REVIEWER IN BASIC CONCEPTS IN NURSING

THEORETICAL FOUNDATIONS OF NURSING / FUNDAMENTALS OF NURSING

CONTEMPORARY NURSING PRACTICE

- Contemporary Nursing Practice includes the definitions of nursing, scope of nursing,
recipients of nursing, setting for nursing practice, and the current standards of clinical nursing
practice.
DEFINITIONS OF NURSING:
• NURSING – According to Virginia Henderson, it is the act of assisting clients (sick or well) in the
performance of activities contributing to health, its recovery or peaceful death that clients will perform
unaided if they had the necessary will, strength or knowledge and to do this in such a way as to help him
gain independence as rapidly as possible.
- Florence Nightingale defined Nursing as an act of utilizing the environment of the patient to assist
him in his recovery.
- According to American Nurses Association (1980), it is the diagnosis and treatment of human
responses to actual or potential health problems.
NURSING AS AN ART – It is an art of caring of sick & well individuals.
The art of nursing comes in as a nurse independently does his or her job. It refers to
the dynamic skills and methods in assisting sick & well individual in their recovery and in
the promotion and maintenance of health. It involves the application of knowledge in the
service of people.
NURSING AS A SCIENCE – It is the “body of knowledge” arrived through scientific
research & logical analysis. It is the scientific knowledge and skills in assisting individual
to achieve optimal health.
NURSING AS A PROFESSION – It is a vocation – a calling in which its members profess
to have acquired special knowledge by training or experience. Nurses provide selfless
service and adhere to the mantra of “Doing no harm”.
• According to the Canadian Nurses Association (1987), Nursing is a dynamic, caring, helping relationship
in which the nurse assists the client to achieve and obtain optimal health.
TIP: Guys! Maraming definitions ang Nursing. Just remember the key terms. Huwag magpapalito! 😊
THEMES ASSOCIATED IN DEFINITIONS OF NURSING
✓ Nursing is CARING.
✓ Nursing is AN ART.
✓ Nursing is a SCIENCE.
✓ Nursing is a CLIENT-CENTERED.
✓ Nursing is HOLISTIC.
✓ Nursing is ADAPTIVE.
✓ Nursing is concerned with HEALTH PROMOTION, HEALTH MAINTENANCE, AND HEALTH
RESTORATION.
✓ Nursing is a HELPING PROFESSION.
RECIPIENTS OF NURSING
1. Consumer – a person who utilizes health care products or services.
2. Patient – a person who is undergoing medical treatment and care. It comes from the Latin word meaning
“to suffer” or “to bear”. People become patients when they seek assistance due to illness/disease or for
surgery.
3. Client – for these reasons, nurses increasingly refer to recipients of health care as clients. A client is a
person who engages the advice or services of another who is qualified to provide this service. The term client
presents the receivers of health care as collaborators in the care.
SCOPE OF NURSING
1. Promoting health (state of optimum functioning or well-being with physical, social, spiritual, and mental
components);
2. Preventing illness (primary, secondary, and tertiary);
3. Restoring health; and
4. Caring for the dying

This reviewer is aimed to help and assist nursing students in pursing the course of BS Nursing. The author of this reviewer is not responsible for errors or omissions. EPSR 2020
DIMENSIONS OF NURSING
1. Nursing Practice
2. Nursing Education
3. Nursing Research

SCOPE OF NURSING PRACTICE IN THE PHILIPPINES

• Republic Act No. 9173 or also known as the PHILIPPINE NURSING ACT OF 2002.
SEC. 28. Scope of Nursing. — A person shall be deemed to be practicing nursing within the meaning
of this Act when he/she singly or in collaboration with another, initiates and performs nursing services
to individuals, families and communities in any health care setting. It includes, but not limited to,
nursing care during conception, labor, delivery, infancy, childhood, toddler, pre-school, school age,
adolescence, adulthood and old age.
As independent practitioners, nurses are primarily responsible for the promotion of health and
prevention of illness. As members of the health team, nurses shall collaborate with other health care
providers for the curative, preventive, and rehabilitative aspects of care, restoration of health,
alleviation of suffering, and when recovery is not possible, towards a peaceful death.

ROLES AND FUNCTIONS OF NURSES

1. Caregiver – Caregiving encompasses the physical, psychosocial, developmental, cultural & spiritual
levels. The Nursing process provide the Nurses framework in providing client care.
2. Communicator – Communication is an integral part to all nursing roles. In this role, nurses identify the
problems of a client and address these verbally or in writing to other members of the health care team. This
role is an important factor in nursing care.
3. Educator – In this role, the nurse helps the clients learn about their health and the health care procedures
that they need to perform to restore and maintain their health by providing them the appropriate health
teachings and health education.
4. Client Advocate - A client advocate acts to protect the client. In this role the nurse may represent the
clients in exercising their rights and help them speak up for themselves.
5. Counselor – helps client recognize and cope with stressful psychological and social problems, develop
interpersonal relationships, and promote personal growth.
6. Change Agent - Nurses are continually coping up with changes in the health care system.
7. Leader – A nurse influences others to work together to accomplish a specific goal.
8. Manager – A nurse manager delegates nursing activities to ancillary workers and other nurses
and supervises and evaluates them.

