Nursing theories: Henderson, Orem, Roy, Nightingale, Peplau and Cultural Care
Core meaning: Nursing theories provide structured explanations of nursing, person, health and environment.
Step-by-step learning
Match each theorist with the central idea.
Learn assumptions, major concepts and the nurse’s role.
Connect the model with one patient-care situation.
Distinguish models using a short comparison table.
Key points to remember
- Henderson: assisting independence in 14 basic needs.
- Orem: self-care deficit and nursing systems.
- Roy: adaptation in four adaptive modes.
- Nightingale: environment and healing.
- Peplau: therapeutic interpersonal relationship.
- Leininger: culturally congruent care.
- Who developed the Adaptation Model?
- In which Peplau phase does the client use available services?
- Which Leininger mode modifies a harmful practice?
- Compare Orem and Henderson theories.
- Explain Peplau’s four phases and nursing roles.
- Describe the three modes of culturally congruent care with examples.
Nursing process
Core meaning: A systematic, client-centred method of assessment, diagnosis, planning, implementation and evaluation.
Step-by-step learning
Collect subjective and objective data.
Analyse data and identify human responses.
Prioritise problems, set measurable outcomes and select interventions.
Perform, delegate and document interventions.
Compare outcomes with criteria and revise the plan.
Key points to remember
- Use SMART outcomes.
- Prioritise airway, breathing and circulation when urgent.
- Differentiate medical diagnosis from nursing diagnosis.
- Document responses and continuity of care.
- What is the first step of the nursing process?
- Which outcome is written in measurable terms?
- Evaluation mainly compares what?
- Explain all steps of the nursing process with an example.
- Prepare a nursing care plan for a patient with impaired mobility.
Pain and stress management
Core meaning: Pain is a subjective sensory and emotional experience; stress is the response to demands that disturb equilibrium.
Step-by-step learning
Use location, quality, intensity, timing and aggravating/relieving factors.
Differentiate acute/chronic pain and physical/psychological stressors.
Positioning, relaxation, breathing, heat/cold where appropriate and distraction.
Administer analgesics safely and monitor effects/adverse reactions.
Document response and modify the plan.
Key points to remember
- Believe the patient’s report of pain.
- Use an age-appropriate pain scale.
- Prevent opioid-related respiratory depression.
- Stress management includes coping, sleep, exercise and social support.
- Which scale is suitable for a conscious adult?
- When should pain be reassessed after intervention?
- Which finding suggests opioid toxicity?
- Discuss nursing and medical management of pain.
- Explain stress, coping mechanisms and the nurse’s role.
Holistic care and alternative medicine
Core meaning: Holistic care addresses physical, psychological, social, spiritual and cultural dimensions of health.
Step-by-step learning
Include beliefs, family, coping and spiritual needs.
Respect client preferences and autonomy.
Combine evidence-based nursing with safe complementary practices.
Assess contraindications and medicine–herb interactions.
Measure function, comfort and satisfaction.
Key points to remember
- Holistic care is not merely alternative medicine.
- Complementary care is used with conventional treatment; alternative care replaces it.
- Respect culture without endorsing harmful practices.
- Which dimensions are included in holistic care?
- Complementary medicine means what?
- What is the nurse’s first duty before supporting herbal use?
- Define holistic nursing and describe its components.
- Discuss benefits and risks of alternative medicine in nursing practice.
Creativity in nursing
Core meaning: Creativity is generating useful, safe and practical new solutions to care problems.
Step-by-step learning
Define the unmet need clearly.
Use brainstorming and team discussion.
Check safety, ethics, cost and feasibility.
Test on a small scale.
Measure outcomes and standardise successful change.
Key points to remember
- Barriers include rigid rules, fear of failure, poor teamwork and lack of resources.
- Innovation must remain evidence-based and safe.
- Quality-improvement cycles support creativity.
- Which factor blocks creativity?
- What comes before implementing an innovation widely?
- Which method generates multiple ideas quickly?
- Explain methods and barriers of creativity in nursing.
- Describe how a nurse can introduce a low-cost ward innovation.
Professional development, ethics, rights and nursing laws
Core meaning: Professional development combines competence, ethics, accountability, rights and legal responsibilities.
Step-by-step learning
Autonomy, beneficence, non-maleficence, justice, fidelity, veracity and confidentiality.
Informed consent, dignity, privacy, information and nondiscrimination.
Understand roles of ICN, ICM, NAN and Nepal Nursing Council.
Document objectively and preserve evidence.
Revise the law applicable three months before the examination.
Key points to remember
- Article 35: health rights; Article 38: women’s rights; Article 39: child rights.
- Informed consent requires information, capacity and voluntariness.
- Medico-legal documentation must be timely, factual and signed.
- Controlled medicines require secure custody and accurate records.
- Which ethical principle means fairness?
- Which article concerns the right to health?
- What is essential for valid informed consent?
- Discuss nursing ethics and client rights.
- Explain management of a medico-legal case.
- Write notes on organ transplantation, narcotic drugs and abortion-related nursing responsibilities.