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324 > mod 5 ch 16 > Flashcards

mod 5 ch 16 Flashcards

1
Q

nursing process

A
  • Critical thinking
  • Patient-centered care
  • Goal-oriented tasks
  • Evidence-based practice
  • Nursing intuition

The nursing process utilizes five sequential steps: assessment, analysis, planning, implementation, and evaluation.

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2
Q

nursing process

A
  • Assessment- gather data, obj and subj
  • analysis- cluster data and id problem
  • planning- dev plan of care to achieve goals
  • implementation- carry out plan
  • evaluation- collect to evaluate, revise plan as needed or end if obj reached
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3
Q

effective use nursing process

A
  • It is organized.
  • It is outcome-oriented.
  • It is collaborative, incorporating an interprofessional team.
  • It is dynamic, changing over time in response to patient needs.
  • It requires knowledge application, analysis, and critical thinking.
  • It is universally adaptable to all types of patients in all kinds of health care settings.
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4
Q

Which nursing skill is essential to utilize throughout the nursing process?

A

Critical thinking

Critical thinking requires that the nurse think logically about the patient’s health problems and how best to address them, and it is used throughout the nursing process.

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5
Q

Place the steps of the nursing process in the order in which each should occur.

A 
Assessment	
Analysis	
Planning	
Implementation	
Evaluation
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6
Q

Match the nursing process characteristic to its description.

A

The nursing process incorporates the interprofessional team.
—Collaborative
Nurses evaluate patient results to determine effectiveness.
—-Outcome-oriented
Nurses use critical thinking for each step of the nursing process.
—–Analytical
The nursing process helps ensure that patient care is well planned.
—–Organized

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7
Q

analysis

A

recognize cues then form diagnostic conclusions based on identified patters

clinical judgement based on collected data
collaborative problem- actual problem treated by interdisciplinary team

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8
Q

critical thinking

A

promotes thorough, comprehensive, and accurate analysis to identify nursing diagnoses unique to the individual patient

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9
Q

diagnostic decision-making process

A

includes clustering data, identifying patient problems, and formulating diagnoses.

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10
Q

International Classification for Nursing Practice (ICNP)

A

standardized nursing language system used for point-of-care documentation for patient data and clinical activity. ICNP language can be used to identify diagnoses, interventions, and outcomes.

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11
Q

Which nursing concept is defined as an actual or potential problem or response to a problem?

A

diagnosis

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12
Q

Which aspects do nurses make judgments about when determining initial nursing diagnoses?

A
  • vulnerabilities
  • pt problems
  • health promotion
  • risk for problems
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13
Q

Which action reflects a primary task in the analysis step of the nursing process?

A

Forming diagnostic conclusions

Nurses form diagnostic conclusions according to identified problems that reflect patient conditions requiring nursing care in the analysis step of the nursing process.

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14
Q

3 types nursing interventions

A
  • nurse-initiated- do not require HCP prescription
  • HCP initiated
  • collaborative
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15
Q

Which term describes how the nursing process changes over time in response to patients’ individual needs?

A

dynamic

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16
Q

Which statement defines collaborative interventions?

A

Involve the expertise of health care team members

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17
Q

Match the type of nursing intervention to the example.

A 
Patient positioning
---Independent
Foley catheter insertion
----Dependent
Respiratory therapy consult
----Interdependent
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18
Q

giving care

A

direct care- care on pts

indirect care- performed on behalf of pts

19
Q

implementing care

A
  • –Reassess the patient.
  • —Review and revise the existing plan of care.
  • –Organize resources and care delivery.
  • —Anticipate and prevent complications.
  • –Implement nursing interventions.
20
Q

Which function describes the primary purpose for documenting nursing interventions?

A

Facilitate communication.

Communication is the most important reason proper documentation is performed. It facilitates communication among all health care team members and decreases the potential for error

21
Q

During the implementation step of the nursing process, a nurse reviews and revises a patient’s plan of care. Place the steps of review and revision in the order in which each should occur.

A
  • Reassess the patient.
  • Review and revise the existing plan of care.
  • Organize resources and care delivery.
  • Anticipate and prevent complications.
  • Implement nursing interventions.
22
Q

critical thinking process

A
  • examine results
  • compare achieved effect w goals and outcomes
  • recognize errors
23
Q

evaluation

A
  • question interventions

- revise plan

24
Q

Which aspect would the nurse consider as a component of the evaluation step of the nursing process?

A

The patient’s achievement of short- and long-term goals

The evaluation phase is specifically when the nurse determines whether the patient’s short- and long-term goals were met.

25
Q

Which critical-thinking functions must the nurse perform to effectively evaluate patient goals during the final step of the nursing process?

A
  • recognizing errors
  • compare achieved effect w goals
  • examine results acc to clinical findings
26
Q

Which questions are critical for the nurse to ask during each step in the nursing process?

A
  • collected data thorough and accurate?
  • could interventions affect pt negatively?
  • are all underlying factors addressed in plan care?
27
Q

Which phrase describes the primary purpose of nursing analysis and diagnosis?

A

communicate pt problems

28
Q

Which questions would the nurse ask to evaluate the effectiveness of nursing interventions?

A
  • should plan be discontinued
  • have new assessment data been id’d should be considered?
  • does plan care need be modified in response to pt changes?
29
Q

Which characteristics of the nursing process allow the nurse to effectively apply critical thinking to patient care?

A
  • organized
  • outcome oriented
  • allows rn apply knowledge
  • rn think analytically
  • incorporates interprofessional tm
30
Q

Which organization defines standards of nursing practice and states that the nursing process forms the foundation for clinical decision making?

A

american nurses association

31
Q

Which step of the nursing process does the nurse use when obtaining the following patient information: blood pressure of 180/75, pulse of 90, and a complaint of chest pain?

A

assessment

32
Q

Which type of data do the patient’s family members, friends, or other nurses provide?

A

secondary

33
Q

Which type of patient assessment takes into account all factors, such as the patient’s physical, psychological, emotional, environmental, cultural, and spiritual health?

A

holistic

34
Q

Which nursing action occurs during the analysis step of the nursing process?

A

cluster pt data to id pt problems

35
Q

Which phrases describe the role of the International Classification for Nursing Practice (ICNP) in the nursing process?

A
  • prov stand rn language
  • id common labels rn diagnoses’
  • prov point care doc for clinical activity
36
Q

During which step of the nursing process would the nurse prioritize nursing diagnoses?

A

planning

37
Q

During which step of the nursing process would the nurse establish long-term goals with the patient?

A

planning

38
Q

Which part of the nursing process involves the nurse setting short-term goals for the patient?

A

planning

39
Q

Which step of the nursing process involves carrying out nursing actions designed to meet a patient’s unique needs?

A

implementation

40
Q

Which intervention reflects direct nursing care?

A

giving injection

41
Q

Which statements reflect the nurse’s role during the implementation step of the nursing process?

A
  • accountable safe practice
  • perform steps intervention accurately
  • understand why intervention planned
42
Q

Which step of the nursing process considers the effectiveness of nursing care?

A

evaluation

43
Q

Which step of the nursing process includes a decision point on whether to discontinue, continue, or revise the plan of care?

A

evaluation

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