EXPANDED CAREER ROLES OF NURSES

1. Nurse Practitioner – A nurse who has an advanced education and a graduate of a nurse practitioner
program.
2. Clinical Nurse Specialist – A nurse who has an advanced degree or expertise and is considered to be
an expert in a specialized area of practice. (e.g., ICU, Emergency, Gerontology, Oncology, OR, etc.)
3. Nurse Anesthetist – A nurse who has completed advanced education in an accredited program in
anesthesiology.
4. Nurse Midwife – An RN who has completed a program in Midwifery, He/she gives prenatal and postnatal
care and manages deliveries in normal pregnancies.
5. Nurse Researcher – Nurse researchers investigate nursing problems to improve nursing care and to
refine and expand nursing knowledge.
6. Nurse Administrator – The nurse administrator manages client care, including delivery of nursing
services. The functions include budgeting, staffing, and planning programs.
7. Nurse Educator – The nurse educator is employed in nursing programs where they mentor student nurses
for classroom and clinical teaching.
8. Nurse Entrepreneur – A nurse who usually has an advanced degree and manages a health-related
business.

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CRITERIA OF A PROFESSION
– An occupation that requires extensive education or a calling that requires special skills, knowledge
and attitudes.
✓ 6 ATTRIBUTES OF A PROFESSION
1. Specialized Training to acquire body of knowledge
2. Code of Ethics
3. Service Orientation
4. Autonomy
5. Ongoing research
6. Professional Organization

SOCIALIZATION TO NURSING
- It is a process where a person learns the ways and means or knowledge, skills or attitudes of the
group to which he belongs to.
✓ PATRICIA BENNER’S STAGES OF NURSING EXPERTISE
1. Novice – student nurse entering a clinical setting where he has no experience at all.
2. Advance – nurse who demonstrates a marginally acceptable performance: depends
on rules and maxims.
3. Competent – 2 or 3 years of experience demonstrates organizational ability but lacks
speed and flexibility of a proficient nurse.
4. Proficient – concerned with long term goals, performance is fluid and flexible compared
to competent nurse.
- has a wholistic view of the client.
5. Expert – no longer relies on maxims, performance is highly proficient, fluid flexible and
has a wholistic view.
- has high perceptual acuity or a clinical eye.
TIP: Just remember the term, NACPE. 😊

HISTORY OF PHILIPPINE NURSING

The earliest Hospitals in the Philippines were:
Hospital Real de Manila (1577) – it was established mainly to care for the Spanish king’s
soldiers, but also admitted Spanish civilians; it was founded by Gov. Francisco de Sande.
San Lazaro Hospital (1578) – founded by Brother Juan Clemente and built exclusively for
patients with leprosy. In the present time, SLH is a tertiary health facility for Communicable
Diseases.
Hospital de Indios (1586) – established by the Franciscan Order; service was in general
supported by alms and contributions from charitable persons.
Hospital de Aguas Santas (1590) – established in Laguna. It was founded by Brother J. Bautista
of the Franciscan Order.
San Juan de Dios Hospital (1596) – founded by the Brotherhood of Misericordia. The support
was delivered from alms and rents; it rendered general health service to the public.
The Philippine and Spanish war in the late 1890s was resulted to number of casualties. With this, many women
have assumed the role of nurses in order to render their service to the wounded soldiers. The emergence of
Filipina nurses brought about the development of Philippines Red Cross. The following people pioneered the
works of Nursing during the Philippines Revolution:
Josephine Bracken — wife of Jose Rizal, installed a field hospital in an estate house in Tejeros.
She provided nursing care to the wounded night and day.
Rosa Sevilla de Alvero — converted their house into quarters for the Filipino soldiers; during the
Philippine-American War that broke out in 1899.
Dona Hilaria de Aguinaldo — wife of Emilio Aguinaldo who organized that Filipino Red Cross.
Dona Maria Agoncillo de Aguinaldo — second wife of Emilio Aguinaldo; provided nursing care
to Filipino soldiers during the revolution, President of the Filipino Red Cross branch in Batangas.
Melchora Aquino a.k.a. “Tandang Sora” — nursed the wounded Filipino soldiers and gave
them shelter and food.

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 Capitan Salome — a revolutionary leader in Nueva Ecija; provided nursing care to the wounded
when not in combat.
Agueda Kahabagan — revolutionary leader in Laguna, also provided nursing services to her
troops.
Hospitals & Schools of Nursing:
Iloilo Mission Hospital School of Nursing (Iloilo City, 1906)
✓ The first hospital in the Philippines which trained Filipino nurses in 1906.
✓ It was ran by the Baptist Foreign Mission Society of America. Miss Rose Nicolet, was the first
superintendent for nurses.
✓ Miss Flora Ernst, an American nurse, took charge of the school in 1942. In April 1944,
graduate nurses took the first Nurses Board Examination at the Iloilo Mission Hospital.
Saint Paul’s Hospital School of Nursing (Manila, 1907)
✓ The hospital was established by the Archbishop of Manila, Jeremiah Harty under the
supervision of the Sisters of St. Paul de Chartres which is located in Intramuros.
Philippine General Hospital School of Nursing (Manila, 1907)
✓ In 1907, with the support of Governor General Forbes and the Director of Health and among
others, she opened classes in nursing under the Auspices of the Bureau of Education.
✓ Anastacia Giron-Tupas was known as the Dean of Philippine Nursing and the first Filipino
Nurse to occupy the position of Chief Nurse and Superintendent. She was also the founder of
the Philippine Nurses Association (PNA).
St. Luke’s Hospital School of Nursing (Quezon City, 1907)
✓ The hospital is an Episcopalian Institution. It began as a small dispensary in 1903. In 1907,
the school opened with three girls admitted.
✓ Vitaliana Beltran was the first Filipino superintendent of nurses and Dr. Jose Fores was the
first medical director of the hospital.
Mary Johnston Hospital and School of Nursing (Manila, 1907)
✓ It started as a small dispensary on Calle Cervantes (now Avenida).
It was called the Bethany Dispensary and funded by the Methodist Mission for the relief of
suffering among women and children.
✓ Sister Rebecca Parrish together with registered nurses Rose Dudley and Gertude Dreisbach
organized the Mary Johnston School of Nursing in 1907.
Philippine Christian Mission Institute Schools of Nursing
✓ The United Christian Missionary Society of Indianapolis, Indiana- a Protestant organization of
the disciples of Christ operated three schools of nursing, namely:
o Sallie Long Read Memorial Hospital School of Nursing (Laoag Ilocos Norte,
1903)
o Mary Chiles Hospital School of Nursing (Manila, 1911)
o Frank Dunn Memorial Hospital (Vigan Ilocos Sur, 1912)
San Juan de Dios Hospital School of Nursing (Manila, 1913)
✓ Through the initiative of Dr. Benito Valdez, the board of inspectors and the executive board of
the hospital passed a resolution to open school of nursing in 1913. The school has been run
by the Daughters of Charity since then. Sister Taciana Tinanes was the first Directress of the
School.
Emmanuel Hospital School of Nursing (Capiz, 1913)
✓ In 1913, the American Baptist Foreign Mission Society sent Dr. PH Lerrigo to Capiz for the
purpose of opening a hospital. Miss Rose Nicolet assisted him.
✓ Miss Clara Pedroso was the first principal.
Southern Islands Hospital School of Nursing (Cebu, 1918)
✓ The hospital was established under the Bureau of Health in 1911.
✓ Miss Anastacia Giron-Tupas organized its school opening in 1918.
✓ Miss Visitacion Perez was the first principal.
Other Schools of Nursing:
Zamboanga General Hospital School of Nursing (1921)
Chinese General Hospital School of Nursing (1921)
Baguio General Hospital School of Nursing (1923)

