Nursing Theory Plan of Care The evidence of nursing research applied into practice and policy is essential for the procurement of quality care. Research utilization is described as the systematic process of utilizing research knowledge into nursing practice for the purpose of enhancing, validating understanding, or changing practice and has a potential to influence beliefs, attitudes, and behaviors of healthcare recipients and its providers (Matthew-Maich, Ploeg, Jack, & Dobbins, 2010). Most practical nursing disciplines create components of research utilization that, according to MacGuire (2006), can clearly amplify the essential nature, meanings, and components of nursing so that a nurse can use this knowledge in a meticulous and meaningful way. In relevance to the case study discussed below, Orem’s Theory of Self-care Deficit will be effectively applied to the health promotion and positive outcomes through supportive educative nursing interventions given to the patient. Case Study “Mr. Issler, your patient, recently moved in with his daughter-in-law after his wife passed away two months ago. The daughter-in-law is no longer married to Mr. Issler’s son, but she is at this emergency room visit with Mr. Issler and states that she wants to help take care of Mr. Issler. She tells you that when Mr. Issler got off the airplane after a two and a half hour flight, he was pale and diaphoretic. She took him to the emergency room at the hospital. He was seen by a cardiologist and has a follow-up appointment next week for an echo cardiogram. The patient tells you he has congestive heart failure (CHF) and a history of deep vein thrombosis (DVT). The cardiologist told him to seek out a primary care provider and have his thyroid checked. The patient tells you he does not know if he has hyper- or hypothyroidism, but he has been taking thyroid medication for years. Mr. Issler has a large bag of medications with him, including
3 Synthroid ® , Lasix ® , Coumadin ® , and metoprolol. Mr. Issler is very pale” (University of Phoenix, 2015, para. 4). “His vital signs are as follows: Pulse- 58, BP 176/84, Respirations- 22, Pulse oximetry 88. He is 72 inches tall and weighs 147 pounds. His labs results are as follows: hematocrit- 29.6%, hemoglobin- 10.4, BUN- 29, Creatinine- 2.0, INR-2.5” (University of Phoenix, 2015, para. 4). Plan of Care PATIENT’S DATA  71years, male  CHF  History of DVT  Vital signs: HR – 58, B/P – 176/84, respirations – 22, oxygen saturation – 88%  Complains of generalized weakness  Complains of shortness of breath (SOB)  Infiltration of bilateral lower lobes on the chest x-ray  Cool, very pale, and diaphoretic skin  States he does not know if he has hypo- or hyperthyroidism  Possesses a large bag of medications, including Synthroid, Lasix, Coumadin, and metoprolol NURSING DIAGNOSIS OUTCOME INTERVENTIONS Impaired gas exchange, R/T excessive fluid in the The patient will demonstrate improved ventilation and Provide supplemental oxygen at the lowest concentration