Theoretical Framework of

Nursing
O 8 by the INTERNTION COUNCI OF NURSES (ICN, 1973) a8 written by Virginia
nur8e i8 to a88i8t the individual, 8ick or well, in the performance of tho8e activitie8
peaceful death that the client would perform unaided if he had the nece88ary 8treng
O elp the client gain independence a8 rapidly a8 po88ible.

4nceptual and The4retical M4dels 41 Nursing Practice
The4rist escripti4n
FLORENE NIGHTINGALE O eveloped the fir8t theory of nur8ing.
O Focu8ed on changing and manipulating
order to put the patient in the be8t po88ible
nature to act.
HILEGAR PEPLAU O Introduced the Interper8onal Model.
O She defined nur8ing a8 a therapeutic, interper8onal
which 8trive8 to develop a nur8e-patient
which the nur8e 8erve8 a8 a re8ource per8on,
8urrogate.
FAYE ABELLAH O efined nur8ing a8 having a problem-8olving
key nur8ing problem8 related to health need8 of
developed li8t 21 nur8ing problem area8
IA JEAN ORLANO O eveloped the three element8 - client behavior,
reaction and nur8e action - compo8e the nur8ing
She ob8erved that the nur8e provide direct
meet an immediate need for help in order to avoid or
alleviate di8tre88 or helple88ne88.
MYRA LEVINE O e8cribed the Four Con8ervation Principle8.
1. con8ervation of energy
2. con8ervation of 8tructured integrity
3. con8ervation of per8onal integrity
4. con8ervation of 8ocial integrity
OROTHY JOHNSON O eveloped the Behavioral Sy8tem Model.
1. Patient8 behavior a8 a 8y8tem that i8 a whole
interacting part8
2. how the client adapt8 to illne88
3. Goal of nur8ing i8 to reduce 8o that the client
move more ea8ily through recovery.


















Thera

MARTHA ROGERS O Conceptualized the Science of Unitary uman
a88erted that human being8 are more than different
the 8um of their part8 the di8tinctive propertie8 of
whole are 8ignificantly different from tho8e of it8
OROTHEA OREM O Empha8ize8 the client8 8elf care need8 nur8ing care
become8 nece88ary when client i8 unable to fulfill
p8ychological, developmental or 8ocial need8.
IMOGENE KING O Nur8ing proce88 i8 defined a8 dynamic interper8onal
proce88 between nur8e, client and health care
BETTY NEUMAN O Stre88 reduction i8 a goal of 8y8tem model of nur8ing
practice. Nur8ing action8 are in primary, 8econdary
tertiary level of prevention
SISTER ALLISTA ROY O Pre8ented the daptation Model. She viewed each
a8 a unified bio-p8ycho8ocial 8y8tem in con8tant
with a changing environment. The goal of nur8ing i8
the per8on adapt to change8 in phy8iological need8,
concept, role function and interdependent relation8
health and illne88.
LYIA HALL O Introduced the notion that nur8ing center8 around
component8 per8on (core), pathologic 8tate and
(cure) and body(care).

JEAN WATSON
O Conceptualized the uman Caring Model. She
that nur8ing i8 the application of the art and human
through tran8per8onal caring tran8action8 to help
achieve mind-body-8oul harmony, which generate8
knowledge, 8elf-control, 8elf-care and 8elf-healing.

ROSEMARIE RIZZO
O Introduced the Theory of uman Becoming. She
empha8ized free choice of per8onal meaning in
value prioritie8, co-creating of rhythmical pattern8, in
exchange with the environment and contran8cending
many dimen8ion8 a8 po88ibilitie8 unfold.
MAELEINE LENINGER O eveloped the Tran8cultural Nur8ing Model. She
that nur8ing i8 a humani8tic and 8cientific mode of
client through 8pecific cultural caring proce88e8
value8, belief8 and practice8) to improve or maintain
health condition
Clear- Liquid Diet

Purpose:
O Relieve thirst and help maintain Iluid balance.
Use:
O !4st-surgically and I4ll4ing acute v4miting 4r diarrhea.
Foods Allowed:
O carb4nated beverages; c4IIee (caIIeinated and decaII.); tea; Iruit-Ilav4red drinks; strained Iruit juices; cle
gelatins; br4th, c4ns4mme; sugar; p4psicles; c4mmercially prepared clear liquids; and hard candy.
Foods Avoided:
O Milk and milk pr4ducts, Iruit juices ith pulp, and Iruit.

