115 nursing theory/betty neuman – Flashcards

_______= Set of defined concepts that are abstract generalizations (focus on general ideas rather than concrete). Explain relationships among phenomena Aim to explain, predict, and control phenomena Provide direction for drawing inferences Can be generated as a result of research

Basic building blocks or elements of theories Abstract description or name of phenomena Includes associated meanings i.e. Fireplace—what does this mean to you? Dictionary Conceptual definition definition

the abstract or theoretical meaning of a concept being studied, it prompts a consistent mental picture about understanding the variable

__________ more abstract in meaning than concepts , idea that cannot be seen or measured directly.

_________ more specific in meaning-measurable

emotional responses

fear

respiratory rate

*A symbolic reoresentation of concepts and interrlationships among variables" a pattern, plan, representation, or description designed to show the structure or workings of an object, system, or concept

-Asserts relationships among constructs. -Provides a theoretical perspective for the study. -Implies links among variables to be tested. -i.e. Measure nursing home residents' consistency, empathy, and reliability during nursing home care.

-Less developed than theoretical frameworks. -More abstract than theoretical frameworks. -Explains phenomena of interest -may not show all inferences that theoretical does -Interrelated concepts are relevant to a philosophical stance. i.e. How do nurses promote patient's self-care.

A ____ is defined as an abstraction of reality, providing a way to visualize reality and to simplify thinking A ____ is a symbolic representation of concepts and interrelationships among variables (Polit & Beck, 2004). A ____ provides a systematic structure and rationale for scholarly activities

________- humans are biophsychosocial adaptive systems who cope with environmental change through adaptation. The environment is the stiumuli and changes are dealt with through adaptation of physical needs, self-concepts, role function, and independence. *Humans adapt to physical need. nurses job to help them adapt*

_________ focuses on the person's ability to perform self-care which is the practive of activities that individuals initiate and peform to maintain life, health, and well-being. The person is the self-care agency- the ability to care for oneself. *We help patients take care of themselves.. Give choices. empowerment*

_____________ Caring for the sick to restore health is the theme. Caring is practiced through interpersonal nurse/patient relationships to promote health.

Nursing is a *goal-oriented* process that incorporates therapeutic and interpersonal practice. Look at goals and help patient establish goals using interpersonal skills

_________person in an energy field in *constant interraction with the environment*. Nursing focuses on the persono as a synergistic phenomenon and nursing helps people achieve their maximum well-being within their potential.

__________The person is an open system that chooses and has options to choose that give meaning in a situation. The patients may be guided to change from known health patterns to new health patterns needed to adjust to their new health status. *person is open sysyem who needs to have choices/options. People can be guide to change health*

___________ focuses on the person as a complete system with interrelated parts: physiologic, psychological, sociocultural, spiritual, and developmental factors. The person maintains balance and harmony between internal and external environments. Wellness=equilibrium.

Community health nurse and clinical psychologist Published her model in 1972 Developed the Neuman Systems Model to help teach graduate students an integrated approach to client care Recognized the need for educators and practitioners to have a framework to view nursing within various contexts

The client systems consists of a basic or core structure that is protected by lines of resistance The basic structure has resources to maintain survival (ie genetic features, normal temperature, organ strength or weakness, self-image, cognitive potential, age, sex) A circle surrounded by a series of concentric rings graphically represents the client The concentric rings around the basic structure form the basis of resource protection for the core of the system

occur outside the individual, e.g. job or finance concerns

________ - occur within person, example is infection, thoughts and feelings

Interpersonal - occur between individuals, e.g. role expectations

_______ made up of the basic survival factors common to all organisms. These include the following: 1.Normal temperature range - body temperature regulation ability 2.Genetic structure - Hair color and bodily features 3.Response pattern - functioning of body systems homeostatically 4.Organ strength or weakness 5.Ego structure 6.Knowns or commonalities - value system -The person's system is an open system - dynamic and constantly changing and evolving -Stability, or homeostasis, occurs when the amount of energy that is available exceeds that being used by the system. -A homeostatic body system is constantly in a dynamic process of input, output, feedback, and compensation, which leads to a state of balance

-Is the outer boundary to the normal line of defense, the line of resistance, and the core structure. -Keeps the system free from stressors and is dependent on the amount of sleep, nutritional status, as well as the quality and quantity of stress an individual experiences. -If the flexible line of defense fails to provide adequate protection to the normal line of defense, the lines of resistance become activated.

-Represents client's usual wellness level. -Can change over time in response to coping or responding to the environment, which includes intelligence, attitudes, problem solving and coping abilities. Example is skin which is constantly smooth and fair will eventually form callous over times.

-the last boundary that protects the basic structure -Protect the basic structure and become activated when environmental stressors invade the normal line of defense. An example would is that when a certain bacteria enters our system, there is an increase in leukocyte count to combat infection. -If the lines of resistance are effective, the system can reconstitute and if the lines of resistance are not effective, the resulting energy loss can result in death.

-Are capable of producing either a positive or negative effect on the client system. -Is any environmental force which can potentially affect the stability of the system: -A person's reaction to stressors depends on the strength of the lines of defense. -When the lines of defense fails, the resulting reaction depends on the strength of the lines of resistance. -As part of the reaction, a person's system can adapt to a stressor, an effect known as reconstitution

forms the outer boundary of the client and protects the normal line of defense. It is the *buffer* for the client and is the first line of defense in response to stressors from the environment It is *dynamic*, can be rapidly altered over a short period of time and is perceived as a protective buffer for preventing stressors from breaking through the solid line of defense. It is important to strengthen this flexible line of defense to prevent a possible reaction.

