TFN – Theoretical Foundation In Nursing

Worksheet
Name: Kristine Mae M. Merhan Score: _________
Course/section: BSN-1B Date: September 24, 2021
__________________________________________________________________________________________

APPLICATION OF FLORENCE NIGHTINGALE’S ENVIRONMENTAL PHILOSOPHY

Critical Thinking Exercises on Nightingale’s Environmental Philosophy

Case History of Bianca Dista

Miss Bianca Dista, a 22 years old female had consulted the health center because of fever since three days ago.
This is accompanied by loss of appetite to eat, body malaise, headache, abdominal pains, dizziness. Her vital signs are as
follows: T = 38.7C, PR = 86 bpm, RR = 21 bpm, BP = 90/60 mmHg.

Miss Dista claims that she had lost weight because of her fever and loss of appetite to eat. She lives in a crowded
community which is constantly submerged in water due to floods. This causes severe problems in sanitation and source
of water supply. Laboratory test and physical examination revealed dengue hemorrhagic fever (DHF). Miss Dista is
extremely worried because she had a neighbor who died because of DHF few months ago. In addition, she is concerned
over financial expenses for her illness and her absence from her job as a crew in fast-food center.

Nursing Care of Miss Dista with Nightingale’s Theory

 In Nightingale’s environmental theory, Miss Dista is the person seeking care. She needs nature’s reparative
process.
 The nursing process and Nightingale’s theory can be used together to provide care for Miss Dista.
 This care involves “nursing the sick”, review of the environment and the client’s lifestyle.

A. Nursing the Sick

Assessment:
Assess the client for the following problems:
 Fever (T= 38.7°C) related to body malaise, headache, dizziness as manifested by changes in the vital
signs.
 Pain related to abdominal pains
 Imbalance Nutrition related to fever and loss of appetite to eat
 Dengue Hemorrhagic Fever (DHF) related to dengue virus/infection
Plan:
1. Fever Related to Body Malaise, Headache, Dizziness
 Observation of the sick. Observe everything about the client. Record all observations which are
factual and not merely opinions.
 Assess underlying condition and body temperature. To obtain comparative baseline data and to
assess contributing factors.
 Monitor vital signs. To assist with measures to reduce body temperature
 Promote a well-ventilated area to the patient. To promote clear flow of air in the patient’s area. One
way of promoting heat loss.
 Promote adequate rest periods. To regain energy.
2. Pain Related to Abdominal Pains
 Assess pain. To have a detailed baseline to treat appropriately and know if it has changed
 Ensure adequate hydration. To promote fluid balance.
 Assess for probable cause of pain. To detect and describe pain.
3. Imbalance Nutrition Related to Fever and Loss of Appetite to Eat
 Ascertain understanding of individual nutritional needs. To determine informational need of the
patient.
 Prevent/Minimize unpleasant odors. May have a negative impact in the appetite.
 Create a meal plan with the patient, to put in a feeding schedule. To keep the diet of the patient so
that she can eat regularly.
 Monitor input and expenditure and body weight periodically. To know the balance of intake and
expenditure food intake of the patient
4. Dengue Hemorrhagic Fever (DHF) Related to Dengue Virus/Infection
 Monitor condition. To determine the need for the intervention.
 Administer antibiotic and antipyretic as prescribed by the physician. Aids in lowering down
temperature
 Render tepid sponge bath. To promote surface cooling
 Encourage increase fluid intake. To promote hydration.
 Instruct the patient to wear clothing that is thin and easy to absorb sweat. To provide sense of
comfort and to decrease body temperature.
 Collaboration: intravenous fluids and appropriate drug delivery program. To provide fluid
replacement and for the particular drug to lower the patient’s body temperature.

B. Physical Environment
Home, Community/Neighborhood and Workplace Assessment:
1. Water. Assess for a contaminant-free functional water system and storage.
2. Cleanliness. Assess for sanitation conditions of community to control and avoid dengue virus/infection.
Assess for the means to maintain sanitation conditions of community.
To keep water supply free from contamination and avoid dengue.

