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NCM 103 - MIDTERMS > Nursing Process: Planning > Flashcards

Nursing Process: Planning Flashcards

1
Q

Third step of the nursing process

A

Planning

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2
Q

4 Main Purposes of Plan of Care

A
  1. Promotes communication among caregivers to promote continuity of care.
  2. Directs care and documentation.
  3. Creates a record that can later be used for evaluation, research, and legal reason.
  4. Provides documentation of health care needs for insurance reimbursement purposes.
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3
Q

ACTIVITIES OF THE PLANNING PHASE

A

→ Attending to urgent priorities.
→ Clarifying expected outcomes.
→ Deciding which problems must be prescribed.
→ Determining individualized nursing interventions.
→ Making sure the plan is adequately recorded.

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4
Q

TRUE OR FALSE?

Focus on what MUST be achieved before what’s NICE to do.

A

TRUE

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5
Q

Deciding which problem must be recorded is influenced by your understanding of:

A

✓ The whole picture of all the problems present
✓ The person’s overall health status and expected discharge outcomes.
✓ The expected length of contact with the patient.
✓ Focus on what MUST be achieved before what’s NICE to do.
✓ The patient’s perception of priorities
✓ Whether there are standard plans that apply, are there critical pathways? Guidelines? Protocols?

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6
Q

“Always check policies and procedures for recording the plan, as they are designed to help ____ ______ and protect ___ ____ ______.”

A

“Always check policies and procedures for recording the plan, as they are designed to help your patient and protect you from legal liability.”

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7
Q

BASIC PRINCIPLES: ATTENDING TO URGENT PRIORITIES.

A
  1. Choose a method of assigning priorities and use it consistently.
  2. Maslow’s hierarchy of needs.
  3. Problems usually present in a cluster
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8
Q

TRUE OR FALSE?

Study the relationships among the problems to determine major priorities.

A

TRUE

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9
Q

TRUE OR FALSE?

Assign high priority to problems that does not contribute to other problems.

A

FALSE

Assign high priority to problems that contribute to other problems.

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10
Q

It serves the purpose of ordering the delivery of nursing care so that the more important or life-
threatening problems are treated before less critical problems are treated.

A

Setting Priorities

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10
Q

TRUE OR FALSE?

Consider state laws, hospital policy statements, and outcome criteria established for the particular setting.

A

TRUE

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11
Q

TRUE OR FALSE?

Do not consider the effect of potential problems when setting priorities.

A

FALSE

Consider the effect of potential problems when setting priorities.

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12
Q

TRUE OR FALSE?

Consider costs, resources available, personnel and time needed to plan and treat each of the patient’s identified problems.

A

TRUE

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13
Q

TRUE OR FALSE?

Focus on the problems the patient feel are less important if this priority does not interfere with medical treatment.

A

FALSE

Focus on the problems the patient feel are MOST important if this priority does not interfere with medical treatment.

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14
Q

TRUE OR FALSE?

It is okay not to consider the patient’s culture, values, and beliefs when setting priorities.

A

FALSE

Consider the patient’s culture, values, and beliefs when setting priorities.

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15
Q

TRUE OR FALSE?

Maslow’s hierarchy of basic need cannot guide the selection of high- priority problems.

A

FALSE

Maslow’s hierarchy of basic need can guide the selection of high- priority problems.

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16
Q

CLARIFYING OR ESTABLISHING OUTCOMES (RESULTS)

A

→ Patient outcome
→ The desired result of nursing care
→ That which one hopes to achieve with the patient and which is designed to prevent, remedy or lessen the problem identified in the nursing diagnosis.

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17
Q

OUTCOME IDENTIFICATION

A

The nurse identifies expected outcomes individualized to the patients.

The nurse develops outcomes for the patient to achieve showing an optimum or improved level of functioning in the problem areas identified in the nursing diagnoses.

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18
Q

refer to the INTENT.

A

Goals and Objectives

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19
Q

refers to results.

A

Outcomes

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20
Q

What you intend to do.

A

Goals and Objectives

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21
Q

What you expect the patient to be able to do

A

Outcomes

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22
Q

Describes what will be observed in the patient after care is done to show the benefits of nursing care.

