Thomas Gordon's Functional Health: A Case Study
From Thomas Gordon’s Functional Health Pattern (Carpenito-Moyet, 2004), three areas of nursing interventions were implemented by registered nurses to promote safe mobility. These interventions aimed to reduce Thomas from falling as well as having skin damages cause by his incontinence and in addition, to support his lower extremities pain.
According to Kneafsey et al. (2013), extended periods of bedridden and inactivities due to low mobility will cause loss of muscle mass, loss in motivation to mobilize and having a fear of falling. Based on his Gordon Functional Health Pattern (Carpenito-Moyet, 2004), Thomas’s goal was to mobilize independently with the help of a walking frame. The first nursing intervention implemented by the registered nurses was to promote Thomas to mobilize safely with a one-person …show more content…
assistance. Linking to Domain 2.2 of Nursing Competency and the use of Hendrick II Fall Risk Model assessment, Thomas scored six - this indicates to the registered nurses that Thomas has a high fall risk (Swartzell et al., 2013). Therefore, nurses should improve their abilities to assess fall risks and implement interventions that modified or eliminated risk when it was possible. For futere references, before Thomas starts mobilizing, registered nurses should educate Thomas to always wear his grip socks in order to prevent him from falling accidentally due to the floor being slippery. Chari et al. (2009) explained that using the socks are effective because it improved traction and it has an impact on the patient’s safety. Furthermore, ensuring that non-slip socks are worn appropriately is essential because if the socks are poorly fitted, it could cause the patient to fall on hazardous objects.
Another nursing intervention applied by the registered nurses is for Thomas to wear his glasses when he is mobilizing. Swenor et al. (2014) suggests that due to Thomas having visual impairment, this could affect his walking pace. Thomas would walk slowly as a way to maintain or improve his perception in mobility safety. Correlating to Domain 2.1 of Nursing Competency, Thomas nursing care should aim in improving both mobility safety by reducing fall risk and to mobilize proper gait by using appropriate mobility aids when Thomas is ambulating (NCNZ,2012). Therefore, fall assessment should aim in raising awareness in Thomas current abilities and for registered nurses to identify strategies to maintain and develop management plan to reduce risk for Thomas while mobilizing.
Second intervention of nursing care is it to prevent Thomas from having integumentary problems - especially around his buttocks areas which was caused by incontinence.
According to Benbow (2012), Thomas could develop localized redness, irritation, skin peeling and fungal infections around the perineum, sacrum, groin, ischia tuberosity and hip (p31). Even though his skin appear to be normal but by being incontinence, it had detrimental effects on Thomas skin integrity. This could be linked to an increase in ulcer development around the following areas. Correlating this to Domain 2.2 of Nursing Competency, Braden Pressure Ulcer Risk Assessment for Thomas total score is 18-which is mild risk developing lesion (NCNZ, 2012 & XDHB, n.d.). This increases the nurse’s awareness of Thomas pressure ulcer risk and choosing the most effective prevention strategies. From Gordon’s Functional Health Pattern (Carpenito-Moyet, 2014) , he would wear sanitary pad during the day and night because he is incontinent majority of the time. Hence, nursing interventions implemented by his registered nurse should include making alterations to new sanitary pad in the morning and
night.
According to Omli et al. (2010), neglecting to change sanitary pad will cause temperature and humidity to rise up causing irritation to the skin, therefore there is a development of ulcers infection. Hence, interventions which involves changning sanitary pad is appropriate in order to reduce irritating skin. Hence, the registered nurse need to have proper interventions to reduce irritating skin. Another nursing intervention include Thomas to wash regularly and remove oil and excretions to prevent odor by using neutral soaps (Sinni=McKeehen & Hazzard, 2010). Kottner et al. (20130 explains that using cleaners and washcloths that contain low-irritating surfactants and moiturizers around the derriere areas prevent skin damages and dryness. Linking to Domain 2.1 of Nursing Competency, preventing skin damage around Thomas lower extremities , nursing care plan must help maintain Thomas personal hygiene and maximize his care plan (NCNZ, 2012)/ Although preserving good skin care is challenge because the patient has to be incontinence and use appropriate assessments and follow up, registered nurses can implement care plan to keep a healthy skin condition by preventing skin barrier damage.
