PRESENTED BY

Mr. NAVJYOT SINGH Choudhary

M.SC NURSING 1st YEAR
Dept. of Pediatric Nursing
Faye Glenn Abdellah was
one of the most influential
nursing theorist and public
health scientists . It is
extremely rare to find
someone who has dedicated
all her life to the
advancement of the nursing
profession and accomplish
this feat with so much
distinction and merit.
Faye Glenn Abdellah was born on
March 13, 1919, in New York City.

EDUCATIONAL ACHIEVEMENTS

In 1942, Abdellah earned a nursing diploma from

Fitkin Memorial Hospital's School of Nursing New
Jersey (now Ann May School of Nursing).
She received her Bachelor of Science Degree in
1945, a Master of Arts degree in 1947 and Doctor
of Education in TeaĐher’s College, Columďia
University. In 1947 she also took Master of Arts
Degree in Physiology.
Abdellah went on to become a nursing instructor and
researcher and helped transform the focus of the
profession from disease centered to patient
centered. She expanded the role of nurses to include
care of families and the elderly.

She worked in many settings. She had been a staff

nurse, a head nurse, a faculty member at Yale
University and at Columbia University, a public health
nurse, a researcher and an author of more than 147
articles and books.
She was selected as Deputy Surgeon General in 1982.
She retired in 1989.
1937 – She wanted to be a nurse on the day she saw
Hindenburg explode.
1949 – She spent 40 years in Public Health Service where
she first became involved in research, being assigned to
perform studies to improve nursing practices.
1960 – She was influenced by the desire to promote
client-
centered comprehensive nursing care.
BASIC TO ALL PATIENTS
1.To maintain good hygiene and physical comfort –
After colonoscopy, patients are usually soiled from
the procedure. It is therefore important to clean them
properly. Physical comfort through proper positioning
in bed.
2.To promote optimal activity: exercise, rest, and
sleep – Patients who were sedated during the
procedure stay in the unit until the effect of the
sedation has decreased to a safe level. As a
nurse, make sure the patients are able to rest and
sleep well by providing a conducive environment for
rest, such as decreasing environmental noise and
dimming the light if necessary.
3.To promote safety through prevention of accident,
injury, or other trauma and through the prevention of
the spread of infection – Making sure
the side rails are always up when leaving the patient .
one way we prevent the spread of infection is
through proper disinfection of the equipments .
4.To maintain good body mechanics and prevent and
correct deformity – Positioning the patient
properly, allowing for the normal anatomical position
of body parts.
5. facilitate the maintenance of a supply of oxygen to all body cells
– when patients manifest breathing problems, oxygen is attached to
them, usually via nasal cannula. Sedated patients are attached to
cardiac monitor and pulse oxi meter while having the oxygen
delivered. When the oxygen saturation falls below the normal
levels, the rate of oxygen is increased accordingly, as per physician's
order.

6. To facilitate the maintenance of nutrition of all body cells –

patients undergoing endoscopic procedures are on NPO. For this
reason it is important to monitor the blood glucose level. When the
patient's blood glucose falls from the normal value, we inject D50W
to the patient or we change the patient's IVF to a dextrose
containing fluid.
7. To facilitate the maintenance of elimination – Providing
bedpans or urinals to patients and at times, insertion of
Foley catheter when the patient is not able to void.

8. To facilitate the maintenance of fluid and electrolyte

balance – Proper regulation of the intravenous solutions as
well as proper incorporations it may have. An example is when
patients have low serum potassium; KCl is incorporated in the
solution.
9.To recognize the physiological responses of the body to
disease conditions—pathological, physiological, and
compensatory – it is important to check the patients for signs
of internal gastrointestinal bleeding by monitoring the blood
pressure and cardiac rate.

10.To facilitate the maintenance of regulatory mechanisms

and functions – When a patient has a difficulty in breathing
and is showing an increase respiratory rate, elevating the head
part of the bed is done to facilitate the respiratory function.
11. To facilitate the maintenance of sensory function –
Sometimes there are semi-conscious patients, in these cases,
it is still necessary to talk to them while performing nursing
interventions to maintain their auditory sense.
12.To identify and accept positive and negative
expressions, feelings, and reactions – most patients feel anxious
before undergoing the procedures. It is necessary to listen to the
patients' expressions and allow them to ask questions. To
decrease their anxiety, proper instructions are given, what they
are to expect, how long the procedure will take, what they should
do during and after the procedure as well as other concerns.