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 Manila Sanitarium Hospital and School of Nursing (1930)
St. Paul School of Nursing in Iloilo City (1946)
North General Hospital and School of Nursing (1946)
Silliman University School of Nursing (1947)
First Colleges of Nursing in the Philippines were:
University of Santo Tomas-College of Nursing (1946)
Manila Central University-College of Nursing (1947)
University of the Philippines Manila-College of Nursing (1948)

NURSING THEORIES & CONCEPTUAL FRAMEWORKS

✓ Theory – According to Kozier & Erb’s (2007), a theory has been defined as a supposition or system of
ideas that is proposed to explain a given phenomenon. Theories are used to describe, predict, and control
phenomena.
✓ Concepts - often called as the building blocks of theories.
✓ Conceptual Framework – is a group of related ideas, statements or concepts. Freud’s structure of the
mind (id, ego, superego) could be considered a conceptual framework.
✓ Grand Theory – broad range of relationships among the concepts of discipline (Fitzpatrick & Whall,
2005).
✓ Paradigm – refers to the pattern of shared understanding and assumptions about reality and the world.

THE METAPARADIGM FOR NURSING

Theoretical work in Nursing focused on articulating relationships among four major concepts: PERSON,
ENVIRONMENT, HEALTH & NURSING. Because these four concepts can be superimposed on almost any
work in Nursing, they are collectively referred to as METAPARADIGM FOR NURSING. The term originates from
two Greek words: meta, meaning “with” and paradigm, meaning “pattern”.
• FOUR CONCEPTS CENTRAL TO NURSING:
✓ Person or client – the recipient of care (includes INDIVIDUALS, FAMILIES, GROUPS &
COMMUNITIES)
✓ Environment – the internal and external surroundings that affect the client. This can be the
physical environment such as families, friends & significant others.
✓ Health – defined as the degree of wellness or well-being that the client experiences.
✓ Nursing – the attributes, characteristics, and actions of nurse in providing care to the client.

NURSING THEORISTS AND THEIR WORKS:

• FLORENCE NIGHTINGALE
✓ The Founder of Modern Nursing
✓ Born in Florence, Italy and became a hero because of the Crimean War and was referred to as
Lady with the Lamp.
✓ Environmental Theory (manipulation of the physical environment as the major component of
nursing care)
✓ Concerns of the Environmental Theory includes proper ventilation, light, cleanliness, warmth, diet
and quiet environment, unnecessary noise, dietary intake, and petty management.
• VIRGINIA HENDERSON
✓ Known for her Definition of Nursing – to assist an individual (sick or healthy) in performing
activities that contribute to health or recovery.
✓ She categorized Nursing activities into 14 components, based on human needs.
The 14 components
1. Breathe normally.
2. Eat and drink adequately.
3. Eliminate body wastes.
4. Move and maintain desirable postures.
5. Sleep and rest.
` 6. Select suitable clothes-dress and undress.
7. Maintain body temperature within normal range by adjusting clothing and modifying
environment

