CA1 PRELIM
altered in order to improve
TFN DAY 1
Nursing Foundation
Theory - foundation for the art and science
(knowledge) of nursing
- Explain how some aspect
performance is organized
- Defining ideas and concepts
- Explaining relationship among the
concepts
- Predicting outcomes
Nursing theory - describes, explains,
predicts and prescribes nursing care
- Generate further knowledge
- Which direction nursing should
develop in the future/ improve
guidelines
- Helps us decide what we know and
what we need to know
Research - testing theories
= Practice - application
Theory research and practice are bound
together in a continuous interactive
relationship
= new information/ revision of another skills
Environmental theory
5 to have healthy environment
- Clean water, air, sanitation,
cleanliness and, good lighting
- Florence Nightingale is based on
five points to obtain healthy home for
it was the fundamental for healing
- Her observation taught her that
unsanitary environment contribute
greatly to ill health and env can be
conditions for a patient and allow
healing to occur
- Boiled water, change linen, clean
wounds, improve ventilation
COMPONENTS OF A THEORY
Phenomenon - observable event (eg.
covid,)
Concepts - abstract description of
phenomena, building blocks of theories
(isolation, reverse isolation, infection,
elderly)
Definitions - meaning of the concept
- Theoretical/conceptual (dictionary)
- Operational (measurable)
Assumptions - statements that describe
concepts (thinking maybe there is a
connection) put it in a testing
THE DOMAIN OF NURSING
Paradigm
- Conceptual framework
Nursing paradigm
- Person (Patient, human, focus)
- Recipient of nursing care
(familyy, community)
- Health (physical, mental, social well
being)
- The degree of wellness or
well being that the client
experiences
- Environment/situation (external, global
effect on the person)
 - Situation, positive or negative
internal and external
surrounding that affects the
patient)
- Nursing (nursing process, science,
dynamic)
- Nurse’s attributes
characteristics and action
provide care on behalf of or
in conjunction with the client
METAPARADIGM CONCEPT
OREM’S SELF-CARE THEORY
Self care
Self-care agency - self care demands
Nursing agency
Self-care agency (care to self)
relates with self care demands because the
pt cannot care to himself
Person: an individual with physical and
emotional requirements for development of
self and maintenance of their well being
Environment: Client’s surrounding which
may affect their ability to perform their self -
care activities
Health - Structural and functional
soundness and wholeness of the individual
(orem)
Nursing - act of specially trained and able
individual to help people deal with their
actual or potential self care deficits
EVOLUTION OF NURSING THEORY
Nightingale - first nursing theorist
Envisions nurses as a body of
educated women
Made the nursing as Profession.
Organized group caring for wounded
soldiers during crimean war
Established school of nursing- ST.
THOMAS HOSP in London.
Started the Nursing Education.
Curriculum Era - 1900 -1940’s
Address the question what
prospective nurses should learn or
should study on how to become
nurse
Emphasizes the standardized
nursing curriculum (mid 1900)
Moving nursing education from
hospital based diploma into colleges
and universities emerges
Emphasized course selection and
content for nursing programs and
gave way to the research era
Focused on learning the research
process and meeting the long-range
goal of acquiring substantive
knowledge to guide nursing practice.
Established the first standardized
curriculum
Idea of moving nursing education
from hosp based on diploma
programs into colleges and
universities emerged. (1930’s)
- Research Era- (1950-1970s)
Started to have a Research
Subject in Univs and Schools
 Nurses began to participate in
research (include in nursing
curricula)
- Graduate Educ Era - (1950-1970s)
Started to have a Masteral Degree
Most nursing masters programs
began to include curriculum
development, trends in nursing,
theoretical foundation.
Include courses development for
nursing model that introduce
students to early nursing theories
and that knowledge development
practices
- Theory Era - (1980-1990s)
Natural outgrowth of Research
Development
Relationship of theory and research
- Theory Utilization Era (2000 at
present)
Emphasis was placed on a middle
range for theory-based practice
Application of theory to the nursing
practice.
Theories are dynamic and responsive to the
changing environment in which we live
Practice - narrow in scope and
focus
LEININGER’S CULTURE CARE THEORY
- Grand theory
- Generate knowledge related to
caring for persons considering their
cultural heritage and values
OREM’S SELF CARE DEFICIT THEORY
- Grand theory
- Suggest patients are better able to
recover when they maintain some
independence over their own
self-care
PENDER’S HEALTH PROMOTION
- Middle range
- Assist nurses in understanding the
major determinants of health
behaviors as a basis for behavioral
counseling to promote healthy
lifestyles
NELSON BREASTFEEDING THEORY
- Practice theory
- Recommend that when educating a
new mother about breastfeeding
BY GOAL ORIENTATION

- Improvement of health of the pt DESCRIPTIVE

- Describe phenomena,
CLASSIFICATION OF THEORY speculate on why
phenomena occur and
BY ABSTRACTION describe the consequences
of phenomena
Grand- broad in scope, complex - Enlightenment and
understanding
Middle ranged - limited in scope
and less abstract PRESCRIPTIVE
- Address nursing
interventions for a
 phenomena and predict their understand your actions and
consequence of a specific relationships being made on the job
nursing intervention through care
- Control and manipulation Experiential knowing -understanding
- ACTION ORIENTED, TEST Interpersonal knowing - awareness
A SPECIFIC NURSING
INTERVENTION

THE LINK BETWEEN THEORY AND

KNOWLEDGE DEVELOPMENT

Fundamentals Patterns of Knowing

EMPIRICAL (The science of nursing)

- Based on the assumption that what
is known is accessible through the
physical senses; seeing, touching,
hearing
- Identify the elements lacking in this
situation to increase ability to
provide care

ETHICS
- Moral components
Strength, weakness, threats
- Matters of obligation which ought to
be done
- Requires considerations of all
patterns of knowing

AESTHETIC
- The art of nursing
- Encompasses knowledge of the
experience of nursing
- Ability to skillfully perform nursing
activities
- Constantly changing as we build on
knowledge with experience

PERSONAL KNOWING
- Knowing what you do and doing
what you know
- Self knowing that is conscious to
know fully who you are and
 proceed to wellness, may outcome
TFN DAY 2 or change

NURSING THEORIST AND THEIR Example: dorothy johnson- beahavioral

WORKS system

Classification of Nursing Theorists 4. According to Alligood

1. By Abstraction
● Grand Nursing Philosophy, Grand theories,
● Middle-ranged Middle-range theories
● Practice
● Nursing Philosophy- most abstract
2. By goal orientation type, general o malawak. Sets forth
● Descriptive the meaning of nursing phenomena
● Prescriptive through analysis, reasoning, and
logical presentation.
3. Classification according to AFAF
MELEIS(nursing theorist who Example:
develop transition theories) Florence Nightingale- Environmental
theory. (Patient- Care theory)
● Needs- based defined Nursing as “the act of utilizing the
- first group of nurses who thought of environment of the patient to assist him in
doing nursing care in conceptual his recovery. Caring for the patient is of
order. The focus is to provide care more importance than the nursing process,
and needs of patient the relationship between patient and nurse,
or the individual nurse.
Example: Virginia Henderson- the - identified five (5) factors: fresh air,
needs theory pure water, efficient drainage,
cleanliness or sanitation, and light or
● Interaction direct sunlight
-nursing and establishment to the
maintenance of relationship.

Example: Hildegard Peplau -nurse to

patient relationship, Joyce travelbee-
human to human relationship

● Outcome
- nurse as controlling and directing
the patient care using the knowledge
of the human and physiological and
behavioral system. to have
improvement to the patient to
 - Mainly concerned with how nurses
care for their patients and how that
caring progress into better plans to
promote health and wellness,
prevent illness and restore health.
- focuses on health promotion as well
as the treatment of disease
- caring is central to nursing practice
and promote health better than a
simple medical cure.

- Nasa gitna si client factors that can

affect. kaya may palabas papasok
kasi yung client pwede makaapekto
sa nakapaligid sakanya and vice
versa. Kaya si nurse nasa labas kasi
the nurse can control or modify.

List of caring behaviors

- Empathy- ability to sense other
peoples emotion
- pwede naman iallow pero not for the
whole day for the emotional of the
Marilyn Anne Ray- Bureaucratic caring
patient.
- challenges participants in nursing to
think beyond their usual frame of
Jean Watson- Transpersonal Caring(
reference and envision the world
beyond the limit of personal entitty.
holistically while considering the
- “Nursing is concerned with
universe as hologram.
promoting health,preventing
- presents a different view of how
illness,caring for the sick, and
health care organization and nursing
restoring health
 phenomena interrelate as wholes
and parts in the systemas
- “From Novice to Expert”
- States that caring practices are
instilled with knowledge and skill
regarding everyday human needs.

- This concept explains that nurses

- By understanding and incorporating develop skills and an understanding
the theory of bureaucratic caring, of patient care over time from a
nurses bring caring into being that combination of a strong educational
makes a human community and an foundation and personal
organization edifying to our spiritual experiences.
well being and intellectual device.
- Yung spiritual ethical caring will
radiate outside the patient.
Maapektuhan niya din yung
community and vice versa
- Nursing conceptual models

Example:
issue of end of life
- You were assign to take care of a
terminally ill patient. by the use of
the bureaucratic theory we could be
able to decide. Matutulunggan natin
kung ano ang magiging way ng
parerender natin ng decision Level of nurse
making. - Expert
Competencies of nurse
- Binigay lahat ng information
- Nireduce anxiety ng family
Patricia Benner (NOVEX)
Nursing Conceptual Models.

- These are comprehensive nursing

theories that are regarded by some
as pioneers in nursing. These
theories address the nursing
metaparadigm and explain the
relationship between them.
● Levine
● Rogers
● Roy
● King
● Orem

Concept- ideas or building blocks

Myra Estrin Levine- Conservation Model,

● According to the Conservation

Model,
● "Nursing is human interaction.
What will be included in the initial plan of
● When a person is in a state of
care?
conservation,it means that the
(1) validate the illness experience,- we
individual has been able to
have to ask by interviewing
effectively adapt to the health
(2) encourage continued use of prayer.
challenges, with the least amount of
Bible reading, and humor to help
effort.
her feel better, - personal integrity
(3) discuss medication therapy and what
CASE STUDY
might help her achieve restful sleep
(4) refer her for blood work to assess
hormone levels (it could be related to
menopausal period)
(5) assist her with determining the meaning
of the symptoms (e.g., menopause or
fibromyalgia).

- This will all revolve to the system all

dimension
 Art of nursing- nursing creativity. What you
learn you apply

The main goal of conservation is to maintain
and maintain the integrity of the system
according to their respective functions and
achieve a balance (equilibrium) through
the provision of nursing interventions so that
individuals can achieve wholeness
Personal integrity-pagkakakilala niya sa
sarili niya
- Open system give and take
● A patient can't be separated from his
or her environment when addressing
health and treatment.
● It provides a way to view the unitary
human being, who is integral with
the universe. Human and his
environment are a single unit and
therefore, must be studied together

Martha Rogers - Theory of Human Ex . outbreak of cholera in barangay. Apply

Beings, science of unitary of human being by

● Nursing as "an art and science that

is humanistic and humanitarian.
● The Science of Unitary Human
Beings contains two dimensions:
the science of nursing, which is the
knowledge specific to the field of
nursing that comes from scientific
research, and the art of nursing,
which involves using nursing
creatively to help better the lives of
the patient. Negative binigay sa environment kung
sansan nagtatapon kaya di rin maganda
Science of nursing- knowledge. Assess ang binabalik sayo
muna bao diagnose, may process ADPIE
Sister Callista Roy- Adaptation Model
● defined nursing as a"health care
profession that focuses on human
life processes and patterns and
emphasizes the promotion of health
for individuals, families, groups, and
society as a whole.
● ” Views the individual as a set of
interrelated systems that strives to
maintain a balance between various
stimuli.

