Nursing Theories

GUIDELINE FOR CASE STUDY: Grand Nursing Theories Based on Human Needs

Purpose: The intent of this assignment is to help students nursing theory integrate nursing theory
into clinical practice.

Guidelines: Each student will read the case study, analyze it, and answer the following questions.
Use relevant journal articles to support your answers. Copy and paste the case study scenario into
your paper.

Case Study
Mr. Juan Duran is a 60-year-old patient who has been coming to the Diabetes Clinic at the VA
for a few months. One day, the Clinic Director, Jim Carlson, finds him wandering the hallway,
appearing somewhat dazed, with a bag of supplies for blood glucose testing and insulin
administration. Mr. Duran tells him that he has been instructed to start insulin for his diabetes but
doesn’t know how. He doesn’t recall receiving any appointments or instructions. Mr. Carlson
finds the Diabetes Nurse Educator, Jenny O’Connell, and asks her to fit Mr. Duran in for an
unscheduled appointment.

Jenny O’Connell starts the appointment with a thorough assessment of Mr. Duran. In addition to
the physical assessment, she covers psycho-social-spiritual issues. She discovers that Mr. Duran
has had diabetes for about 10 years and, recently, his blood glucose levels and HgbA1c cannot be
controlled with oral medications and exercise. The physician wants to start him on insulin.

Here are notes that she took from her assessment:

• Sixty-year-old Mexican American patient. He is exceedingly polite and respectful of health
care personnel (and does not like to interrupt or ask too many questions). He has been in the
United States for more than 50 years; he is a Navy veteran.
• Married; lives with wife in a comfortable apartment in Chula Vista, CA.
• Duran speaks fluent English, but his wife’s English is limited. They speak Spanish at home.
• Because Mr. Duran has limited vision, his wife has to administer the insulin.
• Had one (single) daughter, who was found murdered in the apartment parking lot less than 2
weeks ago, leaving Mr. and Mrs. Duran to care for their child.
• Duran seems befuddled by the insulin and syringes and is stoic when he talks about the loss
of his daughter.

1. Review the situation
2. Select one of the nursing models/theories from this chapter that will help Jenny in assessing
Mr. Duran and planning for his care. Discuss why that particular model was selected.
3. Based on the model selected, what additional information would Jenny want to
collect/assess?
4. Based on the model selected, how would Jenny initiate a plan of care (education) for Mr.
Duran?
5. Do you think that Jenny would assess and plan differently for Mr. Duran’s care if she used
a different model (than the one your group selected) for Mr. Duran? Why or why not.