Nursing Care Plan Using the Roper Logan Tierney Model
This paper presents a nursing assessment and two care plans for a 72-year-old female patient admitted with respiratory and gastrointestinal symptoms and a medical history that includes asthma and Alzheimer's disease. Using the Roper, Logan and Tierney (RLT) model as its framework, the paper identifies patient problems, establishes care goals, and outlines nursing interventions aligned with the model's twelve activities of daily living. The care plan for asthma focuses on respiratory function and patient education, while the Alzheimer's plan addresses safety, self-care, sleep, and environmental modifications. Interdisciplinary collaboration and family involvement are highlighted as essential components of meeting patient care goals.
- Introduction: Patient profile and presenting problems overview
- The Roper, Logan and Tierney Model: Framework origins, components, and activities of living
- Nursing Care Plan: Asthma: Interventions, goals, and breathing-focused daily activities
- Nursing Care Plan: Alzheimer's Disease: Safety, self-care, sleep, and home environment modifications
- Summary of Care Plan Outcomes: Synthesis of both care plans and interdisciplinary input
- Conclusion: Evaluation of RLT model's success across both conditions
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What makes this paper effective
- Clearly applies a named theoretical framework (the RLT model) to real clinical problems, demonstrating how nursing theory translates into practical care planning.
- Structures the two care plans in parallel, making it easy for readers to compare how the same model is adapted to two very different conditions.
- Incorporates multidisciplinary collaboration and family education, reflecting real-world nursing practice and NMC Code requirements.
Key academic technique demonstrated
The paper uses a problem-solving approach rooted in a specific nursing model, citing foundational texts to justify the framework before applying it. This technique — grounding clinical decisions in theoretical evidence — is a core competency in undergraduate nursing education and shows the student can connect academic knowledge to patient care scenarios.
Structure breakdown
The paper opens with a brief patient introduction and problem identification, then explains the RLT model before moving into two detailed nursing care plans. Each care plan includes diagnoses, relevant activities of daily living, planned interventions, and measurable goals. A summary synthesizes both plans, and a short conclusion evaluates the model's effectiveness. This logical, stepwise structure mirrors the nursing process itself.
Introduction
The patient being assessed is a 72-year-old female admitted to the gynaecology ward presenting with diarrhea, vomiting, general malaise, weakness, and a non-productive cough. Her medical history includes Alzheimer's disease, left nephrectomy, aortic repair, asthma, and mobility problems. The two primary problems identified during the assessment are asthma and Alzheimer's disease, and the goal of care is to address both conditions through the application of the Roper, Logan and Tierney (RLT) nursing model.
The Roper, Logan and Tierney Model
The Roper, Logan and Tierney model was the first nursing model to have a model of living as its basis. The framework originated from research conducted by Nancy Roper in 1970, in which she sought to identify the core of nursing activities across any field of nursing practice — activities that could then be supported by the knowledge, skills, and attitudes required for working within individual specialist fields (Holland, Jenkins, and Solomon, 2003). Roper, Logan and Tierney published Elements of Nursing in 1980, identifying the individual aspects of the model as a whole and showing how nursing could use it as a framework for patient care across a wide variety of situations (Holland, Jenkins, and Solomon, 2003).
The model comprises two parts: (1) the model of living, and (2) the model for nursing (Holland, Jenkins, and Solomon, 2003). It identifies five factors associated with the condition of living:
(1) The need to perform activities of living; (2) the nature of a person's lifespan; (3) the presence of a dependence/independence continuum; (4) factors that can influence a person's ability to perform activities of living; and (5) a person's individuality (Timmins and McCabe, 2009).
The activities of living identified within the model are: (1) maintenance of a safe environment; (2) communicating; (3) breathing; (4) eating and drinking; (5) eliminating; (6) personal cleansing and dressing; (7) controlling body temperature; (8) working and playing; (9) mobilizing; (10) sleeping; (11) expressing sexuality; and (12) dying (Timmins and McCabe, 2009).
The most significant contribution of the RLT model is its emphasis on individuality in living, which assists nurses in moving away from what Fawcett (1999) terms a "romance with the medical profession" — a preoccupation with the medical approach that is not always appropriate for nurses or patients (Timmins and McCabe, 2009). Considering the individuality of the patient is reported to allow for "a more meaningful and personalized approach to patient care" (Timmins and McCabe, 2009). The RLT framework also provides the nurse with an opportunity to interview not only the patient but their family members as well, and to document the patient's problems and needs in relation to each particular activity of living.
Nursing Care Plan: Asthma
The nursing care plan for the patient with asthma addresses two activities of daily living: (1) communicating, and (2) breathing. The plan includes the following interventions:
Maintaining the patient's respiratory function and relieving bronchoconstriction while allowing for mucus plug expulsion. Controlling exercise-induced asthma by having the patient sit down, rest, and use diaphragmatic and pursed-lip breathing until shortness of breath subsides. Supervising the patient's drug regimen. Demonstrating the proper use of a metered-dose inhaler. Reassuring the patient during an asthma attack and remaining with her throughout. Placing the patient in a semi-Fowler position and encouraging diaphragmatic breathing. Assisting the patient to relax as much as possible. Administering oxygen by nasal cannula as ordered to ease breathing and increase arterial oxygen saturation during an acute asthma attack. Adjusting oxygen delivery according to the patient's vital signs and arterial blood gas (ABG) measurements. Administering medications and intravenous fluids as ordered. Combating dehydration with IV fluids until the patient can tolerate oral fluids, which will help loosen secretions. Encouraging the patient to express her fears and concerns about her illness. Encouraging the patient to identify and comply with care measures and activities that promote relaxation (Nursing File, 2011).
The goals of the nursing care plan for asthma include: (1) ensuring that the patient understands how to use oxygen and other breathing apparatuses, including inhalers; and (2) ensuring that the patient's family members also understand the use of these devices so that they are able to assist the patient.
Conclusion
The RLT model proved to be an effective framework for planning nursing care for both asthma and Alzheimer's disease in this patient. All necessary elements of each nursing care plan have been addressed and are appropriate for implementation. Family members have been consulted and instructed on how they can best assist the patient, and other healthcare specialists have been consulted and have provided valuable input into both care plans. Taken together, these plans represent a comprehensive, individualized, and theoretically grounded approach to managing the patient's complex health needs.
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