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Flashcards in Nursing Process Part 2 Deck (14)
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1

Assessment:
What are the 5 types of nursing assessments?

comprehensive initital
focused
emergency
time-lapsed
patient centered assessment method

2

What are some skills that help with critical thinking?

reflective practice: journaling and debriefing
concept maps

3

Explain the 5 core values of assessment:

-systematic and comprehensive to identify medical concerns
-determine credibility of info sources
-find normal from abnormal and risk for abnormal
-judgments of significance of data
-check accuracy, reliability, and missing info

4

Assessment:
What are the 2 types of data used?

subjective: info perceived only by the patient
objective: observable and measurable

5

Assessment:
What are some sources of data?

patient
family
record
medical history, physical
labs
therapies

6

Assessment:
What are some problems related to data collection?

poor organization
failure to chart
irrelevant data
recording interpretation rather than observed data

7

What are the 5 steps of assessment?

collect data
identify cues and make inferences
validating data
clustering related data
reporting and recording data
this leads to:
-clinical reasoning (analyzing, synthesizing, reflecting, drawing conclusions)

8

What are the 5 steps of Diagnosis?

-creating a list of suspected problems
-ruling out similar problems
-naming actual/potential problems
-determining risk factors
-identifying resources, strengths, and areas for health promotion

9

What is the prupose, vision, and mission of NANDA?

purpose: implementation of ND
vision: ensure patient safety through standardized terminology
mission: standardized nursing diagnostic
terminology.

10

What is the difference between a ND and a medical diagnosis?

ND: nurse treats independently
Medical: physician directs the treatment
Collaborative: physician and nurse prescribed

11

What does a ND provide?

-a definition of problems and common language for patient needs
-nurse communication
-focus on scope of practice
-foster nursing knowledge

12

What are the 3 types of ND's?

-actual: human response to health conditions or life processes
-risk: same as actual but they may develop
-health promotion: clinical judgment of motivation, desire, and readiness to enhance well-being and does not require a current level of wellness

13

What are the 3 parts of the nursing diagnosis?

-Problem: diagnostic labe
-Etiology: related to "r/t" (don't use medical diagnosis)
(risk and health promotion diagnosis will not have this section)
-Defining characteristics: as evidenced by AEB, (use subjective and objective data)

14

How can you prioritize the ND?

-high: emergent
-intermediate
-low: affect future well being
-Use Maslow Hierarchy: physiologic (food, water air), safety, love and belonging, esteem, self-actualization