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How would you describe planning as it applies to the nursing process?
Nurse sets client-centered goals and expected outcomes and plans nursing interventions, select interventions that will resolve client problems & achieve goals/outcomes.
What is the importance of priority setting as it applies to patient care?
By ranking diagnosis in order of importance you attend to clients most important needs and better organize care activities. Helps to anticipate and sequence interventions when client has multiple problems.
What conditions might cause initial priorities to change?
Priorities change as clients needs change, client in pain could benefit from analgesic, repositioning or relaxation exercises. If client in to much pain to reposition then make analgesic higher priority. Pg 262-3
Where do you begin with priority setting?
At holistic level when you ID & prioritize main diagnosis or problems.
In what circumstances should the client be involved in priority setting?
Whenever possible, clients will assign different priorities than yours. Resolve differences.
What factors affect your ability to set priorities?
- - The model for delivering care,
- - Organization of nursing unit
- - Interruptions from other providers
- - Available resources
- - Policies & procedures
- - Clients condition is changing
- - Supply access.
How would you compare and contrast goals and outcomes?
- Goal = aim, intent or end; reflects pts highest possible level of wellness and independence in function; realistic and based on pt needs and resources pg 239
- Outcome = measureable outcome to evaluate goal achievment.pg 240
Why does a client-centered goal need to be specific and measurable?
Predicted resolution of diagnosis/problem, with evidence of progress
What is a short term goal? long term goal?
- Short term: objective behavior or response that you expect a pt to achieve over short term, usually in less than a week, in acute care over just few hours
- Long term: objective behavior or response that you expect a pt to achieve over long period, usually several days, weeks or months
How are outcomes developed?
Taken from both short & long term goals, determine when specific goal has been met. Pg 266
How do you indicate that an outcome is measurable?
Set standards to which clients response is measured. pg241 eg body temp will remain 98.6
What are the seven guidelines for writing goals and expected outcomes?
- Client centered
- Singular goal/outcome
- Time limited
- Mutual factors
How does the setting of goals and outcomes contribute to good patient care?
Gives practicular guidance in planning interventions
How would you define and develop a nursing care plan?
Enhances continuity of N care by listing specific interventions to achieve goals of care.
What is a nursing intervention?
Interventions are treatments or actions based on clinical judgement & knowledge that nurses perform to meet outcomes.
Why are nursing interventions based on scientific rationale?
Reason you chose a specific nursing action, based on supporting evidence. Includes a reference. Is specific to client situation.
What is the difference between a nursing care plan and an institutional care plan?
Institutional lacks scientific rationale.
What is the advantage of computerized care plans?
Organize and enhance care planning, provide documentation for 3rd party billing. Incorporates current evidence based guidelines to achieve outcomes for specific groups of clients.
How does the nurse work with other disciplines to develop critical pathways?
Multidisciplinary plans outlining treatment plans/interventions clients need. Most based on medical diagnosis not nursing. Ensures better continuity of care cause maps out responsibility of care
How are concept maps used in planning care?
Visual representation of client problems/interventions that shows relationship between them. Gives holistic view of needs to help make better decisions on in care.