- Stress nakakasira ng balance pero

may mga way para makaadapt dito C6 c7 neck cervical

Physiological- assist in basic needs like

elimination, food, bathing

Self-concept- valuing of self. Risk for

depression. Have a support system. Provide
information about

Interdependence-di na makagalaw ng
maayos. Assist patient to stand sit, eat

Role function- breadwinner inaasahan ng

family. Inform family members dapat ilessen
stress

Imogene King- Theory of Goal

Attainment

- states that the goal of nursing care is ● "Nursing is a process of action,

to promote patient adaptation. Her reaction and interaction by which
model asks questions about the nurse and client share information
person who is the focus of nursing about their perception in a nursing
care, the target of that care and situation" and "a process of human
when that care is indicated(tignan interactions between nurse and
mo kung kailan kailangan ng patient client whereby each perceives the
assistance mo para makaadapt other and the situation, and through
patient pag mahina coping communication, they set goals,
mechanism mo negative ang explore means, and agree on means
behavior mo) to achieve goals."
 - Asking patient opinion, their
feedback and their idea,
feeling nila tignan reaction n
patient. Involve patient in
care

- Focuses on each individual's ability

to perform self-care. (assess kung
may kakayahan ba patient mag self
care. Pag di kaya ng self care
agency o katawan we will provide)

Composed of three interrelated theories:

(1) the theory of self-care,
- Focuses on this process to guide (2) the self-care deficit theory, and
and direct nurses in the (3) the theory of nursing systems, wholly
nurse-patient relationship, going compensatory, partially compensatory, and
hand-in hand with their patients to supportive educative.’
meet good health goals. Explains - May mga patient kasi health
that the nurse and patient go teaching lang kailangan para
hand-in-hand in communicating maintindihan procedure. May wholly
information, set goals together, and compensatory kasi comatose kaya
then take actions to achieve those kailangan ng total care. Pag partial
goals. naman kailangan ng assistance

Dorothea Orem -Self-Care Theory,

- she defined Nursing as "The act of

assisting others in the provision and
management of self-care to maintain
or improve human functioning at the
home level of effectiveness."

Therapeutic self care demands , deficiency

 - Supportive educative : Give 14 components of need theory
information about diet, proper body
mechanics or body posture, Pain
management. Assess effectiveness
after the med.
- Nursing goal: to improve
nourishment. Pain compliance,
lessen the pain

Orem's self-care deficit theory suggests

patients are better able to recover when
they maintain some independence over
their own self-care.(kung kaya na ng patient
hayaan na) - The Need Theory emphasizes the
importance of increasing the
patient's independence and focus
Grand theories( galing sa nursing on the basic human needs so that
philosophies or conceptual models na progress after hospitalization
naimrove) would not be delayed.( dapat
- Are works derived from nursing makarecover needs agad ni patient
philosophies, conceptual models, para di na tumagal sa hospital)
and other grand theories that are
generally not as specific as
middle-range theories.

● Henderson
● Abdellah
● Johnson
● Neuman

Virginia Henderson- Nursing Need

Theory

- Focuses on the importance of

increasing the patient's
independence to hasten their
progress in the hospital.
- Emphasizes the basic human needs
and how nurses can assist in
meeting those needs.

Nursing theory related is the maslow.

List one by one the 14 components so that
we can be able to analyze which of the 14
components ang inproprovide sa patient.

Breathing- oxygen
2 need assistance

Faye Glenn Abdellah - the 21 Nursing

Problems Theory

- Changed the focus of nursing from

disease-centered to patient-centered
and began to include families and
the elderly in nursing care
- The nursing model is intended to
guide care in hospitals institutions
but can also be applied to
community health nursing, as well.

(Di sa disease nakafocus kundi sa patient)

Ex: Cancer patient end stage na. Wag na

bigyan ng gamot kasi nasa end stage na. Di
naka focus sas disease. Nakafocus sa
condition ng patient
- The patient-centered approach to
nursing was developed from
Abdellah's practice, and the theory is
considered a human needs theory
- The model has interrelated concepts
of health and nursing problems, as
well as problem-solving, which is an
activity inherently logical in nature.

(common na ginagawa ng c.i NCP, bawat

area NCP para identify patient’s problem)

- The problem-solving approach

introduced by Abdellah has the
advantage of increasing the nurse's
critical and analytical thinking skills
since the care to be provided would
be based on sound assessment and
validation of findings.
Dorothy E. Johnson- Behavioral System
- Model Advocates to foster efficient
and effective behavioral functioning
in the patient to prevent illness and
stresses the importance of
research-based knowledge about
the effect of nursing care on
patients.( may basis effective na)
- Describes the person as a
behavioral system with seven
subsystems.
(ex. May parehas cancer patient iba
behavior ng isa sa isa. Yung isa
depress yung isa parang ok lang.
Kasi nga magkaiba sila ng
subsystem)
- Johnson's Behavioral system model
is a model of nursing care that
advocates the fostering of efficient
and effective behavioral functioning
in the patient to prevent illness.
(kung negative pa ang behavior ng
patient because of subsystem, we
have to focus on that subsystem to
change its behavior)
Behavioral Assessment
Using Johnson's Behavioral System Model,
identify the following:
- Achievement (kaya sigguro ganiyan
si patient kasi siya yung provider ng
needs ng family niya kaya nung
nagkasakit siya feelingg niya di niya
achieve yung support sa fam niya)
- how to do activities of daily living
(ADLs) ( kaya nagging masungit
patient kasi di siya makagalaw, di
niya magawa mga dati niyang
gginagawa)
- Attachment-affiliative (connection
with support system.
Sinusuportahan ba siya ng fam
niya? Maganda ba support ng fam
niya sakanya despite sa sakit niya)
- Aggressive-protective (kung pano
niya vinavalue yung support system
niya. Kumukuha ba siya ng opinion
sa fam niya. Sinusunod niya ba yung
mga suggestion ng mga tao around
him or her)
- Dependency( gano siya
kadependent sa healthcare provider
at fam niya)
- Ingestive (food. Mainit ulo kasi
gutom na, o di makakain.)
Rosemarie Rizzo Parse- Human
Becoming Theory
- "Nursing is a science, and the
performing art of nursing is practiced
in relationships with persons
(individuals, groups, and
communities) in their processes of
becoming."
 personality patient. To include condition in
personality of patient and produce new
indvidual kumbaga may cancer ka na pero
makakapagtrabaho ka pa din.

- Ask patient. Hayaan mo siya

magsabi pa para marealize mo ang
kailangan niya. Let the patient talk

- Explains that a person is more than

the sum of the parts, the
environment, and the person is
inseparable and that nursing is a
human science and art that uses an
abstract body of knowledge to help
people.
- It centered around three themes:
meaning, rhythmicity, and
transcendence.
- Kasi pag naggverbalize siya
( Kunwari ang masakit lang sayo tiyan o makakaprovidde ka ng clarification,
head di lang puro yun ang iaassess mo. maiintindihan niya at malalaman
iaassess din yung ibangg parts)(pag meaning. Pag nainform na anak
nagrender ng care, science and art yun. Pa magkaka transendence na kasi
nagrender ng nursing procedure di lang mababawasan na burden mo . pag
skills dapat may kasamang knowledge. nalaman ng anak marerealize ng
Alam mo ba purpose. Marunong ka nga daughter na kailangan nila ng quality
gawin di mo naman alama rationale. time.
Kailangan maintindahan. O mapunta sa
trancendence o nagimprove behavior niya. The primary purpose of nursing theory is to
We will help the patient understan the improve practice by positively influencing
condition. As the patient understand the health and quality of life of patients.
condition di magigin hindrance condition Nursing theories are also developed to
niya. Dito magkakaroon ng bagong define and describe nursing care, guide
nursing practice, and provide a basis for
clinical decision-making.
(lahan ngg goal natin dito is positive. Quality
of life, ex.nagkaquality time sila ng anak
niya. Change of mind, clarity if mind.
Kailangan ko palangg gawin to para
maimprove health ko.
● Middle-ranged theories
TFN DAY 3
LOCAL NURSING THEORIES
Local Theories and Models of Nursing
Intervention (Philippine Setting)
1. Locsin's Technological Nursing as Caring
Model
2. Agravante's CASAGRA Transformative
Leadership Model
3. Divinagracia's COMPOSURE Model
4. Kuan's Retirement and Role Discontinuity
Model
5. Abaquin's PREPARE ME Holistic Nursing
Interventions
6. Laurente's Theory of Nursing Practice
and Career
7. Synchronicity in Human-space-time: A
theory of Nursing Engagement in a Global
Community
Rozzano C. Locsin- Technological
competency as caring in nursing
- is the harmonious coexistence
(exist together) between
technologies and caring in nursing.
- This practice theory is focused on
knowing person with key elements of
technological knowing, designing,
and participative engaging(despite
this machine treatment to the
patient, the presence of the nurse
will be there)
- The nurse should understand that
the use of technology with this
context either brings the patient
closer to the nurse or increases the
gap between nurse and nurse.
- Ex. ultrasound it will bring closer kasi
nagsheshare ng happiness ang
mother sa nurse.. Gap kapag
nagfofocus na nurse sa technology
- Dapat ineexplain ng nurse mga
machine sa patient
How Does Technology Affect Nursing?
1. Monitoring - mas napadali,
2. Medications - easy access of drug
reference,
3. Health Records- accessible
4. Communication - telehealth
How has the use of technology in
nursing changed the caring part of
nursing?
– mas napadali na
- Ngayong pandemic yung ibang hosp
robot na pumupunta para di mahawa
nurse
- Improved nursing care with the use
of technology
Carolina S. Agravante- CASAGRA
Transformational Leadership Theory
- is focused primarily on the
educational and psycho-spiritual
aspect of nursing
According to the care complex , caring
personality rests on the possession of a
care complex within a person as an energy
source of caring. - The framework
explains and predicts the continuous
formation of nursing leadership behavior
in nursing faculty that will eventually affect
their teaching function.
Servant-leader spirituality - Hinugasan ni
Jesus paa ng disciple , u will serve your
people
Self-mastery - alam mo ginagawa or
tinuturo mo . magiging model ka ng
tinuturuan. To create transformative
behavior to patient or student
Special expertise
Application of the theory
● To be always committed to bring out
the best to every member of the
team.
● Enhancing competence in every
skill, compassion to every service
and empowerment to the nursing
profession.
● Leading and at the same time be of
service.
● Leader with values and committed to
sustain compassionate nursing care
regardless of the different global
challenges we have in today's new
generations.
Carmelita Divinagracia- Theory of
COMPOSURE Behaviors
● COMpetence
● Presence and Prayer
● Open-mindedness
● Stimulation
● Understanding
● Respect and Relaxation
● Empathy
(for critically ill patient)
Assumption – the wellness outcome of a
patient will depend on the intervention the
nurse has when administering the care.
Physiological outcome Behavioral Outcome
EXAMPLE:
A cardiac patient is angry and complaining.
As the nurse, are you going to avoid his
room, or when you have to be there, will you
move in and out as quickly as possible? Is
this the solution?
- Competence - siguro may
nararamdaman na pain o kailangan
ng extra care
- P- jan ka lang sa tabi niya
- O- intindihin mo na lang
- Lagay mo sarili mo sa kondisyon
niya
- Gamitin pag galit na galit na patient
Sister Letty G. Kuan- Retirement and
Role Discontinuity Theory
- She values the effect of retirement
as a phase of one's life and its
accompanying adjustments. She
identified the determinants of
positive perceptions in retirement
and positive reactions toward role
discontinuities
- Sa mga matatanda naman
Retiree - is an individual who has left the
position occupied for the past years of
productive life because he/she has reached
the prescribed retirement age or has
completed the required years of service.
(matanda ka na kaya gusto mo na mag
retire)
Role Discontinuity - is the interruption in
the line of status enjoyed or role performed.
The interruption may be brought about by
an accident, emergency, and change of
position or retirement.
(not about age bata ka pa pero
naacciddente ka)
- Hadlang sa fruitful is prepared
retirement and income kasi wala
silang saving bago mag retire
- Allow patient to speak to know their
concern
Carmencita Abaquin - PREPARE ME”
Interventions
Presence- being with patient in times of
need (therapeutic communication, active
listening, sense of touch, taping back)
sense of security
Reminisce Therapy ( recall pass experience
to have adaptation to past experience. To
bang pain na to naramdaman niyo na po ba
dati? First time niyo po ba to? Ano pong
ginawa niyo dati para maovercome niyo)
Prayer
Relaxation -(breathing exercise)
Meditation -(patient level of awareness para
madivert attention niya sa iba)
(parang composure din , ano ang
intervention )
Values clarification- clarify value of patient
with its insight about his or her disease
PREPARE ME (Holistic Nursing communication, employed
Interventions) informative, psychotherapeutic,
- are the nursing interventions modeling, behavioral, cognitive
provided to address the behavioral, and/or hypnotic
multi-dimensional problems of techniques.
cancer patients that can be given in Ex. pedia ward kasi matatakitin pag
any setting where patients choose to nakakakita ng nurse. Makakita lang ng
be confined. nakaputi umiiyak na di na magpaparticipate
sa procedure mag tatago na yan. Gamitin
nanay o relative para magcommunicate sa
bata at magawa ang nursing procedure.
Use family as an entry point

