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Nurs 232 Nursing process

Assessment Collect, organize, validate and document data
Diagnosis Analyze data, identify health problems, risks, and strengths Formulate diagnostic statements
Planning Prioritize problems/disagnoses Formulate goals/desired outcomes Select nursing interventions Write nursing orders
Implementing; Reassess the client Determine the nurse's need for assistance Implement the nursing interventions Supervise delegated care Document nursing activities.
Evaluate COllect data related to outcomes COmpare data with outcomes Relate nursing actions to client goals/outcomes Continue, modify, or terminate the clients care plan
What is the nursing process? an organized approach to client care used as a means of problem solving. also known as care planning
What is the purpose of the nursing process? to identify a client's health status and actual or potential health care problems or needs, and to deliver specific nursing interventions to meet those needs.
What data does the Assessment contain? Subjective and Objective
Define etiology causal relationship between a problem and its related or risk factors
What does the basic two part statement contain? 1. Problem (P): statement of the client's response 2. Etiology (E): factors contributing to or probably cause of the responses
What words join the basic two part statement? related to
What are Collaborative Problems actions the nurse caries out in collaboration with other health team members such as physical therapists social workers, dietitians, and physicians.
What does nursing focus on? nursing focuses on diagnosis and treatment of patient's response to illness or health problems
What are the components to a 3 part statement? Correct diagnostic label (related to assessment data) Appropriate etiologies ("related to") Relevant "as evidenced by"
What is the Planning process based on? it is baed on findings in the assessment
What should you incorporate in the Planning process your goals for care
What is a sentinel even? an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof.
What is an outcome it is a goal; what the nose hopes to achieve by implementing the nursing intervention.
What is the purpose of the desired goal/outcome? Provide direction for planning nursing interventions Serve as criteria for evaluation client progress Enable the client and nurse to determine when the problem has been resolved Help motivate the client and nurse by providing a sense of achievement
What is delegation "the transfer or lateral transfer of both the responsibility and ACCOUNTABILITY of an activity from one individual to another
what two responsibilities does the nurse have when delegating and assigning? 1. appropriate delegation of duties 2. adequate supervision of personnel to who work is delegated or assigned.
What does an evaluation statement consist of? it has two parts: 1. a conclusion 2. supporting data
Created by: 1390023652