Nursing Care of Patient with Pneumonia and Acute Respiratory Failure Using Roy Adaptation Nursing Model: 2 Case Studies

Abstract

            Pneumonia is the major health problem of adult patient and the cause of death in top 3 of diseases in internal medicine department, Sakon Nakhon hospital. The severe complications that are the cause of death are acute respiratory distress syndrome, respiratory failure and septic shock. The purpose of this case study was to apply the Roy’s adaption model to nursing care of pneumonia patient with respiratory failure. The purposive study was carried out in 2 cases of pneumonia patient with respiratory failure admitted in male medical ward 1, Sakon Nakhon hospital. The history of treatments and data were reviewed from hospital medical records, patient and their relative interview and observation. The nursing diagnosis was determined using the Roy’s adaptation model. The nursing care plan, conclusion and nursing outcome evaluation were carried out.

          The results revealed that 2 case studies were male aged 60 and 61 years old. They were diagnosed as pneumonia with respiratory failure. They had fever and cough for 2–3 days prior to hospital visit and admitted in male medical ward 1. During admission these two patients had increased dyspnea and hypoxemia then they were inserted with endotracheal tube and respirator. This was the crisis situation and patients should be in critical care. According to Roy’s adaptation model, the pneumonia with respiratory failure is the direct stimuli. The 2 patients had 4 adaptation modes as follows 1) physiological mode; they could take self–care activities of daily living even they were slightly tried, 2) self–concept mode; changing the way of thinking, accepting the truth of present being 3) role function mode; they could take care of themselves and their family member mode, the results indicated that the participants could take care of themselves and their and 4) inter–dependence mode; they could get love, care and morale, good relationship among family member. In conclusion, in nursing care of patient, the nurses require the knowledge and skills to enhance patient safety and no complications. The nurses are responsible for improvement of patient’s health, empowerment of patients and families to help them cope with the critical condition of disease.
           Keywords: Pneumonia, Acute respiratory failure, Nursing care, Roy adaptation nursing mode