Home, Community/ neighborhood and workplace plan

1. Water
 Have water checked for contamination in coordination with local department of health personnel.
 Inform the client about water purification and storage techniques.
2. Cleanliness
 Dispose of waste properly. Segregate trash to help prevent and reduce transmission of dengue virus.
 Use insecticides that are effective against mosquitoes.
 Maintain sanitation in the community. Always clean mosquito and flood prone areas.
3. Home and Workplace Assessment
 Light. Assess for adequate windows and working light sources. Sunlight works best.
 Health of Houses. Assess the surrounding environment for pure air, pure water, drainage,
cleanliness, and light.
 Water. Assess for working system that is free from contamination and avoid mosquito and flood
prone areas.
 Drainage. Assess the area for drainage of water; drainage of rain water away from the home.
 Cleanliness. Assess the home and workplace for means to keep the areas clean to reduce
transmission of dengue.
 Bed and Bedding. Assess the bed for space, comfort and cleanliness.
 Noise. Assess the area for loud, offensive and unnecessary noise.
 Personal Cleanliness. Observe proper hygiene practices.

C. Psychological Environment
Assessment Plan:
Miss Bianca Dista has several psychological concerns. She is extremely worried because she had a
neighbor who died because of DHF few months ago. In addition, she is concerned over financial expenses for her
illness and her absence from her job as a crew in fast-food center.

1. Variety.
 Assess the client’s activities before illness.
 Attempt to stimulate variety in the room and with the client during her hospital.
 Encourage visits of relatives and friends.
2. Chattering hopes and advices.
 Avoid personal talk
 Allow her to verbalize her fears and concerns.
 Stimulate the client’s mind
 Theoretical Foundation in Nursing
Rubrics for Worksheet
Name: Kristine Mae M. Merhan
Course/Section : BSN-1B
Criteria 4 3
Content The worksheet is complete
and contains the necessary
elements and information.
Neatness The work is neat throughout
the entire worksheet.
The worksheet is very well
Organization
organized and easy to read.
Gathering of Extracted relevant, accurate,
and factual information.
Information/
Support
Statements
Attractiveness The worksheet is
exceptionally attractive and
visually appealing to the
reader.
Presentation The worksheet presented
clearly, concisely with a
logical progression of ideas.
Language The worksheet contains no
errors in language or
mechanics.
Promptness/ The worksheet is complete
On Time and submitted at due date.
Total Score
Comments:
The worksheet contains
most of the
required elements
and information.
The work is neat throughout
most of the worksheet.
.
The worksheet is mostly
well organized and easy to
read.
Extracted mostly relevant,
accurate, and factual
information.
The worksheet is mostly
attractive and visually
appealing to the reader.
The worksheet presented the
most content with a logical
progression of ideas
The worksheet contains few
errors in language or
mechanics.
The worksheet is complete
and submitted one day late.
Score
Date: September 24, 2021
2 1
The worksheet contains The worksheet does not
only a few of the required contain any of the
elements and required elements and
information. information.
The work is somewhat The work is very sloppy
sloppy and difficult to and difficult to read.
read.
The worksheet is The worksheet is very
somewhat unorganized unorganized and difficult
and difficult to read. to read
Extracted a lot of Extracted irrelevant and
information which wasn’t inaccurate information.
relevant.
The worksheet is The worksheet is
somewhat attractive but formatted in a way that
can be visually is confusing to the
distracting to the reader. reader.
The worksheet is The worksheet is very
somewhat difficult to difficult to read and
read and adequate in showed little thoughts
supporting ideas. and effort.
The worksheet contains The worksheet contains
several errors in language many errors in language
and mechanics. and mechanics.
The worksheet is The worksheet is
complete and submitted incomplete and
two days late. submitted later than two
days.
Prepared by:
MELVIN D CADAO, MAN