The Roy Adaptation Model (RAM) is among the most commonly used models in nursing. The aim of nursing, according to the RAM, is to increase compliance and life expectancy. During its implementation, the RAM evaluates the patient in physiologic mode, self-concept mode, role function mode, and interdependence mode. By doing so, it aims to provide holistic care. This article explains how the RAM can be used to cope with the physiological effects of a patient with cardiovascular disease. To evaluate the state of the cardiovascular patient, the RAM will only assess the physiological mode for the case and apply the necessary nursing process.
The theory of adaptive modes, as used in the RAM, was developed in 1981, and it consists of four parts: physiological, self-concept, role function, and interdependence. Each adaptive method represents a grouping of behaviors that promote the individuals movements towards the general goals (survival, growth, reproduction, and mastery). In the physiological mode, physiological wholeness is achieved by adapting to changes in physiological needs. The regulator coping mechanism is primarily responsible for attaining and maintaining this integrity. Other complicated processes that influence regulatory activities are the senses, fluids, electrolytes, neurological function, and endocrine function. There are five primary needs that a patient needs to receive as listed below to ensure proper care: Exercise and rest, nutrition, elimination of fluids and electrolytes, oxygen, circulations, and regulations.
During the assessment in the physiological mode, the nursing process assesses the primary needs listed above. For oxygenation, one requires a steady process of ventilation and a stable process of gas exchange. The shape of the patient can be checked and has to be normal in regards to the expansion of health on either side. It is where the apex beat is felt on left 5th intercostal space of the mid-clavicular line, and air entry is equal bilaterally. There should be no ronchi or crepitus, no abnormal heart sounds, hearing of S1 & S2, and the blood pressure should be normotensive.
Nutritionally, the patient should be on a diabetic diet. The weight needs to be measured to understand whether there is a trend in weight increase or reduction. The caregiver needs to assess the stability of the patients digestive process. The occurrence of anorexia complaints, as well as not taking adequate food is common among patients. Evaluation of the patients with cardiovascular diseases only are expected to have no abdominal distension, no tenderness; their bowel sounds heard, and percussion revealed dullness over the hepatic area. On elimination of wastes, there need to be no signs of infections, no pain during micturition or defecation. The bladder pattern has to be normal otherwise corrective measures should be started immediately. The stool should also be examined for the patient might have a hard stool resulting from complaints of constipation.
In relations to the activity of the patient, the patient needs to take adequate rest. By this, sleep pattern is watched, and the caregiver should observe that the patient is not disturbed at night due to unfamiliar surroundings. Also, it is advisable that the patient does not follow any peculiar relaxation measure. The patient needs to develop a regular pattern of exercise, with the help of the caregiver (a medical practitioner). By basing on the RAM, the given practice will be essential for blood circulation. There might be some pain in the joints during this physical activity, and it should also be observed so as not to worsen the situation like to develop a swelling over the joints.
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