The last form of nursing care for Thomas is to support his lower extremities pain. Due to being diagnose with vertebral insufficiency fracture lumbar four-post kyphoplasty, he has experienced a lot of pain - however he does not voice is complains (Carpenito-Moyet, 2004). Registered nurses should administer Thomas with Ibuprofen and Paracetemal prescribed by his doctors when he suffers back pain from sitting for long periods. According to Domain 2.2 of nursing competency and from the Standard Observation Chart (ADDs score) when asked about is pain score at rest and on movement, he scored zero out of ten (NCNZ,2012). Even though he do not complain about his pain, one of Thomas nursing intervention include supporting his pain by encouraging him to re-position carefully with pillows when he is lying on the bed. Peterson et al. (2013) emphasized that this will lower risks of ulcers formations and reduce interface pressures. Another nursing intervention include registered nurses to create a quiet and non-disruptive environment with dim lights to promote a relaxed feeling. Long (2014) mentioned that nurses noise surrounding has been recognized as a factor that contributes to sleep loss, confusion, restlessness and increase annoyance levels with administers. Thus, a comfortable environment will help reduce pain and give a sense of comfort to Thomas. In conclusion, linking Thomas’s need to Domain 2.1 of Nursing Competency, Thomas’s pain can be reduced by re-positioning him regularly and ensuring he is comfortable. By allowing him to feel respectable and to feel supported, this will improve his well-being (NCNZ,2012) because although pain is a common experience by the patient, registered nurses should implement appropriate interventions such as support, reassurance and educating patients on self-management of pain.
Overall all nursing plans must be based on evidences gathered from the patient and their assessments. Throughout the implemenation phase, the nurse evaluates the best effectiveness of the nurse intervention by choosing the best care plan which suits the patient’s needs. Through Gordon’s Functional Health Pattern (Carpenito-Moyet, 2004), registered nurse must implement nursing intervention for Thomas which allow him to mobilize safely, prevent Thomas from having skin damage and being able to minimize Thomas from experience pain. It is essential to have a long-term follow-up for Thomas well-being by using appropriate assessment because this will help improve his life expectancy and his care plan interventions. Therefore, by meeting the needs of Domain 2; Management of Nursing Care as a guideline provided by Nursing Council of New Zealand, it demonstrates the importance of respecting and acknowledging the importance of nursing intervention for Thomas well-being (NCNZ, 2012). In conclusion, finding appropriate care plan serve as a guide for appropriate asssessment so that the patient can experience maximal intervention to support their long-term well-being.
According to Kneafsey et al. (2013), extended periods of bedridden and inactivities due to low mobility will cause loss of muscle mass, loss in motivation to mobilize and having a fear of falling. Based on his Gordon Functional Health Pattern (Carpenito-Moyet, 2004), Thomas’s goal was to mobilize independently with the help of a walking frame. The first nursing intervention implemented by the registered nurses was to promote Thomas to mobilize safely with a one-person …show more content…
assistance. Linking to Domain 2.2 of Nursing Competency and the use of Hendrick II Fall Risk Model assessment, Thomas scored six - this indicates to the registered nurses that Thomas has a high fall risk (Swartzell et al., 2013). Therefore, nurses should improve their abilities to assess fall risks and implement interventions that modified or eliminated risk when it was possible. For futere references, before Thomas starts mobilizing, registered nurses should educate Thomas to always wear his grip socks in order to prevent him from falling accidentally due to the floor being slippery. Chari et al. (2009) explained that using the socks are effective because it improved traction and it has an impact on the patient’s safety. Furthermore, ensuring that non-slip socks are worn appropriately is essential because if the socks are poorly fitted, it could cause the patient to fall on hazardous objects.
Another nursing intervention applied by the registered nurses is for Thomas to wear his glasses when he is mobilizing. Swenor et al. (2014) suggests that due to Thomas having visual impairment, this could affect his walking pace. Thomas would walk slowly as a way to maintain or improve his perception in mobility safety. Correlating to Domain 2.1 of Nursing Competency, Thomas nursing care should aim in improving both mobility safety by reducing fall risk and to mobilize proper gait by using appropriate mobility aids when Thomas is ambulating (NCNZ,2012). Therefore, fall assessment should aim in raising awareness in Thomas current abilities and for registered nurses to identify strategies to maintain and develop management plan to reduce risk for Thomas while mobilizing.
Second intervention of nursing care is it to prevent Thomas from having integumentary problems - especially around his buttocks areas which was caused by incontinence.
