NCLEX-PN

H. Self-Care Self-care includes self-initiated activities that promote personal well-being, without relying on medical professionals or other external assistance. For individuals with developmental delays or the elderly, their ability to perform self-care tasks can determine their level of independence. Your comprehensive understanding of local community resources can contribute to prolonging their ability to live in their own homes. Your role involves crafting care plans that involve input from clients, family members, friends, or external caregivers, tailored to each individual's needs and circumstances. Self-Care Deficit Nursing Theory Dorothea Orem is credited with developing the Self-Care Deficit Nursing Theory, which revolves around three nursing systems tailored to a client’s ability to manage their self-care. ●​ Wholly Compensatory Nursing System : This system involves the nurse providing complete care for clients who are unable to perform any self-care activities. Examples include infants, neonates, and comatose clients. ●​ Partly Compensatory Nursing System : In this system, the nurse offers care when the client can manage some but not all self-care tasks. Clients like those acutely ill, who can perform certain tasks like brushing teeth but not bathing, fall under this category. Nurses provide assistance for tasks the clients cannot manage. ●​ Supportive Educative Nursing System (Developmental Nursing System) : Here, the nurse educates and supports the client’s self-care abilities and activities, encouraging their independence. The concept of self-care activities is further divided into Basic Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). ●​ Basic ADLs : These include tasks like bathing, mobility, toileting, personal care, grooming, dressing, and eating. ●​ Instrumental ADLs : These are more complex and include activities like grocery shopping, housework, meal preparation, using the telephone, and transportation. To remember these, use the mnemonic SHAFT ( S hopping, H ousekeeping, A ccounting, F ood preparation, T elephone, T ransportation). To assess a client’s ability to manage self-care in their home environment, nurses may directly observe them or involve physical and occupational therapists. Standardized tools like the Lawton Instrumental Activities of Daily Living Scale, Bristol Activities of Daily Living Scale, Cleveland Scale of Activities of Daily Living, and Katz Index of Independence in Activities of Daily Living are employed. ●​ The Lawton Instrumental Activities of Daily Living Scale evaluates a client’s ability to manage tasks like shopping, meal preparation, medication management, and more. ●​ Katz Index assesses fundamental activities like bathing, feeding, toileting, and continence.

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