A

Expected Outcomes

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23
Q

3 MAIN PURPOSES OF EXPECTED OUTCOMES

A
  1. They are the “measuring sticks.” For the plan of care.
  2. They direct interventions.
  3. They are motivating factors.
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24
Q

At a basic level, determining outcomes requires you to simply “________ ___ _______” or state what
you expect to observe in the patient after you perform an intervention.

A

“reverse the problem”

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25
Q

Describe the benefits expected to be seen at a certain point in time after the plan has been implemented.

A

LONG TERM OUTCOME-

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26
Q

State what you expect to observe in the patient when the problems are resolved or controlled.

A

PROBLEM OUTCOMES

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26
Q

Describe early expected benefits of nursing interventions.

A

SHORT TERM OUTCOME-

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27
Q

State the benefit you expect to observe in the patient after an intervention is performed.

A

INTERVENTION OUTCOMES-

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28
Q

Outcome may relate to problems or interventions.

What are they?

A

TRUE

PROBLEM OUTCOMES
INTERVENTION OUTCOMES

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29
Q

Outcomes describe the specific benefits you expect to see in the patient after care has been given.

A

TRUE

SHORT TERM OUTCOME
LONG TERM OUTCOMES

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30
Q

COMPONENTS OF OUTCOME STATEMENTS

A

→ Subject
→ Verb
→ Condition
→ Performance criteria
→ Target time.

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31
Q

Changes in attitude, feelings, or values.

A

Affective domain

32
Q

Dealing with acquired knowledge or intellectual skills.

A

Cognitive domain

32
Q

Dealing with developing motor skills.

A

Psychomotor domain

33
Q

What actions must the person take to achieve the outcome?

A

VERB

34
Q

Who is the person expected to achieve the outcome.

A

SUBJECT

35
Q

Under what circumstances is the
person to perform the actions?

A

CONDITION

36
Q

How well is the person to perform the actions?

A

PERFORMANCE CRITERIA

36
Q

By when is the person expected to
be able to perform the actions?

A

TARGET TIME

37
Q

An observable activity to the patient will demonstrate at some time in the future showing improvement in the problem area.

A

Patient Behavior

38
Q

Not all outcomes will have______.

A

conditions

39
Q

TRUE OR FALSE?

Specific aides which will facilitate the patient performing a behavior at the level in the criteria and within specified time frame.

A

TRUE

40
Q

TRUE OR FALSE?

Specific aids that will help the patient perform a behavior at the level specified in the criteria portion of the outcome statement.

A

TRUE

41
Q

A stated level or standard for the patient behavior stated in the outcome.

A

PERFORMANCE CRITERIA

42
Q

It specifies a realistic improvement in functioning in the problem area by stated time and will be used to determine whether the outcome was satisfactorily achieved.

A

PERFORMANCE CRITERIA

43
Q

A time or date to clarify how long it would realistically take for the patient to reach the level of functioning stated in the criteria part of the outcome.

A

TIME FRAME

44
Q

A designated time or date when the patient should be able to achieve the behavior.

A

TIME FRAME

45
Q

It clarifies and individualizes the outcome based on the patient’s ability and a realistic expectation for the level of functioning in the future.

A

PERFORMANCE CRITERIA

46
Q

TYPES OF TIME FRAME

A

A. INTERMEDIATE OUTCOMES
B. LONG TERM OR FINAL OUTCOMES
C. DISCHARGE OUTCOMES.

47
Q

It identifies behavior a patient can achieve quickly.

A. INTERMEDIATE OUTCOMES
B. LONG TERM OR FINAL OUTCOMES
C. DISCHARGE OUTCOMES.

A

A. INTERMEDIATE OUTCOMES

48
Q

It gives direction for the nursing care over time.

A. INTERMEDIATE OUTCOMES
B. LONG TERM OR FINAL OUTCOMES
C. DISCHARGE OUTCOMES.

A

B. LONG TERM OR FINAL OUTCOMES

49
Q

It appears in the end of the critical pathways used with the hospitalized patient.

A

C. DISCHARGE OUTCOMES.

50
Q

It tries to identify the maximum level of functioning possible for a patient with a particular nursing diagnosis.