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 8. Keep the body clean and well-groomed and protect the integument
9. Avoid dangers in the environment and avoid injuring others.
10. Communicate with others in expressing emotions, needs, fears, or opinions
11. Worship according to one’s faith.
12. Work in such a way that there is a sense of accomplishment.
13. Play or participate in various forms of recreation.
14. Learn, discover, or satisfy the curiosity that leads to normal development and health
and use the available health facilities
*components 1-9: PHYSIOLOGIC AND SAFETY NEEDS
*components 10 & 14: PSYCHOLOGICAL ASPECTS OF COMMUNICATING
AND LEARNING
*component 11: SPIRITUAL AND MORAL
*component 12 & 13: SOCIOLOGICALLY ORIENTED TO OCCUPATION AND
RECREATION.
• FAYE GLENN ABDELLAH
✓ Typology of Twenty-One Nursing Problems
✓ Her model of nursing was progressive for the time in that it refers to a nursing diagnosis during a
time in which nurses were taught that diagnoses were not part of their role in health care.
1. To maintain good hygiene and physical comfort
2. To promote optimal activity: exercise, rest, sleep
3. To promote safety through prevention of accident, injury, or other trauma and through
prevention of the spread of infection
4. To maintain good body mechanics and prevent and correct deformity
5. To facilitate the maintenance of a supply of oxygen to all body cells
6. To facilitate the maintenance of nutrition for all body cells
7. To facilitate the maintenance of elimination
8. To facilitate the maintenance of fluid and electrolyte balance
9. To recognize the physiologic responses of the body to disease conditions—pathologic,
physiologic, and compensatory
10. To facilitate the maintenance of regulatory mechanisms and functions
11. To facilitate the maintenance of sensory function
12. To identify and accept positive and negative expressions, feelings, and reactions
13. To identify and accept interrelatedness of emotions and organic illness
14. To facilitate the maintenance of effective verbal and nonverbal communication
15. To promote the development of productive interpersonal relationships
16. To facilitate progress toward achievement and personal spiritual goals
17. To create or maintain a therapeutic environment
18. To facilitate awareness of self as an individual with varying physical, emotional, and
developmental needs
19. To accept the optimum possible goals in the light of limitations, physical and emotional
20. To use community resources as an aid in resolving problems that arise from illness
21. To understand the role of social problems as influencing factors in the cause of illness
• DOROTHEA OREM
✓ Self-Care Deficit Theory
✓ Self-Care Theory is based on four concepts:
o Self-Care – practice of activities that individuals initiate and perform on
their behalf to maintain life, health, and well-being
o Self-Care Agency – the human’s ability or power to engage in self-care. It
consists of two agents:
❖ Self-Care Agent – an individual who performs self-care
independently.
❖ Dependent Care Agent – a person other than the individual
provides the care.
o Self-Care Requisites -also called self-care needs, are measures or
actions taken to provide self-care. There are three categories which are:

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 ❖ Universal requisites
❖ Developmental Requisites
❖ Health Deviation Requisites
o Therapeutic Self-Care Demand – refers to all self-care activities required
to meet existing self-care requisites or actions to maintain health and well-
being.
✓ Self-Care Deficit - impaired ability to perform or complete activities of daily living for oneself, such
as feeding, dressing, bathing, toileting. It results when self-care agency is not adequate to meet
known self-care demand.
Theory of Nursing Systems
a. Wholly Compensatory Systems – are required for individuals who are unable to
control and monitor their environment and process information.
b. Partly Compensatory Systems – are deigned for individuals who unable to perform
some, but not all, self-care activities.
c. Supportive-Educative systems – are designed for persons who need to learn to
perform self-care measures and need assistance to do so.
TIP: Ang palatandaan ko kay DOROTHEA ay yung letter ‘D” sa name niya, is for DEFICIT. Lahat
kasi ng Nursing Theorists ay may CARE ang mga theories nila. So, para matandaan ko na SELF-CARE
DEFICIT ang kay DOROTHEA, yung nga letter “D” is for DEFICIT.
• MARTHA ROGERS
✓ Unitary Human Beings
✓ The theory views nursing as both a science and an art. It provides a way to view the unitary human
being, who is integral with the universe. The unitary human being and his or her environment are
one. Nursing focuses on people and the manifestations that emerge from the mutual human-
environmental field process.
✓ Rogers views the person as an irreducible whole, the whole being greater than its parts. Whole
is differentiated from Holistic, the latter often used to mean only the sum of all parts.
✓ The “human field image” perspective surpasses that of the physical body. Both human and
environmental fields are characterized by pattern, a universe of open systems, and four
dimensionally.
5 assumptions about human beings
1. Man is a unified whole – whole not equal to sum of parts.
2. Individual and environment are continuously exchanging matter and energy.
3. Lifecycle evolves irreversibly and uni-directionally along space and time continuum.
4. Life patterns identify individuals.
5. Humans have the capacity for absorption and imagery, language and thought,
sensation and emotion.
TIP: May weird mnemonic ako rito. Hahaha. Eto --- kapag kumain kayo sa KENNY ROGERS
(restaurant), isipin mo na kasama mo yung family mo --- UNITED kayong kumakain. UNITED kayo bilang
HUMAN BEINGS. Hahaha. So, kay MARTHA ROGERS, Unitary Human Beings.
• IMOGENE KING
✓ Goal Attainment Theory
✓ The nurse and patient mutually communicate, establish goals and take action to attain goals.
✓ Humans are open systems in constant interaction with their environment.
✓ Nursing focus: human interact with the environment. - Nursing Goal: humanistic maintenance of
individuals and groups. - Interacting components are personal, interpersonal, social.
✓ Elements: interaction, communication, transaction role, stress.
TIP: Ang palatandaan ko rito ay kapag naging KING (Hari) ka na, may GOAL ATTAINMENT ka
na. Hehe.
• DOROTHY JOHNSON
✓ Behavioral Systems Model
✓ Man’s subsystem
-Behavioral subsystem: addressed by nursing intervention.
- Biological subsystem: addressed by medical intervention.

