Question

CASE STUDY

A 23-year-old male patient is admitted with a fracture of C6 and C7 that has resulted in quadriplegia. He was injured during a football game at the university where he is currently a senior college student. His career as a quarterback had been very promising. At the time of the injury, contract negotiations were in progress with a leading professional football team.

1.Use Roy’s criteria to identify focal and contextual stimuli for each of the four adaptive modes.

Physiological mode:

2.Consider what adaptations would be necessary in each of the following four adaptive modes: (1) physiological, (2) self-concept, (3) interdependence, and (4) role function.

3.Create a nursing intervention for each of the adaptive modes to promote adaptation.

Answer 1

Adaptation : Responding positively to environmental changes.

1) Focal: internal or external stimuli immediately challenging the person in a particular situation (individual needs, family life, changes in environment)

Contextual: which is all stimuli present in the situation that all contribute to the effect of the focal stimulus.

II-1) Physiological adaptations would include nutrition , rest ,activity , protection ,elimination​, Fluids and electrolytes etc. In this mode of physiological activity of all the cells, tissues, organs, & systems of the body.

2)Self concept- include psychological and spiritual elements.It deals with the person’s beliefs & feelings about himself/herself.Encourage the patient to express his concern.

3) Role function:- it include the primary , secondary and tertiary roles the person performs in society.

Primary role: role based on age, sex, developmental state .
Secondary role: role a person assumes to complete tasks associated with a primary role or developmental stage .
Tertiary role: a role freely chosen; temporary.

4)Interdependence : It include coping mechanisms arising close relationships.It associated with one’s relationships and interactions with others.

3) Nursing interventions in each mode :

# Physiological - assess the vitals

Stimuli are the underlying causes or factors contributing to the behaviors observed in first level assessment.

- help the patient to carry out daily activities

- help the patient to change the position to avoid bedsores

- provide small fluid diet

* Self concept - encourage the patient to express his concerns

- provide patient psychological and emotional support

- could sell patient about the rehabilitation method to be used to come out of the situation.

* Role function - the nurse should help the patient to conduct his primary , secondary and tertiary in the society

* Interdependence - the nurse should have a therapeutic relationship with the patient and help him to cope up with the situation by including him in planning the care .