Synchronicity in Human-Space-Time: A
Theory of Nursing Engagement in a
Global Community
- Freslyn lim saco
- Clifford masayao kilat
- Rozanno locsin

Mas mapapasganda quality of life despite of

Synchronicity in the Human-Space-Time
their condition
Theory of Nursing
- is about the innovative process of
Deals on:
nursing engagement expressed as
1. How to care for cancer patients
interpersonal relating,
(kahit hindi basta may
technological knowing,
pinagdadaanan
rhythmical connecting, and
2. Improve the quality of life of patients
transformational engaging. The
with Cancer and other chronic
philosophical and theoretical
diseases/terminal illnesses.
perspectives declare the
evolutionary design in affirming the
meaningful human caring
Cecilia Laurente - Theory of Nursing
experiences within nursing practice.
Practice and Career.
Moreover, theory-based practice
- She emphasized effective
sustains the human science view of
communication and using the family
wholeness of persons while focusing
as an entry point to help a patient.
on the inclusion of the coexistence
(Kahit di cooperative patient pwede
between technology and caring in
tanungin relatives para magparticipate siya
nursing. The practice of nursing
sa enter of care practice
approaches human caring beyond
the customary, fragmented, and
- The nurse can help strengthen the
routinary healthcare commitment.
family's term of knowledge, skills,
and attitude through effective
 Nurse are inside the infinity nakapalibot
sakanila yung mga factor na nakakaaffect
para di magkaroon nung 4 process on the
part of nurse and nurse. They are inside the
human space time/caring moment -
nagkaroon interaction patient and nurse

Case study:

Are the four processes of the Nursing

Engagement Process (NEP) evident?

● Interpersonal Relating –
therapeutic communication (nurture
relationship, appreciate natin yung
wholeness ng patient o ng individual.
We go beyond what is seen)
● Technological Knowing - use of
equipment and interpretation of data
( SUCTIONING, CARDIAC
MONITORING)
● Rhythmical Connecting - engaging
the patient and family in the
implementation of care ( dancing to
the cadence of treatment dapat
makasunod. May [positive
connection makakasunod.dapat
maintiindihan muna ng patient yung
procedure para makasunod siya
● Transformational Engaging - all
the persons involved had
experienced change. (marecognize
niya ang improvement sa kaniyang EX. pre pandemic u wash your hand before
caring movement. Sasabihin niya entering and nag endorsement ito ang
dapat na nagimprove condition niya)
patient mo. binasa mo na chart ni mang
larry nakita mo na condition.
Dance of caring person- interaction/ caring
moment
Are the four processes of the nursing
equipment process (NEP) evident?
Interpersonal relating- sa pagkamusta ng
pakiramdam ng patient.
Technological knowing- alam mo gamitin
yung tech o caring para magkapositive
outcome sa patient (suctioning, cardiac
monitor para iassess vital sign, med kung
para saan at route)
Rhythmic connecting - dahil ininform mo
sila sa procedure si mam jane sasabihan
mo kailan pwede ibigay gamot.
Nakakaengage ka na sa family
Transformational engaging- nagka
positive outcome sa part ni patient
TFN POST TEST 1
1. A new graduate nurse(Novice)is best
able to demonstrate caring behavior
according to Patricia Benner towards
the client by:
- Seeking assistance to a more
experienced nurse before attempting a
new procedure
2. A number of nursing theorists
discuss and describe the concept of
caring in nursing practice. According
to Jean Watson, caring is defined as
a:
- Central to nursing practice and promotes
health better than a simple medical cure.
3. The nurse has elected to apply
Orem’s concepts of caring. Which one of
the following nursing activities is an
example of this theories
“supportive-educative” nursing system
in the caring process?
- Teaching the client on how to do
self-injection of insulin
4. In relation to caring, the most
important aspect for a student nurse to
learn in application of Peplau’s theory is:
- Establishing a relationship
5. Caring is evident in many ways in
nursing practice. Confidentiality which is
one caring behavior is best
demonstrated when the nurse:
- Closes the door and covers the client
during a bath
6. The nurse manager is not satisfied
with the hygienic care that is provided by
a particular staff member on the unit. To
improve the care provided to the older
adult clients on the unit by this staff
member, the nurse manager will apply
the Novice to Expert Theory by?
 - Bring the staff member into a
client’s room and demonstrate a
gentle bath
7. A nurse is reading about different
theories of caring and wants to adopt
Leininger’s theory as an approach for his
clients. A key element in this theory is
that it includes:
- Transcultural perspectives
8. Mrs. XY 50 years old female patient
was admitted in the Medical Ward due to
Hypertension with a BP of 180/120. She
is complaining of headache and nausea.
She is admitted in a semi private room
with the other patient of the same
diagnosis, the patient was accompanied
by families and children, who are
coughing and sneezing constantly,
which makes Mrs. XY anxious and
unable to sleep.
Considering Rogers Theory on Unitary
Human Being. Rogers states that nurses
is in constant mutual process with whom
they cared and have opportunity to
pattern the environment for change.
Applying this major assumption, what
immediate intervention of the nurse can
be made for Mrs. XY?
- Arrange another room for the patient
which is more conducive to healing
9. In applying the Science of Unitary
Human Being Theory what ways the
nurse can alter the way care is
provided to promote improvement of
symptoms?
- All of the above
- Calming the environment
- Limit interruptions
- Limiting the number of visitors
10. The four major concepts in nursing
theory are the?
- Person, Environment, Nursing, Health
11. Henderson Need Theory stated that
the function of the nurse is to assist
the individual, sick or well, in the
performance of those activities
contributing to health that he would
perform unaided if he has the
necessary strength, will and
knowledge, and do this in such a way
as to help him gain independence as
rapidly as possible. This theory is
categorized as what type of theory
based on abstraction?
- Grand theory
12. A nurse teaching a newly diagnosed
elderly women with diabetes about
insulin use is an example of what
concept of metaparadigm?
 teacher first before being a leader,
always demonstrating transformative
- Nursing type of leadership, which is
characteristic of?

13. If we are considering if this patient

can afford this particular type of
treatment. We are focusing on what - Servant leadership
concept of metaparadigm?

17. Nurse Ronnie uses technology in

nearly every aspect of his nursing
- Environment profession. With the use of an
invasive arterial monitoring line, the
nurse can monitor and assess the
14. What is the correct arrangement of patient health condition much better
the nursing process? and be able to perform other
procedures like assessment of the
1 - Nursing diagnosis patient and establishing
communication by talking to the
2 - Implementation patient. This is an example on the
application of what local nursing
3 - Assessment theory?

4 - Evaluation

5 – Planning - Technological Competency in Nursing

Theory

- 31524
18. During the community health nursing
duty, a student nurse is doing an
interview with a near retiring couple.
15. Who explained the Typology of
While doing the interview, the student
twenty-one Nursing problems?
finds out that couple is concerned of
their retirement.

- Faye Glenn Abdellah The couple ask the student nurse how
can they be able to have a happy
retirement? The student nurse wis
16. You’ve noticed that your nurse correct if she answered:
manager demonstrated passion for
serving her staff rather than being
served. She always takes time to
listen to her staff, prefers to be a
- “To have a happy retirement you should
prepare before that day comes and be
able to enjoy each day.”
19. On a home visit, the head of the
family member had an accident and
can no longer return to work. In the
interview, the head of the family
stated that he is the breadwinner and
6 years from now will be retiring and
has limited savings. If you want to
apply nursing care to this type of
patient to have a positive outlook,
you need to apply what local nursing
theory?
- Retirement and Role Discontinuity
Theory
20. Nurse Myra is the nurse caring for a
patient who had miscarriage and
underwent dilatation and curettage,
while Nurse Myra is taking her vital
signs she noticed that the patient’s
heart rate is at 120 beats per minute
she also saw her crying. Her patient
verbalizes “More than the physical
pain that I am feeling right now, I feel
really devastated in loosing another
child, I think it is really my fault”
thinking about the COMPOSURE
behaviors Theory, what should be the
best action/s of Nurse Myra?
- Verify doctor’s order for pain
medications, stay with the patient and ask
to verbalize feelings, listen, empathized,
and discuss relaxation techniques
21. Nurse Diana is the chief nurse of a
new hospital, she is currently in the
process of setting up the oncology
unit, Nurse Diana is applying the
Theory of “PREPARE ME”
Intervention when she make sure that
which of the following will be evident
in the nursing care?
- All of the above
- There is a conference/family room
for doctors to discuss status of the
patient to family members, Trainings
are provided to health care providers
teaching them interventions as part
of treatment modalities, support
group and therapy sessions is
always provided.
- Socialization and freedom to
express one’s faith were encouraged
- Nurses station is strategically
located so that patients can easily
reach out to them and feel the
nurse’s presence
22. Nurse Stephanie is the nurse caring
for Celine, a 21-year-old patient
diagnosed with pancreatic cancer
stage 3. After her 2nd cycle of
chemotherapy Celine told Nurse
Stephanie that she wants to be
independent as possible in doing her
activities of daily living so she can
feel more alive and healthier.
Nurse Stephanie understands that Celine 25. Which of the following statement/s
wants to increase her level of about the application of
independence to achieve quality of Transformative Leadership Theory
life, and be able to go home much is/are correct?
faster, she can assist her in attaining
this by applying which nursing
theory?
- All of the above
- The need theory
- Leader with values and committed
to sustain compassionate nursing
care regardless of the different global
23. In the Theory of Synchronicity in challenges in today’s new
Human - Space -Time, the nurse was
generations.
able to immediately perform nursing
interventions with the use of - Enhancing competence in every
technology and be able to assess and
skill, compassion to every service
interpret the vital signs of the patient
and empowerment to the nursing
is an example of what process of this
theory?
profession.