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 ✓ Goal of Nursing
a. demonstrate behavior commensurate to social demands.
b. modify behavior to support biological needs.
c. benefit from physician’s skill and knowledge.
d. demonstrate behavior that does not give evidence of unnecessary trauma.
✓ Nursing focus: behavior modification to foster equilibrium.
• HILDEGARD PEPLAU
✓ Interpersonal Relationship in Nursing
✓ Purpose of nursing is to educate and to be a nurturing force to a patient for him to get a new view
of himself.
✓ Interaction is a maturing force.
Phase of Nurse – Patient Relationship
1. Orientation – The client seeks and the nurse assists the client to understand the problem
and the extent of the need for help.
2. Identification – selective response of the client to those who can meet his needs; affected by
client’s belief.
3. Exploitation – client takes control of the situation by extracting help from nurse.
4. Resolution – evaluation of care and discharge of client.
TIP: Kay PEPLAU naman, yung PEPL sa PEPLAU niya ay for PEPL, meaning PEOPLE. Diba
kapag Interpersonal, you communicate with PEoPLe. Tandaan lang yung PEPL----PEOPLE kaya
INTERPERSONAL.
• JEAN WATSON
✓ Philosophy and Science of Human Caring
✓ Watsons (2005) believes that the practice of caring if central to nursing; it is the unifying focus for
practice.
10 Carative Factors:
✓ Formation of a Humanistic-altruistic system of values;
✓ Instilling Faith-Hope;
✓ Cultivating a sensitivity to self and others;
✓ Developing a helping-trust relationship;
✓ Promoting an expression of feelings;
✓ Using problem-solving for decision-making;
✓ Promoting teaching-learning;
✓ Promoting a supportive environment;
✓ Assisting with gratification of human needs; and
✓ Allowing for existential-phenomenological forces.
TIP: Eto pa, kay JEAN WATSON naman. Kapag kasi nagpupunta akong WATSONS, naiisip ko
na skin CARE products ang flagship nila. Isipin mo na sa WATSONs ay may mga skin CARE
products. WATSONs > CARE as in HUMAN CARING.
• IDA JEAN ORLANDO
✓ Deliberative Nursing Process Theory
✓ This allows nurses to formulate an effective nursing care plan that can also be easily adapted
when and if any complexity comes up with the patient.
✓ She proposed that “patients have their own meanings and interpretations of situations and
therefore nurses must validate their inferences and analyses with patients before drawing
conclusions.”
• MADELEINE LEININGER
✓ Transcultural Nursing Theory
✓ For her, nursing is a humanistic and scientific mode of helping a client through specific
cultural caring processes (cultural values, beliefs and practices) to achieve optimal health.
✓ Culture – it consists of the values, beliefs, systems of language, communication, and practices
that a group of people share with.
✓ In order for nurses to assist people of diverse cultures, Leininger presents three intervention
modes:
Culture care preservation and maintenance

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 Culture care accommodation, negotiation, or both
Culture care restructuring and repatterning
• BETTY NEUMAN
✓ Health Care Systems Model
✓ She developed this model based on the individual’s relationship to stress, the reaction to it, and
reconstitution factors that are dynamic in nature. Reconstitution is the state of adaptation to
stress.
✓ According to her, a person is an open system that consists of a basic structure or central core of
energy resources such as:
Physiological variable which pertains to the structure and functions of the body.
Psychological variable which pertains to mental processes and relationships.
Sociocultural variable which pertains social and cultural expectations and
activities.
Developmental variable which pertains to those processes related to
development over the lifespan.
Spiritual variable which pertains to the influence of spiritual beliefs.
✓ Neuman categorizes stressors as:
Intrapersonal stressors – occur within the individual (e.g. a disease, an infection)
Interpersonal stressors – occur between individuals (e.g. unrealistic role
expectations)
Extra personal stressors – occur outside the person (e.g. financial constraints)
• SISTER CALLISTA ROY
✓ Adaptation Model of Nursing
✓ Roy (1997) defines adaptation as “the process and outcome whereby the thinking and feeling
person uses conscious awareness and choice to create human & environmental integration”.
✓ She views the client as a biophysical being that responds to a feedback cycle of input (stimuli),
throughput (control processes), and output (behaviors or adaptive responses).
✓ The goal of Callista Roy’s model is to enhance life processes through adaptation in four adaptive
modes. Individuals respond to needs (stimuli) in one of the four modes:
Physiologic Mode – It involves the body’s basic physiologic needs and ways of
adapting with regard to:
o Fluid & electrolytes
o Activity & Rest
o Circulation & Oxygen
o Nutrition & Elimination
o Protection
o The Senses
o Neurologic
o Endocrine Function
Self-Concept Mode – It has two components: Physical Self which involves
sensation & image. The other one is the Personal Self which involves self-ideal,
self-consistency, and the moral-ethical self.
Role Function – refers to the duties based on given positions within society.
Interdependence Mode – refers to one’s relations with significant others and
support systems.
• ROSEMARIE RIZZO PARSE
✓ Theory of Human Becoming
✓ Parse’s Model of Human Becoming emphasizes how individuals choose and bear
responsibility for patterns of personal health.
✓ Parse (1999) proposed three assumptions about human becoming:
Human becoming is freely choosing personal meaning in situations in the
intersubjective process of relating value priorities.
Human becoming is cocreating rhythmic patterns or relating in mutual process with
the universe.
Human becoming is cotranscending multidimensionally with emerging possible.

