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The student selects a grand theory or a middle range theory of nursing and analyzes and applies the chosen theory by following a synthesized method of analysis below. You should address the following components:
Title of theory; theorist’s name, affiliation,
Main idea of the theory
List of assumptions of the theory (if applicable)
List of major concepts of the theory with concept definitions or brief description of the
Your list of references
Theory Description
Profile of theorist
Purpose and scope or level of theory
Origin of theory
Major concepts and propositions
Theory Analysis
Are concepts clearly defined and logically connected?
Is there a model or diagram that contributes to clarifying theory?
Are concepts measureable (operationally defined)?
Can you understand it well enough to apply it to practice?
Theory Evaluation and application to the Case Study
Is the theory congruent with current nursing practice?
Has it been tested (give an example of one research article using the theory as a framework)
Is the theory culturally relevant?
Does the theory contribute to the discipline/science of nursing
Would you find this theory useful in your workplace? How? In what context/setting?
Case Study
History of Present Illness:
A 49-year-old woman presents to the emergency department complaining of abdominal pain. About 36 hours ago, she began having dull, intermittent abdominal pain in the right upper and lower abdominal quadrants, about 3 out of 10 in severity. She had just finished a Sunday “fried chicken” dinner with her family when the pain started. Shortly after the pain started, she developed nausea that has not gone away. Today, she developed a fever of 102.7°F, and the pain became more persistent and severe, now almost 10 out of 10. The pain worsens when she tries to walk and when the car hit bumps in the road. She has never had pain like this before, not even when she had a “gallbladder attack” 1 year ago.
She tells you her gallbladder was removed, but after you finish the interview, her husband pipes in and says: “honey, remember, they did not take out the gallbladder, they just went in and took out a stone from the duct with that scope.” She was encouraged to have the gallbladder removed, but her husband says the surgeons were worried about her ability to heal at the time given her HbA1c (13.6), asking that she get better control of her sugars before they would operate. She has achieved adequate control of her diabetes but has yet to have the cholecystectomy.
Summary 1
36 hours of RUQ and RLQ abdominal pain
Worse with fried foods
Developed a fever, now pain is worse with movement or car bumps
Had Choledocholithiasis with stone retrieval
Recommended cholecystectomy but surgeons refused because A1c too high
Now has an A1c appropriate for surgery
PMH
– DM2 (7.5 A1c)
+ Neuropathy
+ Nephropathy
+ NO retinopathy
CKD2
Constipation
Gallstone
Choledocholithiasis
Medications
NPH insulin BID
Metformin
glipizide
gabapentin
docusate prn
Senna prn
Past Surgical Hx
C-section 15 years
Surgical mesh repair ventral
ERCP
Allergies
NKDA
Family Hx
Mom: DM2, IBS
Dad: unknown
Social Hx
Tobacco: None
ETOH: None
Drugs: None
Works: Caterer
Lives: Husband
Vital Signs Temp: 99°F BP: 95/70 HR: 104
RR: 14
Sat: 98% RA
Weight: 80 kg
Physical
No icterus
Tachycardia but regular
Without involuntary guarding or rebound tenderness
Negative Murphy’s sign; no fluid wave
PbciMS x 4 (all 4 extremities intact)
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