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What is the definition of a nursing diagnosis?
A clinical judgment about individual, family, or community responses to actual and potential health problems or life processes.
What are the 4 types of nursing diagnoses?
- Actual nursing diagnoses
- "risk for" nursing diagnoses
- wellness nursing diagnoses (pt healthy, want to keep that way)
- collaborative problems
What are the five components in writing a nursing diagnoses?
- defining characteristics
- related factors
- risk factors
What are some example nursing diagnoses?
- •Constipation related to inadequate fluid intake
- •Ineffective individual coping related to fear of medical diagnosis
- •Risk for impaired skin integrity related to immobility
What are the two high-level steps in the planning process?
- 1. establish priorities
- - threats to physiological integrity
- - the health care setting
- - client's perception of need
- - client's self-care ability
- 2. establish outcomes
- - defining outcomes: measurable and realistic
- - types of outcomes: nursing-sensitive client outcome
- - nursing outcomes classification (NOC) system
What are the 7 features of a proper goal and expected outcome?
- singular goal or outcome
- mutual factors
What are the nursing skills of intervention?
- managing (you can delegate activity, but not accountability)
What are the four types of interventions?
- direct care nursing intervention
- indirect care nursing intervention
- nurse-initiated intervention
- physician-initiated intervention
What are the 6 elements of an intervention?
- who (provides the care)
- what (the care required to meet the need)
- where (home, hospital, or clinic)
- when (time delivered/sequence of events)
- why (rationale)
- how (method; individualizes a client's care(
What are common core interventions found in the Nursing Intervention Classification (NIC) system?
- active listening
- emotional support
- infection control and protection
- vital signs monitoring
- medication management
Name 3 nursing implementation skills
What are the three possible evaluations of nursing outcomes?
- goals met
- goals partially met
- goals not met