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LEGAL ASPECTS IN NURSING
✓ Nursing Practice is governed by many legal concepts. It is important for nurses to know the basics
of legal concepts. An essential concept of professional nursing practice and the law is the
accountability.
Informed Consent – is an agreement by which a patient/client to accept a course
of treatment or a procedure.
Two types:
o Express – may be either oral or written agreement. The more the
invasive the procedure, the more it requires written permission.
o Implied – when an individual’s nonverbal behavior indicates
agreement. For example, when an individual position their bodies
for an injection or when they cooperate when taking vital signs.
Elements of an informed consent:
o Voluntary
o Informed
o Competent
o Signature
✓ To give consent voluntarily, the patient/client must not feel coerced. Coercion invalidates the
consent.
Areas of Potential Liability in Nursing
o Crime – an act committed that violates the public law and can be
punished by a fine or imprisonment. It is classified as:
▪ Felonies – a crime of serious nature, e.g. Murder.
▪ Manslaughter – second-degree murder
o Misdemeanor – an offense of a less serious in nature but can be
punished by a fine or short-term jail sentence or both, e.g. When a
Nurse slaps a patient/client’s face.
o Tort – a civil wrong that is committed against a person or person’s
property. It may be classified as:
▪ Unintentional – do not require intent but do not
require the element of harm
❖ Negligence – failure to meet a
standard of behavior that caused
harm or injury to others.
❖ Malpractice – “professional
negligence”, a negligence occurred
while the person was performing as a
professional. This includes six
elements:
- Duty
- Breach of Duty
- Foreseeability
- Causation
- Harm or injury
- Damages
▪ Intentional Tort – wrongful acts done on a purpose.
❖ Assault – an attempt or threat to
touch another person.
❖ Battery – willful touching of a person
that may or may not cause harm.
❖ False Imprisonment – “unjustifiable
detention of a person without warrant
to confine the person” (Guido, 2006).
❖ Invasion of Privacy

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 ❖ Defamation – libel and slander
Libel – a defamation by means of
writing, print, or pictures.
Tip: L is for LETRA.
Slander – a defamation by spoken
word or false word by which a
reputation is damaged.
Tip: S is for SINABI.
MORALITY & ETHICS
✓ Ethics – a discipline that is concerned with what is morally right & wrong.
✓ Morality – personal standards of what is right and wrong in conduct, character and attitude.
✓ Bioethics – ethics that are applied to human life or health.
✓ Nursing Ethics – ethics applied to nursing practice.
Moral Principles
o Autonomy – refers to right to make one’s own decisions.
o Nonmaleficence – is duty to “do no harm”
o Beneficence – means “doing good”.
o Justice – referred to fairness.
o Fidelity – means being faithful to agreements and promises.
o Veracity – refers to telling the truth
o According to the Code of Ethics for Nurses (ANA, 2001), accountability
means “answerable to oneself and others for one’s own actions,” while
responsibility refers to “the specific accountability or liability associated
with the performance of duties of a particular role.”
HEALTH CARE DELIVERY SYSTEM
✓ Health Care System – According Miller-Keane (1987), it is an organized plan of health services.
✓ Health Care Delivery – According to Williams-Tungpalan (1981), it is a network of health facilities
and personnel which carries out the task of rendering health care to the people.
Philippine Health Care Delivery System – classified as:
o Public – financed through tax-based system from the government
▪ National – DOH (Regional Hospitals, Medical
Centers, DOH representatives, etc.)
▪ Local – LGU (Provincial & District Hospitals, RHUs,
Barangay Health Stations, etc.)
o Private – run by individuals & companies
▪ Profit – Private hospitals, clinics
▪ Non-profit – organizations, foundations
Levels of Disease Prevention (WONCA, 2003)
o Primary Prevention: action taken to avoid or remove the cause of a health
problem in an individual or a population before it arises.
• Health Promotion
• Specific Protection (e.g. Immunizations)

o
Secondary Prevention: action taken to detect a health problem at an early
stage in an individual or a population, thereby facilitating a cure or reducing
or preventing it spreading or long-term effects.
e.g. Screening, Case Finding, Early Diagnosis
o Tertiary Prevention: action taken to reduce the chronic effects of a health
problem in an individual or a population by minimizing the functional
impairment consequent to the acute or chronic health problem
e.g. Rehabilitation
o Quaternary Prevention: Action taken to protect individuals
(persons/patients) from medical interventions that are likely to cause more
harm than good.
✓ Referral System – proper channeling of health services.

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NURSING PROCESS
✓ Nursing Process is a systematic, rational method of planning and providing individualized nursing
care. The phases of the nursing process – Assessment, Diagnosis, Planning, Implementation,
and Evaluating. In short, ADPIE. The purpose of the nursing process is to identify the client’s health
status, to establish plans to meet the identified needs & to deliver interventions to meet those needs.
✓ Lydia Hall originated the term nursing process in 1955, Dorothy Johnson (1959), Ida Jean Orlando
(1961), and Ernestine Wiedenbach (1963) were among the first to use it refer to a series of phases
describing the practice of nursing.
Characteristics of Nursing Process
o Cyclic (a cycle) that is continuously changing (dynamic) rather than staying
the same (static)
o Client-centered - nurse organizes plan of care according to client problems
rather that nursing goals
o Interpersonal & Collaborative – nurse-patient relationship
o Universally applicable – used as a framework for all nursing care in all types
of clinical settings, with clients of all age groups.
ADPIE
o ASSESSMENT – is the systematic and continuous collection,
organization, validation & documentation of data (information). There
are four types of assessment: Initial Assessment, Problem-focused
Assessment, Emergency Assessment, and Time-lapsed Assessment.
▪ Types of Data
1. Subjective Data – also referred symptoms or covert data;
client’s point of view (S for SINABI NG PASYENTE). Examples
of subjective are itching, pain, feelings of worry, etc.
2. Objective Data – also referred to as signs or overt data;
measurable data obtain by observation or physical examination
(O for na-OBSERVE MO SA PASYENTE). Examples of objective
data are discoloration of skin, BP of 120/80 mmHg, etc.
▪ Sources of Data
1. Primary – the client is the primary source of data
2. Secondary – Family members/significant others, other
health professionals, records, reports, laboratory & diagnostic
analyses.
▪ Data Collection Methods
1. Observing – to observe is to gather data using senses; it is a
conscious, deliberate skill that is developed through effort and with
an organized approach.
2. Interviewing – planned communication between the patient
and the nurse.
3. Examining – the physical examination/assessment is a
systematic data collection that uses observation.
o DIAGNOSIS –clinical judgment made after thorough, systematic data
collection of an individual, family or community responses to actual and
potential health problems.
▪ North American Nursing Diagnosis Association (NANDA)
- The purpose of NANDA is to define, refine, and promote
taxonomy of nursing diagnostic terminology of general use to
professional nurses.
TIP: Okay guys. Ang NANDA ay may list ng mga iba’t ibang nursing
diagnosis na gagamitin niyo once na nag-du-duty na kayo. Isa yun
handbook. Doon kayo mag-be-based as a reference kapag gagawa
kayo ng nrsg dx.

