For example- A person is diagnosed with diabetes then the diet of the person is completely changed plus he or she has to take the medicine and follow a suggested exercise by the physician. All these things change the routine of the person suffering from the disease.

Another example can be suppose a person has met an accident and he or she is not able to  walk properly after that , it completely changes the daily activities of living of the affected person.

Nursing actions

The nursing actions include some of the services like treatment for the patient, procedure of the treatment and the activity to get the result of diagnosis for the nursing actions.

Following are some of the actions related to the nursing actions:

a. Nursing planning

It contains the procedures or actions which the nurse does to diagnose the problem of the patient. The activities in the nursing planning ensure that  the care of the patient is done in satisfactory quality. Nursing planning also ensures the safety of the patient.

Lets take the example used in Politico economic factor, i.e. in state of the war the nurse has to completely and very politely diagnose the problem of the people living in these sensitive circumstances.

b. Intervention

It is one of the most important parts of the nursing actions which are performed by the nurses. It includes the treatments and the actions which the nurses perform in the treatment of the disease.

The interventions can be independent or collaborative or we can say that direct or indirect. When the nurse is caring for the patient they tend to follow the nursing process.(Moss, J., Coenen, A. and Mills, M.E., 2003)

Types of intervention

Independent -This kind of intervention is performed by the nurse independently.

Dependent-This kind of intervention is performed under the order of the physician

Interdependent- This kind of intervention is performed by all the members involved in the treatment.

Let’s take the example of the accident used in biological factors , in this case where the person has met an accident then the nurse has to do the counseling of the patient also  to keep him or her happy and calm.

c. Evaluation

In the process of evaluation the nurse uses all the information gathered about the patient and sometimes of required the nurse also uses the information of the earlier patients. The evaluation is done by the nurses for checking whether the outcome is related to the expectation or not.

The evaluation process conducted by the nurse is not anywhere related to the intervention.

Let’s take the example of a depresses man used in the Politico economic factor, in this case the nurse uses various examples to make the person calm and for making him relaxed.(Benner, P.E., Tanner, C.A. and Chesla, C.A., 2009)

References

Morton, P.G., Fontaine, D., Hudak, C.M. and Gallo, B.M., 2005. Critical care nursing: a holistic approach (Vol. 1). Philadelphia: Lippincott Williams & Wilkins.
Leininger, M.M. and McFarland, M.R., 2002. Transcultural nursing concepts, theories, research and practice.
Virginia Henderson, 1997. Basic principles of nursing care. Amer Nurses Pub.
Watson, R., Stimpson, A., Topping, A. and Porock, D., 2002. Clinical competence assessment in nursing: a systematic review of the literature. Journal of advanced nursing, 39(5), pp.421-431.
Yanhua, C. and Watson, R., 2011. A review of clinical competence assessment in nursing. Nurse Education Today, 31(8), pp.832-836.
Whelan, L., 2006. Competency assessment of nursing staff. Orthopaedic Nursing, 25(3), pp.198-202.
Alligood, M.R., 2014. Nursing theorists and their work. Elsevier Health Sciences.
Timmins, F. and O'Shea, J., 2004. The Roper–Logan–Tierney (1996) model of nursing as a tool for professional development in education. Nurse education in practice, 4(3), pp.159-167.
Wimpenny, P., 2002. The meaning of models of nursing to practising nurses. Journal of Advanced Nursing, 40(3), pp.346-354.
Healy, P. and Timmins, F., 2003. Using the Roper-Logan-Tierney model in neonatal transport. British journal of nursing, 12(13), pp.792-798.
Moss, J., Coenen, A. and Mills, M.E., 2003. Evaluation of the draft international standard for a reference terminology model for nursing actions. Journal of biomedical informatics, 36(4), pp.271-278.
Benner, P.E., Tanner, C.A. and Chesla, C.A., 2009. Expertise in nursing practice: Caring, clinical judgment, and ethics. Springer Publishing Company.