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FUNDAM
NURSING

FACTS AND TIDBITS

CONCEPTS OF HEALTH AND ILLNESS

WORLD HEALTH ORGANIZATION

IS THE STATE OF COMPLETE PHYSICAL, MENTAL, AND SOCIAL WELL-BEING AND NOT MERELY THE ABSENCE
OF DISEASE AND INFIRMITY

CLAUDE BERNARD
IS THE ABILITY TO MAINTAIN THE INTERNAL MILIEU.
ILLNESS IS THE RESULT OR FAILURE TO MAINTAIN THE INTERNAL ENVIRONMENT

WALTER CANNON
IS THE ABILITY TO MAINTAIN HOMEOSTASIS OR DYNAMIC EQUILIBRIUM
HOMEOSTASIS IS REGULATED BY THE NEGATIVE FEEDBACK MECHANISM

FLORENCE NIGHTINGALE
IS BEING WELL AND USING ONES POWER TO THE FULLEST EXTENT
HEALTH IS MAINTAINED THROUGH THE PREVENTION OF DISEASES VIE ENVIRONMENTAL HEALTH FACTORS

VIRGINIA HENDERSON
IS VIEWED IN TERMS OF THE INDIVIDUALS ABILITY TO PERFORM 14 COMPONENTS OF NURSING CARE UNAIDED

BREATHE NORMALLY
EAT AND DRINK ADEQUATELY
ELIMINATE BODY WASTES
MOVE AND MAINTAIN DESIRABLE POSTURES
SELECT SUITABLE CLOTHES/ DRESS AND UNDRESS
MAINTAIN BODY TEMPERATURE WITHIN NORMAL RANGE
KEEP THE BODY CLEAN AND WELL-GROOMED AND PROTECT THE INTEGUMENT
AVOID DANGERS OF THE ENVIRONMENT AND AVOID INJURING OTHERS
COMMUNICATE WITH OTHERS IN EXPRESSING EMOTIONS, NEEDS, FEARS, OR OPINIONS
WORSHIP ACCORDING TO ONES FAITH
WORK IN SUCH A WAY THAT THERE IS A SENSE OF ACCOMPLISHMENT
PLAY OR PARTICIPATE IN VARIOUS FORMS OF RECREATION
LEARN, DISCOVER, OR SATISFY THE CURIOSITY THAT LEADS TO NORMAL DEVELOPMENT AND HEALTH AND THE USE THE AVAILABLE HEALTH FACILITIES

ILLNESS AND DISEASE

ILLNESS
IS A PERSONAL STATE IN WHICH THE PERSON FEELS UNHEALTHY
ILLNESS IS A STATE IN WHICH THE PERSONS PHYSICAL, EMOTIONAL, INTELLECTUAL, SOCIAL,

DEVELOPMENTAL AND SPIRITUAL FUNCTIONING IS DIMINISHED OR IMPAIRED COMPARED WITH

PREVIOUS EXPERIENCE

ILLNESS IN=S NIT SYNONYMOUS WITH DISEASE

DISEASE
AN ALTERATION IN BODY FUNCTIONS RESULTING IN THE REDUCTION OF CAPACITIES OR A SHORTENING OF
THE NORMAL LIFE SPAN

STAGE OF ILLNESS
SYMPTOM EXPERIENCE
ASSUMPTION OF SICK ROLE
MEDICAL CARE CONTACT
DEPENDENT PATIENT ROLE
RECOVERY AND REHABILITATION

SYMPTOM EXPERIENCE
EXPERIENCE SOME OF THE SYMPTOMS
PERSON BELIEVES THAT SOMETHING IS WRONG

ASSUMPTION OF SICK ROLE

ACCEPTANCE OF ILLNESS
SEEKS ADVICE

MEDICAL CARE CONTACT

SEEKS ADVICE TO PROFESSIONALS FOR VALIDATION OF REAL ILLNESS, EXPLANATION OF SYMPTOMS,
REASSURANCE OR PREDICTION OF OUTCOME