Full- Liquid Diet

Purpose:
O !r4vide an adequately nutriti4us diet I4r patients h4 cann4t che 4r h4 are t44 ill t4 d4 s4.
Use:
O Acute inIecti4n ith Iever, GI upsets, aIter surgery as a pr4gressi4n Ir4m clear liquids.
Foods Allowed:
O clear liquids, milk drinks, c44ked cereals, custards, ice cream, sherbets, eggn4g, all strained Iruit juices, c
vegetable s4ups, puddings, mashed p4tat4es, instant breakIast drinks, y4gurt, mild cheese sauce 4r pureed
seas4ning.
Foods Avoided:
O nuts, seeds, c4c4nut, Iruit, jam, and marmalade

Soft Diet

Purpose:
O !r4vide adequate nutriti4n I4r th4se h4 have tr4ubled cheing.
Use:
O patient ith n4 teeth 4r ill-Iitting dentures; transiti4n Ir4m Iull-liquid t4 general diet; and I4r th4se h4 c
highly seas4ned, Iried 4r ra I44ds I4ll4ing acute inIecti4ns 4r gastr4intestinal disturbances such as gas
ch4lelithiasis.
Foods Allowed:
O very tender minced, gr4und, baked br4iled, r4asted, steed, 4r creamed beeI, lamb, veal, liver, p4ultry, 4
bac4n 4r seet bread; c44ked vegetables; pasta; all Iruit juices; s4It ra Iruits; s4It bread and cereals; all
are s4It; and cheeses.
Foods Avoided:
O c4arse h4le-grain cereals and bread; nuts; raisins; c4c4nut; Iruits ith small seeds; Iried I44ds; high Iat
sauces; spicy salad dressings; pickled meat, Iish, 4r p4ultry; str4ng cheeses; br4n 4r ild rice; ra vege
lima beans and c4rn; spices such as h4rseradish, mustard, and catsup; and p4pc4rn.

Sodium- Restricted Diet

Purpose:
O Reduce s4dium c4ntent in the tissue and pr4m4te excreti4n 4I ater.
Use:
O Heart Iailure, hypertensi4n, renal disease, cirrh4sis, t4xemia 4I pregnancy, and c4rtis4ne therapy.
Modifications:
O Mildly restrictive 2 g s4dium diet t4 extremely restricted 200 mg s4dium diet.
Foods Avoided:
O Table salt; all c4mmercial s4ups, including b4uill4n; gravy, catsup, mustard, meat sauces, and s4y sauce;
cream, and sherbet; s4das; beet greens, carr4ts, celery, chard, sauerkraut, and spinach; all canned vegetab
peas;
O All baked pr4ducts c4ntaining salt, baking p4der, 4r baking s4da; p4tat4 chips and p4pc4rn; Iresh 4r can
cheeses; sm4ked 4r c4mmercially prepared meats; salted butter 4r margarine; bac4n, 4lives; and c4mmer
salad dressings.

Renal Diet

Purpose:
O C4ntr4l pr4tein, p4tassium, s4dium, and Iluid levels in the b4dy.
Use:
O Acute and chr4nic renal Iailure, hem4dialysis.
Foods Allowed:
O High-bi4l4gical pr4teins such as meat, I4l, Iish, cheese, and dairy pr4ducts range beteen 20 and 60 mg
O !4tassium is usually limited t4 1500 mg/day.
O Vegetables such as cabbage, cucumber, and peas are l4est in p4tassium.
O S4dium is restricted t4 500 mg/day.
O Fluid intake is restricted t4 the daily v4lume plus 500 mL, hich represents insensible ater l4ss.
O Fluid intake measures ater in Iruit, vegetables, milk and meat.
Foods Avoided:
O Cereals, bread, macar4ni, n44dles, spaghetti, av4cad4s, kidney beans, p4tat4 chips, ra Iruit, yams, s4ybe
gingerbread, apric4ts, bananas, Iigs, grapeIruit, 4ranges, perc4lated c4IIee, C4ca-C4la, 4range crush, sp4r
breakIast drinks such as Tang 4r Aake

High- Protein, High- Carbohydrate Diet

Purpose:
O T4 c4rrect large pr4tein l4sses and raises the level 4I bl44d albumin. May be m4diIied t4 include l4Iat,
l4-ch4lester4l diets.
Use:
O Burns, hepatitis, cirrh4sis, pregnancy, hyperthyr4idism, m4n4nucle4sis, pr4tein deIiciency due t4 p44r ea
geriatric patient ith p44r intake; nephritis, nephr4sis, and liver and gall bladder dis4rder.
Foods Allowed:
O General diet ith added pr4tein.
Foods Avoided:
O Restricti4ns depend 4n m4diIicati4ns added t4 the diet. The m4diIicati4ns are determined by the patient`s

Purine- Restricted Diet

Purpose:
O Designed t4 reduce intake 4I uric acid-pr4ducing I44ds.
Use:
O High uric acid retenti4n, uric acid renal st4nes, and g4ut.
Foods Allowed:
O General diet plus 2-3 quarts 4I liquid daily.
Foods Avoided:
O Cheese c4ntaining spices 4r nuts, Iried eggs, meat, liver, seaI44d, lentils, dried peas and beans, br4th, b4u
4atmeal and h4le heat, pasta, n44dles, and alc4h4lic beverages. Limited quantities 4I meat, Iish, and s

