Question

Mrs Jone is a 34years old single mother with two school age children. Mrs Jones suffered multiple facial injuries as a result of car accident several months ago .The injuries have healed without complications, but she has moderate residual scarring.

Assessment of Mrs Jones begins with the behaviours manifested from the adaptive modes.The nurse uses observational skills , intuition, measurements and interview skill to collect data. The nurse involves mrs Jones in the assessment to verify the nurse's own perceptions. The exception is the self concept mode: some of her behaviour are ineffective in relation to adaptation, as evidenced by mrs Jones avoidance of social gatherings, wearing dark glasses and hats, wearing heavy makeup to cover her scars.

Next, the nurse and mrs Jones set goals to promote adaptation. Goal setting for mrs Jones within the framework involve statement of measurable behavioural outcomes of nursing care that will promote adaptation related to body image within the self concept mode. The nurse , in collaboration with mrs Jones , chooses interventions based on current best practices to promote adaptation by either changing stimuli or strengthening mrs Jones adaptive processes. Evaluation focuses on judging the effectiveness of the nursing intervention in relation to mrs Jones behaviour. In addition , if any other nursing problems are uncovered during the assessment, the nurse addresses those problems simultaneously using the process described and incorporating best  practice to provide appropriate nursing care

Develop a plan of care for mrs Jones based on other potential and actual nursing problems typical of a patient with the same medical diagnoses or symptom and demographics.

Develop a care plan for additional nursing problem using Roy's theory as the basis of practice while considering addressing at least one of the four adaptive modes in your response

Answer 1

Scar refers to the formation of collagen fibers to heal the damaged dermis. Residual scars often leads to body image disturbances.

Disturbed body image related to intentional hiding of body part secondary to residual scarring.

Goals:

-Patient verbalizes her acceptance of herself

-Patient will improve her self esteem.

-Patient will include the family members in her treatment action.

Planning and Rationale;

1) Assess patients activity of daily living as person with altered body image affect the daily activity and responsibility.

2) Assess the social roles of the person as any changes in the body figure will results in social withdrawal behavior.

3) Encourage the patient to ventilate his feeling regarding his condition. This help the nurses to carefully to identify any negative statements about patient self concept.

4) Help patient to achieve coping strategies about his bodily changes.

5) Involve patient to participate in peer group activities and this promote patient to develop a positive response.

6) Involve other support services like psychiatrist, occupational therapist,social services to rectify emotional problems.

Roy adaptation model : This theory focused on helping individuals to promote adaptation. It consist of four components namely person,health,environment and nursing. The four adaptive modes are physiological needs, self concept, role function and interdependence.

Self concept mode is selected for this scenario:

Physical self: Mrs Jones is very anxious about her body disfigurement resulting from scar. Having social isolation behavior to hide her residual scarring.

Interdependence mode: She doesn't maintain good social relationship as evidence by avoidance of social gatherings, wearing dark glasses and hats, wearing heavy makeup to cover her scars.