Angela J.

Simbulan
BSN-1Y1-4

CU-8: Johnson, Roy, Neuman Theories

1. Use the six nursing process and nursing care plan of Roy’s Adaptation
Theory for a patient with severe depression.

Assessment of Behaviors

 Physiological-physical mode- The patient human body down regulates

to preserve homeostasis, leading to significant & potentially life-
threatening medical consequences & cognitive deficits .
 The patient needs physiologic integrity. Manifestation of all
physiologic activities comprising the human body.

 Self-Concept Group Identity Mode- The patient possibly struggle with

shape and weight overvaluation, which has negative impact on self-
esteem, self-worth, and self-confidence.
 The patient needs psychic and spiritual integrity. Composite of beliefs
and feelings about oneself that directs all behavior.

 Role Function Mode- The patient struggle with autonomy and sense of
control. Struggle with identity in society.
 The patient needs social integrity. Pertains to roles and expectations
of the person in society in relationship to others.

 Interdependence Mode- The patient struggle with trusting others.

Struggle to establish & maintain friendships or intimate relationships.
Social withdrawal & isolation.
 The patient needs relational integrity. To feel secure in nurturing
relationships through the giving & receiving of love, respect, and
value.

Assessment of Stimuli

 Focal stimuli- Deficits in cognition and behavior have frequently been

described in severely depressed patients.
  Contextual stimuli- The patient is lack of social support. Stressful
events of life and care demands.
 Residual stimuli- The patient’s residual stimuli is social roles.

Make a statement or nursing diagnosis of the person’s adaptive state

 The patients having a hard time in coping to situational or maturational

crises, hopelessness related to long-term stress and fatigue related to
stress and anxiety

Set a goal to promote adaptation

- The following are the set of goals need to achieve upon the treatment:

 To determine degree of impairment

 To assess coping abilities and skills
 To assist client to deal with current situation
 To provide for meeting psychological needs
 To promote wellness

Implement intervention aimed at managing the stimuli

- To achieve the set goals, the following should be follow:

 Provide for patient’s physical needs. Assist with self-care and personal

hygiene. Encourage patient to eat. Give warm milk or back rubs at
bedtime to improve sleep.
 Plan activities for times when the patient’s energy level peaks.
 Assume active role in initiating communication. This can be done by
sharing observation of patient’s behavior, speaking slowly and allowing
ample time for him to respond, encouraging him to talk and write down
feelings, and by providing a structured routine which may include non-
competitive activities.
 Avoid feigned cheerfulness, but don’t hesitate to laugh with him and
point out the value of humor.
 Educate patient about depression. Explain that depression can be eased
by expressing feelings and engaging in pleasurable activities. Emphasize
that there are effective methods available for relief of symptoms.
 Help patient recognize distorted perceptions and link them to his
depression.
  Ask patient whether he thinks about death or suicide. Signal an
immediate need for consultation and assessment. Risk of suicide is
higher with lifting of depressed mood.
 Stress the need for medication compliance. Review adverse effects with
the patient.

Evaluate whether the adaptive goal has been met

 Patient’s ability to assess current situation accurately.

 Patient’s ability to identify ineffective coping behaviors and
consequences.
 Verbalization of awareness of own coping abilities and of feelings
congruent with behavior.
 Meet physiological needs as evidenced by appropriate expression of
feelings, identification of options, and use of resources.

2. Create nursing intervention for a patient with quadriplegia sustained

from an incidence happened in football game that caused him injuries
and fracture of C6 and C7.
 Identify signs of grieving (shock, denial, anger, depression)
- Patient experiences many emotional reactions to the injury and its actual
or potential impact on life. These stages are not static, and the rate at
which patient progresses through them is variable.

 Provide simple, accurate information to patient and SO regarding

diagnosis and care. Be honest; do not give false reassurance while
providing emotional support.
 Assist patient and SO to verbalize feelings about situation, avoiding
judgment about what is expressed.
 Note comments indicating that patient expects to walk shortly and is
making a bargain with God. Do not confront these comments in early
phases of rehabilitation.
 Encourage patient to take control when possible (establishing care
routines, dietary choices, diversional activities).
 Accept expressions of anger and hopelessness. Avoid arguing. Show
concern for patient.
 Set limits on acting out and unacceptable behavior when necessary
(abusive language, sexually aggressive or suggestive behavior).
 3. How the Newman’s Model helps the individual to react with certain
stressors like Covid-19 pandemic.

- The coronavirus disease 2019 (COVID-19) pandemic may be stressful for

people. Fear and anxiety about a new disease and what could happen can be
overwhelming and cause strong emotions in adults and children. Neuman’s
Model helps the individual to react with stressors like Covid-19 pandemic,
because it is let us flexible to strengthen our defense to upcoming stress like
Covid-19 pandemic. he Neuman Systems model provides the nurse with a
comprehensive assessment in terms of caregiving and explains how the
primary, secondary and tertiary prevention interventions can be used in
problem-solving. Using the Neuman Systems Model to help understand the
environmental forces that impact the client system will offer nurses insight into
the family's coping ability