Bland Diet

Purpose:
O !r4visi4n 4I a diet l4 in Iiber, r4ughage, mechanical irritants, and chemical stimulants.
Use:
O Gastritis, hyperchl4rhydria (excess hydr4chl4ric acid), Iuncti4nal GI dis4rders, gastric at4ny, diarhhea, sp
c4nstipati4n, biliary indigesti4n, and hiatus hernia.
Foods Allowed:
O Varied t4 meet individual needs and I44d t4lerances.
Foods Avoided:
O Fried I44ds, including eggs, meat, Iish, and sea I44d; cheese ith added nuts 4r spices; c4mmercially pre
meats; cured meats such as ham; gravies and sauces; ra vegetables;
O p4tat4 skins; Iruit juices ith pulp; Iigs; raisins; Iresh Iruits; h4le heats; rye bread; bran cereals; rich p
ch4c4late; jams ith seeds; nuts; seas4ned dressings; caIIeinated c4IIee; str4ng tea; c4c4a; alc4h4lic and
beverages; and pepper.

Low-Fat, Cholesterol- Restricted Diet

Purpose:
O Reduce hyperlipedimia, pr4vide dietary treatment I4r malabs4rpti4n syndr4mes and patients having acute
I4r Iats.
Use:
O Hyperlipedimia, ather4scler4sis, pancreatitis, cystic Iibr4sis, sprue (disease 4I intestinal tract characterize
malabs4rpti4n), gastrect4my, massive resecti4n 4I small intestine, and ch4lecystitis.
Foods Allowed:
O N4nIat milk; l4-carb4hydrate, l4-Iat vegetables; m4st Iruits; breads; pastas; c4rnmeal; lean meats;
Foods Avoided:
O Remember t4 av4id the Iive C`s 4I ch4lester4l- c44kies, cream, cake, c4c4nut, ch4c4late; h4le milk and
cream pr4ducts, av4cad4s, 4lives, c4mmercially prepared baked g44ds such as d4nuts and muIIins, p4ult
marbled meats
O Butter, 4rdinary margarines, 4live 4il, lard, pudding made ith h4le milk, ice cream, candies ith ch4c
sauces, gravies and c4mmercially Iried I44ds.

Diabetic Diet

Purpose:
O Maintain bl44d gluc4se as near as n4rmal as p4ssible; prevent 4r delay 4nset 4I diabetic c4mplicati4ns.
Use:
O Diabetes mellitus
Foods Allowed:
O Ch44se I44ds ith l4 glycemic index c4mp4se 4I:
1. 45-55 carb4hydrates
2. 30-35 Iats
3. 10-25 pr4tein
O C4IIee, tea, br4th, spices and Ilav4ring can be used as desired.
O Exchange gr4ups include: milk, vegetable, Iruits, starch/bread, meat (divided in lean, medium Iat, and hig
exchanges.
O The number 4I exchanges all4ed Ir4m each gr4up is dependent 4n the t4tal number 4I cal4ries all4ed.
O N4n-nutritive seeteners (s4rbit4l) in m4derati4n ith c4ntr4lled, n4rmal eight diabetics.
Foods Avoided:
O C4ncentrated seets 4r regular s4It drinks.

Acid and Alkaline Diet

Purpose:
O Furnish a ell balance diet in hich the t4tal acid ash is greater than the t4tal alkaline ash each day.
Use:
O Retard the I4rmati4n 4I renal calculi. The type 4I diet ch4sen depends 4n lab4rat4ry analysis 4I the st4ne
Acid and alkaline ash food groups:
1. Acid ash: meat, h4le grains, eggs, cheese, cranberries, prunes, plums
2. Alkaline ash: milk, vegetables, Iruits (except cranberries, prunes and plums.)
3. Neutral: sugar, Iats, beverages (c4IIee, tea)
Foods allowed:
O Breads: any, preIerably h4le grain; crackers; r4lls
O Cereals: any, preIerable h4le grains
O Desserts: angel I44d 4r sunshine cake; c44kies made ith4ut baking p4der 4r s4da; c4rnstarch,
O !udding, cranberry desserts, ice cream, sherbet, plum 4r prune desserts; rice 4r tapi4ca pudding.
O Fats: any, such as butter, margarine, salad dressings, Crisc4, Spry, lard, salad 4il, 4live 4il, etc.
O Fruits: cranberry, plums, prunes
O Meat, eggs, cheese: any meat, Iish 4r I4l, t4 serving daily; at least 4ne egg daily
O !4tat4 substitutes: c4rn, h4miny, lentils, macar4ni, n44dles, rice, spaghetti, vermicelli.
O S4up: br4th as desired; 4ther s4ups Ir4m I44d all4ed
O Seets: cranberry and plum jelly; plain sugar candy
O Miscellane4us: cream sauce, gravy, peanut butter, peanuts, p4pc4rn, salt, spices, vinegar, alnuts.
Restricted foods:
O N4 m4re than the am4unt all4ed each day
1. Milk: 1 pint daily (may be used in 4ther ays than as beverage)
2. Cream: 1/3 cup 4r less daily
3. Fruits: 4ne serving 4I Iruits daily (in additi4n t4 the prunes, plums and cranberries)
4. Vegetable: including p4tat4es: t4 servings daily
5. Seets: Ch4c4late 4r candies, syrups.
6. Miscellane4us: 4ther nuts, 4lives, pickles.

