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