- Committed to bring out the best to

every member of the team.
- Technological knowing

24. As the nurse enters the patient’s

room, she looked straight into the
patient’s eyes, smiled as she began
to introduce herself and asked, “How
are you?” The nurse facial
TFN POST TEST DAY 2
expression showed concern and
compassion and held the patient’s
1. The metaparadigm for nursing
hand while she assessed her vital
includes four concepts which are
signs, pain, and surgical incision.
The nurse is applying what process
central to nursing, namely:
in the theory of Human-Space-Time?
Nursing, health, environment, person

2. Nurse Gela is a staff nurse in the

- Interpersonal relating pay ward. Florence Nightingale’s
Theory of Modern Nursing is
applied by Nurse Gela in the
following situations, EXCEPT:
 although a universal phenomenon
is largely based on one's way of
Helping the patient achieve life?
independence as early as possible.
Madeleine Leininger

6. Lydia Hall’s theory is centered on

3. The application of Martha the care, core and cure
Rogers’s Science of Unitary components of health. Which of
Human Beings, which emphasized the following components is
the human being as a unified thought to be central to nursing?
whole, is seen in which of the
following situations? care

Nurse Mica is preparing a

patient with a herniated disc
scheduled for a laminectomy. 7. Based on Hildegard Peplau’s
She asks the patient to sign interpersonal relations model in
the consent and to remove nursing, when a client
any jewelry, and checks for experiences a “felt need” and
baseline vital signs. She seeks professional help, this is a
listens to the patient for any task of the:
concerns and expressions of
orientation phase
anxiety and agrees to contact
the hospital chaplain for
spiritual services.
8. Sustaining a state of balance in
energy flow that is with in the
unique biological realities of the
4. This nursing theorist incorporated
individual as a product of
the major principle of maintaining
adaptation is based on the theory
one's health through the use of
of:
different agencies and
compensatory approaches in Estrine Levine
meeting one's health needs:

Dorothea Orem
9. As a nurse, you know that the
principle of Environmental Theory
is:
5. Who is this nursing theorist who
emphasized that human caring,
 The act of utilizing
the surroundings of
the patient to assist
him in his recovery
10. She proposed that nursing is
assisting individuals to gain
independence in relation to the
performance of activities
contributing to health or its
recovery:
Virginia Henderson
11. Sister Callista Roy conceptualized
the Adaptation Model wherein the
client exists through adaptation
within an environment, with the
nurse as a regulatory mechanism
in situations of health and illness.
She classified the responses of
individuals into 4 modes. Which of
the following is not included?
Spiritual mode
12. In the late 20thcentury, much of
the theoretical work in nursing
focused on articulating
relationships among four major
concepts: person, environment,
health and nursing. Dianne may
be wrong about her answer but
she also give her question to
Jonnie. Who among the following
theorists conceptualizes that both
human and environmental fields
are characterized by pattern, a
universe of open systems and
four dimensionality.
.Martha Rogers
13. Paradigm refers to a pattern of
shared understandings and
assumptions about reality and the
world. Julius came in and became
interested with their discussion.
Carina then gave Julius her
question. Which of the following
theory has received worldwide
recognition and is a major force in
redefining nursing as a
caring-healing health model?
Human Caring theory
14. Nursing research is more often
informed by mid level theories
that focus on the exploration of
concepts such as pain,
self-esteem, learning and
hardiness.Julius took his book
and looked for possible answers.
He then asked the group which of
the following theory emphasizes
how individuals choose and bear
responsibility for patterns of
personal health. The theorist
contends that the client, not the
nurse is the authority figure and
decision maker.
Human Becoming theory
15. Critical Theory is used in 17. Professor Santos continued
academia to describe theories that questioning his students about
help elucidate how social the different nursing theorists.
structures affect a wide variety of Who among the following
human experiences from art to theorists focuses on the
social practices. Kevin answered individual’s ability to transcend in
hesitantly and shared to the group his current state of health?
his question. Who among the
following theorists views the
client as an open system Rosemarie Rizzo Parse
consisting of a basic structure or
central core of energy resources
surrounded by two concentric
18. In this theory of nursing, the
Betty Neuman nurse assists the client
confronted by stress through
16. A philosophy is a belief system, utilizing the appropriate mode of
often an early effort to define prevention to maintain stability:
nursing phenomena, and serves
as the basis for later theoretical Betty Neuman
formulations.Kathy was then
overwhelmed with the groups
knowledge about the different
19. She believes that clinical nursing
nursing theorists. She gave it a try
practice is composed of
to ask them, who among the
philosophy, purpose, practice and
following theorists believes that
art that are essential in helping
her theory offers insight into
the client restore optimum health
nurse’s interactions with
functioning.
individuals and groups within the
environment? It highlights the Ernestine Weidenbach
importance of a client’s
participation in decisions that 20. She broadly grouped nursing
influence care and focuses on care into 21 problem areas to
both the process of nurse client guide care and promote the use of
interaction and the outcomes of nursing judgement.
She also
care. Introduced Patient – Centered
Approachesto Nursing Model:
Imogene King
Faye Glenn Abdellah
 BRANCHES OF PHARMACOLOGY

PHARMACOLOGY - When a drug is introduced in the

DAY 1 body it will cause a change, the
- Study of biological events of target cell has a receptor and this
chemicals will result in a drug taking effect.

Sources of drugs - Drug will bind to receptor (to receive)

1. Animals(oldest) - insulin before
comes from the pancreas of cows = PHARMACODYNAMICS
and pigs
2. Plants - - Drug is an antigen, The body’s react
- 10 plants approved by DOH to a drug means
1. St. John's Worth (drug for PHARMACOKINETICS (movement
depression) of drug)
2. Allium sativum
(Garlic/Bawang),
3. Blumea balsamifera (Nagal
camphor/sambong), DIFFERENT PROCESSES
4. Cassia alata (Ringworm
bush/akapulko), LIBERATION
5. Clinopodium douglasii
(Mint/yerba Buena), ABSORPTION
6. Ehretia microphylla (Scorpion
bush/Tsaang Gubat), DISTRIBUTION
7. Momordica charantia (Bitter
Melon/Ampalaya), METABOLISM
8. Peperomia pellucida (Silver
bush/ulasimang Bato), EXCRETION
9. Psidium guajava
(Guava/Bayabas), RIGHTS OF DRUG ADMINISTRATION
10. Quisqualis indica (Rangoon
creeper/niyug-niyogan), and 1. Right medication
11. Vitex negundo (Five-leaved 2. Right dose
Chaste Tree/lagundi). 3. Right patient (3 times; preparing,
about to administer,
3. Inorganic compounds 4. Right time
- Magnesium, chlorine, potassium, 5. Right route (safest-oral , not- Iv
iron there is no turning back
6. Right documentation
4. SYNTHETIC 7. Right Client education
- Genetic engineering 8. Right To refuse
- Insulin gets now from (e.coli) 9. Right assessment
10. Right evaluation

PHARMACODYNAMICS
- How can a drug produced a change
in the body
- drug does to the body
ACTIONS OF DRUG
- Replace a missing substance
(Addison's disease (lack
corticosteroids, insulin, cortisol, T3,
T4)
- Increase cellular activities
(Stimulate the cell eg., epinephrine,
digoxin)
- Depress cellular activities
(beta blockers, OLOL)
- Interfere with a growth of a foreign
cell
(chemo drugs, antibiotics)
DRUGS ACTION MAYBE THROUGH
1. Receptors
2. Enzymes and pumps
3. Chemical interaction
4. Altering metabolic process
DRUG RECEPTOR INTERACTIONS
- INSULIN (transport the sugar to the
cell) need to bind to the receptor first
to enter into the cell
AGONIST
- Stimulate the activity of cell
ANTAGONISTS
- Block
- Two types:
➔ Competitive antagonist
- Binds to a same receptor
- Potency of an agonist is
reduced (since may nauna
sa kanya)
- One receptor but have many
drugs
= Diazepam and Flumazenil
➔ Non Competitive antagonist
- Binds to a different receptor
- Prevents potency of an
agonist
- Not compete in the same
of receptor because they have
different receptors
- The effect of other drug will
definitely block the effect of
the other drug
= Epinephrine and
phenoxybenzamine
(adrenergic agent alpha
blocker)
AUTONOMIC DRUGS
SNS
Receptor (alpha and beta)
- Adrenergic
- Alpha (a1, a2)
- Beta (b1, b2)
PSNS
(nicotinic and muscarinic)
- Cholinergic
DRUG- ENZYME INTERACTIONS (ase)
enzyme
= Cholinesterase inhibitors
- This will break down acetylcholine
Impulse - runs along with a nerve, carries
with a message (electrical impulse)
Neurotransmitters - The chemicals from
neuron, they will transmit the message from
the neuron

- Muscle will contract when
acetylcholine comes in and when
cholinesterase comes the muscle
will relax for the enzyme has break
down
Neostigmine (tigmine drug for myasthenia
gravis - weakness and paralysis)
- This will block the cholinesterase
(the muscle will contract)
INHIBITING PUMPS
Reuptake inhibitors
- There will be impulse in the axon
terminal and will secrete
neurotransmitter
- 5ht - serotonin
- 5ht reuptake so the receptor will be
free and will be again accept 5ht
= SSRI (anti depressant) selective serotonin
reuptake inhibitor
- Accdg to biogenic amine theory,
people are depressed bec lack of
norepi, dopamine and serotonin
- The goal is to increase nor epi, dop,
serotonin
- 5ht Inhibits reuptake to stay in the
receptor so it will increase
PHARMACOKINETICS
- The response of the body to the
drugs
1. LIBERATION
- Drug enters the body, travel to the
stomach, release of active ingredient
= LIBERATION
2. ABSORPTION
- In the blood
Routes of drug absorption
1. Enteral route (GIT)
- Oral, rectal, and nasogastric
- Fastest enteral route is rectal
because of the blood vessels
- Store suppository in the
refrigerator in the chiller (sa
labas lang)
2. PARENTERAL ROUTE
- IV, IM, ID, SUB Q
- Fastest = IV
- Second = IM (vascularize)
3. TRANSMUCOSAL
- Sublingual, inhalation, topical
- Fastest = sublingual
3. METABOLISM (Biotransformation =
Before distribution in oral, it has to pass the
liver for it to have many enzymes (p450
Cytochromes - will act on drug and break
down - new drug nabawasan 100mg?)
- The liver detoxify drugs, and all
First pass effect - oral drug broken down
by the liver to become new drug and less
active
- Occurs only in oral
- If there’s a liver cirrhosis, the new
drug will less 10mg then the effect to
body is toxicity (so less dose dapat,
liver and kidney problems, elderly,
pedia) elederly and pedia compute
for drug less dose
If IV
- Same amount of drug (full strength of
the drug because it passes the
metabolism as well as the 1st pass
effect)
4. DISTRIBUTION
- Transported in the target cell
- Bind in receptor to have an effect

5. EXCRETION
- Whatever is not use by the cell will
be eliminated
- Organ: kidney major elimination,
lungs, feces, skin

—-----

DOSE
- Amount of drug to be administered - Eg. cefuroxime T ½ = 12hrs
to the patient 6am = 500 mg, after 12hrs (PM) -
6PM 250 mg na lang, next 6am
SCHEDULE 125mg na, 6 pm, 62.5mg, 6am
- Frequency, how many doses per day 31.25, 6 pm, 15.61, 6am 7.8mg, 6
pm, 3.9mg, 6am 1.9mg, 6 pm,
RECOMMENDED DOSE 0.9mg, 6am 0.45mg, 6 pm, 0.2mg,
- Right amount of the drug and the 6am 0.1mg, 6 pm, = something
right schedule - 7 days ung 500mg
- Taking aspirin for the longest
CRITICAL CONCENTRATION time that has hypertension
- Level of drug in the blood which (blood thinner)
produces a therapeutic effect - If the pt needs to be surgery,
it has to be delayed since he
THERAPEUTIC EFFECT used aspirin and he will
- Favorable response after a bleed out, so we need to
treatment of any kind defer or discontinue aspirin
- Cure by 5-7 days, the half life of
the drug will be eliminated
LOADING DOSE - Board exam q: how much is
- Initial dose, immediate response left in the body after 5 half
lives (15.61mg)
HALF LIFE (T)
- Time it takes for a drug to become GRAPH
half of its previously peaked level X graph represent the hour
Y amount of the drug in the body

