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Chapter 7 and Chapter 8 Case Studies

Chapter 7 and Chapter 8 Case Studies

Sample Answer 

Chapter 7 and Chapter 8 Case Studies

Part A: Case Study Chapter 7

Question 1

Johnson’s behavioral system theory is a nursing model that supports the promotion of effective and efficient patient behavioral functioning to prevent disease. In particular, Johnson defines the patient as having seven critical subsystems (parts) that must balance for the client to regain or maintain a holistic state of equilibrium (Pope & Gordon, 2010). This implies that the particulate subsystems (including the four individual components of each system, including set, drives, observable behavior, and choices) must balance to produce a holistic impact. Johnson also views the whole as being greater than the individual subsystems. For the nurse, this includes understanding Angela’s behavioral set components. The nurse plays a critical role in protecting, nurturing, and stimulating Angela’s behavior.

Question 2

Johnson’s theory suggests that the environment comprises all components that do not form part of the patient’s behavioral system, even though they play a critical role in completing the system (Pope & Gordon, 2010). They are often manipulated by the nurse, and they form part of sustenance imperatives. Johnson’s model can assist the nurse in identifying the essence of the environment in nursing by looking at what motivates Angela to take her surgery, including the presence of her mom, the inscriptions on her plaster cast, as well as the bunny. These external elements complete the patient’s behavioral system.

Question 3

The homeorrhesis focus of Johnson’s model will, in this case, focus on creating a balance between nursing care (surgery) and affiliate and attachment subsystem, especially considering that Angela is strongly attached to her relatives, including the father in Iraq, mother, and siblings. She also needs to find a balance between the six other of Johnson’s proposed patient subsystems.

Part B: Case Study Chapter 8

Question 1

Some of the factors that should be considered when the nurse assesses the self-care agency of Mrs. Anderson in order to determine her care needs include universal self-care requisites (the needs that all people universally have), development self-care requisites, and health deviation requisites (the needs that occur due to Mr. Anderson’s health condition).

Question 2

Some of the self-care deficits that can be identified for Mrs. Anderson include the inability to take her medicines as prescribed and the incapability to perform basic duties like eating and taking care of herself. She also has the problem of keeping time and preparing her grandchildren for school.

Question 3

Based on Orem’s theory of self-care deficits, the most appropriate plan of care for Mrs. Anderson should start with helping her perform self-care duties, including reminding her to eat, take her calcium medicines, and perform other self-care functions. She should also be trained to wake up early in the morning and prepare her grandchildren for school. This should also involve the provision of an environment that promotes personal growth to meet future demands.

References

Pope, B., & Gordon, S. (2010). Nursing theories and nursing practice. F. A. Davis Company.

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Question 


Chapter 7 and Chapter 8 Case Studies

Case study chapter 7
The preoperative area was busy. Five patients were waiting for their 7 A.M. surgeries. Over to one side was Angela, lying quietly on the stretcher holding her stuffed toy. The pink fluffy bunny was small enough to comfort a 5-year-old girl and snuggle next to her neck. As the circulating nurse for Angela’s case came to take Angela back to the operating room, she noticed the red heart that had been drawn on the plaster cast. The heart was in the center of the long leg cast and had the inscription “daddy’s big girl” in the center. The cast also had brightly colored flowers with smiling faces in the middle with the names Josey, Billy, Chelsea, and Pepper taking up the remaining area. Angela hadn’t looked at the nurse yet, but was petting her bunny with her left hand. This motion made the IV machine beep. The nurse glanced at Angela’s toes— no swelling, pink, and since Angela was griping the edge of her cast with her toes the nurse knew that all toes were moving without difficulty. A noise cased the nurse to turn and see a tall woman with long red hair rush toward Angela. At this moment, Angela cried out “Mommy, you came! Look at Bunny!” As the nurse looked from Angela and the bunny toward the woman, another stuffed animal peeped from the woman’s hand. Angela was ecstatic “Eeyore! You brought me Eeyore!” Angela turned to the nurse, saying, “Now I can have my surgery. But they can’t break my daddy’s heart. I’m sending it to him in Rock” Angela’s mother turned to the nurse, winked, and said quietly “Iraq.” Angela smiled and put her right thumb in her mouth but quickly stopped. Her eyes opened wider, “Oh, I’m a big girl. I don’t suck my thumb any more.”

Chapter 7 and Chapter 8 Case Studies

Chapter 7 and Chapter 8 Case Studies

Question 1:
Based on this case study, how would the nurse describe the holistic versus the particulate importance of Johnson’s model?

Your Answer:

Question 2:

How might Johnson's model guide the nurse in recognizing the importance of environment in this case study?

Your Answer:

Question 3:

What would the homeorrhesis focus of this model provide in this case study?

Your Answer:

Cast study chapter 8
In anticipation of the home health nurse visit scheduled for later in the morning, Mrs. Anderson reflected on her current living situation: The grandchildren were late for school again! What would their mother say? Ever since Mrs. Anderson had moved in with her daughter-in-law, it seemed that she just couldn’t do things the way her daughter-in-law wanted her too. She wondered if she would ever get it right. She had volunteered to make breakfast for the children and see them off to school in the mornings, since both her son and daughter-in-law left for work before the children left for school. She felt she had to help out somehow to repay her family. They had been helping her since before she fell and then had to have surgery. Her hip was healing nicely after the surgery and the doctor said she might be able to stop using the walker soon, but it seemed to be taking too long to her. The medicines were so difficult to take. The calcium pills were so big! Sometimes she just wanted to be back in her little apartment and be taking care of herself by herself. She just didn’t understand why everyone thought she would forget to eat or take care of herself. She was doing just fine! She did very well when she was helping her late husband Fred. She helped with the bathing and turning and getting him out of bed when he couldn’t walk anymore. The home health nurses always told her what a good job she was doing with her husband. It just didn’t seem like 9 months since he had passed away.

Question 1:

What factors should be considered when the nurse assesses the self-care agency of Mrs. Anderson in order to determine Mrs. Anderson’s nursing care needs?

Your Answer:

Question 2:

What self-care deficits can be identified for Mrs. Anderson?

Your Answer:

Question 3:

Using Orem’s theory of self-care deficits, develop a plan of care for Mrs. Anderson.

Your Answer:

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