High- Fiber Diet

Purpose:
O S4Iten the st44l
O Exercise digestive tract muscles
O Speed passage 4I I44d thr4ugh digestive tract t4 prevent exp4sure t4 cancer causing agents in I44d
O L4er bl44d lipids
O !revent sharp rise in gluc4se aIter eating.
Use:
O diabetes, hyperlipedemia, c4nstipati4n, diverticulitis, anticarcin4genics (C4l4n)
Foods Allowed:
O rec4mmended intake ab4ut 6 g crude Iiber daily
O All bran cereal
O Watermel4n, prunes, dried peaches, apple ith skin; parsnip, peas, Brussels spr4ut, sunIl4er seeds.

Low Residue Diet

Purpose:
O Reduce st44l bulk and sl4 transit time
Use:
O B4el inIlammati4n during acute diverticulitis, 4r ulcerative c4litis, preparati4n I4r b4el surgery, es4ph
intestinal sten4sis.
Foods Allowed:
O Eggs; gr4und 4r ell-c44ked tender meat, Iish, p4ultry; milk, cheeses; strained Iruit juice (except prune):
canned apples, apric4ts, peaches, pears; ripe banana; strained vegetable juice: canned, c44ked, 4r strained
beets, green beans, pumpkin, squash, spinach; hite bread; reIined cereals (Cream 4I Wheat)
ealth Promotion Guideline8 cro88 ife8pan

Intra-uterine

Oxygen
O T4 meet the Ietal demands I4r 4xygen, the pregnant m4ther gradually increases her n4rmal bl44d Il4 by
third, peaking at ab4ut 8 m4nths.
O Respirat4ry rate and cardiac 4utput increase signiIicantly during this peri4d.
O Feta circulati4n travels Ir4m the placenta thr4ugh umbilical arteries, hich caries de4xygenated bl44d a
Ietus.
utrition and Fluids
O The Ietus 4btains n4urishment Ir4m the placental circulati4n and by sall4ing amni4tic Iluid.
O Nutriti4nal needs are met hen the m4ther eats a ell-balanced diet c4ntaining suIIicient cal4ries and nu
b4th her needs and th4se 4I the Ietus.
O Adequate I4lic acid, 4ne 4I the B vitamins, is imp4rtant in 4rder t4 prevent neural tube deIects
O F4lic rich I44ds are green leaIy vegetables, 4ranges, dried beans and suggest she take a vitamin suppleme
I4lic acid.
Rest and Activity
O The Ietus sleeps m4st 4I the time and devel4ps a pattern 4I sleep and akeIulness that usually persist aIte
O Fetal activity can be Ielt by the m4ther at ab4ut the IiIth lunar m4nth 4I pregnancy
limination
O Fetal Ieces are I4rmed in the intestines Ir4m sall4ed amni4tic Iluid thr4ugh4ut the pregnancy, but are
excreted until aIter birth.
O Urine n4rmally is excreted int4 the amni4tic Iluid hen the kidneys mature (16 t4 20 eeks).
%emperature Maintenance
O Amni4tic Iluid usually pr4vides a saIe and c4mI4rtable temperature I4r the Ietus.
O SigniIicant changes in the maternal temperature can alter the temperature 4I the amni4tic Iluid and the Iet
O SigniIicant alter in temperature increases due t4 illness, h4t hirlp44l baths, 4r saunas may result in birth
O In the last eeks 4I gestati4n, the Ietus devel4ps subcutane4us Iatty tissue st4res that ill help maintain b
temperature at birth.
Safety
O The b4dy systems I4rm during the embry4nic peri4d. As a result, the embry4 is particularly vulnerable t4
terat4gen, hich is anything that adversely aIIects n4rmal cellular devel4pment in the embry4 4r Ietus.
O It is imp4rtant I4r the nurse t4 inquire ab4ut p4ssible pregnancy hen giving medicati4ns that are kn4n
als4 ask hen the 4man is scheduled I4r tests that inv4lve radi4graphy (x-ray).
O Sm4king, alc4h4l, and drugs can aIIect the envir4nment I4r the Ietus. Sm4king has been ass4ciated ith p
sp4ntane4us ab4rti4n, l4-birth eight inIants, and sudden inIant death syndr4me and learning dis4rders
O Fetal alc4h4l syndr4me (FAS), a result 4I impaired mit4ch4ndrial devel4pment, leads t4 micr4cephaly, m
retardati4n, learning dis4rders, and 4ther central nerv4us system deIects.

