Chamberlain College of Nursing :NR 226 Final Exam Study Outline 1 Latest,100% CORRECT
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NR 226
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NR 226
Chamberlain College of Nursing :NR 226 Final Exam Study Outline 1 Latest
*****ADPIE for ALL!!****
The Nursing Process
o The purpose of the nursing process is to diagnose and treat human responses (e.g., patient symptoms, need for knowledge) to actual or potential health problems. Use of ...
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Chamberlain College of Nursing :NR 226 Final Exam Study Outline 1
Latest
*****ADPIE for ALL!!****
The Nursing Process
o The purpose of the nursing process is to diagnose and treat human
responses (e.g., patient symptoms, need for knowledge) to actual or
potential health problems. Use of the process allows nurses to help
patients meet agreed-on outcomes for better health.
o The nursing process requires a nurse to use the general and specific
critical thinking competencies described earlier to focus on a
particular patient's unique needs. The format for the nursing process
is unique to the discipline of nursing and provides a common
language and process for nurses to “think through” patients' clinical
problems
• 5 Steps of the Nursing Process (ADPIE)
o Assessment
▪ Phases of interview/assessment
• An interview is an approach for gathering subjective and
objective data from a patient through an organized
conversation. An initial interview involves collecting a
nursing health history and gathering
information about a patient's condition
• 1. Orientation and Setting an Agenda
o Begin an interview by introducing yourself and
your position and explaining the purpose of the
interview. Explain why you are collecting data and
assure patients that all of the information will be
confidential.
o Your aim is to set an agenda for how you will
gather information about a patient's current chief
concerns or problems. Remember, the best clinical
interview focuses on a patient's goals, preferences,
and concerns and not on your agenda.
• 2. Working Phase-Collecting Assessment or Nursing Health
History
o Start an assessment or a nursing health history
,with open- ended questions that allow patients to
describe more clearly their concerns and problems.
For example, begin by having a patient explain
symptoms or physical concerns and describe what
he or she knows about the health problem or ask
him or her to describe health care expectations.
, o Use attentive listening and other therapeutic
communication techniques that encourage a
patient to tell his or her story.
• 3. Terminating an Interview
o Termination of an interview requires skill. You
summarize your discussion with a patient and
check for accuracy of the information collected.
Give your patient a clue that the interview is
coming to an end. For example, say, “I have just
two more questions. We'll be finished in a few
more minutes.”
o This helps a patient maintain direct attention
without being distracted by wondering when the
interview will end.
▪ Methods of obtaining data
• An assessment is necessary for you to gather
information to make accurate judgments about a
patient's current condition. Your information comes
from:
• The patient through interview, observations, and physical
examination.
• Family members or significant others' reports and
response to interviews.
• Other members of the health care team.
• Medical record information (e.g., patient history,
laboratory work, x-ray film results, multidisciplinary
consultations).
• Scientific and medical literature (evidence
about disease conditions, assessment techniques,
and standards).
▪ Subjective Data
• Subjective data are your patients' verbal descriptions of
their health problems. For example, Mr. Lawson's self-
report of pain at the area
where his incision slightly separated is an example of
subjective data. Subjective data include patients'
feelings, perceptions, and self-report of symptoms.
• Only patients provide subjective data relevant to their health
condition. The data often reflect physiological changes,
which you further explore through objective review of
body systems.
, ▪ Objective Data
• Objective data are observations or measurements of a
patient's health status. Inspecting the condition of a
surgical incision or wound, describing an observed
behavior, and measuring blood
pressure are examples of objective data.
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