Ch 17: Imementing Flashcards

1
Q

What is carried out during implementing

What does implementing help achieve and what are the outcomes

When is there a better outcome

What does the nurse continue to do during implementing and what is then to the care plan

Why are interventions documented

A

Evidence-based nursing actions that were planned or carried out during implementing

Implementing = achieve valued health outcomes:

  • promote health
  • prevent disease
  • restore health
  • facility coping with altered functioning

Better outcomes occur when patient can and is an active participant

Nose continues to collect data and the care plan is modified

Interventions documented for reimbursement

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2
Q

What kind of report is the nursing interventions classification (NIC)


What does each intervention have what is each intervention and what kind of reading is providing

In all nursing interactions what is the nurse concerned with what are we trying to meet for the patient

A

 The NIC is a report to construct a taxonomy (classification) of nursing interventions

Each intervention has a label, definition, set of activities for the nurse to do in a short list of background readings

Do you know nursing interactions the nurses concerned with the patient response to health and illness any ability to meet basic human needs

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3
Q

How do the nursing outcome classifications ( nOC) come about

Give the 3 goals of The nursing outcome classifications

A

Nursing outcome classifications (NOC) a come about due to a classification of patient outcomes

3 goals of NOC:

  • identify, label, validate classify patient outcomes and indicators
  • evaluate validity and usefulness of classification in clinical testing
  • define and test measurement procedures for outcomes and indicators
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4
Q

Why do we try to develop a CoMmOn nursing language

A

Common nursing language (NIC) developed to optimize delivery of safe, high-quality, cost-effective care

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5
Q

In the chart picture what do we do when we implement

A
  • Carry out the plan!!!
  • continue data collection and modify plan of care as needed
  • Document care
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6
Q

What are ways to engage in clinical reasoning as you are implementing care
Status
EBP
MODIFY

A
  • reassess for changes and status that indicate different interventions
  • use EBP interventions and be open to better ways to address problems
  • Monitor patients response to be able to modify plan of care
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7
Q

What is Alfaro’s rule to know if our actions are effective

A

Alfaros rule :

-Assess, reasses, revise, record

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8
Q

Give the components for the checklist for organizing certain clinical responsibilities

  • name
  • cc/reason
  • status
  • Basic human needs
  • priority/events
  • special needs
  • Family
A
  • Patient profile and name to be addressed
  • Chief complaint and reason for admission
  • Current health status
  • Routine assistance to meet basic human needs
  • Priorities for nursing care and special daily events
  • Special teachings, counseling, advocacy needs
  • Special family needs
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9
Q

What determines how successful the plan the nurse implement will be

To provide competent and efficient care how much is a nurse stay

A

A nurse is interpersonal competence GREATLY. determines how successful the plan will be

To remind competent and efficient care nurses should stay professional and communicate with others

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10
Q

What is the best way to implement interventions

What do you need to do right before implementing and why

How should you approach the patient (the whole patient)
-2 ways

What do you modify nursing interventions according to?
D&p
Will
Previous/current

A

The best way to implement nursing interventions is to do it in a partnership with the family and the patient

Right before you implement RESASSESS to see if the patient still needs the care

Approach the patient holistically and caringly

Modifying nursing interventions according to

  • developmental/cycle social background
  • patients willingness to participate
  • response to previous nursing measures and progress towards goal and outcome
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11
Q

When you’re implementing interventions what do you do them within

Why should you ALWAYS Question the nursing intervention



A

When implementing interventions do within scope of practice and ethically

 ALWAYS Question interventions to make sure they are the best of all possible alternatives

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12
Q

Define nursing interventions by the NIC

Define direct care define indirect care

What is the invoices at the end of the day for patient to have

A

Nurse interventions: treatments performed to enhance patient outcomes based on clinical judgment

Direct care: treatment through interaction with patient

Indirect care: performed away from patient on behalf of patient by interdisciplinary members

End of day emphasis:
-Health promotion/maintenance
-disease prevention

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13
Q

Define protocols

Define standing orders
-what do standing orders give patients

How are protocols in standing orders done



A

Protocols: STRICT written plans detailing nursing activities in specific situations
-routine aspects

Standing orders: orders that let nurse initiate action that typically require physician
-give nurse power

Protocols and standing orders are done independently by nurse

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14
Q

What is the #1 nursing action before interventions (care)

A

1 nursing action before interventions (care) = REASSESS

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15
Q
What  what do nurses use specialized abilities to do when planning care
Determine
Promote 
Assist 
Resources
Anticipate
A
  • Determine new or continuing need for assistance
  • promote self-care
  • assist patient to achieve valued health outcomes
  • organized necessary resources
  • anticipate unexpected outcomes/situations
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16
Q

What are a few things to keep in mind when implementing the plan of care

A

Reassess patient and review care plan

Clarify competency

Organize resources (equipment/environment)

Anticipate unexpected situation

Prevent errors/omissions

Promote self-care, teaching, counseling, advocacy

Assist patients to meet outcomes 

17
Q

What should each nursing intervention be supported by

What should each nursing intervention be within and consistent to

What do you want to ensure about nursing interventions and the specific patient

If you have a question about an order what do you do

A

Ensure each nursing intervention is supported by EBP

Each nursing intervention should be within the scope of practice and consistent with policy

Be sure nursing actions are safe for this particular patient and individualized

Question any questionable order

18
Q

Describe patient variables

Describe nursing variables

A

Patient variables: influences pt

  • developmental stage
  • psychosocial background and culture

Nursing variables:

  • resources (lacking)
  • current standard of care (lacking)
  • research findings
  • ethical and legal guides to practice (within standard of care)

19
Q

What type of assessment is an important intervention
-What changes as patient changes

Why do you wanna monitor the patient’s response to planned interventions

How is ongoing risk management used
At risk
Promote

A

Ongoing assessment collection is an important intervention
-plan of care changes as patient changes

Monitor patients response to plan interventions to determine if effective care plan

 ongoing risk management  identify problems patient is at risk for, ALLOWS INTERVENTION To promote health

20
Q

What is the # 1 question you want to ask if a patient is noncompliant with care and why do you want to do ? (2 Things)

What are a few considerations when Implementing plan of care

A

1 question to ask if patient is noncompliant: why is patient not following therapy

  • reassess strategy
  • Think of changes to get patient participation
Consider:
-lack of
• Family support 
•understanding about benefits
-Low value attached to outcome (patient does not care)
-adverse physical or emotional effects of treatment
-cannot afford treatment
- limited access to treatment
21
Q

Define delegation

You do have the right to delegate, but what must you do after delegating

What do you want to consider when delegating and how do you want to communicate (what do you communicate)

Who is responsible for the effects after delegation has been given

A

Delegation: transfer of responsibility of activity to another person well retaining accountability for outcome

After delegating FOLLOW UP!!
-consider the five rights and -communicate clearly about what, how, any alerts that need to be given to you

The RN is responsible for the effects after delegation

22
Q

Give the five rights of delegation

A
  1. Right task
    - what cannot be delegated and what others cannot do
  2. Right circumstance
    -  patient MUST be stable
    - 🚫 emergency
  3. Right person
    - UAP
  4. Right directions and communication
    - be clear
    - give instructions, clarify information, ensure UAP understands, give criteria for alert
  5. Write supervision and evaluation
    - FOLLOW UP



23
Q

What do you do as a student if you have been Delegated something that you cannot perform safely

What do you never want to do in regards to activities that have been delegated to you

A

If you cannot carry out delegation:
-tell the nurse giving you the delegation consult your instructor

NEVER try to perform interventions beyond your capacity WITHOUT supervision