Chapter 16: Outcome and Identification Planning

Question 1

3 elements of comprehensive planning

Answer 1

1. initial
2. ongoing
3. discharge

Question 2

3 types of interventions

I sort of disagree…

Answer 2

1. nursing
2. physician
3. collaborative

Question 3

Informal planning

Answer 3

Informal planning is a link between identifying a patient’s strength or problem and providing an appropriate nursing response. This occurs, for example, when a busy nurse first recognizes postpartum depression in a patient, takes time to assess a patient who received bad news about tests, or reassesses a patient for pain. Formal planning involves prioritizing diagnoses, formally planning interventions, and coordinating the home care of a patient being discharged.

Question 4

Ongoing planning

Answer 4

Ongoing planning is problem oriented and has as its purpose keeping the plan up to date as new actual or potential problems are identified.

Question 5

Discharge planning

Answer 5

During discharge planning, the nurse uses teaching and counseling skills effectively to help the patient and family develop sufficient knowledge of the health problem and the therapeutic regimen to carry out necessary self-care behaviors competently at home.

Question 6

standardized planning

Answer 6

Standardized care plans are prepared care plans that identify the nursing diagnoses, outcomes, and related nursing interventions common to a specific population or health problem.

Question 7

initial planning

Answer 7

Initial planning addresses each problem listed in the prioritized nursing diagnoses and identifies appropriate patient goals and the related nursing care.

Question 8

Maslow

Answer 8

Maslow’s hierarchy: (1) physiologic needs, (2) safety needs, (3) love and belonging needs, (4) self-esteem needs, and (5) self-actualization needs. #2 is an example of a physiologic need, #4 is an example of a love and belonging need, #1 is an example of a self-esteem need, and #3 is an example of a self-actualization need.

Question 9

Critical pathway

Answer 9

A critical pathway represents a sequential, interdisciplinary, minimal practice standard for a specific patient population that provides flexibility to alter care to meet individualized patient needs. It also offers the ability to measure a cause-and-effect relationship between pathway and patient outcomes

Question 10

Algorithm

Answer 10

An algorithm is a binary decision tree that guides stepwise assessment and intervention with intense specificity and no provider flexibility

Question 11

Guidelines

Answer 11

Guidelines are broad, research-based practice recommendations that may or may not have been tested in clinical practice

Question 12

Order set

Answer 12

order set is a preprinted provider order used to expedite the order process after a practice standard has been validated through analytical research.

Question 13

Affective outcomes

Answer 13

Affective outcomes describe changes in patient values, beliefs, and attitudes.

Question 14

Cognitive outcomes

Answer 14

Cognitive outcomes (a) describe increases in patient knowledge or intellectual behaviors;

Question 15

Psychomotor outcomes

Answer 15

psychomotor outcomes (b) describe the patient’s achievement of new skills

Question 16

Clinical outcomes

Answer 16

Clinical outcomes describe the expected status of health issues at certain points in time, after treatment is complete

Question 17

Functional Outcomes

Answer 17

Functional outcomes (b) describe the person’s ability to function in relation to the desired usual activities.

Question 18

QOL outcomes

Answer 18

Quality-of-life outcomes (c) focus on key factors that affect someone’s ability to enjoy life and achieve personal goals.

Question 19

Differences between interventions for

• possible diagnosis
• actual diagnosis
• risk diagnosis
• collaborative diagnosis

Answer 19

An intervention for a possible diagnosis is to collect more patient data to confirm or rule out the problem. An intervention for an actual diagnosis is to reduce or eliminate contributing factors to the diagnosis. Interventions for a risk diagnosis focus on reducing or eliminating risk factors, and interventions for collaborative problems focus on monitoring for changes in status and managing these changes with nurse- and physician-prescribed interventions.

Question 20

Concept map

Answer 20

A concept map care plan is a diagram of patient problems and interventions. The nurse’s ideas about patient problems and treatments are the “concepts” that are diagrammed. These maps are used to organize patient data, analyze relationships in the data, and enable the nurse to take a holistic view of the patient’s situation

Question 21

6 important factors when selecting outcomes

Answer 21

NOC recommends considering the following factors when selecting outcomes: (1) the type of health concern, (2) the nursing or medical diagnoses, (3) patient characteristics, (4) available resources, (5) patient preferences, and (6) treatment potential.

Question 22

Characteristics of measurable outcomes

Answer 22

To be measurable, outcomes should have the following:
Subject: the patient or some part of the patient
Verb: the action the patient will perform
Conditions: the particular circumstances in or by which the outcome is to be achieved (not every outcome specifies conditions)
Performance criteria: expected patient behavior or other manifestation described in observable, measurable terms
Target time: when the patient is expected to be able to achieve the outcome