A. INTERMEDIATE OUTCOMES
B. LONG TERM OR FINAL OUTCOMES
C. DISCHARGE OUTCOMES.

A

B. LONG TERM OR FINAL OUTCOMES

51
Q

It identifies the behavior the patient is expected to achieve to be safely discharged from the institution.

A. INTERMEDIATE OUTCOMES
B. LONG TERM OR FINAL OUTCOMES
C. DISCHARGE OUTCOMES.

A

C. DISCHARGE OUTCOMES.

52
Q

TRUE OR FALSE?

Keep outcome long.

A

FALSE

Keep outcome short.

53
Q

TRUE OR FALSE?

Make outcome specific.

A

TRUE

54
Q

TRUE OR FALSE?

Whenever possible, the outcome is important and valued by the patient and family only

A

FALSE

Whenever possible, the outcome is important and valued by the patient, family, the nurse and the physician.

55
Q

TRUE OR FALSE?

The outcome is an observable or immeasurable patient behavior.

A

FALSE

The outcome is an observable or measurable patient behavior.

56
Q

TRUE OR FALSE?

The outcome is congruent with and supportive of other therapies.

A

TRUE

57
Q

TRUE OR FALSE?

For an actual nursing diagnosis, the outcome is a patient behavior that demonstrates reduction or alleviation of the problem.

A

TRUE

58
Q

TRUE OR FALSE?

The outcome is a realistic for the patient’s capabilities in the time span you designate in your outcome.

A

TRUE

59
Q

TRUE OR FALSE?

For at risk medical diagnosis, the outcome is a patient behavior that demonstrates the maintenance of the current status of health or functioning.

A

FALSE

For at risk NURSING diagnosis, the outcome is a patient behavior that demonstrates the maintenance of the current status of health or functioning.

60
Q

TRUE OR FALSE?

Derive each outcome from only one nursing diagnosis.

A

TRUE

61
Q

TRUE OR FALSE?

The outcome can be unrealitic for the nurse’s level of skill, experience and time/ workload.

A

FALSE

The outcome realistic for the nurse’s level of skill, experience and time/ workload.

62
Q

TRUE OR FALSE?

Designate a specific time for the achievement of each outcome.

A

TRUE

63
Q

TRUE OR FALSE?

Write outcomes in terms of nursing actions behavior, patient behavior.

A

FALSE

Write outcomes in terms of patient behavior, not nursing actions.

64
Q

3 BASIC STEPS TO DETERMINING WHICH PROBLEMS MUST BE RECORDED

A
  1. Create a problem list.
  2. Decide which problem must be managed in order to achieve the overall outcomes of care
  3. Determine what documentation will guide how to teach problem will be managed.
65
Q

PLANNING – BEGIN BY PRIORITIZING CLIENT PROBLEMS

A

→ Prioritize list of client’s nursing diagnoses using Maslow.
→ Rank as high, intermediate or low.
→ Client specific
→ Priorities can change.

66
Q

TYPES OF PLANNING

A

→ Initial
→ Ongoing
→ Discharge

67
Q

Admission

A. Initial
B. Ongoing
C. Discharge

A

A. Initial

68
Q

Confinement

A. Initial
B. Ongoing
C. Discharge

A

B. Ongoing

69
Q

Before discharge

A. Initial
B. Ongoing
C. Discharge

A

C. Discharge

70
Q

PLANNING – TYPES OF GOALS

A

→ Short term goals
→ Long term goals

71
Q

GOALS ARE PATIENT CENTERED AND SMART

A

o S - Specific
o M – measurable
o A – attainable
o R – relevant
o T – time bound

72
Q

INTERVENTIONS – 3 TYPES

A

→ INDEPENDENT (Nurse initiated)
→ DEPENDENT (Physician initiated)
→ COLLABORATIVE

73
Q

Any action the nurse can initiate without direct supervision.

A

INDEPENDENT (Nurse initiated)

74
Q

Nursing action requiring MD orders.

A

DEPENDENT (Physician initiated)

75
Q

Nursing actions performed jointly with other health care team members.

A

COLLABORATIVE

76
Q

OTHER FACTORS IN PRIORITIZING:

A

→ Client’s health status and belief.
→ Client’s priorities
→ Available resources
→ Urgency of the health problem
→ Medical treatment plan.

77
Q
A

NCM 103 - MIDTERMS (7 decks)

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