Fundamentals: Chapter 18 Flashcards
When does a nurse begin planning?
After identification of the patient’s nursing diagnosis and collaborative problems
What does planning involve?
setting priorities, identifying patient-centered goals and expected outcomes, and prescribing individualized nursing interventions
What is the term for the ordering of nursing diagnosis or patient problems using determinations of urgency and/or importance to establish a preferential order for nursing actions?
priority setting
What are the classifications of a patient’s priorities?
High
Intermediate
Low
Which diagnosis have a high priority?
if untreated, result in harm to patient or others
Which diagnosis have an intermediate priority?
involve non-emergent, non life-threatening needs of patient
Which diagnosis have a low priority?
affect the patient’s future well-being
What is a “cognitive shift”?
shifting of attention from one patient to another during the conduct of the nursing process
What two factors does a nurse determine during planning in order to provide a clear focus for the type of intervention needed to care for your patient and to then evaluate the effectiveness of these interventions?
Goal
Expected outcome
What is a broad statement that describes a desired change in a patient’s condition of behavior?
Goal
What is a measurable criterion to evaluate goal achievement?
Expected outcome
What kind of knowledge does a nurse apply to plan patient care?
medical
sociobehavioral
nursing science
What is a patient-centered goal?
reflects a patient’s highest possible level of wellness and independence in function
What is a short-term goal?
an objective behavior or response that you expect a patient to achieve in a short time (usually < week)
What is a long-term goal?
an objective behavior or response that you expect a patient to achieve over a longer period of time (weeks, months etc)
How do expected outcomes direct nursing care?
they are the desired physiological, psychological, social, developmental, or spiritual responses that indicate resolution of a patient’s health problems
What is a measurable patient, family/community state, behavior, or perception that is largely influenced by and sensitive to nursing interventions?
nursing-sensitive patient outcome
What are the 7 guidelines for writing goals and expected outcomes?
- Patient-Centered
- Singular Goal/Outcome
- Observable
- Measurable
- Time-Limited
- Mutual Factors
- Realistic
What kind of terms are best used to evaluate/measure outcomes precisely? (5)
Quality
Quantity
Frequency
Length
Weight
Which three areas must a nurse be competent in when choosing suitable nursing interventions?
Knowing the scientific rational for the intervention
Possessing the necessary psychomotor and interpersonal skills
Being able to function within a particular setting to use the available health care resources effectively
What are independent nursing interventions?
actions that a nurse initiates (do not require an order)
What do independent nursing interventions pertain to?
ADLs, health education and promotion, and counseling
What are dependent nursing interventions?
actions that a physician initiates (requires an order)
What are collaborative interventions?
therapies that require the combined knowledge, skill, and expertise of multiple health care professionals
What are the six factors to consider when choosing interventions?
- Characteristics of the nursing Dx
- Goals and expected outcomes
- Evidence base for the intervention
- Feasibility of the intervention
- Acceptability to patient
- Your own competency
What are the 3 levels of the Nursing Interventions Classification (NIC) model?
Domains (broad terms)
Classes (30 clinical categories)
Interventions (542 clinical interventions)
What is a plan of care that includes nursing diagnosis, goals and/or expected outcomes, specific nursing interventions, and a section for evaluation finding so any nurse is able to quickly identify a patient’s clincal needs and situation?
nursing care plan
Why is a nursing care plan important?
reduces the risk for incomplete, incorrect, or inaccurate care
How does a nursing care plan enhance continuity of care?
lists specific nursing interventions needed to achieve the goals of care
What are patient care management plans that provide the multidisciplinary health care team with the activities and tasks to be put into practice sequentially/
critical pathways
What is a process by which you seek the expertise of a specialist such as your nursing instructor, a physician, or a clinical nurse educator to identify ways to handle problems in patient management or the planning and implementation of therapies?
Consultation