DEPENDENT PATIENT ROLE

THE PERSON BECOMES A CLIENT DEPENDENT ON THE HEALTH PROFESSIONAL FOR HELP
ACCEPTS/REJECT HEALTH PROFESSIONALS SUGGESTIONS
BECOMES MORE POSITIVE AND ACCEPTING

RECOVER AND REHABILITATION

GIVES UP THE SICK ROLE AND RETURNS TO FORMER ROLES AND FUNCTIONS

CONCEPTUAL AND THEORETICAL

MODELS OF NURSING PRACTICE

HILDEGARD PEPLAU
DEFINED NURSING AS THERAPEUTIC, INTERPERSONAL PROCESS WHICH STRIVES TO DEVELOP A NURSE-PATIENT
RELATIONSHIP IN WHICH THE NURSE SERVES AS A RESOURCE PERSON

IDENTIFIED THE FOUR PHASES OF THE NURSE-PATIENT RELATIONSHIP

ORIENTATION THE NURSE AND THE CLIENT INITIALLY DO NOT KNOW EACH OTHER. THE CLIENT ATTEMPTS TO FIND

DIFFICULTIES AND THE AMOUNT OF NURSING HELP THAT IS NEEDED

IDENTIFICATION THE CLIENT RESPONDS TO HELP PROFESSIONALS OR THE SIGNIFICANT OTHERS WHO CAN MEET THEIR
IDENTIFIED NEEDS. BOTH THE CLIENT AND THE NURSE PLAN TOGETHER AND APPROPRIATE PROGRAM TO FOSTER HEALTH
EXPLOITATION THE CLIENTS UTILIZE ALL AVAILABLE RESOURCES TO MOVE TOWARDS A GOAL OF MAXIMUM HEALTH
FUNCTIONALITY
RESOLUTION REFERS TO THE TERMINATION PHASE OF THE NURSE-CLIENT RELATIONSHIP. IT OCCURS WHEN THE CLIENTS
NEEDS ARE MET AND HE/SHE CAN MOVE ON TO A NEW GOAL.

FAYE ABDELLAH
21 NURSING PROBLEMS

TO MAINTAIN GOOD HYGIENE AND PHYSICAL COMFORT

TO PROMOTE OPTIMAL ACTIVITY: EXERCISE, REST, SLEEP
TO PROMOTE SAFETY THROUGH PREVENTION OF ACCIDENT, INJURY, OR OTHER TRAUMA AND THROUGH PREVENTION OF THE SPREAD OF INFECTION
TO MAINTAIN GOOD BODY MECHANICS AND PREVENT AND CORRECT DEFORMITY
TO FACILITATE THE MAINTENANCE OF A SUPPLY OF OXYGEN TO ALL BODY CELLS
TO FACILITATE THE MAINTENANCE OF NUTRITION FOR ALL BODY CELLS
TO FACILITATE THE MAINTENANCE OF ELIMINATION
TO FACILITATE THE MAINTENANCE OF FLUID AND ELECTROLYTE BALANCE
TO RECOGNIZE THE PHYSIOLOGIC RESPONSES OF THE BODY TO DISEASE CONDITIONSPATHOLOGIC, PHYSIOLOGIC, AND COMPENSATORY
TO FACILITATE THE MAINTENANCE OF REGULATORY MECHANISMS AND FUNCTIONS
TO FACILITATE THE MAINTENANCE OF SENSORY FUNCTION
TO IDENTIFY AND ACCEPT POSITIVE AND NEGATIVE EXPRESSIONS, FEELINGS, AND REACTIONS
TO IDENTIFY AND ACCEPT INTERRELATEDNESS OF EMOTIONS AND ORGANIC ILLNESS
TO FACILITATE THE MAINTENANCE OF EFFECTIVE VERBAL AND NONVERBAL COMMUNICATION
TO PROMOTE THE DEVELOPMENT OF PRODUCTIVE INTERPERSONAL RELATIONSHIPS
TO FACILITATE PROGRESS TOWARD ACHIEVEMENT AND PERSONAL SPIRITUAL GOALS
TO CREATE OR MAINTAIN A THERAPEUTIC ENVIRONMENT
TO FACILITATE AWARENESS OF SELF AS AN INDIVIDUAL WITH VARYING PHYSICAL, EMOTIONAL, AND DEVELOPMENTAL NEEDS
TO ACCEPT THE OPTIMUM POSSIBLE GOALS IN THE LIGHT OF LIMITATIONS, PHYSICAL AND EMOTIONAL
TO USE COMMUNITY RESOURCES AS AN AID IN RESOLVING PROBLEMS THAT ARISE FROM ILLNESS
TO UNDERSTAND THE ROLE OF SOCIAL PROBLEMS AS INFLUENCING FACTORS IN THE CAUSE OF ILLNESS

