Putting on the neuman systems composition

Paper type: Health and fitness,

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With concerns of your day to day living we do not have sufficient time and price range to be choosy of the sort of food or perhaps the nutritional value of it, what we think of nowadays is merely to have something to satisfy our hunger without considering the nutrients that our body system needs each day. When we notice diet today often we come across it as losing weight by using controlling food intake, but the truth is diet could also mean eating nourishing foods to supplement the body’s demands of nutrients and the kind of foods that people are going to ingest.

While statistics record show that in the United States as many as 20% of hospitalized people are hypokalemic; however , hypokalemia is clinically significant in just about 4-5% of these people. Severe hypokalemia is relatively rare. Up to 14% of outpatients who experience laboratory assessment are found being mildly hypokalemic. Approximately 80 percent of people who will be receiving diuretics become hypokalemic. Sex Chance is equivalent in males and females.

The researcher chose hypokalemia as a theme for a case study in acute adult disorders for the reason that hypokalemia is a perilous disease that is normally neglected by the people in the sense that people does not know what the condition is all about. The researcher thinks that through studying the whole course of illness, insights and new data can be obtained in working with hypokalemia which could help pupils, nurses and any investigator who would undertaking in the analyze of hypokalemia

Theoretical Framework

The researcher aimed to use Neuman Devices Model in a client with hypokalemia. This kind of theory naturally developed to satisfy or enhance for the client’s demands the specialist wants to validate and to validate the theory for it on an serious condition called hypokalemia. The first focus of the Neuman Devices Model may be the wellness of the client/client system in relation to environmental stress and reactions to fret (Fawcett, 1995).

In relation to it is wholistic approach According to the Neuman Systems Unit and systemic perspective generally, health and wellness is described as the coordination or the amount of system stability, that is, the situation in which each of the parts and subparts (variables) will be in balance or tranquility with the whole of the client/client system (Neuman, 2002)

Betty Neuman’s Systems Model is dependent on concepts related to stress and reaction to anxiety. The Neuman Systems Style includes the physiological, psychological, sociocultural, developmental, and spiritual variables at all levels of the system (Neuman, 2002). The physiological variable relates to mental human relationships and processes. The sociocultural variable handles those features of the system that require social and cultural communications and anticipations. The developing variable relates to developmental operations and needs that vary while the system grows. The religious variable works with the anatomy’s beliefs and their influence and is, according to Neuman, the least understood inspite of its importance (Frisch, 2006).

Basic Structure consists of prevalent client endurance factors, and also unique person characteristics. This represents the standard system strength resources (Neuman, 2002). Client/client system a composite of variables (physiological, psychological, sociocultural, developmental, and spiritual), each of which is actually a subpart coming from all parts, varieties the whole of the customer. The client being a system is consisting of a core or basic structure of survival elements and adjacent protective concentric rings.

The concentric rings are composed of similar factors, yet serve varied and various purposes in either preservation, attainment, or maintenance of program stability and integrity or perhaps combination of these. The client is recognized as an open program in total user interface with the environment. The client can be considered a system, plus the term can easily used alternately with the client/client system (Neuman, 2002). Content the factors of a person in connection with the internal and external environment contain the whole consumer system (Neuman, 2002)

Amount of reaction the level of reaction is a amount of system instability resulting from stressor invasion with the normal lines of defense. Environment is identified as “all factors affecting and affected by the system which is “all external and internal factors or influences surrounding the determined client or perhaps client system. Neuman features identified 3 relevant conditions. The internal environment ” consists of all makes or interactive influences interior to or contained only within the restrictions of the identified client/client system. The exterior environment ” consists of most forces or interactive influences external to or existing outside the described client/client system and is social and extrapersonal in nature(Neuman, 2002). Reviews the process within just which matter, energy, and information, as system outcome, provide feedback for corrective action to alter, enhance or stabilize the machine.

Flexible lines of defense is a protective buffer for the client’s normal or a stable express. Ideally, this prevents invasion of causes and retains the client system free from stress factor reactions or perhaps symptomatology (Fawcett, 1995). Objective the system target is stability for the purpose of consumer survival and optimal health and fitness. Health a continuum of wellness to illness, energetic in characteristics, that is constantly subject to transform. Optimal health and fitness or balance indicates that total program needs will be being achieved. A reduced condition of wellness is the reaction to unmet requirements. The client is at a powerful state both wellness or perhaps illness, in varying deg, at any point in time. Input/Output the situation, energy, and information changed between client and environment that is getting into or giving the system at any time in time. Lines of resistance contain specific known and unknown external and internal resource elements that support the client’s basic framework and normal defense series thus protecting system integrity.

