Ida Orlando

Please respond to the following case study below and elaborate in a 300 word essay and 3 references no more than 3 years old. Please make sure respond in first person. Thanks. Here is the following case study: Orlando’s Nursing Process Theory is based on discovering and resolving problematic situations. The role of the nurse is to interpret the meaning of a patient’s behavior, identify the immediate need for help and meet the patient’s needs. The theory contains five interrelated concepts that address the problematic situation. Professional Nursing Function: Organizing Principle – The nurse gathers information through assessment to understand a patient’s behavior and determine if the patient is in need of help. (Alligood, 2014) The Patient’s Presenting Behavior: Problematic Situation – Behaviors can be verbal, nonverbal or physical. They may or may not be a plea for help and are not reliable. The nurse and patient must explore the presenting behavior and identify the problem and solution. (Alligood, 2014) Immediate Reaction: Internal Response – The nurse’s automatic reaction to a patient’s presenting behavior. This reaction comprises perceptions, thoughts, feelings, knowledge and experiences. (Alligood, 2014) Deliberative Nursing Process: Reflective Inquiry – The nurse-patient interaction is dynamic. The patient’s behavior affects the nurse and the nurse’s behavior affects the patient. In order to be successful in interpreting the patient’s behavior the nurse must focus on the patient and not on assumptions about the patient. (Alligood, 2014) Improvement: Resolution – When the patient’s need for help has been met, there is improvement. If the patient’s behavior has not changed, the nursing function has not been met and the nurse continues the process until there is improvement. (Alligood, 2014) Orlando’s theory can be applied to the case study in the following way: Professional Nursing Function: organizing Principal: Mrs. Goldberg’s behavior presents as a sad affect. During the conversation, she notes that the symptoms she has been experiencing: muscle weakness and unsteadiness, fatigue when eating and weight loss are concerning to her. She also reports a lack of intimacy with her husband and that her children rely on her for extracurricular activities. Finally, she verbalizes fear over an MS diagnosis and blames herself for not feeling well. From the conversation, I can determine that Mrs. Goldberg’s symptoms, personal issues, fear and guilt are causing her distress and affecting her behavior. It appears that she is in need of help. The Patient’s Presenting Behavior: Problematic Situation: Mrs. Goldberg’s behavior is nonverbal – sad affect, and verbal – verbalization of fear and guilt. Based on Mrs. Goldberg’s presenting behavior, I would have a conversation with her to discuss her affect. We would discuss any concerns, issues or questions she might have and come up with a possible solution to resolve her feelings of fear and guilt. I would suggest education for her and her family about MS and support for her and her family. If necessary, I would involve other care providers. Setting up daily goals would allow Mrs. Goldberg to focus on small accomplishments. I would also provide emotional support and assist Mrs. Goldberg with ADLs, mobility and improving her nutrition. Immediate Reaction: Internal Response: Based on my perception, knowledge and experience, it is clear that something is upsetting Mrs. Goldberg which requires further assessment and intervention. Deliberative Nursing Process: Reflective Inquiry: I would obtain information during my assessment and conversation with Mrs. Goldberg. I would note information contained in the chart or received during report, but would not let that influence my feelings about Mrs. Goldberg’s behavior. Improvement: Resolution According to Orlando’s theory, if Mrs. Goldberg’s needs for help are met her behavior will change and if not, her behavior will continue. If there is no change in her behavior, she will need to be reassessed and different nursing interventions will need to be used until her behavior changes. Reference Alligood, M.R. (2014). Nursing theory: utilization & application (5th ed.). St. Louis, MO: Mosby Elsevier