Kozier & Erb's Fundamentals of Nursing 10th Edition by Shirlee Snyder,Audrey Berman,Geralyn Frandsen

Exercise 3

After morning report, the nurse, Megan, approaches Robbie James, a 10-year-old boy lying quietly in his hospital bed. She introduces herself and writes her name on the white board in the room, so that when Robbie's mother arrives, she will know the name of Robbie's nurse. Megan's client assignment today consists of four acutely ill children of different ages. As Megan makes her initial rounds, she assesses the immediate needs of each child and begins to prioritize her nursing activities.
Megan has her own needs. She is tired from the night before when her own daughter was up late with coughing and fever. She is com-fortable with her arrangements for child care, however, and is able to focus on her care of the clients on the pediatric unit.
When Megan returns with intravenous morphine, Robbie barely speaks, a pinched look of discomfort on his face. Using the FACES pain scale, Robbie has identified his pain as the "worst possible pain." This is his first day postop after surgery for a ruptured appendix, and he has a nasogastric (NG) tube in place, draining to wall suction. Megan administers the medication according to unit protocol and continues her assessment. She checks patency and placement of the NG tube and measures Robbie's vital signs.
Megan notes a "walking chart" on the wall beside Robbie's bed. The walking chart includes spaces to place a sticker each time Rob-bie walks in the hall. Robbie knows that after three stickers, he can choose a prize from the treasure box. Before Megan leaves the room she suggests to Robbie, "When you feel better from this medicine, m help you walk, and we'll put another sticker on that chart!"
In the theory of bureaucratic caring, Ray suggests that different aspects of the hospital system influence the choice making of the nurse. Describe how each of the following aspects influences the nurse's care:
Spiritual-ethical caring
Physical
Technologic
Social-cultural
Educational
Legal