An example may be the body’s mobilization of white-colored blood cellular material or activation of immunity process mechanisms. Performance of the lines of amount of resistance in reversing the reaction to stressors permits the system to reconstitute; ineffectiveness leads to strength depletion (Neuman, 2002). Typical line of defense is the sound boundary collection that encircles the busted internal lines of amount of resistance. This collection represents the actual client is now, the state that the client has become incredible over time, or maybe the usual wellbeing level. The conventional defense line is a standard against any deviancy in the usual wellness state can be discovered (Neuman, 2002). Prevention while intervention typology or methods for nursing action and determinants to get entry of both customer and registered nurse into the medical care system. Main prevention: before a reaction to stressors arises. Secondary prevention: treatment of symptoms following a reaction to stressors Tertiary prevention: maintenance of optimal wellbeing following treatment.

Reconstitution represents the return and maintenance of system steadiness, following remedying of stressor reaction, which may lead to higher or perhaps lower level of wellness than previously. Balance a state of balance or harmony demanding energy exchanges as your customer adequately copes with causes to retain, achieve, or preserve an ideal level of health, thus preserving system sincerity. Stressors happen to be environmental elements, intra-, inter-, extrapersonal factor in nature which may have potential for disrupting system stability. A pressure is any kind of phenomenon that may penetrate the two flexible and normal lines of defense, resulting in both positive or perhaps negative outcome (Neuman, 2002).

Intrapersonal stressors are within the internal environment of the client/client system and can include such forces as conditioned and autoimmune responses. Sociable stressors are in the external environment. They will occur in the boundary between the client/client program and the proximal external environment an contain such pushes as position expectations and communication patterns. Extrapersonal stressors also are in the external environment. They occur at the boundary of the client/client system plus the distal external environment and can include such pushes as monetary concerns or social guidelines (Fawcett, 1995).

Wellness/Illness wellness is the symptom in which almost all system parts and subparts are in harmony while using whole system of the client. Wholeness is based on interrelationships of parameters, which identify the amount of resistance an individual needs to any stressor. Illness indicates disharmony among the parts and subparts from the client program. Wholistic something is considered wholistic when virtually any parts or subparts may be organized in to an interrelating whole. Wholistic organization can be one of keeping parts complete or stable in their romantic relationships; folks are viewed as wholes whose component parts will be in active interdependent discussion.

Exploration Design

The researcher in this study employed the case study method. The truth study style involves an intensive exploration of just one unit of study, such as a person, very small number of subject matter, family, group, community, or institution ( Burns & Grove, 2003).

Research place

The study was conducted in Cebu City Medical Center located at N. Bacalso Opportunity, Cebu Metropolis. Cebu City Medical Center (CCMC) is a three hundred bed potential government medical center that provides all residents of Cebu City. Your customer was accepted at the heart stroke ward, third floor which will accommodates clientele with physical complaints, grouped under Inside Medicine (IM) as cardiovascular system problems. This can be a 10 foundation capacity ward which provides patients confessed with cardiovascular system problems.

Exploration Instrument

The researcher applied Gordons useful health pattern as a research instrument which can be categorized in 11 websites namely health perception management pattern which in turn explains of what the client perceives in her state, nutritional-metabolic design explains intended for the diet from the client and regarding meals groups as well as the number of helpings per day, reduction pattern pertains to urinary and bowel patterns, exercise- activity pattern points out to the actions of everyday living of the consumer which also contains exercise, sleep-rest pattern specifies the number of hours the client naps or on what moments of the day the client takes his rest/ possibly its constant or annoyed, cognitive perceptual pattern identifies the level of cognitive maturation with the client, self-perception pattern means on how the customer perceives or perhaps sees their self, role-relationship design explains the role from the client in her as well as society, sexuality-sexual functioning this domain talks about if the client is sexually active or perhaps not plus the number and age gap from the children the client has, coping-stress management pattern means on how the client will react to stress and what would the client do to solve it, and values-belief program identifies the idea or religious beliefs of the consumer and their spiritual practices.

Data gathering procedure

A transmittal letter was sent to the primary nurse of cebu metropolis medical center. The researcher chose a client which had an severe condition to become interviewed, prior to the interview the researcher told the client the purpose and the goals of the interview, wherein your customer agreed with her total consent and understanding. The researcher conducted a data review of the customer followed by doing a physical examination and would an interview using Gordon’s Wellness pattern tool.

