NURSING THEORISTS
IMPORTANT THEORISTS
1. Florence Nightingale - Environment
theory
2. Hildegard Peplau - Interpersonal theory
3. Virginia Henderson - Need Theory
4. Fay Abdella - Twenty One Nursing
Problems
5. Ida Jean Orlando - Nursing Process
theory
6. Dorothy Johnson - System model
7. Martha Rogers -Unitary Human beings
8. Dorothea Orem - Self-care theory
9. Imogene King - Goal Attainment theory
10. Betty Neuman - System model
11. Sister Calista Roy - Adaptation theory
12. Jean Watson - Philosophy and Caring
Model
13. Madeleine Leininger -Transcultural
nursing
14. Patricia Benner - From Novice to Expert
15. Lydia E. Hall - The Core, Care and Cure
16. Joyce Travelbee - Human-To-Human
Relationship Model
17. Margaret Newman - Health As
Expanding Consciousness
18. Katharine Kolcaba - Comfort Theory (3
existing forms: relief, ease and
transcendence)
19. Rosemarie Rizzo Parse - Human
Becoming Theory (a combination of
biological, psychological, sociological,
and spiritual factors, and states that a
person is a unitary being in
continuous interaction with his or her
environment. It is centered around
three themes: meaning, rhythmicity,
and transcendence)
20. Ernestine Wiedenbach - The Helping Art
of Clinical Nursing
1. FLORENCE NIGHTINGALEENVIRONMENTAL THEORY
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First nursing theorist
Unsanitary conditions posed health
hazard (Notes on Nursing, 1859)
5 components of environment
 ventilation, light, warmth, effluvia,
noise
External influences can prevent,
suppress or contribute to disease or
death.
Nightingale’s Concepts
1. Person
Patient who is acted on by nurse
 Affected by environment
 Has reparative powers
2. Environment

Foundation of theory. Included
everything, physical, psychological, and
social
3. Health

Maintaining well-being by using a
person’s powers
 Maintained by control of environment
4. Nursing


Provided fresh air, warmth, cleanliness,
good diet, quiet to facilitate person’s
reparative process
2. HILDEGARD PEPLAU -INTERPERSONAL
RELATIONS MODEL
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Based on psychodynamic nursing
using an understanding of one’s own
behavior to help others identify their
difficulties
Applies principles of human relations
Patient has a felt need
Peplau’s Concepts
1. Person
An individual; a developing organism
who tries to reduce anxiety caused by
needs
 Lives in instable equilibrium
2. Environment

THE 14 COMPONENTS
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Not defined
3. Health
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Implies forward movement of the
personality and human processes
toward creative, constructive,
productive, personal, and community
living
4. Nursing

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A significant, therapeutic, interpersonal
process that functions cooperatively
with others to make health possible
Involves problem-solving
3. VIRGINIA HENDERSON -THE NATURE OF
NURSING
"The unique function of the nurse is to assist the
individual, sick or well, in the performance of those
activities contributing to health or its recovery (or to
peaceful death) that he would perform unaided if he
had the necessary strength, will, or knowledge. And
to do this in such a way as to help him gain
independence as rapidly as possible. She must in a
sense, get inside the skin of each of her patients in
order to know what he needs".

She emphasized the importance of
increasing the patient’s independence so
that progress after hospitalization would
not be delayed (Henderson,1991)
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Breathe normally. Eat and drink
adequately.
Eliminate body wastes.
Move and maintain desirable postures.
Sleep and rest.
Select suitable clothes-dress and
undress.
Maintain body temperature within
normal range by adjusting clothing and
modifying environment
Keep the body clean and well groomed
and protect the integument
Avoid dangers in the environment and
avoid injuring others.
Communicate with others in expressing
emotions, needs, fears, or opinions.
Worship according to one’s faith.
Work in such a way that there is a sense
of accomplishment.
Play or participate in various forms of
recreation.
Learn, discover, or satisfy the curiosity
that leads to normal development and
health and use the available health
facilities.
4. FAY ABDELLA- TOPOLOGY OF 21
NURSING PROBLEMS
A list of 21 nursing problems
 Condition presented or faced by the
patient or family.
 Problems are in 3 categories
 physical, social and emotional
 The nurse must be a good problem
solver
Abdella’s Concepts
1. Nursing
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A helping profession
A comprehensive service to meet
patient’s needs
Increases or restores self-help ability
Uses 21 problems to guide nursing care
2. Health
Excludes illness
 No unmet needs and no actual or
anticipated impairments
3. Person