Infants

Health xaminations
O Screening 4I neb4rns I4r hearing l4ss; I4ll4-up at 3 m4nths and early interventi4n by 6 m4nths iI appr
O At 2 eeks and at 2,4,6, and 12 m4nths
Protective Measures
O Immunizati4ns: diptheria,tetanus, acellular pertussis (DTa!), inactivated p4li4virus vaccine (IV!),
mumps-rubella (MMR), Haem4philus inIluenzae type B (HIB), hepatitis B (HepB), varicella and inIluenz
rec4mmended
O Flu4ride supplements iI there is adequate ater Ilu4ridati4n (less than 0.7 part per milli4n)
O Screening I4r tubercul4sis
O Screening I4r phenylket4nuria (!U) and 4ther metab4lic c4nditi4ns
O !r4mpt attenti4n I4r illnesses
O Appr4priate skin hygiene and cl4thing
Infant Safety
O Imp4rtance 4I supervisi4n
O Car seat, crib, playpen, bath, and h4me envir4nment saIety ,measures
O Feeding measures (e.g., av4id pr4pping b4ttle)
O !r4vide t4ys ith n4 small parts 4r sharp edges
O Eliminate t4xins in the envir4nment (e.g., chemicals, rad4n, lead, mercury)
O Use sm4ke and carb4n m4n4xide (CO) detect4rs in h4me
utrition
O Breast-Ieeding t4 age 12 m4nths
O Breast-Ieeding and b4ttle Ieeding techniques
O F4rmula preparati4n
O Feeding schedule
O Intr4ducti4n 4I s4lid I44ds
O Need I4r ir4n supplements at 4 t4 6 m4nths
limination
O Characteristics and Irequency 4I st44l and urine eliminati4n
O Diarrhea and its eIIects
Rest/ Sleep
O Establish r4utine I4r sleep and rest patterns
Sensory Stimulation
O T4uch: h4lding, cuddling, r4cking
O Visi4n: c4l4rIul, m4ving t4ys
O Hearing: s44thing v4ice t4nes, music, singing
O !lay: t4ys appr4priate I4r devel4pment

%oddlers

Health xaminations
O At 15 and 18 m4nths and then as rec4mmended by the primary care pr4vider
O Dental visit starting at age 4I 3 4r earlier
Protective Measures
O Immunizati4ns: c4ntinuing DTa!, I!V series, pneum4c4ccal, MMR, Haem4philus inIluenzae type B, hep
and inIluenza vaccines as rec4mmended
O Screenings I4r tubercul4sis and lead p4is4ning
O Flu4ride supplements iI there is inadequate ater Ilu4ridati4n (less than 0.7 part per milli4n)
%oddler Safety
O Imp4rtance 4I c4nstant supervisi4n and teaching child t4 4bey c4mmands
O H4me envir4nment saIety measures (e.g., l4ck medicine cabinet)
O Outd44r saIety measures (e.g., cl4se supervisi4n near ater)
O Appr4priate t4ys
O Eliminate t4xins in envir4nment (e.g., pesticides, herbicides, mercury, lead, arsenic in playgr4und materia
O Use sm4ke and carb4n m4n4xide (CO) detect4rs in h4me
utrition
O Imp4rtance 4I nutriti4us meals and snacks
O Teaching simple mealtime manners
O Dental care
limination
O T4ilet training techniques
Rest/Sleep
O Dealing ith sleep disturbances
Play
O !r4viding adequate space and variety 4I activities
O T4ys that all4 'acting 4n behavi4rs and pr4vide m4t4r and sens4ry stimulati4n

Preschoolers

Health xaminations
O Every 1 t4 2 years
Protective Measures
O Immunizati4ns: c4ntinuing DTa!, I!V series, MMR, hepatitis, pneum4c4ccal, inIluenza, and 4ther
rec4mmended
O Screenings I4r tubercul4sis
O Visi4n and hearing screening
O Regular dental screenings and Ilu4ride treatment
Preschooler Safety
O Educating child ab4ut simple saIety rules (e.g., cr4ssing the street)
O Teaching child t4 play saIely (e.g., bicycle and playgr4und saIety)
O Educating t4 prevent p4is4ning; exp4sure t4 t4xic materials
utrition
O Imp4rtance 4I nutriti4us meals and snacks
limination
O Teaching pr4per hygiene (e.g., ashing hands aIter using bathr44m)
Rest/ Sleep
O Dealing ith sleep disturbances (e.g., night terr4rs, sleepalking)
Play
O !r4viding times I4r gr4up play activities
O Teaching child simple games that require c44perati4n and interacti4n
O !r4viding t4ys and dress-ups I4r r4le-playing