Chapter two

Benefits and Conversation

This chapter presents an appraisal using the Neuman Systems Unit in evaluating and dealing with clients with hypokalemia. Situational Appraisal

The client can be described as 38-year old female, which will currently lives at baranggay ylaya talamban Cebu Town. She was born on march 10, 1975, she is a Roman Catholic by beliefs and is the youngest amongst two daughters of the second family her father acquired, and is today an orphan and a widow. Your woman perceives her current condition as a payment for her sins, the customer’s sister stated that the client acquired times where she experienced epilepsy and sometimes with seizures but it faded later in time. She is presently unemployed and only works as another even though she had an volatile source of income the girl still managed to eat 3 times daily but with limitation of food intake veg is the main food source they can afford and is also only in one food group drinks drinking water depending on her needs or if she’s thirsty.

Reduction pattern can be on a daily basis or depending upon the. Her daily activity comes with waking up, sleeping, and would go to work which is considered as non-active. Sleep and rest patterns are modified she naps 6-9 hours daily nevertheless is interrupted she wakes up at night and has problems in slipping back to sleeping. The client was a third 12 months high school level but it was not a hindrance to her to find a job. The client views himself as reliant and hopeless at some occasions due to her illness. Your woman was the most youthful daughter she sought all the attention of her father and mother but the lady did not rely on them she proved helpful hard to be employed and she found a job as a manufacturing plant worker her elder sister was had a child and which she also loved because her individual, and later was married.

The girl was committed but under no circumstances had a child but the girl acted as being a mother to her sister’s son, in her current state she has not any partner in every area of your life and is certainly not sexually energetic for her living a single your life free of responsibilities is fine, next by the loss of both her parents the girl was in depressed and drowned himself in her work for over following her reduction, it was likewise aggravated when ever her partner died in an accident which she experienced the hard time for you to accept and was depressed which made her forget about her job, the most stressed out moment of her your life where the girl resorted to the use of prohibited drugs took place when her nephew passed away it was the most painful loss for her since she treated her nephew as her own child. The only family member that is playing her is her parent sister all her littermates on her dad’s first family is not near to them. Your customer believed that her present condition is actually a punishment with her since the lady forgot her obligations in the church and thought like a creditor is known as a sin and she is spending money for it.

Theory-Based Evaluation

Physiological loss of system stability demonstrated in muscle some weakness as noticed in difficulty in breathing and inability to ambulate

Psychological decrease of system balance demonstrated in feelings of uselessness and helplessness

Sociocultural loss of program stability seen in lack of financial support after hospitalization and relative support

Developing loss of program stability seen in unemployment, dependence, and a decrease in proficiency in current age bracket.

Spiritual loss of system steadiness in emotions of uselessness


Is deficient consumption. Poor potassium intake exclusively is a great uncommon reason for hypokalemia but occasionally are visible very older individuals struggling to cook on their own or unable to chew or perhaps swallow very well. Over time, this kind of individuals can accumulate a significant potassium deficit. One other clinical situation where hypokalemia may arise due to poor intake is patients receiving total parenteral nutrition (TPN), where potassium supplementation may be inadequate for a prolonged period of time. The second is increased excretion. Increased excretion of potassium, specifically coupled with poor intake, is considered the most common source of hypokalemia. The most typical mechanisms bringing about increased reniforme potassium failures include enhanced sodium delivery to the collecting duct, as with diuretics; mineralocorticoid excess, much like primary or secondary hyperaldosteronism; or improved urine flow, as with an osmotic diuresis.

Gastrointestinal losses, mostly from diarrhea, also are common causes of hypokalemia. Vomiting is a common cause of hypokalemia, but the pathogenesis of the hypokalemia is complex. Gastric substance itself contains little potassium, approximately twelve mEq/L. Nevertheless , vomiting creates volume destruction and metabolic alkalosis. These types of 2 operations are combined with increased suprarrenal potassium excretion. Volume depletion leads to second hyperaldosteronism, which will, in turn, causes enhanced cortical collecting tubule secretion of potassium in response to enhanced sodium reabsorption. Metabolic alkalosis also increases collecting tubule potassium secretion due to the decreased availability of hydrogen ions to get secretion reacting to sodium reabsorption. Another is due to a shift via extracellular to intracellular space.

This pathogenetic mechanism regularily accompanies increased excretion, ultimately causing a potentiation of the hypokalemic effect of increased loss. Intracellular shifts of potassium typically are episodic and frequently will be self-limited, for example , with severe insulin remedy for hyperglycemia. Regardless of the trigger, hypokalemia creates similar signs and symptoms. Because potassium is overwhelmingly an intracellular cation and because a variety of elements can regulate the actual serum potassium attentiveness, an individual can get very considerable potassium losses without exhibiting frank hypokalemia. Conversely, hypokalemia does not always reflect an absolute deficit altogether body potassium stores.