MYRA ESTRINE LEVINE

FOUR CONSERVATION PRINCIPLES

CONSERVATION OF ENERGY
CONSERVATION OF STRUCTURAL INTEGRITY
CONSERVATION OF PERSONAL INTEGRITY
CONSERVATION OF SOCIAL INTEGRITY

DOROTHY JOHNSON
BEHAVIORAL SYSTEMS MODEL
INGESTIVE
ELIMINATIVE
AFFILIATIVE
AGGRESSIVE
DEPENDENCE
ACHIEVEMENT
SEXUAL ROLE IDENTITY

MARTHA ROGERS

SCIENCE OF UNITARY HUMAN BEING

DOROTHEA OREM
SELF-CARE AND SELF-CARE DEFICIT THEORY
WHOLLY COMPENSATORY SYSTEM
PARTIALLY COMPENSATORY SYSTEM
SUPPORTIVE-EDUCATIVE

IMOGENE KING

GOAL ATTAINMENT THEORY

BETTY NEUMANN
HEALTHCARE SYSTEMS MODEL
PHYSIOLOGICAL
PSYCHOLOGICAL
SOCIO-CULTURAL
SPIRITUAL
DEVELOPMENTAL

SISTER CALLISTA ROY

ADAPTATION THEORY

LYDIA HALL

CARE, CORE, CURE

MADELEINE LEININGER

TRANSCULTURAL NURSING MODEL

JOSEPHINE PETERSON AND LORETTA ZDERAD

HUMANISTIC NURSING PRACTICE THEORY

MARGARET NEWMAN

HEALTH AS AN EXPANDING CONSCIOUSNESS

PATRICIA BENNER
NOVICE

BEGINNER WITH NO EXPERIENCE

TAUGHT GENERAL RULES TO PERFORM TASKS
RULE-GOVERNED BEHAVIOR IS LIMITED AND INFLEXIBLE

ADVANCED BEGINNER

DEMONSTRATES ACCEPTABLE PERFORMANCE

PRINCIPLES BASED ON EXPERIENCE BEGIN TO FORMULATE GUIDED ACTIONS

COMPETENT

A NURSE WITH 2-3 YEARS EXPERIENCE IN THE SAME AREA

MORE AWARE OF LONG TERM GOALS GAIN PERSPECTIVE FROM PLANNING OWN ACTIONS BASED ON CONSCIOUS, ABSTRACT AND
ANALYTICAL THINKING

PATRICIA BENNER
PROFICIENT

PERCEIVES AND UNDERSTANDS SITUATIONS AS WHOLE PARTS

MORE HOLISTIC UNDERSTANDING IMPROVES DECISION-MAKING
LEARNS FROM EXPERIENCE WHAT TO EXPECT IN CERTAIN SITUATIONS AND HOW TO MODIFY PLANS

EXPERT

NO LONGER RELIES ON PRINCIPLES OR GUIDELINES TO CONNECT SITUATIONS AND DETERMINE ACTIONS

MUCH MORE BACKGROUND EXPERIENCE
HAS INTUITIVE GRASP OF CERTAIN SITUATIONS
PERFORMANCE IS NOW FLUID, FLEXIBLE AND HIGHLY-PROFICIENT

ROLES AND FUNCTIONS OF THE NURSE

CAREGIVER
DECISION MAKER
PROTECTOR
CLIENT ADVOCATE
MANAGER
REHABILITATOR
COMFORTER
COMMUNICATOR
TEACHER
COUNSELOR
COORDINATOR
LEADER
ROLE MODLE
ADMINISTRATOR