13.To identify and accept interrelatedness of emotions and organic

illness – Encourage patients to verbalize their feelings and allow
them to cry when they have the need to do so will help them
emotionally. Some patients are diagnosed with malignancy after
the procedure and during this time the emotional needs of the
patient is a priority.
14. To facilitate the maintenance of effective verbal and
nonverbal communication – when patients are not able to
express themselves verbally, it is important to assess for
nonverbal cues. For instance when patients are in pain,
assessing for facial grimacing.

15. To promote the development of productive interpersonal

relationships – allow the patient's significant others to stay
with the patient before and after the procedure. This allows for
bonding and promotes interpersonal relationship.
16. To facilitate progress toward achievement of personal
spiritual goals – nurse usually visits the patients in the unit.
Patients may benefit from this, allowing them time to
practice their faith.

17. To create and/or maintain a therapeutic environment -

providing proper lighting, proper room temperature, a
quiet environment are done to patients staying in the unit.
18. To facilitate awareness of self as an individual with
varying physical, emotional, and developmental needs – care
to patients vary according to their developmental needs.
Allowing the parents to stay during the procedure help the
pediatric patients in their emotional and developmental
needs.
19. To accept the optimum possible goals in the light of
limitations, physical, and emotional – The goals for each
patient vary depending on the capability of the patient. The
nutritional goal for a patient with a PEG tube for instance will
be
different, knowing that the patient has limited feeding options.

20. To use community resources as an aid in resolving

problems arising from illness – Some patients live far from the
city and thus referral to health centers is sometimes done.
21. To understand the role of social problems as influencing
factors in the cause of illness – Some patients who are
diagnosed with amoebic colitis for instance are advised to
avoid buying street foods to which the preparation they are
not sure of, and also avoid drinking water that are not safe.
Abdellah describes people as
having physical, emotional, and
sociological needs. These needs
may overt, consisting of largely
physical needs, or covert, such as
emotional, sociological and
interpersonal needs- which are
often missed and perceived
incorrectly
The individuals (and families) are
the recipients of nursing, and
health, or achieving of it, is the
purpose of nursing services.
Emphasis should be placed upon
prevention and rehabilitation.
Holistic approach must be taken by
the nurse to help the client achieve
state of health. However the nurse
must accurately identify the lacks or
deficits regarding health that the
client is experiencing. These lacks or
deficits are the client’s health needs.
The environment is implicitly
defined by Abdellah as the home
or community from which patient
comes. Society is included in
͞plaŶŶiŶg for optiŵuŵ health.͟
However, as Abdellah further
delineated her ideas, the focus of
nursing service is clearly the
individual.
These would mean a comprehensive
nursing service, this would include:
1. Recognizing the nursing problems of the
patient.
2. Deciding the appropriate actions to take
in terms of relevant nursing principles.
3. Providing continuous care of the
individual’s total health needs.
4. Providing continuous care to relieve pain
and discomfort.
5. Adjusting total nursing care plan to
meet
the patient’s individual needs.
6.Helping the individual to become more self directing in
attaining or maintaining a healthy state of mind and body.
7.Instructing nursing personnel and family to help the
individual
8.Helping the individual to adjust to his limitations and
emotional problems.
9.Working with allied health professional in planning for
optimum health

Carrying out continuous evaluation and research to improve

nursing techniques and to develop new techniques to meet all
the health needs of the people.
1. Observation of health status
2. Skills of communication
3. Application of knowledge
4. Teaching of patients and families
5. Planning and organization of work
6. Use of resource materials
7. Use of personnel resources
8. Problem-solving
9. Direction of work of others
10. Therapeutic use of the self
11. Nursing procedures
 Physical, Sociological, emotional
Needs