___________ the usual state of health Internal (patterns of health behaviors, lifestyle, and cultural influences) and external (pollution, altitude) factors influence the baseline functioning of a client If a stressor breaks through the flexible line of defense and comes in contact with the normal line of defense, a reaction will occur within the system. The client will exhibit symptoms or illness. Outer solid circle. It represents a stability state that is unique for each individual and reflects a state of health that is maintained over a period of time

____________ Functions as a protective mechanism for the basic structure. The main purpose is to protect the basic structure's (CORE) integrity If the lines of resistance are effective in their protection, the system is able to reconstitute and return to a steady state. When lines of resistance are ineffective, death of a system may occur The series of broken rings surrounding the basic core structure. These rings represent resource factors that help the client defend against a stressor

Inherent within the client are 5 different variables... -Physiological: bodily structure and function -Psychological: mental processes and relationships -Sociocultural: social and cultural influences -Developmental: life developmental processes -Spiritual: belief influences Spiritual: may or may not be acknowledged or developed by the client. The spiritual variable is on a continuum of development....the client may have a complete unawareness of the spiritual variable, deny its presence, or have a conscious and highly developed undersatndingThe Spiritual Variable Spirit controls the mind, and the mind consciously or unconsciously controls the body The spiritual variable affects or is affected by a condition and interacts with other variables in a positive or negative way Fulton (1995) studied the spiritual variable in depth and identified 4 spiritual needs The need for meaning and purpose in life The need to receive love and give love The need for hope and creativity The need for forgiving, trusting relationships with self, others, and God, or a deity, or a guiding philosophy

name the five client variables

"All internal and external factors or influences surrounding the identified client or client system" The influence of the client on the environment and the environment on the client may be positive or negative

stimuli that produce tension and have the potential for causing system instability Intrapersonal: forces that occur within the client system boundary (ie autoimmune response) Interpersonal: forces that occur between one or more individuals (ie role expectations) Extrapersonal: forces that occur outside the system, but at a greater distance than interpersonal (ie social policy, financial circumstances, employment)

Wellness and Illness are on opposite ends of the continuum Wellness exists when more energy is built and stored than expended, whereas death occurs when more energy is needed than is available to support life Health as seen as varying levels within a normal range, rising and falling throughout the life span Health is described as dynamic, changing all the time

Nursing's major concern is to keep the client system stable by Accurately assessing the effects and possible effects of the environmental stressors Assisting client adjustments required for optimal wellness Prevention as Intervention

______= can begin once a stressor is suspected or identified, before a reaction has occurred. These interventions protect the normal line of defense and strengthen the flexible lines of defense Goal of primary prevention... "retain" optimal stability or wellness Health promotion, immunizations, exercise

______= occurs after the system reacts to a stressor. The focus is on strengthening the internal lines of resistance and protecting the client through treatment of symptoms. Goal...regain optimal system stability. If secondary prevention is unsuccessful and reconstitution does not occur, the basic structure will be unable to support the system and death will occur.

_________=: occurs after the system has been treated through secondary strategies. It may occur at any point after system stability has begun to be reestablished Goal....maintain wellness or protect the client system reconstitution through supporting existing strengths.

Although each individual client or group as a client system is unique, each system is a composite of common known factors or innate characteristics within a normal, given range of response contained within a basic structure.

Many known, unknown, and universal environmental stressors exist. Each differs in its potential for disturbing a client's usual stability level, or normal lines of defense. The particular interrelationships of client variables—psychological, physiological, sociocultural, developmental, and spiritual—at any point in time can affect the degree to which a client is protected by the flexible line of defense against possible reaction to a single stressor or a combination of stressors.

Each individual client/client system has evolved a normal range of response to the environment that is referred to as a normal line of defense, or usual wellness/stability state. It represents change over time through coping with diverse stress encounters. The normal line of defense can be used as a standard from which to measure health deviation

When the flexible line of defense is no longer capable of protecting the client against an environmental stressor, the stressor breaks through the normal line of defense. The interrelationships of variables determine the nature and degree of the system reaction or possible reaction to the stressor

. The client, whether in a state of wellness or illness, is a dynamic composite of the interrelationships of variables. Wellness is on a continuum of available energy to support the system in an optimal state of system stability.

Implicit within each client system is a set of internal resistance factors known as lines of resistance, which function to stabilize and return the client to the usual state of wellness (normal line of defense) or possibly to a higher level of stability following an environmental stressor reaction.

. Primary prevention relates to general knowledge that is applied to client assessment and intervention in identification and reduction of possible or actual risk factors associated with environmental stressors to prevent possible reaction. The goal of health promotion is primary prevention.

Secondary prevention relates to symptomatology following a reaction to stressors, appropriate ranking of intervention priorities, and treatment to reduce their noxious effects.

Tertiary prevention relates to the adjustive processes taking place as reconstitution begins and maintenance factors move the client back in a circular manner toward primary prevention.

The client as a system is in dynamic, constant energy exchange with the environment.

What kind of stressor? Autoimmune response

What kind of stressor? Role expectation- force between 1 or more people

what kind of stressor? Financial circumstance, employment

________- begin when the stressor is suspected or identified. Diabetic-seek treatment, recognizes s&s, support groups, exercise, etc.

_________: When the client system reacts to a stressor Goal to regain optimal stability. Diabetic starts insulin tx., seeks additional support.

_________- When the system has been treated through secondary strategies (could be when stability has begun to be re-established.—goal is to maintain wellness). Young IDDM male pt. is in the ICU with BS above 700.

What is the line that is dynamic and keeps the central core healthy moment by moment?

name the 4 concepts of nursing theory

name the 5 client variables