Download Sister Callista Roy: Adaptation Model and Dorothy Johnson Behavioral System
CASE STUDY and more Exercises Nursing in PDF only on Docsity! THEORETICAL FOUNDATION ACTIVITY Sister Callista Roy: Adaptation Model CASE STUDY: A 23-year-old male patient is admitted with a fracture of C6 and C7 that has resulted in quadriplegia. He was injured during a football game at the university where he is currently a senior. His career as a quarterback had been very promising. At the time of the injury, contract negotiations were in progress with a leading professional football team. Quadriplegia Tetraplegia: Also known as quadriplegia, it is the paralysis that results in the partial or total loss of use of all four limbs. From: Diagnosis and Treatment of Spinal Cord Injury, 2022 1. Use Roy’s criteria to identify focal and contextual stimuli for each of the four adaptive modes. 2. Consider what adaptations would be necessary in each of the following four adaptive modes: (1) physiological, (2) self-concept, (3) interdependence, and (4) role function. 3. Create Nursing Intervention for each of the adaptive modes to promote adaptation. [1.] Physiological: Focal Stimuli: Spinal cord injury a fracture of C6 and C7 that has resulted in quadriplegia. Contextual Stimuli: Healthy 23 year old senior that plays football in the university. Adaptations necessary: Due to his injury that resulted in paralysis to all his four limbs, the patient would be unable to perform basic tasks like a healthy normal human could do. As a result, the patient would need to receive extra care to meet his physical needs and keep him healthy. ● Due to his impaired respiratory muscles the patient may require respiratory support. And to prevent bed sores and ulcers, implementing a strict schedule for repositioning with specialized pressure-relieving cushions or mattresses can help him greatly. Establishing a regular schedule for bowel and bladder care to help minimize complications. And administering medications for pain and physical therapy to address muscle spasticity. Helping maintain a comfortable body temperature through appropriate room temperature and clothing. Also ensuring proper nutrition and hydration to support overall health. [2.] Self-Concept: Focal Stimulus: The sudden loss of his mobility and his ability to function normally, also the end of his promising football career. Contextual Stimulus: 23 year old university senior that lost his future aspirations, his confidence and his self-esteem. Adaptations necessary: The injury has damaged his future career greatly. From being a healthy young man to suddenly losing the ability to function normally. He may experience loss of self-confidence and a low self-esteem. He may also question his own life and his life purpose. Therefore, it is necessary for us to assist the patient with the help of his support system like his family and friends. To help him to uplift his own physical and personal self to improve his health condition. ● Due to his condition one of the things the patient would need is emotional support like listening and counseling to help the patient recognize and adjust to his new self. Encourage the patient to plan, set and achieve short-term goals. Promote the acceptance of his new self and help him develop new life goals. [3.] Interdependence: Attachment-affiliative - He is married with two children who appear to be supportive of him. He has many family and friends who visit him frequently and he is cheerful and tries to engage with his visitors every time . Aggressive-protection - He appears to be protective of his family, as everytime they hug him he becomes tearful and appreciates each of their visits. Dependency- The patient's mood is dependent on the people around him. He requires company to help him cope with his loneliness and needs the support of close friends and family to cheer him up. Ingestive: Since his mood is dependent on the people around him, there could be a possibility that because he is emotionally unstable he could develop an eating disorder or a situation wherein he would only eat when there are people around.The nursing staff monitors the patient's bowel movements and urination frequency. They inquire about any discomfort or difficulty the patient may be experiencing during these eliminative processes. Eliminative: It appears that the patient's have no difficulties in regards to his bowel movements and urination frequency. There is no indication about discomfort or difficulty that the patient may be experiencing during the eliminative processes. Environmental Assessment- The patient and his wife are involved in their church and various social activities. However due to his hospitalization, the patient is in a hospital setting, which is a major environmental aspect affecting his behavioral responses. His friends and family visited him frequently, offering social support and interaction within the hospital setting; but, following their visit, he would sit in the dark room and sleep. Structural Components (drive goal) - As he seeks affiliation and support from his family and friends, the patient's drive/goal appears to be to retain social connections and cope with the stressors of his illness. The patient seems motivated to return home immediately and get back to his life outside the hospital. Functional Requirements - Socialization that is provided by his friends and family is vital to the patient as it appears it is his way of coping and avoiding loneliness. He is continuously seeking social interaction and connection when visitors are present, to help him cope better with environmental change, giving him a lighter room and activities to do will help him greatly. Nursing: Assistance with his physical and emotional well-being during his hospital stay. Provide care and encourage the patient to be open and socialize with friends, family and others.Include him and families thought in planning for care to make them feel heard and included. Be encouraging and positive during the patient's stay.