If u give right dose and schedule you are

giving the recommended dose, if u are
giving the recommended dose u are able to
reach the critical concentration and if u
reach the critical concentration then u will
be able to give therapeutic effect
Eg., amoxicillin 500mg every 8 hrs for 7
days
T 1/2 : 8hrs
= 6 vials since on 1st dose he used 200 mg
to have a loading dose
Overdose in paracetamol give antidote =
acetylcysteine
Morphine = naloxone (narcan or evzio)

recommended dose=
Right dose - 500mg
Schedule: every 8hrs for 7 days DOSAGE FORMS OF DRUGS
after 8hrs pababa na give another 500 mg
until A. SOLID
Critical concentration - Only time to start a 1. Tablet
cure - Scored (has division)
4 half lives to start therapeutic effect easily divided
- Layered (2 or more
2 dose for every freq for 3 days- overdose chemicals in the
late 1hr or 30 mins is okay tablet, eg. Neozep,
2 antibiotics they have different targets one alaxan)
for protein synthesis other is cell wall, u can - Enteric coated
mix them it is warranted. (board e: tablets that
pag maintenance, maintain the drug then u are not dissolve in the
have therapeutic effect, when stop half life stomach but in an
is going down continues or plateau alkaline environment
vitamins 3x a day if water soluble no which locate at small
problem because it will just excrete intestines - lesser
if there is resistant the antibiotic will be gastric irritation) don't
change crush it will defeat its
own purpose
- Chewable (liquid
Loading dose forms are better
- usually higher that recommended dose absorbed eg,.
and use for emergency Antacids, potencee or
ascorbic acid).
-initial dose or the first dose = give - Sustained release
immediate effect (the liberation and
absorption are
eg., remdesivir RD 100mg OD x 5 days delayed and not at
1 vial = 100mg the same time
therefore the duration
How many vials do pt must have to is longer.)
complete the 5 days?
NURSING INTERVENTION
- Patient cannot swallow:
Scored tablet - can crushed
Layered - can crushed
Enteric coated - cannot crushed,
need to swallow whole
Chewable - can crushed
Sustained release - cannot release,
once u liberate the chemical then
absorption will follows
2. Capsule
A, Hard gel (powdered)
B. Soft gel (fluid like
vitamins)
3. Lozenges
Two important properties are
antiseptic action (destroy
the
bacteria) and anesthetic
action (relieve pain)
B. LIQUID
1. SYRUP
- Sugar based and
clear and have flavors
- For kids
2. SUSPENSION
- Chemicals do not mix
with the water
- Shake before use
3. ELIXIR
- Contains ALCOHOL
- Cause drowsiness
- Avoid driving and
operating big
machineries
C. TOPICAL
1. Ointment
- Oil base
- Use for dry lesion
2. Cream
- Water based
- For wet lesion
3. Lotion
- medicated lotion
- Use if the lesion is
wide or extensive
4. Patch
- Apply over dry and
non hairy areas and
rotate the sites to
prevent irritation
- When have hairy
patient, trim only,
shave can cause
abration
PHARMACOLOGY TIPS
- Remembering medications and the
body system affected
- Review the sympathetic and
parasympathetic nervous system
since many medications have
actions that affect these systems
NERVOUS SYSTEM
➔ Neuron
Functional unit of your nervous
system
◆
➔ Dendrites - fingerlike projections
➔ Soma or cell body - where u have
nucleus
➔ Axon
➔ Myelin sheath - Cover the axon,
insulator of electricity, it will not allow
the passage of electricity
➔ Nodes of ranvier - areas of axon
without myelin sheath
 ➔ Impulse - runs along the nerve, - Nerve there will be transmission of
carries with a message or impulses
information
NEUROTRANSMITTERS
= message should reach the end of the - Chemicals in the body acting as
series (synapse) messengers
- Whenever there will be an impulse
the movement of impulse along the ACETYLCHOLINE (ACH)
neuron is one direction, from the - Muscle contraction
dendrites to the soma and to the - Memory
axon - Too much can cause bipolar
- Electrical impulse pass through the - Less cause alzheimer's disease
axon by Jumping (saltatory
conduction) along the nodes of NOREPINEPHRINE AND EPINEPHRINE
ranvier until it reach the axon (NE/E)
terminal. - Catecholamines (NE, E, D) released
by nerves in the SNS
Presynaptic nerve - before synapse - Affecting depression if deficient and
ADHD
Postsynaptic nerve - after synapse - Too much cause schizophrenia and
mania
= after series of nerves, the end point will be
the EFFECTOR CELL (can be a muscle, DOPAMINE (DOPA)
gland or another nerve) - Coordination of impulses and
responses
- When there is an impulse, only up to - Cognitive behavior (thinking,
the axon terminal will be releasing learning, reasoning)
neurotransmitters (chemicals) and - Too much cause schizophrenia and
this will carrying the message and mania
then cross the synapse binds on the - Less can cause depression,
receptor on the dendrites, once it hit parkinson’s and ADHD
the receptor on the dendrites will
again form another electrical impulse SEROTONIN (5HT)
so the message now transfer into - For arousal (being awake) and sleep
electrical impulse once again, jump - Preventing depression
again in nodes of ranvier up to along - Promotes motivation
axon terminal then release - Chocolates, banana will make u
neurotransmitters then finally the happy
axons terminal will bind to the - Too much cause schizophrenia
receptors - Lack cause depression
- The effect in muscle is contraction
- Gland,Secretions/ release of GAMMA-AMINOBUTYRIC ACID (GABA)
hormones - Inhibits nerve activity
- Inhibitory neurotransmitter
 - Use for depression
- Prevents overexcitability or
stimulation such as seizure activity
- Too much cause treats seizure
- Anticonvulsant drugs action is
affecting gaba = stimulate
- short
Parasympathetic - For cranial nerve
379,10 and lumbar
- Long
Postganglionic sympathetic is long
Postganglionic parasympathetic is short

CHOLINERGIC NERVES - If a nerve

produces stores and releases ACh

ADRENERGIC NERVES - Producing epi

and NE, produce in adrenal medulla

DOPAMINERGIC NERVE - producing

dopamine
SEROTONERGIC NERVES - produces
serotonin

Gabanergic - Producing GABA

ANS SYMPA PARASYMPA
AUTONOMIC NERVOUS SYSTEM
General response Fight or flight Rest and digest
- Includes two neurotransmitters
- NE and ACh Origin thoracolumbar craniosacral
- Two branches
Preganglion nerve short long
1. Sympathetic
- Adrenergic nervous neurotransmitter ACh ach
system
Postganglion long short
- Using NE, nerve
adrenalines
2. Parasympathetic neurotransmitter NE ach
MAOI’S -
- Cholinergic antidepressant
- Acetylcholine
Termination of MAO - Acetylcholineste
impulse breakdown rase - break
SNS NE, dopa, 5HT down
= in your spinal cord there will be spinal acetylcholine
COMT
nerves that will get out both sides
Ganglions - group of nerve bodies or soma
that is found outside the SNS
PREGANGLIONIC
- There are spinal nerve that will come out
from the spinal cord (cervical, thoracic, ANS SYMPA PARASYMPA
lumbar, sacral nerve) to the ganglion
HEART Inc. HR, HR,
Sympathetic come from thoracic and CONTRACTILITY CONTRACTILITY

lumbar
LUNGS Inc. RR BRONCHOCONST Basta sympathetic lahat ng secretion mag
- bronchus BRONCHODILATO RICTION
R (allows more air)
dedecrease.

PUPILS DILATE: CONSTRICT:

MYDRIASIS MEIOSIS Kidney blood flow- decrease, kunti lang
(accomodate more
light)
nafoform na urine ,

GIT CONSTIPATION DIARRHEA

(blood flow, motility, Urinary bladder- retention of urine
secretions)

KIDNEY Dec. - URINE Inc. MORE URINE Blood vessel - vasoconstriction

- Blood flow FORMED FORMED

URINARY BLADDER Sphincter contract Sphincter contract Pag sympathetic- u dont poo and u dont
- Sphincter Detrusor muscle Detrusor relax
- Detrusor relax pee
muscle EMPTYING OF
RETENTION OF BLADDER
URINE

BLOOD VESSELS VASOCONSTRICTI VASODILATION Autonomic SYMPATHETIC PARASYMPATH

(smooth muscle) ON
Nervous System ETIC

Response to HR HR Contractility
HEART Contractility(Incr (decrease)
PHARMA DAY 2 ease)

LUNGS RR Bronchoconstricti
Neurotransmitter For sympathetic- BRONCHUS Bronchodilation on

Norepinephrine PUPILS Dilate Midriasis Constrict Meiosis

GIT(blood flow, Constipation Diarrhea

Neurotransmitter For parasympathetic- motility,
acetylcholine secretions) Decrease
secretion

Termination of impulse for sympathetic - Kidney Decrease-> increase-> more

-Blood flow urine formed urine formed
catechol-O-methyltransferase (COMT) or
monoamine oxidase (MAO), Urine Bladder Relax contract Contract
-sphincter Relax
-Detrusor muscle Retention of Emptying of
Termination of impulse for urine bladder

parasympathetic -acetylcholine BLOOD VASOCONSTRI VASODILATION

VESSELS CTION
(smooth muscle)
Response of sympathetic to the heart -
increase contractility

Response of sympathetic for the lungs- SYMPATHETIC (SNS) / ADRENERGIC

bronchodilation PARASYMPATHETIC(PSNS) /
CHOLINERGIC
For pupils- mydriasis
Agonist - Stimulate Antagonist - block
For GIT- decrease blood flow
Mimetic - copy, gaya2 Lytic-
block,destroy, dissolve
Anxiolytic- block the anxiety, pampakalma
Mucolytic- dissolve mucus
Thrombolytic- dissolve thrombus
Tocolytic- block the tone of the muscle
Sympathomimetic to the heart-
sympatho(sns) mimetic(copy) , increase the
heart rate
Sympathomimetic to the bronchus- increase
RR and bronchodilation
Sympathomimetic to the GIT- Constipation
Sympathomimetic to the Bladder- retention
Sympathomimetic to the blood vessel-
vasoconstriction
Sympathomimetic to the blood flow of the
kidney- decrease u dont pee
Parasympathomimetic to the GIT- Diarrhea
Parasympathomimetic to the blood vessel
Vasodilation
Parasympathomimetic to the pupils- meiosis
Parasympathomimetic to the bronchus-
bronchoconstriction
Sympatholytic to the pupils- meiosis
Sympatholytic to the blood vessel-
vasodilation
Sympatholytic to the bladder- emptying of
the urine
Sympatholytic to the Heart- decrease heart
rate
Sympatholytic to the
bronchus-bronchoconstriction
Parasympatholytic to the pupils- Midriasis
Parasympatholytic to the GIT- Constipation
Adrenergic Agonist to the heart- Increase
RR
Cholinergic Agonist to the blood vessels-
Vasodilation
Adrenergic Antagonist to the GIT- Diarrhea
According to our OR- when you put the
patient under the surgery aside from
anesthesia.
The Atropine sulfate -lessen the
secretion to decrease risk of aspiration.
Because atropine is anticholinergic drugs- it
block parasympathetic so it dominates SNS.
the secretion will be decrease
Diatabs- iniinom pag may diarrhea. (1 dose,
1 hrr LBM ay tapos) Anticholinergic action
for constipation
Schizophrenia - Antipsychotic,
Neuroleptics side effects: NMS- Neuroleptic
malignant syndrome, tardive dyskinesia,
pseudoparkinsonism, akathisia,
anticholinergic side effect - constipation
increase fluid intake, increase fiber,
Retention of urine- less sodium intake,
schedule bladder breaks or bladder training,
void before taking the drug,
decrease secretion or dryness of mouth
AUTONOMIC NERVOUS SYSTEM DRUGS
Adrenergic Agonist/ Receptors/
sympathetic receptors
 Sv(Amount of blood that is ejected per beat)
konti ang pumasok how much blood volume
comes out? Decrease. That is your sv. BP
will also decrease