COMMUNICATION IN NURSING

COMMUNICATION
IS THE MEANS TO ESTABLISH A HELPING AND HEALING RELATIONSHIP.
ALL BEHAVIOR COMMUNICATION INFLUENCES BEHAVIOR
IS THE VEHICLE FOR ESTABLISHING A THERAPEUTIC RELATIONSHIP
IS THE MEANS BY WHICH AN INDIVIDUAL INFLUENCES THE BEHAVIOR OF ANOTHER, WHICH LEADS TO TH
SUCCESSFUL OUTCOME OF THE NURSING INTERVENTION

BASIC ELEMENTS OF COMMUNICATION

SENDER
MESSAGES
RECEIVER
FEEDBACK
*MEDIUM

MODELS OF COMMUNICATION
VERBAL COMMUNICATION
NONVERBAL COMMUNICATION

CHARACTERISTICS OF GOOD COMMUNICATION

SIMPLICITY
CLARITY
TIMING AND RELEVANCE
ADAPTABILITY
CREDIBILITY

THE 10 RIGHTS OF MEDICATION ADMINISTRATION

RIGHT DRUG
RIGHT PATIENT
RIGHT DOSE
RIGHT ROUTE
RIGHT TIME AND FREQUENCY
RIGHT DOCUMENTATION
RIGHT HISTORY AND ASSESSMENT
RIGHT TO REFUSE
RIGHT DRUG-DRUG INTERACTION RIGHT EDUCATION AND INFORMATION

PQRST PAIN ASSESSMENT

PRECIPITATING FACTOR
QUALITY
RADIATION
SEVERITY
TIMING

MEDICATION ADMINISTRATION

ORAL ADMINISTRATION
ADVANTAGES

EASIEST AND MOST DESIRABLE WAY TO ADMINISTER MEDICATION

MOST CONVENIENT
SAFE AND DOES NOT BREAK THE SKIN BARRIER
USUALLY IS LESS EXPENSIVE

DISADVANTAGES

INAPPROPRIATE IF THE CLIENT CANNOT SWALLOW AND IF GIT HAS REDUCED MOTILITY
INAPPROPRAITE FOR CLIENTS WITH NAUSEA AND VOMITING
DRUG MAY HAVE UNPLEASANT TASTE
DRUG MAY DISCOLOR THE TEETH
DRUG MAY IRRITATE THE GASTRIC MUCOSA

DRUG FORMS OF ORAL ADMINISTRATION

SOLID TABLET, CAPSULE, PILL, POWDER

*SUSTAINED RELEASE OR ENTERIC-COATED TABLETS

LIQUID SYRUP, SUSPENSION, EMULSION, ELIXIR, MILK AND OTHER ALKALINE SUBSTANCES

SUBLINGUAL
A DRUG THAT IS PLACED UNDER THE TONGUE WHERE IT DISSOLVES
WHEN THE MEDICATION IS IN CAPSULE AND IS ORDERED SUBLINGUALLY, THE FLUID MUST BE ASPIRATED
FROM THE CAPSULE AND PLACED UNDER THE TONGUE

A MEDICATION GIVEN BY THE SUBLINGUAL ROUTE SHOULD NOT E SWALLOWED, OR DESIRED EFFECTS MAY
NOT BE ACHIEVED

BUCCAL
A MEDICATION THAT IS HELD IN THE MOUTH AGAINST THE MUCOUS MEMBRANES OF THE CHEEK UNTIL
THE DRUG DISSOLVES

THE MEDICATION SHOULD NOT BE CHEWED, SWALLOWED OR PLACED UNDER THE TONGUE
CLIENT SHOULD BE TAUGHT TO ALTERNATE THE CHEEKS WITH EACH SUBSEQUENT DOSE TO AVOID
MUCOSAL IRRITATION

