TWENTY-ONE NURSING PROBLEMS by Faye Glenn Abdellah

METAPARADIGM IN NURSING

PERSON
Abdellah classifies the beneficiary of care as individuals. However, she does not
set standard limits on the nature and essence of human beings. The twenty one nursing
problems relate with biological, psychological and social aspects of individuals and can
be said to correspond to concepts of importance.

HEALTH
In this theory, the concept of health is defined as the center and purpose of
nursing services. Although Abdellah does not give a definition of health, she speaks to a
total health needs and a healthy state of mind and body in her description of nursing
as a comprehensive service.

ENVIRONMENT
The idea of environment is addressed by Abdellah and is included in planning
for optimum health on local, state, national, and international levels. However, as
Abdellah elaborates her ideas, the apex of nursing service is the individual.

NURSING
The concept of nursing in this theory is generally grouped into twenty-one
problem areas for nurses to work out their judgement and appropriate care. Abdellah
considers nursing to be an all-inclusive service that is based on the disciplines of art
and science that serves individuals, sick or well, cope with their needs.
1.

OVERT: which is obvious or can be-seen condition

2.

COVERT: This is an unseen or masked one.

TYPOLOGY OF TWENTY-ONE NURSING PROBLEMS

1.

To maintain good hygiene and physical comfort;

2.

To promote optimal activity: exercise, sleep, rest;

3.
To promote safety through prevention of accident, injury, or other trauma and
through the prevention of the spread of infection;
4.

To maintain good body mechanics and prevent and correct deformity;

5.

To facilitate the maintenance of a supply of oxygen to all body cells;

6.

To facilitate the maintenance of nutrition of all body cells;

7.

To facilitate the maintenance of elimination;

8.

To facilitate the maintenance of fluid and electrolyte balance;

9.
To recognize the physiological responses of the body to disease conditionspathological, physiological and compensatory;
10.

To facilitate the maintenance of the regulatory mechanism and functions;

11.

To facilitate the maintenance of sensory function;

12.

To identify and accept positive and negative expressions, feelings and reactions;

13.

To identify and accept interrelatedness of emotions and organic illness;

14.

To facilitate the maintenance of effective verbal and non verbal communications;

15.

To promote the development of productive interpersonal relationship;

16.

To facilitate progress toward achievement and personal spiritual goals

17.

To create or maintain a therapeutic environment;

18.
To facilitate awareness of self as an individual with varying physical emotional
and developmental needs;
19.
To accept the optimum possible goals in the light of limitations physical and
emotional;
20.
and

To use community resources as an aid in resolving problems arising from illness;

21.
To understand the role of social problems as influencing factors in the cause of
illness.

The Twenty one nursing problem of Abdellah elaborated that the core in nursing service
is the individual, the beneficiary of care. The twenty one nursing problems relate with
biological, psychological, and social aspects of individuals and can be said to
correspond to concepts of importance. Abdellahs theory generally grouped the areas
for nurses to work out twenty-one nursing problems for them to utilize their judgment
and to give their appropriate care towards the client.
We chose also to have Abdellahs theory because of some enumerated problems
that were very applicable to our clients case. We nurses should provide assistance in
maintaining good hygiene and also provision of comfort, we should promote optimal
activity (exercise, rest ,sleep) especially to our client who need to have enough rest and
sleep, we are also oblige to promote safety to our client through prevention of accident
or injuries by simply doing preventive measures (raising side rails) , facilitating
maintenance of a supply of oxygen to all body cells as well as facilitating the
maintenance of fluid and electrolyte balance, and we also need to recognize the
physiological responses of the body towards the disease condition of our client
Abdellahs theory would give confidence to the simplification of principles and as a
result, would give guide care and promote the development of nurses judgemental
ability.
Florence Nightingales Environmental Theory

In this theory, Nightingale emphasizes the importance of the environment as a factor to

the patients health. It is mentioned in her theory that a nurse can manage the
environment of the patient in various ways to improve the patients recovery. She
developed the relationship of the elements between ventilation, light, patients position
in the room, cleanliness, darkness, noise and patient stimulation, sickroom and the rest
of the relationships between the house and the surrounding neighborhood. She added
that the environment needs to be modified to prevent disease, as evidenced by her
discussion of the homes of the poor, the workhouses, and preventing exposure of
children to measles. She also emphasized the importance of the nurse-patient
relationship suggesting cooperation and collaboration.

In relation to our patients situation, we the health care providers should see to it that the
patients environment is conducive for recovery and as much as possible, comfortable.
Also we have to make sure that the area is clean, has good ventilation, no foul odor so
as to protect her from acquiring infection that could lead to further complication. Has the
right temperature and is free of noise and because of her condition, she needs all the
rest she can get. Support is also essential to the nurse-patient relationship. This could
help in establishing rapport and the patient would feel that we really are sincere in
caring for her.