Side effect
- Increase bp(hypertension) –
SINUPRET

- No resistant
- Take only for 5 days not more than
because it ma cause a rebound
decongestant effect
Alpha 1 is seen in tissues such as bladder
sphincter, blood vessel, iris
● Midodrine- Anti hypotensive drug/
ALPHA(SNS) 1 ADRENERGIC (SNS) Vasopressor , for orthostatic
AGONIST(STIMULATE) hypotension,
- Effect is in blood vessel that cause
● Phenylephrine- part ng neozep, vasoconstriction
decolgen, bioflu. - Increase TPR , Increase BP
A decongestant.
For allergic rhinitis inflammation in ALPHA 2(stimulate opposite)
the nose, med will act on the blood ADRENERGIC AGONIST
vessel effect and will cause - Found in CNS membrane
vasoconstriction. Blood flow to that - Pancreas produce insulin → less
area is decrease, reduce oxygen insulin release→ hyperglycemia
and nutrients to the cell that will (sympathetic need lot of energy)
result to the cell shrinking
For eye exam to cause dilation ● Clonidine
Effect on the heart- none kasi - brand name (Catapress)
walang alpha 1 receptor sa heart. - Sublingual/oral
Bladder -retention - Decrease bp
Blood vessel - vasoconstriction - Hypotensive drug
Iris- Mydriasis - Have SNS effect – Norepinephrine
(sns) Release. Weaken sympathetic
BP=HR X SV X TOTAL PERIPHERAL parasympathetic dominate
RESISTANCE/PRESSURE IN BLOOD → decrease HR → decrease BP →
VESSEL- Directly proportional ex. When vasodilation → decrease TPR –? Decrease
there is tachy bp increase, if patient having BP
diarrhea blood volume will decrease
because of decrease water, hemorrhage BV
will decrease preload decrease (amount of
blood that goes back to the heart .
 ● Methyldopa

- Increase HR , increase Contractility ● Terbutaline

- Potassium enters the cell- - FOR Asthma & COPD
antiarrhythmic drugs - Premature labor- TOCOLYTIC Block
- Also found in kidneys - increase tone of muscle of uterus that cause
renin release. If you have increase relaxation. If the contraction persist it
renin. If you have renin you will have may cause abortion
angiotensin 1, aldosterone all of
these cause increase in bp Blood vessels of lungs, heart, and skeletal
muscle – Vasodilation
● Dobutamine
- Synthetic dopamine Liver- glycogenolysis (breakdown of
- CHF - pagod na puso glycogen) - hyperglycemia
- sympathomimetic
● ISOXSUPRINE
- TOCOLYTIC
Side effects
- palpitation/increase HR
- hypertension ALPHA ADRENERGIC ANTAGONIST
SNS SNS BLOCK- block sns
psns dominate

BETA 2 ADRENERGIC RECEPTOR (lungs, ● Phentolamine

Uterus, blood vessels of lungs heart and - Used for hypertensive crisis due to
skeletal muscle, liver) (sns) PHEOCHROMOCYTOMA(tumor in
the adrenal medulla(Catecholamine ,
Lungs epinephrine is produced here) and
- Bronchodilation MAOI’s
- PHEOCHROMOCYTOMA - Have a
● Albuterol /Salbutamol hypersecreting hormone→ increase
- Bronchodilator norepinephrine(Sns) → hypertension
- for ASTHMA / COPD - MAOI’s - Monoamine oxidase
- oral inhibitors (blocking mao). No Break
Down norepinephrine→ increase
Side effect NE→ Excess of norepinephrine →
- Palpitations hypertension
- Tremors

Beta 2 > beta 1 that is why it activate the ALPHA 1 ADRENERGIC ANTAGONIST
fight or flight response SNS SNS BLOCK- block
sns psns dominate
Uterus
- Relaxation of uterus
● Prazosin → bind to blood vessels →
vasodilation → decrease TPR →
Hypertension
● Doxazosin- 2 timer, loves blood
vessel and urinary bladder To
prevent calculi, UTI
- Blood vessel – Vasodilation
→ decrease TPR → for
hypertension
- Urinary bladder → emptying
bladder → benign prostatic
hypertrophy.. Nacocompress
urine may pressure,
dribbling, after coitus there is
a blood streaks because of
the compression. Empty the
bladder only but not reduce
the size. can cause UTI can
ascend to kidney and can
damage it.
● Terazosin- 2 timer, loves blood
vessel and urinary bladder, To
prevent calculi, UTI
- Blood vessel – Vasodilation
→ decrease TPR → for
hypertension
- Urinary bladder → emptying
bladder → benign prostatic
hypertrophy.. Nacocompress
urine may pressure,
dribbling, after coitus there is
a blood streaks because of
the compression. Empty the
bladder only but not reduce
the size. can cause UTI can
ascend to kidney and can
damage it.
● Alfuzosin → urinary bladder →
emptying of urinary bladder → BPH
● Tamsulosin
- Commonly use also used for
BPH
BETA ADRENERGIC BLOCKERS
“OLOL”
Indication:
1. For Hypertension → slow down HR
→ decrease BP
2. Negative inotropic effect
3. Angina, antianginal drug -
decrease oxygen supply , increase
oxygen demand, goal : increase O2
supply decrease O2 demand,, dec
HR → workload of the heart will also
decrease →oxygen demand will
decrease →O2 supply increase
4. Myocardial infarction
5. Supraventricular arrhythmia-
regulate and control contraction of
heart
6. CHF ( cautious) - dec HR → Dec
workload of heart → energy diverted
for contraction of heart → increase
force of contraction (inotropic)
7. Anxiety-( propranolol) tachycardia,
tremors, palpitation —> decrease
heart rate
8. Migraine - vasoconstriction
9. Open angle glaucoma - (betaxolol,
timolol)
10. Arrhythmia , atrial fibrillation
Side effect
● Bradycardia - monitor HR , hold if
heart rate is <60 bpm
● Hypotension - monitor bp , hold if bp
is < 90/60 mmhg, avoid getting up
from supine
● Bronchoconstriction - monitor breath
sound baka may wheezing, avoid in
asthma , COPD
 ● Hypoglycemia (mask) - monitor
serum glucose every now and then.
Caution because the ycan mas
hypoglycemia
● Impotence
Do not take beta blockers for hypertension
kasi maoolol talaga kayo
EXAMPLE
PATIENT
60 yr old male smoker, non alcoholic drinker
Health status: Asthma
Diag: Hypertension→ beta blocker though
may asthma beta 1 specific adrenergic
blocker because the action is specific to
beta 1 doesn’t have effect in beta 2 so it
cannot cause bronchoconstriction
BETA 1 -SELECTIVE ADRENERGIC
BLOCKERS
- For patients with Asthma and COPD
B- ISOPROLOL, BETAXOLOL
E- SMOLOL
A- CEBUTOLOL,ATENOLOL
M - ETOPROLOL
Propranolol - non specific (drug of choice
for tachycardia and tremors of
hyperthyroidism
Atenolol- specific
Metoprolol- specific
Parasympathetic or Cholinergic
Receptors
Muscarinic agonist to the pupil- Meiosis
PSNS stimulate
Antinicotinic to the bladder - retention
CENTRAL NERVOUS SYSTEM
There will be an impulse (normal) since this
is a muscle, acetylcholine will bind to the
receptor, so there will be contraction of the
muscle. Cholinesterase will come in and it
will breakdown acetylcholine. Muscle now
will relax that is normal.
IN Myasthenia Gravis- an autoimmune
problem. The antibody is not attacking the
antigen but attacking the receptor. There will
be no receptor. There are a lot of
acetylcholine but no receptor so there will
be no contraction. There will be relaxation.
This will manifest paralysis. However if
there are still receptor it can just manifest
weakness only
Initial sign - ptosis
From eyes to down - descending paralysis
● PTOSIS
CHECK PALPEBRAL FISSURE ?
● DIPLOPIA-DOUBLE VISION
● MASK LIKE FACIAL EXPRESSION
● DYSPHAGIA - RISK? WEAKENING
OF LARYNGEAL MUSCLES
 ● RESPIRATORY MUSCLE Diagnostic test: Tensilon test- give
WEAKNESS edrophonium Chloride(cholinergic drug)
● LEAD RESPIRATORY ARREST
● Risk of aspiration Route : IV
● PREPARE AT BEDSIDE
TRACHEOSTOMY SET Expected outcome of test: increase
muscle strength. Improve paralysis
Nursing priority: Airway
Dysphagia CHOLINERGIC CRISIS
Immobility - Weakness
- Paralysis
There is no cure for MG
cause :Overdose of cholinergic drug-
Give anticholinesterase- It will block toxicity
cholinesterase there will no breakdown of
acetylcholine. It will stay there and there will Treatment:
be a contraction Anticholinergic drugs

Cholinergic- acetylcholine Diagnostic test: Tensilon test- give

Anticholinesterase- protect acetylcholine so edrophonium Chloride(cholinergic drug)
it is cholinergic
Route : IV
Treatment:
cholinergic drug Expected outcome of test : worsen
● Neostigmine condition because the prob is an overdose
● Pyridostigmine of cholinergic drug and you use a
● Physostigmine cholinergic drug in testing.

Diagnostic
● Edrophonium Chloride (transition) WHAT SHOULD PREPARE DURING
TEST:
MYASTHENIC CRISIS VS. CHOLINERGIC ATROPINE- ANTIDOTE for cholinergic
CRISIS crisis. It should be at bedside.

MYASTHENIC CRISIS IN GBS, ascending paralysis galing baba.

- Weakness
- Paralysis Immune - there is antibodies → supposed to
attack or foreign bodies
cause : underdose of cholinergic drug -
weakness and paralysis

Treatment: cholinergic drugs

FUNDAMENTALS OF NURSING c. Before
DAY 1 administering
to the patient
3. Right Dose
Module 1: Administration of Medication - Double check
- Pts taking multiple
Fundamental rule: Never administer an drugs
unfamiliar medication. Always double check - Abrupt change of
order
Rationale: to prevent errors for
- Available meds is not
protecting the patient and the license pag
equal to the ordered
napahamak patient mawawala license mo
dose
6 Basic Rights Administration rules
Child’s dose
1. Right Patient
A 3 yrs old child, weighing 30 lbs. Is to
- Conscious
receive a therapeutic dose of aspirin the
- Directly ask the client
average adult dose is 5 grams and the
to state the name
child’s dose is unknown. How many grams
- Unconscious
will the nurse administer?
- CHECK ID
BRACELET/band/tag/ - Clark’s rule
label - Wt in(lbs)/150 x Adult dose
- MAR (Medication
Administration Ex. 30/ 150 x 5= 150/150 =1 gram
Record) paperless na
- Label in headboard or - Friel’s rule
footboard of bed, wall - Age in (months)/150 x Adult
of headboard, door dose
2. Right Drug
- Expiration date (decrease Ex. 36/150 x 5 = 180/150 =1.2 grams
effect)
- Color - Young’s rule
- Spelling - Age (yrs)/ age (yrs) +12 x
- Label 3x Adult dose
a. Before going
Ex. 3/3+12 x 5= 15/ 15= 1 gram
to the
dispensing
unit
b. Before Adult dose:
opening or
pouring the D/S X Q = desired / stock x quantity
medication’
Doctor’s order
 - 700 mg of drug x per orem 3 times
a day. Available stock is 500 mg pe
tab
1. How many tab will be given
for 7 days?
- 750 mg / 500 mg = 1.5 x 3 = 4.5 x 7
days = 31.5 tabs
1L of PNSS is charted for 12 hrs. The Drop
factor is 10. The solution has been running
for 9 and a half hrs with 400 cc remaining.
How many gtts/min is needed to complete
the entire solution.
= 400 X 10

150 mins.