One who has physical, emotional, or
social needs
 The recipient of nursing care.
4. Environment
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SUSTENAL CARE NEEDS
 To facilitate the maintenance of a supply
of oxygen to all body cells

To facilitate the maintenance of
nutrition of all body cells

To facilitate the maintenance of
elimination

To facilitate the maintenance of fluid
and electrolyte balance

To recognize the physiological
responses of the body to disease
conditions
Did not discuss much
Includes room, home, and community
21 NURSING PROBLEMS
Three major categories

Physical, sociological, and emotional
needs of clients

To facilitate the maintenance of
regulatory mechanisms and functions

Types of interpersonal relationships
between the nurse and patient

To facilitate the maintenance of sensory
function.

Common elements of client care
BASIC TO ALL PATIENTS
 To maintain good hygiene and physical
comfort

To promote optimal activity: exercise,
rest and sleep

To promote safety through the
prevention of accidents, injury, or other
trauma and through the prevention of
the spread of infection

To maintain good body mechanics and
prevent and correct deformity
REMEDIAL CARE NEEDS
 To identify and accept positive and
negative expressions, feelings, and
reactions

To identify and accept the
interrelatedness of emotions and
organic illness

To facilitate the maintenance of effective
verbal and non verbal communication

To promote the development of
productive interpersonal relationships

To facilitate progress toward
achievement of personal spiritual goals

To create and / or maintain a
therapeutic environment

To facilitate awareness of self as an
individual with varying physical ,
emotional, and developmental needs
RESTORATIVE CARE NEEDS
 To accept the optimum possible goals in
the light of limitations, physical and
emotional

To use community resources as an aid in
resolving problems arising from illness

To understand the role of social
problems as influencing factors in the
case of illness
5. IDA JEAN ORLANDO- DELIBERATIVE
NURSING PROCESS
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The deliberative nursing process is set in
motion by the patient’s behavior
All behavior may represent a cry for
help. Patient’s behavior can be verbal or
non-verbal.
The nurse reacts to patient’s behavior
and forms basis for determining nurse’s
acts.
Perception, thought, feeling
Nurses’ actions should be deliberative,
rather than automatic
Deliberative actions explore the
meaning and relevance of an action.
6. DOROTHY JOHNSON-BEHAVIORAL
SYSTEMS MODEL
The person is a behavioral system
comprised of a set of organized,
interactive, interdependent, and
integrated subsystems
 Constancy is maintained through
biological, psychological, and
sociological factors.
 A steady state is maintained through
adjusting and adapting to internal and
external forces.
Johnson’s 7 Subsystems
 Affiliative subsystem - social bonds
 Dependency - helping or nuturing
 Ingestive - food intake
 Eliminative - excretion
 Sexual - procreation and gratification
 Aggressive - self-protection and
preservation
 Achievement - efforts to gain mastery
and control
Johnson’s Concepts
1. Person

A behavioral system comprised of
subsystems constantly trying to maintain
a steady state
2. Environment

Not specifically defined but does say
there is an internal and external
environment
3. Health

Balance and stability.
4. Nursing
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External regulatory force that is
indicated only when there is instability.
7. MARTHA ROGERS -UNITARY HUMAN
BEINGS
Energy fields
Fundamental unity of things that are
unique, dynamic, open, and infinite
 Unitary man and environmental field
Universe of open systems

Energy fields are open, infinite, and
interactive
Pattern
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Characteristic of energy field
 A wave that changes, becomes complex
and diverse
Pandimensionality

