nursing process Flashcards
(48 cards)
Define nursing process
the diagnosis and treatment of human responses to actual or potential health problems. (ANA 1980)
Who was the first person to introduce the term “nursing process” in 1955?
Lydia Hall
Who identified functional health patterns in 1976?
Marjory Gorden
Who are the group of people in charge of the terminology used in nursing and when were they established?
NANDA - North American Nursing Diagnosis Association, 1982
Who is the leader of NANDA, and what college was she an instructor at?
1989 Lynda Carpenito/ Nursing Dx/ approved by ANA
what year did the ANA revise the definition of nursing?
2003
When does NANDA refine their nursing diagnosis list?
every two years, biennial
The nursing process is a problem solving process for nursing care…
its systematic, dynamic, interactive, flexible, and theoretically based
components of the nursing process (5)
assessing, diagnosing, planning, implementing, and evaluating
what are the benefits of the nursing process?
patient, nurse, and professional benefits
nursing benefits in the nursing process
continuity of care, individualized patient centered care, encourages patient and family participation in care
nurse benefits in the nursing process
professional growth, innovated/creative in style of care, and more effective in adm. care/ collaborate with other HCW
professional benefits in the nursing process
defines our scope of practice, our role to the consumer, and what we do for other HCP
Assessing in the nursing process
collect, organize, validate, and document data. first step in the nursing process, systematic, identifies current/potential problems, holistic approach, and utilize therapeutic comm. techniques
Methods of data collection
observation, interview patient and family, physical exam, and review chart
Types of data
subjective and objective
Sources of data
primary, secondary, HCT, health records, and literature
Data validation
ensures accuracy of info., validates data directly with the patient, compares findings with patients’ chart, and utilize references as needed
Data interpretation
cues: data acquired through one of five senses (sub. and obj. data) the more cues, more potential
for accurate diagnosis and inferences: always subjective, nurses judgment or interpretation of the cues
Diagnosis
second step in the NP. clinical judgment, provide basis for interventions
Steps in developing a nursing diagnosis
identify the problem using NANDA list, id etiology, and id the defining characteristics
Types of nursing diagnosis
actual, risk, health problems, and syndrome
Actual nursing diagnosis
clinically validated (S/S), actual Dx does not appear in ND statement, statement comes from NANDA list whenever possible (3 parts)
What are the three parts to the nursing diagnosis?
problem (NANDA label and definition), etiology (related to and risk factors), and defining characteristics (S/S)