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 ▪ Types of Nursing Diagnosis
1. Actual Diagnosis – is a client problem that is present in the
time of assessment. Example: Ineffective breathing pattern, etc.
2. Risk Nursing Diagnosis – shows presence of risk factors
that indicate a problem. Example: Risk for impaired skin integrity
related to immobility, Risk for Injury related to generalized
weakness, Risk for Infection related to post-surgical incision, etc.
3. Wellness Diagnosis - clinical judgment about an individual,
family and community in transition from a specific level of wellness
to a higher level of wellness. Example: Readiness for Enhanced
Family Coping, Readiness for Enhanced Spiritual Being
4. Possible Nursing Diagnosis - evidence about a certain
problem is unclear and need to gather more data to support it.
5. Syndrome Diagnosis – a diagnosis that is associated with a
cluster of other diagnosis
▪ Components of Nursing Diagnosis
1. Problem and its definition – describes the client’s health
problem. It contains qualifiers such as:
o Deficient
o Impaired
o Decreased
o Ineffective
o Compromised
2. Etiology (Related factors and Risk factors) – identifies the
probable cause of the health problems.
3. Defining Characteristics – cluster of signs & symptoms that
indicate presence of a particular diagnostic label.
o Basic Three-Part Statements – The basic three-part nursing
diagnosis statement is called the PES format and includes the
following:
▪ Problem (P) – statement of the client’s response (NANDA label)
▪ Etiology (E) – factors contributing to the response
▪ Signs & Symptoms (S) – defining characteristics manifested by
the client
Examples:
1. Acute Pain related to surgical incision as manifested by facial
grimace and verbal report of pain in a scale of 7/10 in the post-
surgical site.
2. Fluid Volume Deficit related to frequent loss of bowel movement
as manifested by decreased skin turgor.
o PLANNING–is a deliberative, systematic phase of the nursing process that
involves decision making and problem solving. In planning, the nurse
formulates client’s goal and designs the nursing interventions required to
prevent, reduce, or eliminate the client’s health problems.
▪ TYPES OF PLANNING
- Initial Planning
- Ongoing Planning
- Discharge Planning
▪ PRIORITY SETTING
- is the process of establishing a preferential sequence for
addressing nursing diagnosis and interventions. Nurses use
Malow’s Hierarchy of Needs when setting priorities. Physiologic
needs such as air, food, and water are basic needs and receive the
higher priority than need for security or activity. Thus, nursing
diagnosis such as Ineffective Airway Clearance and Impaired Gas
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 Exchange would take priority over nursing diagnoses such as
Anxiety or Ineffective Coping.
▪▪ Characteristics of the Planning Process
▪ S – Specific
M – Measurable
A – Attainable
R – Realistic
T – Time bound

o IMPLEMENTING- consists of doing and documenting the activities that are

specific nursing actions needed to carry out the intervention. The nurse
performs or delegates the nursing activities for the interventions that were
developed in the planning step.
▪ IMPLEMENTING SKILLS
- Cognitive Skills – include problem solving, decision
making, critical thinking, clinical reasoning, and creativity.
- Interpersonal skills – these are activities, verbal and
non-verbal, people use when interacting directly to one
another.
- Technical skills – are purposeful “hands-on” skills such
as manipulating equipment, giving rejections, bandaging,
moving, lifting, and repositioning clients.
▪ TYPES OF INTERVENTIONS
1. Independent – A nurse can carry these interventions on
their own. Example of independent nursing action is
educating a patient about a medication.
2. Dependent – These interventions require an order from
a physician, such as drug prescription.
3. Interdependent – Nurses work with other members of
the health care team in performing these interventions.
o EVALUATING- is a planned, ongoing purposeful activity in which clients
and health care professional determine:
▪ Client’s progress toward achievement of goals/outcomes
▪ The effectiveness of Nursing Care Plan
- After the care plan has been implemented, the nurse
evaluates the client’s health status and effectiveness of the
care plan in achieving client’s goals.
o DOCUMENTING – the process of making an entry on a client record is
called recording, charting or documenting.
- WHEN IT IS NOT DOCUMENTED, IT IS UNDONE.
▪ Purposes of Client Records
1. Communication
2. Planning Client Care
3. Auditing Health Agencies
4. Research
5. Education
6. Health Care Analysis
HEALTH, WELLNESS, & ILLNESS
✓ Traditionally, health was defined in terms of presence or absence of disease.
✓ Nightingale (1860/1969) defined health as a state of being well and using every power the individual
possesses to the full extent.
✓ The World Health Organization (WHO) in 1948 defined health in a more holistic view as a “state of
complete physical, mental and social well-being, not merely the absence of disease or infirmity.”
✓ Wellness is a state of well-being. Anspaugh, Hamrick, & Rosato (2011) propose seven components of
wellness:

