TWENTY

ONE NURSING PROBLEMS

FAYE GLENN ABDELLAH

FAYE GLENN ABDELLAH

Dr Abdellah worked as Deputy Surgeon General in US and Chief Nurse Ocer for the US Public Health Service , Department of Health and Human Services, Washington, D.C. According to her, nursing is based on an art and science that mold the aKtudes, intellectual competencies, and technical skills of the individual nurse into the desire and ability to help people , sick or well, cope with their health needs.

ABDELLAHS THEORY AND THE FOUR MAJOR METAPARADIGMS

NURSING
Nursing is a helping profession. In Abdellahs model, nursing care is doing something to or for the person or providing informaNon to the person with the goals of meeNng needs, increasing or restoring self- help ability, or alleviaNng impairment.

NURSING
Nursing is broadly grouped into the 21 problem areas to guide care and promote use of nursing judgment. She considers nursing to be comprehensive service that is based on art and science and aims to help people, sick or well, cope with their health needs.

PERSON
Abdellah describes people as having physical, emoNonal, and sociological needs. These needs may overt, consisNng of largely physical needs, or covert, such as emoNonal and social needs. The paNent is described as the only jusNcaNon for the existence of nursing.

PERSON
Individuals (and families) are the recipients of nursing. Health, or achieving of it, is the purpose of nursing services.

HEALTH
In PaNentCentered Approaches to Nursing, Abdellah describes health as a state mutually exclusive of illness. Although Abdellah does not give a deniNon of health, she speaks to total health needs and a healthy state of mind and body in her descripNon of nursing as a comprehensive service.

SOCIETY AND ENVIRONMENT

Society is included in planning for opNmum health on local, state, naNonal, and internaNonal levels. However, as she further delineated her ideas, the focus of nursing service is clearly the individual. The environment is the home or community from which paNent comes.

USE OF 21 PROBLEMS IN THE NURSING PROCESS

ASSESSMENT PHASE
Nursing problems provide guidelines for the collecNon of data. A principle underlying the problem solving approach is that for each idenNed problem, perNnent data are collected. The overt or covert nature of the problems necessitates a direct or indirect approach, respecNvely.

NURSING DIAGNOSIS
The results of data collecNon would determine the clients specic overt or covert problems. These specic problems would be grouped under one or more of the broader nursing problems. This step is consistent with that involved in nursing diagnosis.

PLANNING PHASE
The statements of nursing problems most closely resemble goal statements. Once the problem has been diagnosed, the nursing goals have been established.

IMPLEMENTATION PHASE
Using the goals as the framework, a plan is d e v e l o p e d a n d a p p r o p r i a t e n u r s i n g intervenNons are determined.

EVALUATION PHASE
The most appropriate evaluaNon would be the nurse progress or lack of progress toward the achievement of the stated goals.

10 STEPS TO IDENTIFY THE CLIENTS PROBLEMS

1. Learn to know the paNent. 2. Sort out relevant and signicant data. 3. Make generalizaNons about available data in relaNon to similar nursing problems presented by other paNents. 4. IdenNfy the therapeuNc plan. 5. Test generalizaNons with the paNent and make addiNonal generalizaNons.

6. Validate the paNents conclusions about his nursing problems. 7. ConNnue to observe and evaluate the paNent over a period of Nme to idenNfy any aKtudes and clues aecNng his behavior. 8. Explore the paNents and familys reacNon to the therapeuNc plan and involve them in the plan.

9. IdenNfy how the nurses feels about the paNents nursing problems 10.D iscuss and develop a comprehensive nursing care plan

11 NURSING SKILLS TO BE USED IN DEVELOPING A TREATMENT TYPOLOGY

1. 2. 3. 4. 5. 6.

ObservaNon of health status Skills of communicaNon ApplicaNon of knowledge Teaching of paNents and families Planning and organizaNon of work Use of resource materials

7. Use of personnel resources 8. Problem-solving 9. DirecNon of work of others 10.TherapeuNc use of the self 11.Nursing procedure

THREE MAJOR CATEGORIES

Physical, sociological, and emoNonal needs of clients. Types of interpersonal relaNonships between the nurse and paNent. Common elements of client care.

21 NURSING PROBLEMS

1. To maintain good hygiene and physical comfort. 2. To promote opNmal acNvity: exercise, rest and sleep. 3. To promote safety through the prevenNon of accidents, injury, or other trauma and through the prevenNon of the spread of infecNon. 4. To maintain good body mechanics and prevent and correct deformity.

5. To facilitate the maintenance of a supply of oxygen to all body cells. 6. To facilitate the maintenance of nutriNon of all body cells. 7. To facilitate the maintenance of eliminaNon. 8. To facilitate the maintenance of uid and electrolyte balance.

9. To recognize the physiological responses of the body to disease condiNons 10.To facilitate the maintenance of regulatory mechanisms and funcNons 11.To facilitate the maintenance of sensory funcNon.

12.To idenNfy and accept posiNve and negaNve expressions, feelings, and reacNons 13.To idenNfy and accept the interrelatedness of emoNons and organic illness 14.To facilitate the maintenance of eecNve verbal and non verbal communicaNon 15.To promote the development of producNve interpersonal relaNonships

16.To facilitate progress toward achievement of personal spiritual goals 17.To create and / or maintain a therapeuNc environment 18.T o facilitate awareness of self as an individual with varying physical , emoNonal, and developmental needs

19.To accept the opNmum possible goals in the light of limitaNons, physical and emoNonal 20.To use community resources as an aid in resolving problems arising from illness 21.To understand the role of social problems as inuencing factors in the case of illness

Think about this:

The purpose of life is a life of purpose. - Robert Byrne Robert Eugene Byrne (born April 20, 1928 in N e w Y o r k C i t y ) i s a l e a d i n g American chess player, a Grandmaster, and a c h e s s a u t h o r . H e w o n t h e U . S . Championship in 1972, and was a World Chess Championship Candidate in 1974.