School-Age Children

Health xaminations
O Annual physical examinati4n 4r as rec4mmended
Protective Measures
O Immunizati4ns as rec4mmended (e.g., MMR, mening4c4ccal, tetanus-diphtheria, adult preparati4n |Td|)
O Screening I4r tubercul4sis
O !eri4dic visi4n, speech, and hearing screenings
O Regular dental screenings and Ilu4ride treatment
O !r4viding accurate inI4rmati4n ab4ut sexual issues (e.g., repr4ducti4n, AIDS)
School-Age Child Safety
O Using pr4per equipment hen participating in sp4rts and 4ther physical activities (e.g., helmets, pads)
O Enc4uraging child t4 take resp4nsibility I4r 4n saIety (e.g., participating in bicycle and ater saIety c4u
utrition
O Imp4rtance 4I child n4t skipping meals and eating balance diet
O Experiences ith I44d that may lead t4 4besity
limination
O Utilizing p4sitive appr4aches I4r eliminati4n pr4blems (e.g., enuresis)
Play and Social Interactions
O !r4viding 4pp4rtunities I4r a variety 4I 4rganized gr4up activities
O Accepting realistic expectati4ns 4I child`s abilities
O Acting as r4le m4dels in acceptance 4I 4ther pers4ns h4 may be diIIerent
O !r4viding a h4me envir4nment that limits TV vieing and vide4 games and enc4urages c4mpleti4n 4I
healthy exercise

Adolescents

Health xaminations
O As rec4mmended by the primary care pr4vider
Protective Measures
O Immunizati4ns as rec4mmended, such as adult tetanus diphtheria vaccine, MMR, pneum4c4ccal, and he
O Screening I4r tubercul4sis
O !eri4dic visi4n and hearing screenings
O Regular dental assessments
O Obtaining and pr4viding accurate inI4rmati4n ab4ut sexual issues
Adolescent Safety
O Ad4lescent`s taking resp4nsibility I4r using m4t4r vehicles saIely (e.g., c4mpleting a driver`s educati4n c
seat belt and helmet)
O Making certain that pr4per precauti4ns are taken during all athletic activities (e.g., medical supervisi4n, p
equipment)
O !arent`s keeping lines 4I c4mmunicati4n 4pen and being alert t4 signs 4I substance abuse and em4ti4nal
the ad4lescent
utrition and xercise
O Imp4rtance 4I healthy snacks and appr4priate patterns 4I I44d intake and exercise
O Fact4rs that may lead t4 nutriti4nal pr4blems (e.g., 4besity , an4rexia nerv4sa, bulimia)
O Balancing sedentary activities ith regular exercise
Social Interactions
O Enc4uraging and Iacilitating ad4lescent success in sch44l
O Enc4uraging ad4lescent t4 establish relati4nships that pr4m4te discussi4n 4I Ieelings, c4ncerns, and Iears
O !arents` enc4uraging ad4lescent peer gr4up activities that pr4m4te appr4priate m4ral and spiritual values
O !arents` acting as r4le m4dels I4r appr4priate s4cial interacti4ns
O !arents` pr4viding a c4mI4rtable h4me envir4nment I4r appr4priate ad4lescent peer gr4up activities
O !arents` expecting ad4lescents t4 participate in and c4ntribute t4 Iamily activities

oung Adults

Health %est and Screenings
O R4utine physical examinati4n (every 1 t4 3 years I4r Iemales; every 5 years I4r males)
O Immunizati4ns as rec4mmended, such as tetanus-diphtheria b44sters every 0 years, mening4c4ccal vaccin
in early ad4lescence, and hepatitis B vaccine
O Regular dental assessments (every 6 m4nths)
O !eri4dic visi4n and hearing screenings
O !r4Iessi4nal breast examinati4n every 1 t4 3 years
O !apanic4la4u smear annually ithin 3 years 4I 4nset 4I sexual activity
O Testicular examinati4n every year
O Screening I4r cardi4vascular disease (e.g., ch4lester4l test every 5 years iI results are n4rmal; bl44d press
hypertensi4n; baseline electr4cardi4gram at age 35)
O Tubercul4sis skin test every 2 years
O Sm4king: hist4ry and c4unseling iI needed
Safety
O M4t4r vehicle saIety reinI4rcement (e.g., using designated drivers hen drinking, maintaining brakes and
O Sun pr4tecti4n measures
O W4rkplace saIety measures
O Water saIety reinI4rcement (e.g., n4 diving in shall4 ater)
utrition and xercise
O Imp4rtance 4I adequate ir4n intake in diet
O Nutriti4nal and exercise Iact4rs that may lead t4 cardi4vascular disease (e.g., 4besity, ch4lester4l, and Iat
vig4r4us exercise)
Social Interactions
O Enc4uraging pers4nal relati4nship that pr4m4te discussi4n 4I Ieelings, c4ncerns, and Iears
O Setting sh4rt-and l4ng- term g4als I4r 4rk and career ch4ices