Common Elements Of Patient Interpersonal Relationship

Area
Nursing Practice
Aďdeallah’s ŵaiŶ goal is the
improvement of the nursing education.
The ŵost iŵportaŶt iŵpaĐt of Aďdellah’s
theory to the nursing practice is that it
helped transform the focus of the
professioŶ froŵ ďeiŶg ͞disease- ĐeŶtered͟
to ͞patieŶt-ĐeŶtered.͟
The steps of the nursing process are
assessment, diagnosis, planning, implem
entation and evaluation
Professors and educators realized
the importance of client centered
care rather than focusing on
medical interventions. Nursing
education then slowly deviated
its concentration from the
complex, medical concepts, into
exercising better attention to the
client as the primary concern.
It’s ǀery stroŶg Ŷurse-centered
orientation—is, on the other
haŶd, it’s ŵajor ĐoŶtriďutioŶ to
nursing education.
Her theories continue to guide researchers
to focus on the body of nursing knowledge
itself, the identification of patient problems,
the organization of nursing interventions,
the improvement of nursing education, and
the structure of the curriculum.
The extensive research done regarding the
patieŶt’s Ŷeeds aŶd proďleŵs has serǀed as a
foundation for the development of what is
now known as nursing diagnoses.
Nursing problems provide guidelines
for the collection of data.
A principle underlying the problem
solving approach is that for each
identified problem, pertinent data
are collected.
The overt or covert nature of the
problems necessitates a direct or
indirect approach, respectively.
NURSING DIAGNOSIS
The results of data ĐolleĐtioŶ ǁ ould deterŵiŶe the ĐlieŶt’s
specific overt or covert problems.
These specific problems would be grouped under one or more
of the broader nursing problems.
This step is consistent with that involved in nursing diagnosis
PLANNING PHASE
The statements of nursing problems most closely resemble
goal statements. Once the problem has been diagnosed, the
nursing goals have been established.
IMPLEMENTATION
Using the goals as the framework, a plan is developed and
appropriate nursing interventions are determined.
EVALUATION
The most appropriate evaluation would be the nurse
progress or lack of progress toward the achievement of the
stated goals..
The case of Simar
He experienced severe chest pain. In addition he
experienced shortness of breadth, tachycardia and
profuse diaphoresis.
 Assessment
reveals: cardiac Past History : He
damage had gone through
similar episodes
since past 2 years.
PAIN

IMPAIRED CARDIAC FUNCTIONING`

WORK RELATED STRESS

FAILURE TO SEEK MEDICAL

ATTENTION
STAGES OF Abdellah nsg Nsg intervensions Nsg
ILLNESS problem intervensions
Basic to care 1. To maintain good 1. Administer oxygen Amount of pain
hygiene and 2. Elevate headrest
physical comfort 3. Reposition of client
4. Administer analgesics
as advised

Susternal care 5 to facilitate the 1 promote rest Vital signs.

needs maintenance of supply 2 Place in sitting position
of oxygen to body 3 Promote deep
cells breathing and
coughing exercises
4 Implement exercises
as tolerated

Remedial care 13 To identify and 1to find the nature of his knowledge of
needs accept the job. relationship
interrelatedness of 2explore his work related between stress
emotional and organic goal and his illness
illness 3stress associated with
jobs.
Stages of illness Abdellah nsg Nsg intervensions Criterion measure
problems
Restorative care 20 to use 1. Teach early Knowledge about
needs community signs and the use of
resources as an symptoms of community
aid in resolving cardiac resources.
problems arising distress.
from illness 2. Teach course of
action .
Aďdellah’s theory has iŶterrelated the
concepts of health, nursing problems and
problem solving as she attempts to create
a different way of viewing nursing
phenomenon.
The major limitation of Abdellah theory and
the twenty one nursing problems is their
very strong nursing centered orientation.
With the orientation appropriate use might
be the organization of teaching content for
nursing students, the evaluation of a
students, performance in the clinical area or
both. But in terms of client care there is little
emphasis on what the client is to achieve.
UsiŶg Aďdellah’s ĐoŶĐepts of health, ŶursiŶg
problems, and problem solving, the theoretical
statement of nursing that can be derived is the use
of the problem solving approach with key nursing
problems related to health needs of people. From
this framework, 21 nursing problems were
developed.
Aďdellah’s theory proǀides a ďasis for deterŵiŶiŶg
and organizing nursing care. The problems also
provide a basis for organizing appropriate nursing
strategies.