According to Benbow (2012), Thomas could develop localized redness, irritation, skin peeling and fungal infections around the perineum, sacrum, groin, ischia tuberosity and hip (p31). Even though his skin appear to be normal but by being incontinence, it had detrimental effects on Thomas skin integrity. This could be linked to an increase in ulcer development around the following areas. Correlating this to Domain 2.2 of Nursing Competency, Braden Pressure Ulcer Risk Assessment for Thomas total score is 18-which is mild risk developing lesion (NCNZ, 2012 & XDHB, n.d.). This increases the nurse’s awareness of Thomas pressure ulcer risk and choosing the most effective prevention strategies. From Gordon’s Functional Health Pattern (Carpenito-Moyet, 2014) , he would wear sanitary pad during the day and night because he is incontinent majority of the time. Hence, nursing interventions implemented by his registered nurse should include making alterations to new sanitary pad in the morning and
night.
According to Omli et al. (2010), neglecting to change sanitary pad will cause temperature and humidity to rise up causing irritation to the skin, therefore there is a development of ulcers infection. Hence, interventions which involves changning sanitary pad is appropriate in order to reduce irritating skin. Hence, the registered nurse need to have proper interventions to reduce irritating skin. Another nursing intervention include Thomas to wash regularly and remove oil and excretions to prevent odor by using neutral soaps (Sinni=McKeehen & Hazzard, 2010). Kottner et al. (20130 explains that using cleaners and washcloths that contain low-irritating surfactants and moiturizers around the derriere areas prevent skin damages and dryness. Linking to Domain 2.1 of Nursing Competency, preventing skin damage around Thomas lower extremities , nursing care plan must help maintain Thomas personal hygiene and maximize his care plan (NCNZ, 2012)/ Although preserving good skin care is challenge because the patient has to be incontinence and use appropriate assessments and follow up, registered nurses can implement care plan to keep a healthy skin condition by preventing skin barrier damage.
The last form of nursing care for Thomas is to support his lower extremities pain. Due to being diagnose with vertebral insufficiency fracture lumbar four-post kyphoplasty, he has experienced a lot of pain - however he does not voice is complains (Carpenito-Moyet, 2004). Registered nurses should administer Thomas with Ibuprofen and Paracetemal prescribed by his doctors when he suffers back pain from sitting for long periods. According to Domain 2.2 of nursing competency and from the Standard Observation Chart (ADDs score) when asked about is pain score at rest and on movement, he scored zero out of ten (NCNZ,2012). Even though he do not complain about his pain, one of Thomas nursing intervention include supporting his pain by encouraging him to re-position carefully with pillows when he is lying on the bed. Peterson et al. (2013) emphasized that this will lower risks of ulcers formations and reduce interface pressures. Another nursing intervention include registered nurses to create a quiet and non-disruptive environment with dim lights to promote a relaxed feeling. Long (2014) mentioned that nurses noise surrounding has been recognized as a factor that contributes to sleep loss, confusion, restlessness and increase annoyance levels with administers. Thus, a comfortable environment will help reduce pain and give a sense of comfort to Thomas. In conclusion, linking Thomas’s need to Domain 2.1 of Nursing Competency, Thomas’s pain can be reduced by re-positioning him regularly and ensuring he is comfortable. By allowing him to feel respectable and to feel supported, this will improve his well-being (NCNZ,2012) because although pain is a common experience by the patient, registered nurses should implement appropriate interventions such as support, reassurance and educating patients on self-management of pain.
Overall all nursing plans must be based on evidences gathered from the patient and their assessments. Throughout the implemenation phase, the nurse evaluates the best effectiveness of the nurse intervention by choosing the best care plan which suits the patient’s needs. Through Gordon’s Functional Health Pattern (Carpenito-Moyet, 2004), registered nurse must implement nursing intervention for Thomas which allow him to mobilize safely, prevent Thomas from having skin damage and being able to minimize Thomas from experience pain. It is essential to have a long-term follow-up for Thomas well-being by using appropriate assessment because this will help improve his life expectancy and his care plan interventions. Therefore, by meeting the needs of Domain 2; Management of Nursing Care as a guideline provided by Nursing Council of New Zealand, it demonstrates the importance of respecting and acknowledging the importance of nursing intervention for Thomas well-being (NCNZ, 2012). In conclusion, finding appropriate care plan serve as a guide for appropriate asssessment so that the patient can experience maximal intervention to support their long-term well-being.