CHAPTER IX

NURSING APPROACH
A. NURSING THEORY
VIRGINIA HENDERSON
The Principles and Practice of Nursing
I belive that the function the nurse performs is primarily an independent one- that of acting for the patient when
he lacks knowledge , physical strength, or the will to act for himself as he would ordinarily act in health, or in
carrying out prescribed therapy. This function is seen as complex and creative, as offering unlimited opportunity for
the application of the physical, biological and social sciences and the development of skills based on them.
(Henderson, 1960)

MAJOR CONCEPTS
HUMAN OR INDIVIDUAL
Henderson considers the biological, psychological, sociological, and spiritual components.
She defined the patient as someone who needs nursing care, but did not limit nursing to illness care.
SOCIETY or ENVIRONMENT
She did not define environment, but maintaining a supportive environment is one of the elements of her 14
activities.
She sees individuals in relation to their families but minimally discusses the impact of the community on the
individual and family.
She supports the tasks of private and public health agencies keeping people healthy.
She believes that society wants and expects the nurses service of acting for individual who are unable to function
independently.
HEALTH
Health was not explicitly define, but it is taken to man balance in all realms of human life.
NURSING
Henderson believed that 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 a 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.

SUBCONCEPTS
14 Activities for client assistance

Physiological
1.
2.
3.
4.
5.
6.
7.
8.
9.

Breath 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

Psychological Aspects of Communicating and Learning

10. Communicate with others in expressing emotions, needs, fears, or opinions
11. Learn, discover or satisfy the curiosity that leads to normal development and health and use the available
health facilities
Spiritual and Moral
12. Worship according to ones faith

Sociologically Oriented to Occupation and Recreation

Assumptions

Nurses care for patients until patients can care for themselves once again.
Patients desire to return to health.
Nurses are willing to serve and that nurses will devote themselves to the patient day and night
Nurses should be educated at the university level in both arts and sciences.
Henderson also believes that mind and body are inseparable. It is implied that the mind and body are
interrelated.

Strength and Weaknesses

Hendersons work is relatively simple yet generalized with some limitations. Her work can be applied to
the health of individual of all ages. Limited in a way that it can generally applied to fully functional individuals.
Each of the 14 activities can be the basis for research. Although the statements are not written in testable
terms, they may be reformulated into researchable questions.
Strength
The concept of nursing formulated by Henderson in her definition of nursing and the 14 components of
basis nursing is uncomplicated and self-explanatory. Therefore, it can be used without difficulty as a guide for
nursing practice.
Weakness

A major shortcoming in her work is the lack of a conceptual linkage between physiological and other
human characteristic

B. PRIORITIZATION OF PROBLEMS
NURSING DIAGNOSIS

JUSTIFICATION

Impaired gas exchange related to alveolar-

Gas exchange in the respiratory system is an

capillary membrane changes and mucus plugging

important part of respiration. It helps switch

as evidenced by dyspnea, restlessness and

harmful gases with good gases. Carbon dioxide

diaphoresis.

is harmful to the body if it accumulates, but during

1.

the gas exchange process this gas is removed

and replaced with oxygen. It is important for the
body to receive adequate oxygen and carbon
dioxide for maintaining functions on our systems,
for it to keep the body running to sustain life.

2.

Ineffective Airway Clearance related to

Achieving clear airway prevents a COPD patient

retained secretions and ineffective cough.

from

hypoxia

and

other

complications

an

obstructed airway can give.

3. Ineffective Breathing Pattern related to

Ineffective breathing pattern and shortness of

decreased lung expansion and obstruction as

breath are due to the ineffective respiratory

evidenced by dyspnea, abnormal lung sounds

mechanics of the chest wall and lung resulting to

and cough.

air trapping that promotes more additional

problem to a patient with airflow limitation.

4. Activity Intolerance related fatigue

This problem is at 3

rd

priority, the patient body

weakness is a side a normal sign and symtptoms

in COPD patients. The body compensates for the
lack of oxygenation in the body. Assisting in
activities of daily living can help the patient cope
with the problem.
5. Knowledge

Deficit

related

information/unfamiliarity
resources

with

to

lack

th

of

This problem is at 5 priority because it is not an

information

immediate and a life threatening problem. Also

with the help of proper health teaching.

In

addition, it can greatly initiate necessary lifestyle

changes and help patient participate in treatment
regimen.

6. Risk for aspiration related to muscle fatigue

The patient is at risk for aspiration due to fatigue

secondary to chronic obstructive pulmonary

and generalized body weakness. The problem

disease.

can be prevented with supervision from care

givers while the patient is eating.

7. Risk for ineffective protection related to

The patient is at risk because he belongs to one

decrease immunity secondary advance age

of the vulnerable group specifically the elder

and use of cortiscosteroids.

population. With the normal physiologic changes,

the clients immunity has decreased and this is
one of the factors that can greatly affect his
health.