Variance from wellness| Nursing intervention| Reconstitution| Weak extremitiesSubjective tips: “dili nako malihok ako mga tiil as verbalized by the customer. Objective cues: * Client lying about bed * Foot plantar flexed. 5. Weak muscle mass strength and low muscle mass tone in extremities. Trouble breathingSubjective cues: ” usahay mag lisod ko ug ginhawa since verbalized by clientObjective cues: * Enlarged chest cavity. * Make use of accessory muscles in inhaling * Fast deep breaths * Presence of sinus prongs on the bedside. Dangers for muscle atrophy and foot droppingSubjective cues: mura ug ning gamay akong mga bati-is as verbalized by the client. Objective cues: * Customer is laying on bed * Foot plantar flexed * Immobility of the reduce extremities

* No existence of feet board 2. No RANGE OF MOTION exercises performed. | 5. Promote ROM exercises to avoid muscle atrophy on the influenced limb 5. Provide ft . board to support the foot and avoid plantarflexion which causes ft . drop. * Encourage your customer to eat a balanced diet associated with bananas to get potassium replacement * Provide medications since prescribed 2. Monitor the customer for any difficulties * Position the client upon semi-fowlers placement. * Advise client to accomplish abdominal inhaling or pursed lip inhaling and exhaling. * Keep an eye on for signs of hypoxia

2. Administer o2 prn while prescribed. * Promote RANGE OF MOTION exercises. * Provide foot board. 5. Encourage the S. O. to do sponge bathing to market circulation. 5. Encourage the customer to move the and workout the toes of the feet. | Goal: proven techniques and lifestyle changes in order to meet physiologic requirements. Reconstitution: lines of level of resistance building. Goal: promoted methods and physical exercises to meet physiologic needsReconstitution: lines of amount of resistance buildingGoal: advertised techniques and exercises to stop the happening of physiologic problemsReconstitution: lines of amount of resistance building and strengthening the flexible lines of security.

Response of the client on the Interventions Supplied

The client surely could see through their self on identifying and putting first the problems through based on her judgment associated with the researcher’s appraisal of her determined stressor the client was able to recoup in the treatment, the client could come up with alternatives on the conditions that were the majority of attainable and many important to her which is attaining the optimum level of functioning. The consumer was able to gain a increased self-esteem and a positive prospect in life, reconstitution of her lines of defense and strengthening each lines is progress, through positive opinions the client was able to see through everything that the physiological body is not only the only factor in healing nonetheless it should consist of the mind, the spirit, the society, and development to obtain a wholistic and faster recovery coming from illness.

Realization and Tips


The Neuman Systems Unit was successful, efficient in providing a wholistic nursing care to the client with hypokalemia. The evaluation made was thorough and was based on the the particular client and the care provider perceives thus giving a collaborative and certain hint in regards to what the problem is where effective alternatives can be raised. Though the method is quite complicated and difficult at some moments, it just needs practice in implementing the model to familiarize this.

The research figured the Neuman Systems Unit is an effective instrument which can improve the nurses critical and analytical thinking by data gathered based on the client’s initial response as well as the nurses wisdom thereby minimizing the event of an error in figuring out problems and providing nursing care.


Based on the findings, observations and the conclusion utilizing the Neuman Systems Model is beneficial and wholistic enough inside the approach of any client with hypokalemia. Listed below are the research workers suggestions and recommendations

1 nurse practitioners have to do a thorough analysis on their customers not only by identifying the main problems yet also simply by assessing anybody as a whole it can be done with the use of the Neuman Systems assessment and analysis tool.

2 Interventions vary from client to client others may vary although there is no such thing as being a uniformed intervention thereby it is necessary for the nurse to evaluate for the needs of the client.


Burns and Grove (2003) Understanding Medical research 3 rd edition Watts. B. Saunders

Elsevier Company

Fawcett, Jacqueline (1995) Analysis and Evaluation of Conceptual Models of Nursing 3rd ed. Farreneheit. A. Davis Company

Frisch N., Frisch L. (2006) Psychiatric Mental Health Nursing jobs 3rd male impotence. Thomson Delmar Learning Company

Karch, Amy (2008) Lippincotts Nursing Medication Guide: Wolters Kluwer Lippincott Williams & Wilkins Organization

Medical-Surgical Medical Made Extraordinary Easy (2004). Lippincott Williams & Wilkins Company Springhouse

Neuman, Betty and Fawcett, Jacqueline 2002 The Neuman Systems Model 4th release Prentice Corridor Company


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