Middle-Aged Adults

Health %est and Screening
O !hysical examinati4n (every 3 t4 5 years until age 40, then annually)
O Immunizati4ns as rec4mmended, such as a tetanus b44ster every 10 years, and current rec4mmendati4ns
vaccine.
O Regular dental assessments (e.g., every 6 m4nths)
O T4n4metry I4r signs 4I glauc4ma and 4ther eye diseases every 2 t4 3 years 4r annually iI indicated
O Breast examinati4n annually by primary care pr4vider
O Testicular examinati4n annually by primary care pr4vider
O Screenings I4r cardi4vascular disease (e.g., bl44d pressure measurement; electr4cardi4gram and ch4leste
directed by the primary care pr4vider)
O Screenings I4r c4l4rectal, breast, cervical, uterine, and pr4state cancer
O Screening I4r tubercul4sis every 2 years
O Sm4king: hist4ry and c4unseling, iI needed
Safety
O M4t4r vehicle saIety reinI4rcement, especially hen driving at night
O W4rkplace saIety measures
O H4me saIety measures: keeping hallays and stairays lighted and uncluttered, using sm4ke detect4r, us
mats and handrails in the bathr44ms
utrition and xercise
O Imp4rtance 4I adequate pr4tein, calcium, and vitamin D in diet
O Nutriti4nal and exercise Iact4rs that may lead t4 cardi4vascular disease (e.g., 4besity, ch4lester4l and Iat
vig4r4us exercise)
O An exercise pr4gram that emphasizes skill and c44rdinati4n
Social Interactions
O The p4ssibility 4I a middle crisis: enc4urage discussi4n 4I Ieelings, c4ncerns, and Iears
O !r4viding time t4 expand and revie previ4us interests
O Retirement planning (Iinancial and p4ssible diversi4nal activities), ith partner iI appr4priate

lders

Health Test and Screening
O T4tal ch4lester4l and high density lipid pr4tein measurement every 3 t4 5 years until age 75
O Aspirin, 81 mg daily, iI in high- risk gr4up
O Diabetes mellitus screen every 3 years, iI in high-risk gr4up
O Sm4king cessati4n
O Screening mamm4gram every 1 t4 2 years (4men)
O Clinical breast exam annually (4men)
O !ap smear annually iI there is a hist4ry 4I abn4rmal smears 4r previ4us hysterect4my 4I malignancy (Uni
!reventive Services Task F4rce, 2003)
4 Older 4men h4 have regular, n4rmal !ap smear 4r hysterect4my I4r n4nmalignant causes d4 N
smear bey4nd the age 4I 65
O Annual digital rectal exam
O Annual pr4state-speciIic antigen (!SA)
O Annual Iecal 4ccult bl44d test (FOBT)
O Sigm4id4sc4py every 5 years; c4l4n4sc4py every 10 years
O Visual acuity screen annually
O Hearing screen annually
O Depressi4n screen peri4dically
O Family vi4lence screen peri4dically
O Height and eight measurements annually
O Sexually transmitted disease testing, iI high- risk gr4up
O Annual Ilu vaccine iI 4ver 65 4r in high-risk gr4up
O !neum4c4ccal vaccine at 65 and every 10 years thereaIter
O Td vaccine every 10 years
Safety
O H4me saIety measures t4 prevent Ialls, Iire, burns, scalds, and electr4cuti4n
O W4rking sm4ke detect4rs and carb4n m4n4xide detect4rs in the h4me
O M4t4r vehicle saIety reinI4rcement, especially hen driving at night
O Elder driver skills evaluati4n (s4me states require I4r license reneal)
O !recauti4ns t4 prevent pedestrian accidents
utrition and xercise
O Imp4rtance 4I a ell-balanced diet ith Ieer cal4ries t4 acc4mm4date l4er metab4lic rate and decreas
activity
O Imp4rtance 4I suIIicient am4unts 4I vitamin D and calcium t4 prevent 4ste4p4r4sis
O Nutriti4nal and exercise Iact4rs that may lead t4 cardi4vascular disease (e.g., 4besity, ch4lester4l and Iat
exercise)
O Imp4rtance 4I 30 minutes 4I m4derate physical activity daily; 20 minutes 4I vig4r4us physical activity 3
limination
O Imp4rtance 4I adequate r4ughage in the diet, adequate exercise, and at least six 8-4nce glasses 4I Iluid da
c4nstipati4n
Social Interaction
O Enc4uraging intellectual and recreati4nal pursuits
O Enc4uraging pers4nal relati4nships that pr4m4te discussi4n 4I Ieelings, c4ncerns, and Iears
O Assessment 4I risk Iact4rs I4r maltreatment
O Availability 4I s4cial c4mmunity centers and pr4grams I4r seni4rs