2. How many tab will be given = 4000/150 = 26 or 27 gtts/min

within a day?
- 750 mg / 500 mg = 1.5 x 3 =4.5 Ex. 1 L of d5w is divided for 8 hrs. The drop
factor is 20, the solution has been running
tabs
for 5 and a half hrs with 400 cc remaining.
How many gtts/min. To finish the entire set.

= 400 X 20
3. If the stock is 250 mg per
tab, how many tab each 150 mins.
dose? = 53 gtss/min
- 750 mg / 500 mg = 3 tabs

4. Right frequency
- Intervals
IV calculation
OD- once a day
Micro- 60
BID- twice a day 8
Macro - 15
TID - three times a day 8 6
gtts/ min. = total volume (cc) x drop factor
QID- Four times a day 8 1 6
# of hrs. 60 mins.
HS - Hours of sleep/ after bedtime 8 12
Ex . 4 8

=1L of DSLR X infant q4 around the clock

8hrs 60 mins. Ac- before meals

= 1000 ml x 60 Pc- after meals

8 hrs 60 mins.
prn - as needed/ as necessary
= 60,000/480= 125 qgtts/ min. (microdrops)
Stat- now/immediately/at once

Ex. Post prardial- after meals

qod - every other day - Slowest in terms of absorption -kasi
mag papass sa liver dun siya
masysythesize at mamemetabolize
- Most comfortable - wala masyadong
5. Right route preparations or technical ways to
a. Per orem -mouth instruct open lang mouth, no
b. Otic- ears intricate, reposition
c. Optic -eyes
d. Parenteral - other than the GI tract Types::
(ID, SC, IM, IV, IO
intraosseous/bone, intrathecal/spinal Liquid type:
canal, arterial, intrasynovial/synovial
spaces/knee basta gumamit ng Syrup
karayom) Suspension(Powder gawin dilute)
Solution
Elixir

Nursing Consideration:
6. Right Documentation
1. Consider calibration
R: to get the exact amount of drug
1. After the procedure
2. No erasures - cross out and initial . pag 2. Consider the lower meniscus
buong chart namali icross yung buong chart -ilalim ng
and initial and proceed to the correct chart cup/dropper/syringe. Pag in
3. No superimpositions coma di oral risk for
4. No blank spaces aspiration
5. Universal Abbreviations
3. Label against the palm
magkakastain for protection it
can be imprinted in front of
Local Pinas lang oks lang kung ginagamit the bottle
ng buong org - TSIV( Through slow IV push)
4. Smudging:: return to
MGH- me go home pharmacy for replacement

PGH- please go home

Solid type

Tablet
Per orem Capsule
Lozenges
- Position: high back rest, head above Pills
the bed elevated, upright, fowlers to
Nursing Consideration:
prevent aspiration
- safest - no pain 1. Enteric Coated- don’t crush , don’t
- Most accessible - kita agad bibig ng chew to prevent GI upset or
patient abdominal pain
 2. Sublingual - under the tongue ● Mydriatics - dilation
lalagay kung saan maraming vessel ● Miotics- constriction
it takes place the fast absorption. If it ● Anti infective- anti bacterial/
is dry mabagal absorption kaya microbial infection, optic
provide sips of water 1 cc will do to drops or ointment, (thrombex
moisten the oral mucosa. Ex. , erythromycin, azithromycin,
nitroglycerin bacterial in nature
3. Otic/ Ears as topical ● Lubricant- to provide
moisture and prevent
P-osition (side lying position ) irritation , Bysin- lubricant
anti irritant.
A-ge of the patient (3 yrs. Old above
pull pinna up and back, below 3 yrs
old down and back to straighten the
ear canal. FUNDA DAY 2

S-olution (warm to prevent FORMS:

discomfort, imerse to warm water,
noon niroroll it in between palms A. Liquid type (drops)
gently pero ngayon warm na.) - Neck hyperextend, Pull
down the lower conjunctival
D-irection (side of the ear canal to sac and form a canal.
prevent temporary hearing loss, - Administer 2-3 drops on the
prevent damage to eardrum lower outer thirds of the
conjunctiva, Bawal sa inner
A-bsorption (press the tragus 3x third kasi andun yung naso
massage ) lacrimal duct wherein fast
absorption might take place.
T-imeline (before going to the next We can’t afford that kasi
ear 5 mins if both ears are ordered) baka magka systemic
- The tip of the canister will not
T-echnique (clean procedure)
touch the eye. To prevent
cross contamination.
- To prevent systemic
OPTIC: EYES progression press inner
canthus for 20-30 secs. Sa
Position: neck hyperextended or ibang ref 60 seconds
look into the ceiling, supine and B. Solid (ointment)
extend neck - Colors of ointment -
yellowish, whitish,
OD- occulodextride (right eye) translucent
- Pull down the lower
OS- occulosinister (left)
conjunctival sac,
OU- both eyes
 - Instill 1 cm of ointment kapag
23-24
mas maliit pa mata lesser pa
di absolute Angle 10 - 15 45 90
- From inner to outer canthus pero 10
degree
Parenteral s sa
exam -
- Most invasive, painful, dangerous, Principl
fastest in absorption. e: the
more
- Fastest - IV , Slowest - SC the
- Can cause Bleeding, blood borne parallel
diseases infection, HIV, HEPA B it is to
kaya minsan chinecheck first yung the
PTT partial thromboplastin, PT skin,
Prothrombin time, check ang liver. the
better
- Apple universal precaution
especially when handling seminal
fluid,blood, vaginal secretion
- Hand Wash before and after
- Used needles dispose to
sharp container
- Never Recap needle after
use kasi pag natusok ka
kailangan ka itest specially
pag hiv patient tinusukan.
Unang test 2 weeks , pag
negative another test 6
months. Sa hepa mas
matagal nasa 3 months SC ng obese - 90 degrees na kasi makapal
based in incubation period masyado taba

Principles

Needle and Gauges ID

- Bevel up
ID SC IM - No red ink
- No massaging
Length ⅜⅝ ⅝½ ½
1 and
1/2 Allergy test/ Skin test
2- obese
- Painful
Gauge 25-27 25-26 Child-
The higher 24-25 Purpose:
the number
the smallest adult -
 - To check SC
hypersensitivity we
want to prevent - Rotate Site of the injection to
anaphylaxis(a severe prevent
form of allergic lipodystrophy/Lipoatrophy/lipohypertr
reaction) ophy(breakdown of subcu fats)
- Nag order doc ng
antibiotic pero di nag IV
skin test. I skin test
- Consider regular insulin only insulin
pa din kahit walang
that can be given IV ex. Humulin r
order doctor
clear, short acting
- Position : palms up ,
inner surface of Cocktails - mix 2 types of insulin,
forearm the 1st and 2nd. 1st insulin is the regular
- Alcohol, idy kasi pag insulin & 2nd is NPH intermediate acting.
basa papasok alcohol Sino una mo iaaspirate? Regular o nph?
mas lalong painful Regular Because clear before cloudy to
- Composition - 0.9 cc prevent cross contamination
of sterile water or
PNSS. 0.1 cc of Rotation
drug . 0.9 + 0.1 = 1 cc
(tuberculin syringe) - Bawal sa 2 inch radius ng
- To form a wheal 0.1 navel turukan. Imaginary 1
cc is enough. Yung inch square tapos sa kada
natira na 0.9 square ka tutusok para
dispose/discard. madami magamit na
- Evaluation bumabalik tutusukan. 1 inch / 2.5 cm
after 30 mins. Kaya distance sa tinusukan . at
nilalagay yung time least 4 weeks pwede na
ng plus 30 mins. matusukan uli yung
Check kung nagreact ininjectionan. Pag ubos na sa
yung bleb/wheal stomach sa braso naman
tapos sa hita. Fastest
SC absorption sa abdomen

- Rotate Site of the injection to

prevent
lipodystrophy(breakdown of
subcu fats)
- Di inaaspirate especially
kung iinject heparin kasi lalo
magkaka bleeding

Insulin therapy sc/ IV

 Principle:
- Pull the skin laterally
- Retract the skin laterally/ Pinch and
twist
- Before itusok ang karayom idisplace
skin
- Aspirate then release
- 10 secs nakabaon ang karayom.
Allowable period for the meds to be
dispersed or to be distributed evenly.
- Airlock -type of z track tech
magdadagdag ng air sa loob ng
syringe additional technique. Pwede
s sa IM pero sa IV bawal may air

Vial and ampule

- For those who are diagnose with VIAL

type 1 diabetes mellitus
1. Injected air = amount of drug
withdrawn, 2 cc air = 2 cc
med aspirate

IM

- Aspirate before releasing the

medication kasi baka may
tinamaang ugat dahil
superficial ang vein. Pag 2. Release air on the air space
super bright high pressure wag papaabutin sa solution-
blood galing artery. Pag to prevent bubble formation
medyo dark walang oxygen 3. SOLID FORM NA VIAL
kaya galing vein powder kailangan idilute
according to the
Z track technique manufacturer’s order
4. Types
- purpose
a. Single dose vial
Discard pag may
- to deliver large volume of solution
- - if the drug is irritating natira
- if will cause permanent staining b. Multi dose vial
- will seal the medication to prevent Good for 24 hr only,
leakage discard natira
P
 5. Linisan bago tusukan nasal cannula pwede kumain, pag naka
partial rebreather npo muna to decrease
oxygen demand

AMPULE NO ALCOHOL AND OIL - volatile

substances, directly flammable,
- glass flask/ like
bowling pin NO BATTERY OPERATED TOYS-
1. Check the expiration date to prevent unexpected ignition that might
2. Tap the neck start fire.
3. File the neck
4. Brake with gauze pad , pag Clothing: cotton based
may bubog maglagay ng clothing to prevent static friction or electricity
filter
5. O2 precaution- no smoking place
near the bed, container or O2 tank bed,
Principle : Vial before ampule to door,
prevent contamination
Devices
Pag dalawang vial kailangan may
ibang hub na karayom sa isang vial di A. Pulse oximeter
pwede gamitin yung pinantusok sa isa sa - Measure O2 sat
isa pang vial tas sa pasyente kasi pupurol - O2 sat is the
yan percentage of the
oxygen carrying
MODULE NO. 2 : CONCEPT OF capacity of the RBC
OXYGENATION - 95-100% dapat , pag
below di ka pwede sa
1. O2 Therapy home treatment
- Primary purpose - - Don’t expose to direct
reverse hypoxia (low sunlight to have an
oxygen in cells or accurate result
tissue kaya kailangan takpan ng pillow o
ng supplemental linen
oxygen) - Pagchinecheck ang
- Difficulty of monitor at andun O2
breathing sat anong vital sign
- Shortness of ang katabi - pulse
breath rate/heart rate
- orthopnea
Hypoxemia- low oxygen in the blood
Position: High fowlers to
increase lung expansion Anoxia- absence of oxygen