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 o
Environmental
o
Social
o
Emotional
o
Physical
o
Spiritual
o
Intellectual
o
Occupational
MODELS OF HEALTH AND WELLNESS
➢ Clinical Model – people viewed as physiological system with related
functions, and health is identified by the absence of signs and symptoms
of disease or injury. It is considered the state of not being “sick”. In this
model, the opposite of health is disease or injury.
➢ Role Performance Model – In this model, health is defined in terms of an
individual’s ability to fulfill societal roles – to perform his/her work. It is
assumed in this model that sickness is the inability to perform one’s work
role.
➢ Adaptive Model – In this model, health is a creative process; disease is a
failure in adaptation, or maladaptation. The aim of this is to restore the
ability of the person to adapt, to cope.
➢ Eudaimonistic Model – In this model, the highest spiration of people if
fulfillment and complete development, which is actualization. Illness in this
model, is a condition that prevents self-actualization.
➢ Agent-Host Environment Model – also called as the ecologic model, it
was originated in the community health work of Leavell and Clark (1965)
and has three dynamic interactive elements:
o Agent – any environmental factor or stressor (biologic,
chemical, mechanical, physical, or psychosocial) that by its
presence or absence cam lead to a disease or injury.
o Host – Person(s) who may or may not be risk of acquiring a
disease. Family history, age, and lifestyle habits influence
the host’s reaction.
o Environment – All factors external to the host that may or
may not predispose the person to the development of
disease.
➢ Health-Illness Continua – Health-Illness continua can be used to measure
a person’s perceived level of wellness. Health and Illness or disease can
be viewed as the opposite ends of a health continuum.
ILLNESS & DISEASE
✓ Illness is a highly personal state in which the person’s physical, emotional, intellectual, social,
developmental, or spiritual functioning is thought to be diminished. It is not synonymous with disease and
may or may not be related to disease.
Two types of Illness:
Acute Illness - Sudden in onset, less than six (6) months
Chronic Illness - Gradual in onset, more than six (6) months

Types of Chronic Illness

- Exacerbation Period - characterized by active signs and
symptoms of the illness.
- Remission - Periods where no signs and symptoms are
present.
✓ Disease can be described as an alteration in body functions which result to reduction of capacities or a
shortening of the normal life span.
✓ The causation of a disease or condition is called its etiology.

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 SUCHMAN (1979) DESCRIBED FIVE STAGES OF ILLNESS
o Stage 1: Symptom Experience – In this stage, a person experiences
some symptoms such as pain, rash, cough, fever, or bleeding. Stage 1 has
three aspects:
▪ The physical experience of symptoms
▪ The cognitive aspect
▪ The emotional response
o Stage 2: Assumption of the sick role – The individual now accepts the
sick role and seeks confirmation from family and friends.
o Stage 3: Medical Care Contact – Sick people seek the advice of a health
care professional.
o Stage 4: Dependent Client Role
o Stage 5: Recovery or Rehabilitation – The client is expected to relinquish
the dependent role and assume former roles and responsibilities.
COMMUNICATION TECHNIQUES IN NURSING

✓ Communication – It is the exchanging of ideas, information, feelings, data between two or more
people. It is a basic component of human relationships, including nursing. The intent of communication
is to obtain a response/feedback.
Components of Communication
o Sender – a person who initiates a message.
o Message – it is what is actually said or written.
o Receiver – a person who is the decoder, who must perceive what the
sender intended (interpretation).
o Response – it is the message that the receiver returns to sender. It is
also called feedback.
Modes of Communication
o Verbal Communication – it uses spoken or written word.
o Non-verbal Communication – uses other forms, such as gestures or
facial expressions, and touch. Sometimes called body language.
o Electronic Communication – form of communication that evolved with
the use of technology.
Personal Space – is the distance people prefer in interactions with others. Proxemics
is the study of distance between people in their interactions.
o Intimate: 0 to 1 ½ feet
o Personal: 1 ½ to 4 feet
o Social: 4 to 12 feet
o Public: 12 feet and beyond
Therapeutic Communication
o Using silence – accepting pauses or silences without interjecting any
verbal response.
o Providing general leads – using statements that encourage the client to
verbalize.
e.g. “Can you tell me how it is for you?”
“Would it help to discuss your feelings?”
o Using touch – providing appropriate sense of touch to reinforce feelings.
e.g. putting arm over the client’s shoulder.
o Restating or Paraphrasing – actively listening to the client’s basic
message and repeating those thought and/or feelings in similar words.
e.g. Client: “I couldn’t manage to eat my dinner last night”
Nurse: “You had difficulty eating yesterday.”
Client: “Yes, I was very upset after my family left.”
o Offering self – suggesting one’s presence, interest, or wish to
understand the client without making ay demands.
e.g. “I’ll stay with you until your daughter arrives.”
o Presenting reality – helping the client to differentiate the real from the
unreal.
e.g. “That telephone ring came from the program on television.”
o Acknowledging – giving recognition, in a nonjudgmental way, of a
change in behavior.
e.g. “You trimmed your beard and mustache and washed your
hair.”
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 “I notice you keep squinting your eyes. Are you having
difficulty seeing?”
Nontherapeutic Communication
o Stereotyping
o Agreeing and disagreeing
o Being defensive
o Challenging
o Probing
o Testing
o Rejecting
o Changing topics and subjects
o Giving common advice

###

Happy Nursing, future Rehistradong Nars! Para sa Diyos, sa Pamilya, sa Pangarap at sa Bayan!
Godspeed!

I’m _______________________________, RN ______ 😊

(name) (year)

NOTE:
For the references, I used my 10th Edition Kozier & Erb’s Fundamentals of Nursing book. For the History of Philippine
Nursing, I got the info from the Nurseslabs. Credits to their respective owners. This is solely for educational use. Pardon
me from errors & omissions.

This reviewer is aimed to help and assist nursing students in pursing the course of BS Nursing. The author of this reviewer is not responsible for errors or omissions. EPSR 2020