Josie Santiago, Xiomara Ortiz, Margarita Acosta,

Charles García, Antonio Carrasquillo

A home care nurse visits an elderly
client who lives alone and is restricted to
bed because of pain in his joints due to
osteoarthritis. During conversation, the
nurse finds that the client feels sad and
inadequate due to his disability.
I. Briefly discuss your nursing theory.

 Peplau’s theory focus on the interpersonal process and therapeutic

relationship that develops between the nurse and client.

II. How should the nurse prioritize the client’s needs?

 Oriented, when the patient is admitted, the nurse help the client to
recognize and understand his problem, determine the need for help.

 Identification, intensive treatment period, the nurse permits exploration

of feelings to aid the patient, reorients feelings and strengthens positive
forces in the personality to provided needed satisfaction.

 Exploitation, convalescents rehabilitation, the nurse can project new goals

to be achieved through personal effort and power shits from nurse to the
patient, delays gratification to achieve the newly formed goals.

 Resolution, discharge, patient puts aside old goal to adopts new goals
(gradually), the patient frees himself from identification with the nurse.
III. Would the integration (application) of another theory be
necessary?
 We can applied in this case the integration of other theories it
is necessary,
 Florience Nightingale, the goal to place the patient best
condition for good healthcare, (nursing.)
 Faye Glenn Abdellah, nursing care, having physical,
emotional, sociologic needs. (Person)
 Lydia E. Hall, facilitate achievement of the client personal
goals, (Environment).
 Maslow’s, Love needs sense of safety, patient need to feel
they are loved to avoid loneliness and isolation.
 Imogene M. King, internal and external, environment,
continually interacts to assist in adjustments to change,
(Environment).
VI. What functional patterns should the nurse assess during the
assessment of activity levels in the client?
 Nursing diagnoses, formulated the outcomes, goals, intervention is
base on mutually establish. The physical mobility related to pain in the
patients joints due to osteoarthritis, pharmacological measures for pain
relieve, and activity’s which divests the patients mind. Frequently
visits the patient enquired for any needs assisted the client in doing his
self care activities, massage all the extremities with pain. Patients may
ask for doubts of his illness, verbalized his anxiety has reduced.
 Cognitive Perceptual
A. Chronic Pain
 Activity-Exercise
A. Impaired Physical Mobility
B. Activity Intolerance
C. Self Care-Deficit-Feeding, Bathing/Hygiene, and
Dressing/Grooming
 Self-Perception
A. Disturbed Body Image
 V. Prioritize three interventions (using NIC) for this patient.

 Aromatherapy 1330, page. 141

 Use education and training

 Determine individual response to the selected aroma prior to use (like vs.
dislike).
 Obtain verbal consent to use of aromatherapy.

 Art therapy 4330, page 142

 Provide art supplies appropriate for development level and goals for
therapy.
 Discuss description of drawing or artistic creation with patient.
 Observe patient approach to artistic medium.
 Body mechanics promotion 0140, page 183.
 Assist to demonstrate appropriate sleeping positions.
 Use the principals of body handling and movement’s aids.
 Conservative therapy which includes:
 Balance rest with activity
 Apply thermal therapies (heat or cold)
 Analgesic Therapy
 Instruct the client on the use of analgesics and NSAIDS prior to
activity and around the clock as needed
 Instruct the client on proper body mechanics
 Encourage the use of complementary and alternative therapies,
including acupuncture, tai chi, hypnosis, magnets
 Encourage the use of splinting for joint protection and the use of
larger joints
 Encourage the use of assistive devices to promote independence,
elevated toilet seat, shower bench, etc.
 Encourage a well balanced diet and ideal body weight
VI. What will your expected outcomes be? (Use NOC)

 Adaptation to physical disability 1308, page 161.

 Accepts need for physical assistance, 130812

 Use strategies to reduce stress related to disability, 130806

 Health Orientation 1705, page 383

 Focus on maintaining role performance, 170503

 Focus in wellness, 170501

 Joint movement 0203, page 406

 All joints

 Knowledge, depression management 1836, page 440

 Relationship treatment regimen goal, 183607

 Personal treatment therapeutic effects, 138309
 Factors that alleviate depression, 183613