Nur8ing Re8earch

O Research is a quest I4r an anser t4 a questi4n.
O n4ing the anser t4 a questi4n requires a scientiIic meth4d and n4t merely asking Ir4m vari4us pers4n
4bserving several situati4ns that may 4ut-rightly pr4vide haphazard ansers t4 p4sed questi4ns.
O Systematic pr4cess 4I c4llecting and analyzing inI4rmati4n in 4rder t4 increase 4ur understanding 4I the
ab4ut hich e are c4ncerned 4r interested.
O Is a careIul, systematic study and investigati4n in s4me Iields 4I kn4ledge undertaken t4 disc4ver 4r est
principles.
O The scientiIic meth4d 4I d4ing a research may be brieIly stated in these steps:
Step 1. Identify the problem
A research 4riginates Ir4m a pr4blem, an unansered questi4n 4r an uns4lved pr4blem. An inquisitive pers4n sp
4I kn4ing hy things g4 r4ng 4r unusual that in s4me ays th4se may aIIect human liIe.
Step 2. Limit the problem
The pr4blem may be very br4ad. Try t4 I4cus, kn4 the sc4pe, established b4undaries, set the breadth 4r make a
line s4 that y4u ill kn4 hat are included and hat are excluded. This ill ultimately make y4ur study manag
Step 3. Formulate Hypothesis
Hyp4thesis is a brilliant c4njecture 4r a tentative s4luti4n t4 a pr4blem. It is testable statement 4I a res4luti4n t4 a
questi4n. S4me studies use the term assumpti4n t4 mean the expected 4utc4me 4I an investigati4n 4rinquiry.
Step 4. Collect Data
Implausible statements shall be supp4rted by Iactual, unbias, truthIul, and c4nvincing evidences gathered thr4ug
4I a careIully devised plan. The prep4nderance 4I needed inI4rmati4n ill make a genuine research.
Step 5. Interpret Data and Make a Conclusion
Extract meanings Ir4m tabulated, c4llated, siIted 4r 4rganized data. Data ill be meaningless iI y4u ill n4t dedu
generalizati4ns Ir4m them. Statistical t44ls may aid y4u in measuring the signiIicance 4I 4ne Iact4r t4 an4ther. T
may evaluate, accept, reject, decide 4r c4nclude based 4n the data gathered.
Pure versus Applied Research
Pure or basic research is a study 4riented t4ards the devel4pment 4I a the4ry. It aims t4 pr4vide kn4ledge 4
Applied research is an investigati4n that enriches a s4luti4n t4 a practical pr4blem. It seeks t4 impr4ve human
pr4viding kn4ledge that can be used I4r practical applicati4n.
"ualitative versus "uantitative Research
"ualitative Research is undertaken t4 anser questi4ns ab4ut the pleth4ra 4I phen4mena primarily aimed at giv
and understanding 4I nature based 4n the 4bserver`s vie p4int. It als4 inquires 4n c4ntext and meaning, embark
analysis 4bservati4n.
"uantitative Research is c4nducted t4 Iind ansers t4 questi4ns ab4ut relati4nships am4ng measurable variable
4I explaining, c4ntr4lling, and predicting phen4mena. It is kn4ing the 4utc4me stated in numerical data.
COMPARATIVE CHARACTERISTICS OF QUANTITATIVE AND QUALITATIVE RESEARCH
FEATURE QUANTITATIVE QUALITATIVE
!urp4se O T4 explain and predict
O T4 c4nIirm and validate
O T4 test the4ry
O T4 describe and explain
O T4 expl4re and interpret
O T4 build the4ry
!r4cess O F4cused
O n4n variables
O Established guidelines
O Static design
O C4ntext-Iree
O Detached vie
O H4listic
O Unkn4n variables
O Flexible guidelines
O Emergent design
O C4ntext-b4und
O !ers4nal vie
Data C4llecti4n O Representative
O Large sample
O Standardized instruments
O InI4rmative, small sample
O Observati4ns, intervies
Data Analysis O Deductive analysis O Inductive analysis
Rep4rt 4I Iindings O Numbers
O Statistics, aggregated data
O F4rmal v4ice, scientiIic style.
O W4rds
O Narratives
O Individual qu4tes
O !ers4nal v4ice
O Library style.