A nonlinear domain without time or
space
Roger’s Definitions
Integrality

Continuous and mutual interaction
between man and environment
Resonancy
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9. IMOGENE KING-GOAL ATTAINMENT
THEORY
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Continuous change longer to shorter
wave patterns in human and
environmental fields
Helicy
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Continuous, probabilistic, increasing
diversity of the human and
envrionmental fields.
Characterized by nonrepeating
rhymicities
Change
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8. DOROTHEA OREM- SELF-CARE MODEL
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Self-care comprises those activities
performed independently by an
individual to promote and maintain
person well-being
Self care agency is the individual’s ability
to perform self care activities
Self- care deficit occurs when the person
cannot carry out self-care
The nurse then meets the self-care
needs by acting or doing for; guiding,
teaching, supporting or providing the
environment to promote patient’s ability
Wholly compensatory nursing systemPatient dependent
Partially compensatory- Patient can
meet some needs but needs nursing
assistance
Supportive educative-Patient can meet
self care requisites, but needs assistance
with decision making or knowledge

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Open systems framework
Human beings are open systems in
constant interaction with the
environment
Personal System
 individual; perception, self,
growth, development, time space,
body image
 Interpersonal
 Society
Personal System
 Individual; perception, self,
growth, development, time space,
body image
Interpersonal
 Socialization; interaction,
communication and transaction
Society
 Family, religious groups, schools,
work, peers
The nurse and patient mutually
communicate, establish goals and take
action to attain goals
Each individual brings a different set of
values, ideas, attitudes, perceptions to
exchange
10. BETTY NEUMAN - HEALTH CARE
SYSTEMS MODEL
The person is a complete system, with
interrelated parts
 maintains balance and harmony
between internal and external
environment by adjusting to stress and
defending against tension-producing
stimuli
 Focuses on stress and stress reduction
 Primarily concerned with effects of stress
on health
 Stressors are any forces that alter the
system’s stability
 Flexible lines of resistance - Surround
basic core
 Internal factors that help defend against
stressors
 Normal line of resistance - Normal
adaptation state
 Flexible line of defense - Protective
barrier, changing, affected by variables
 Wellness is equilibrium
Nursing interventions are activates to:
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strengthen flexible lines of defense
strengthen resistance to stressors
maintain adaptation
11. SISTER CALISTA ROY - ADAPTATION
MODEL
Five Interrelated Essential Elements
1. Patiency- The person receiving care
2. Goal of nursing- Adapting to change
3. Health-Being and becoming a whole
person
4. Environment
5. Direction of nursing activitiesFacilitating adaptation
 The person is an open adaptive system
with input (stimuli), who adapts by

processes or control mechanisms
(throughput)
The output can be either adaptive
responses or ineffective responses
12. JEAN WATSON - PHILOSOPHY AND
SCIENCE OF CARING
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Caring can be demonstrated and
practiced
Caring consists of carative factors
Caring promotes growth
A caring environment accepts a person
as he is and looks to what the person
may become
A caring environment offers
development of potential
Caring promotes health better than
curing
Caring is central to nursing
WATSON’S 10 CARATIVE FACTORS
Forming humanistic-altruistic value
system
 Instilling faith-hope
 Cultivating sensitivity to self and others
 Developing helping-trust relationship
 Promoting expression of feelings
 Using problem-solving for decision
making
 Promoting teaching-learning
 Promoting supportive environment
 Assisting with gratification of human
needs
 Allowing for existentialphenomenological forces
Watson’s Concepts
 Person
 Human being to be valued, cared
for, respected, nurtured,
understood and assisted
 Environment
 Society
 Health
 Complete physical, mental and
social well-being and functioning
 Nursing