Diet : place in small frequent B. Incentive spirometer

meals or in some case NPO. pag naka
 - To increase alveolar Which is better? Nasal or venturi?
expansion
- Included prevention - Venturi
plan of atelectasis
- Advantage of venturi
C. humidifier
- Precise oxygen delivery in the
- Provide moisture
absence of venturi pwede ipalit ang
Because oxygen is a
nasal cannula
dry gas
Pano pag ang O2 85%
Nasal cannula- Oxygen that doesn’t need a
humidifier, you can transfuse even without a - Non rebreather mask because it can
humidifier kasi madalas mababang liters per give 95-100 pure oxygen
meter lng ang trinatransfuse sa patient and
the rest may humidifier (venturi,simple face
mask, partial rebreather mask.,)
Wall outlet supplemental therapy
O2 delivery system
– color coded ( green- oxygen, blue- nitrous
- Low -nasal cannula(2-6 liters/min) oxide/laughing gas, white-suction , yellow-
- moderate, - venturi Medical kit/compressed kit)
- Severe - venturi, non rebreather
mask (95-100% pure O2 ) mahirap
pag binibigay sa bata or baby baka
magka toxicity pwedeng mabulag SUCTIONING
called (Retinopathy of prematurity
- Process of removing pulmonary
(ROP), also called retrolental
secretions Will be the one to cause
fibroplasia (RLF) and Terry
patient difficulty of breathing that can
syndrome,
lead to development of pneumonia

Priority:
Ex. question in board
- Prevent hypoxia pero pag sobra
Example of COPD
sobra na pagsasuction ang mga
- Emphysema manifestation ay (decrease heart
- Chronic bronchitis rate/bradycardia) stop suction and
provide supplemental oxygen in 2-3L
Is it low, moderate or high? - To prevent hypoxia hyperventilate
before and after
- Low flow - Position::
- conscious - semi fowlers
How many liter - Unconscious- side lying to
prevent aspiration
- 2-3 liters/min
- Technique - sterile
 - Dominant hand- absolutely
ANT water rile
sterile water
- Non dominant- clean
- Apply Suction upon
Kapag may lumabas sa exam kung 5, 20 ,
withdrawal To prevent trauma
15 secs.
Suction catheter sizes
- 5 answer because the shorter the
time of suction the better to prevent
- Adult- 12-18
hypoxia lalo na sa tracheal mas
- Child - 8-10
malakas mag hypoxic state pag di
- Infant -5-8
minanage.
Suction pressure (mmhg)
3. Chest-Physiotherapy
- part of the procedure of bronchial
hygiene
Primary purpose:

Portable Wall - Displace the phlegm.

- Prevent the recurrence of
Adult 10-15 110-120 pneumonia.
Child 5-10 95-110 1. Done: before meals
however pwedeng after
Infant 3-5 50-955
meals pero(2-3 hours)

120- thick and tenacious

Contraindications:
a. Causative Pulmonary
Tuberculosis lalong dudugo
Suction type
b . History of MI/ Angina
ORAL NASAL TRACH C. bony structures avoid
EAL scapula and vertebrae,

DURATI 10-15 10-15 5-10 D. breast of woman

ON secs. secs. secs. Components:

LENGT 3-5 3-5 2-3 a. Percussion- cuffing and tapping

H inches inches inches para may mabuong pressure at
tip of the tip of the matransmit sa thoracic cavity to
nose to nose to shaken and loosen the phlegm
earlobe earlobe
b. Vibration- fine and shaky motion
REST 20-30 20-30 2-3 upon exhalation instruct inhale
PERIOD secs. secs mins.
exhale
LUBRIC Clean KY jelly NSS/ste c. Postural drainage:
● Apex- upright leaning forward - Cross sectional (1 time only
● Base- trendelenburg position data collection )
● R Lung- left side lying - Ex. level of
● L Lung- right side lying competence ng 4th
yr student in
preparation of
student bedside goal
NURSING RESEARCH
in practice
RESEARCH - scientific process of inquiry - Longitudinal
- Multi time series
(question based)
Ex: competence of
- Empirical staff nurse of yr 1
- Evidenced based then chineck uli after
- Experience 3 yrs and 5 yrs
- Experimentation
- Prospective
(scientific based) - Forward

- methods/steps Ex: grades will

determine success in board exam,
The Research tree
- Retrospective
1. According to purpose of objective
- historical research
2 types

- Basic/Pure
4. According to Design
- surveys
- Quantitative
- Applied 1. Experimental
a. True
2. According to scope or coverage
- Action research Manipulation
- 1 problem only Randomization
Control
- Evidence based
b. Quasi

Lacking
3. According to time dimension
2. Non experimental pandemic
A. Comparative interviewing
kung para san
- compare
gamit
B. Correlational H. Narrative analysis
- Association - Integrative
- Not the cause interview
but might
affect
Variables: objecti if the study
C. Descriptive
Characteristics of variables
- number
- Observable
- Measurable

- Qualitative Types:
A. Grounded theory
- dependent variable
- Own theory
- effect
B. Phenomenology
- Independent variable
- Lived
- cause
experiences
C. Ethnography Ex. smoking causes cancer
- Health belief
and practices Independent- smoking
6 months at
least Dependent- cancer
D. Historical
E. Case study Ex. Elderly client care satisfaction and
F. Delfi study nurses competency
- Convene
Independent- nurses competency
experts para
magconceptu Dependent- elderly clients care satisfaction
alize ng book
G. Photovoice
- Experience
mo as a Variables according to kinds of data
student nurse
ng pandemic. Quantitative
Pic sa loob ng
kwarto yung - Quantitative data - measurement ex.
experience height ,weight, temperature
nung - Qualitative data - describing the data
ex. Color, taste, odor
 - Codel ex. Male 1 female 2 Ex: pearson R 97/100

Categorize data

Quantitative categorizing Non Parametric group

- Discrete data Nominal- describing, characteristics,

- Can count exact feature, attributes ex blue eyes,
- Continuous data straight hair, mababang uri ng data
- Approximation may
butal Ordinal- ranking ex. Top 1 23, 1st
2nd 3rd
Ex. no. of student inside this virtual meeting
-discrete Ex. likert 12345

No. of letters on the first page of the book- Spearman rho

discrete

No. of passengers inside the bus- discrete

Procedures about data
No. of fallen dry leaves on the ground-
discrete 1. Collection- gather data
2. Presentation - organize data
` 3. Analysis – manipulate, mathematical
formula
Height and weight of patient - continuous 4. Interpretation - drawn out conclusion

Age of patient - continuous

Temp - continuous How to collect data

Mean =2.75: continuous 1. Establish appropriate number of

samples (representation)

Population (N) - parameters

Scale of measurement dito malalaman kung
anong statistics lang ang pwedeng gamitin Ex. nursing student ng fatima

Parametric group All client in this hospital

Interval - 0 has a value ex. Temp 0 Sample (n) respondents - stats,

degrees means freezing there is a sample represents the
value characteristics the population has,
percentage type
Ratio - fix zero point. Zero means
zero. Ex. nursing student na pretty
 Elderly with fracture a. Probability sampling technique
(randomization) . by means of luck
a. Percentage type- 10% ok, and chance
20% better
Ex. 5000/370 pang 13th na name
Ex. chief nurses in
metro manila. May 15 - simple random sampling
at napasali mo 11. - Lalagay sa fish bowl
Good sample kahit - Systematic random sampling
kalahari good pa din - Nth term
pasok pa din. - Cluster random sampling
- Ex. dept ukuha
b. Margin of error (e)- minimal representative kada
percentage that allows the cluster
study to get error. - Stratified random sampling
- 1st yr, 2nd yr, 4th yr
e- 5% - 0.05 hanapin total number
kunin percentage
e-1% -0.01
kunin di ko nagets
Sloving formula: potek
- Multi stage random sampling
M= N - Population estimate
- Ex. pinas start sa
brgy. Hanggang
maging provincial,
1 + N (e)^2
regional
Pharmaceutical nag 1% para sure na ang
Non probability Sampling
gamot talagang effective
- Prejudice
Pero pag mga responses ok na yung 5%
- Selective
= 5000/1+5000(0.01)^2 - Subjective
- judgment
= 3.333

5000/1+5000(0.05)^2 =370
a. Purposive- at least 3
ang kailangan interview out of 5000 para b. Quota
masabing representative c. Convenience//accidental -depende
sa lugar asan respondent
Rule: the larger number of sample the better d. Snowball - networking, hidden
population high risk for
descrimination, ex prostitute, drug
dependent
2. Sampling technique
DATA in research b. Construct validity-
norm,standard
1. Collection of data c. Content validity- highly
relevant ex. Does this
10 , 20 interview/questionnaire question need to be included
a. Direct method/ indirect -research experts mag check
nitong tatlo mga PHD
Advantage: increase probability of valid
response 5. Test of reliability
- Cronback alpha -probability
disadvantage : costly
dapat 0.85 above
b. Indirect method - Opinion - agree,
disagree, strongly
-ex. Paper and pencil - - Perception - 1234
quistionality 6. Presentation data
- Methods of data presentation
Features: a. Textual- paragraph form
b. Graphical- visual form
a. Brief i. Line graph- 2 point
b. Clear are connected
c. Concise (straight, broken,
1. Source dotted
- Original- researcher mode ii. Picture
- Pilot testing/experts iii. Bar graph
- Adapted- modified c. Tabular- rows & columns
- Adapted- whole i. Frequency
distribution table
Adv: not expensive, not time
consuming C. observation method:

Dis: increase probability of invallid Can’t talk - plants

respondent
Can’t write- animals
2. Parts - depends on statement of the
problem
- 1: Demographic profile
- 2: level care client 3. Research data analysis and interpretation
satisfaction
- 3:: tenureship/ length of stay a. quantitative analysis- descriptive
3. Sets - depend on no. of respondent analysis (statistics)
4. Validation of questionnaires- validity i. Simple measures
a. Face validity- itsura ng 1. frequency count (f)
questionnaire ex indention, 2. Percentage (%)
grammar 3. rank
 B. Compare 2 sample means

- dependent t-test- 2 data from

same person ex. Length of
experience, job satisfaction

C. compare more than 2 groups

- ANNOVA (analysis of
variance)(AKA F-test,
Fischer’s test

NON- PARAMETRIC- nominal & ordinal

b. Measures of central tendency/ - Mann whitney test (u-test)

location - Kruskal wallis (h-test) 2 or mores
i. mean/average
ii. Median Measures of association
iii. Mode (relationship) correlation -
c. Measures of
variability/dispersion/spread r- value
i. Range (r)
ii. standard deviation (s) the - 0.01-0.09 negligible
bigger the wider spread - 0.10-0.20 v. low, v.
iii. Variance (s)^2 weak
- 0.21-040 low, weak
Inferential statistics = hypothesis answer - 0.41-0.60 marked,
ave, moderate
1. Measures of comparisons - 0.61-0.80 strong, high
- Parametric (interval ,ratio) - 0.81- 0.99 v. strong, v.
a. Compare 2 groups high
i. Z-test
-population 1.00 perfect
and sample
mean, sd is r- 0.86 very strong
from direct relationship
population
r.0.58 marked direct
mean
relationship
ii. T-test
- The sd 1- perfect direct
is from relationship
sample
mean
 r.-0.87 -v strong
indirect relationship

PARAMETRIC (interval data)

- Product nominal coefficient of

correlation - (pearson r)

NON PARAMETRIC (Ordinal)

- Rank order coefficient of correlation

( spearman rule)

B. Qualitative analysis - interpretation of

responses (thematic)

REVIEW OF RELATED

- To gather data what is already

known or unknown in the topic
- To determine what gaps
- To fill in gaps
- To know the case

OPERATIONAL DEFINITION OF TERMS

- Own terms
- What do you mean icu nurses in ur
res.

SCOPE AND LIMITATION

- saklaw