TOPICAL
APPLICATION OF A MEDICATION TO A CIRCUMSCRIBED AREA OF THE BODY
DERMATOLOGIC
OPTHALMIC
OTIC
NASAL

DERMATOLOGIC
INCLUDES LOTIONS, LINIMENT AND OINTMENTS OR POWDER
BEFORE APPLICATION, CLEAN THE SKIN THOROUGHLY BY WASHING THE AREA GENTLY WITH SOAP AND
WATER, SOAKING AN INVOLVED SITE OR WASHING AWAY LOCALLY DEBRIDING TISSUE

USE SURGICAL ASEPSIS WHEN OPEN WOUND IS PRESENT

REMOVE PREVIOUS APPLICATION BEFORE THE NEXT APPLICATION
USE GLOVES WHEN APPLYING A MEDICATION OVER A LARGE SURFACE
APPLY ONLY A THIN LAYER OF MEDICATION TO AVOID SYSTEMIC ABSORPTION

OPTHALMIC
INSTILLATION TO PROVIDE AN EYE MEDICATION THAT THE CLIENT REQUIRES
IRRIGATION TO CLEAR THE EYE OF NOXIOUS OR OTHER FOREIGN MATERIALS
INSTILL EYE DROPS INTO THE LOWER CONJUNCTIVAL SAC
INSTILL A MAXIMUM OF 2 DROPS AT A TIME. WAIT FOR 5 MINUTES BEFORE ADDITIONAL DROPS ARE TO BE APPLIED
AVOID DROPPING A SOLUTION DIRECTLY ON THE CORNEA BECAUSE IT CAUSES DISCOMFORT
INSTRUCT THE CLIENT TO CLOSE THE EYES GENTLY. SHUTTING THE EYES TIGHTLY WILL CAUSE SPILLAGE OF THE
MEDICATION

OTIC INSTILLATION
TO REMOVE CERUMEN OR PUS OR TO REMOVE A FOREIGN BODY
WARM THE SOLUTION TO BODY TEMPERATURE. FAILURE TO DO SO MAY CAUSE VERTIGO, DIZZINESS,
NAUSEA AND PAIN

STRAIGHTEN THE EAR CANAL

INSTILL THE EARDROPS ON THE SIDE OF THE AUDITORY CANAL TO ALLOW THE DROPS TO FLOW IN AND
CONTINUE TO ADJUST THE BODY TEMPERATURE

ASK THE CLIENT TO REMAIN IN SIDE-LYING POSITION FOR ABOUT 5 MINUTES

NASAL
NASAL INSTILLATION ARE USUALLY INSTILLED FOR THEIR ASTRINGENT EFFECTS, TO LOOSEN SECRETIONS AND FACILITATE
DRAINAGE AND TREAT INFECTIONS OF THE NASAL CAVITY AND SINUSES. (DECONGESTANTS, STEROIDS, CALCITONIN)

HAVE THE CLIENT BLOW THE NOSE PRIOR TO NASAL INSTILLATION

ASSUME A BACK LYING POSITION, OR SIT UP AND LEAN BACK
ELEVATE THE NARES BY PRESSING THE TIP OF THE NOSE SLIGHTLY WITH THE THUMB. WHILE THE CLIENT INHALES, SQUEEZE
THE BOTTLE

KEEP HEAD TILTED BACK FOR 5 MINUTES AFTER INSTILLATION OF THE NASAL DROPS
WHEN THE MEDICATION IS USED ON A DAILY BASIS, ALTERNATE THE NARES TO PREVENT IRRITATION

INHALATION
USE OF A NEBULIZER OR A METERED-DOSE INHALER
SEMI OR HIGH-FOWLERS OR STANDING POSITION TO ENHANCE THE FULL EXPANSION OF THE LUNGS
ALLOWING DEEPER INHALATION OF THE MEDICATION

SHAKE THE CANISTER SEVERAL TIMES TO ENSURE UNIFORM DOSAGE DELIVERY

POSITION THE MOUTHPIECE 1 TO 2 INCHES FROM THE CLIENTS MOUTH. AS THE CLIENT STARTS
INHALING, PRESS THE CANISTER DOWN TO RELEASE ONE DOSE OF THE MEDICATION.