Concerned with promoting and
restoring health, preventing
illness
13. ROSEMARY PARSE - HUMAN
BECOMING THEORY
Human Becoming Theory includes
Totality Paradigm
 Man is a combination of
biological, psychological,
sociological and spiritual factors
 Simultaneity Paradigm
 Man is a unitary being in
continuous, mutual interaction
with environment
 Originally Man-Living-Health Theory
Parse’s Three Principles
 Meaning
 Man’s reality is given meaning
through lived experiences
 Man and environment cocreate
 Rhythmicity
 Man and environment cocreate (
imaging, valuing, languaging) in
rhythmical patterns
 Cotranscendence
 Refers to reaching out and
beyond the limits that a person
sets
 One constantly transforms
 Person
 Open being who is more than
and different from the sum of the
parts
 Environment
 Everything in the person and his
experiences
 Inseparable, complimentary to
and evolving with
 Health
 Open process of being and
becoming. Involves synthesis of
values
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
Nursing
 A human science and art that
uses an abstract body of
knowledge to serve people
14. MADELEINE LEININGER - CULTURE
CARE DIVERSITY AND UNIVERSALITY
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According to transcultural nursing, the
goal of nursing care is to provide care
congruent with cultural values, beliefs,
and practices
Sunrise model consists of 4 levels that
provide a base of knowledge for
delivering cultural congruent care.
Cultural care preservation
 help maintain or preserve health,
recover from illness, or face death
Cultural care accommodation
 help adapt to or negotiate for a
beneficial health status, or face
death
Cultural care re-patterning
 help restructure or change
lifestyles that are culturally
meaningful
15. PATRICIA BENNER - FROM NOVICE TO
EXPERT
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1.
2.
3.
4.
5.
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Described 5 levels of nursing experience
and developed exemplars and paradigm
cases to illustrate each level
Novice
Advanced beginner
Competent
Proficient
Expert
Levels reflect:
 movement from reliance on past
abstract principles to the use of
past concrete experience as
paradigms
 change in perception of situation
as a complete whole in which
certain parts are relevant
16. LYDIA E. HALL - THE CORE, CARE AND
CURE
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The theory contains of three
independent but interconnected circles:
1. the core,
2. the care and
3. the cure
The core is the person or patient to
whom nursing care is directed and
needed. The core has goals set by
himself and not by any other person.
The core behaved according to his
feelings, and value system.
The care circle explains the role of nurse
The cure is the attention given to
patients by the medical professionals.
NUTRITION DIET AND THERAPY
VITAMINS
Thiamine / B1

Deficient among
ALCOHOLIC. (CBQ)
Riboflavin /B2
 Support skin health
 Prevents cheilosis
 Prevents stomatitis
WATER SOLUBLE VITAMINS
Food Sources
Deficiency
F ortified grain (bread, pasta, flour)
O ats, peas, and yeast
O ranges
L egumes and seeds
E gg, fish and meats(pork)
D ried milk
Beri beri(CBQ)
B read and MILK
I nclude lean meats
B eef and dark meat chicken
I nclude fish
G rains (cereals)
Ariboflavinosis
▪stomatitis
-mouth
inflammation
▪glossitis
-painful red tongue
with sore throat
▪Cheilosis
-chapped and
fissured lips (CBQ)
Niacin/B3
 support skin,
nervous and digestive
system
 prevents pellagra.
(CBQ)
Keyword: INAY ASIN for:
Fish
Meat
Poultry (chicken and egg)
Pellagra : (CBQ)
characterized by
diarrhea, dermatitis,
dementia, and
death
Others : whole grains &fortified cereals
Pantothenic/B5


Converts food to
energy
Male penis
enhancement
Pyridoxine/B6
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
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Supports nervous
system.
Prevents
Peripheral
Neuropathy/neurit
is
Helps to relieve
Nausea and
vomiting in
pregnancy
TAKE NOTE:

AVOID B6 containing
vitamins when taking
LEVODOPA drug.
(Pyridoxine decreases
M ilk, whole-grain breads and cereals
A vocado and corn
L egumes
E gg yolks
S oybeans
Rare, bit
deficiency may
lead to depression
and fatigue
M eats (chicken, beef)
E ggs and cereals
A ny starch vegetables – green leafy
T una
S almon
Hypochromic,
microcytic
anemia.
Peripheral
neuropathy. (CBQ)
Take note: kidney
diseases can cause
vitamin B6
deficiency
effects of levodopa.)
(CBQ)

GIVE B6 to patient
with TB under
INH/isoniazid
medication to prevent
neurologic adverse
effects of this drug.
(CBQ)
Biotin/B7


Help energy and amino
acid metabolism
Help in the synthesis
of fat glycogen
Folic acid/B9



red blood cell
maturation
prevent anemia
Prevents neural tube
defects
(myelomeningocelele)
(CBQ)
Cobalamin /B12
 nerve tissue health
 brain function

production of red blood
cells
 assist in the production
of DNA and RNA.
B arley, broccoli, brewer's yeast
I nclude egg and cheese
O rgan meats
T una
I nclude fortified cereals
N uts and and legumes
Alopecia and scaly
erythematous
dermatitis
F ortified cereals
O rgan meat ( liver )
L eafy green vegetables
I nclude LEGUMES
C itrus fruit likevorange juice
Neural tube defects
like spina bifida.
Meningocele
myelomenigocele
Best sources: green leafy vegetables
( spinach, broccoli, moringa/malunggay)
(CBQ)
C lams and mussels
O ats ( fortified cereals)
B eef
A nchovies and sardines
L iver
A lmonds ( fortified)
M ilk products ( cheese, yogurt)
I nclude soy based products
N uts
ASCORBIC ACID / VITAMIN C
FUNCTIONS:
C ell protection ( antioxidant)
I mproves iron absorption – (CBQ)
T endons , collagen and blood vessel formation
R epair tissues ( wound healing and scar formation)
U se to improve GUMHEALTH – (CBQ)
S upports immunity
VITAMIN C SOURCES :
A ll citrus fruits(CBQ)
S trawberry
C abbage, cauliflower, broccoli
O range
R ed bell pepper
B ayabas ( guava) (CBQ)
I nclude kiwi
C antaloupe
DEFICIENCY: SCURVY – (CBQ)– increase intake of FRUITS – (CBQ)
Megaloblastic
anemia
Megaloblastic
anemia
Pernicious anemia
(CBQ)
Risk: vegan and
post-op
gastrectomy
FAT SOLUBLE VITAMINS (VITAMIN A, D, E, K)
RETINOL / VITAMIN A
Vitamin A functions:
M aintains normal vision, skin health – (CBQ)
A ntioxidant
T eeth, Skin and cellular health
A gainstinfections (immunity functions)
TAKE NOTE:
o Vitamin A is stored in the liver
o The liver stores vitamin A, D, E, K
SOURCES:
M ilk, cheese and butter – (CBQ)
A ny dark yellow vegetables SQUASH and carrots. – (CBQ)
L iver products (cod liver, beef, turkey, chicken)
I nclude green leafy vegetables (moringa/malunggay, broccoli and cantaloupe)
N uts (pistachios) and black eyed peas.
A ny dark yellow fruits: mango, papaya and apricots – (CBQ)
W hite/ yellow sweet potato – (CBQ)
TAKE NOTE:
 Liver is a very rich source of vitamin A.
 Avoid taking supplements containing vitamin A, including fish liver oil and liver products,
unless advised if you're pregnant.
Deficiency condition: Vitamin A deficiency (VAD)
Causes:
1.
Lack of nutritional intake of vitamin A rich foods
2.
Lack of fat or oil in the diet (Fatty oil absorbs Vitamin A) (CBQ)
3.
Poor absorption or rapid utilization of Vitamin A during illness
Eye Signs
1.
Nyctalopia / night blindness – FIRST sign of VAD
2.
Xeropthalmia (eye membrane dryness)
3.
Bitot’s spot (foamy soapsuds-like spots on sclera of the eye)
4.
Corneal xerosis (dryness of the cornea)
5.
Keratomalacia (softening of the cornea) and total blindness (END stage)
TAKE NOTE:
Alcoholism can cause deficiency in vitamin A(CBQ)
EARLY SIGN of VITAMIN A DEFICINECY/VAD is NIGHT BLINDNESS. (CBQ)
END STAGE of VITAMIN A DEFICIENCY is BLINDNESS. (CBQ)
Vitamin A toxicity: HYPERvitaminosis A
DIETS
Clear Liquid Diet
THERAPEUTIC DIETS
DESCRIPTION
foods/fluids that have no residue and
are liquid at room temperature
Primarily to prevent dehydration and
relieve thirst
Ordered before lab tests, examinations,
and surgery. – (CBQ)
Full Liquid Diet
▪Foods that are liquid or turns to liquid
when at room temperature– (CBQ)
- Provides nourishment for clients having
difficulty chewing/swallowing solid food
EXAMPLES
C lear soup and broth
C offee, water, tea
C lear juices– (CBQ)
C arbonated drinks
G inger ale
G elatin and popsicles– (CBQ)
M ilk and milkshakes– (CBQ)
I ce cream and sherbet
L iquid veggie and fruit juices
C ustard and pudding
S trained soup, fruit and
veggie juices, strained fruit–
(CBQ)
Mechanical Soft Diet
prescribed for patients who are unable to
chew due to dental problems, have
difficulty swallowing, or are recovering from
surgery
all soups, all liquids, cooked
veggies, canned fruit, ground
meat & veggies, tender fish &
poultry
Bland Diet
For gastrointestinal problems like
peptic ulcers and/or allergies
NO seasoning or fiber– (CBQ)
▪mashed potatoes. – (CBQ)
▪Milk products
▪White bread
▪Cooked cereals
BRAT diet
For gastrointestinal upsets like diarrhea
Bananas– (CBQ)
Rice
Applesauce
Toasted
BROW diet
For Celiac disease
▪Avoid foods like: B.R.O.W
B arley
R ye
O ats
W heat
GLUTEN FREE DIET– (CBQ)
Foods allowed:
C orn
R ice
O therslikefruits/veggies
P otato
Low purine diet
For Gouty arthritis/ high uric acid– (CBQ)
AVOID internal meat organs,
anchovies, sardines, fava
beans, spinach and asparagus
High Fiber Diet
Patients with constipation, diverticulosis
Cereals, fruits & vegetables
Lactose free diet
Lactose intolerance
Avoid lactose containing milk
products
SLEEP HYGIENE
SLEEP HYGIENE: A series of recommendations and practices designed to improve sleep
quality, quantity, and daytime alertness.
S tick to a sleep schedule, DRINK A GLASS OF WARM MILK BEFORE BED(CBQ)
L imit daytime naps. Exercising before sleep is NOT advisable.
E nsure a quite, relaxed and non stimulating room
E lectronic gadgets like cellphones, watching TV, playing radio should be AVOIDED (CBQ)
Pay attention to what you eat and drink ( AVOID EATING HEAVY MEALS BEFORE SLEEP)
 Avoid caffeinated foods and drinks like coffee, chocolates, soda, tea.
TAKE NOTE
MILK contains TRYPTOPHAN ( natural sedative component that induces sleep)
Bruxism
Insomnia
Narcolepsy
Cataplexy
Night terror
Nocturia
Enuresis
Sleep apnea, obstructive sleep
apnea
somnambulism
Somniphobia
Somniloquy
Nocturnal emission
SLEEP DISORDERS
Involuntarily grinding or clenching of the teeth while sleeping.
difficulty in falling asleep and/or maintaining sleep when no other
cause is found for these symptoms
Excessive daytime sleepiness (EDS) often culminating in falling
asleep spontaneously but unwillingly at inappropriate times(CBQ)
a sudden weakness in the motor muscles that can result in collapse
to the floor. (CBQ)
abrupt awakening from sleep with behavior consistent with terror
A frequent need to get up and urinate at night.
bed-wetting, in which the person does not arouse from sleep, but
the bladder nevertheless empties.
Obstruction of the airway during sleep, causing lack of sufficient
deep sleep, often accompanied by snoring.
Stops of breathing of at least ten seconds, 30 times within seven
hours of sleep, classifies as apnea.
Sleepwalking or engaging in activities that are normally associated
with wakefulness (such as eating or dressing), which may include
walking, without the conscious knowledge of the subject. (CBQ)
dread/ fear of falling asleep or going to bed.
Sleep talking
Wet dream, sex dream or sleep orgasm
involuntary ejaculation of semen during sleep