What is the nursing process? - A systematic problem-solving process that guides all nursing actions
What is the purpose of the nursing process? - To help the nurse provide goal-directed, client-centered
care
What are the two types of goals used in nursing? - Short-term and long-term
What are the steps of the nursing process? - Assess, diagnose, plan, implement, evaluation (ADPIE)
Assessment - Gather data
Diagnosis - Identify client's health needs
Planning Outcomes - Decide goals you want to achieve with your nursing activities
Planning Interventions - choose interventions to help client achieve stated goals
Implementation - action phase when you carry out or delegate actions you previously planned
Evaluation - Judge whether your actions have successfully treated or prevented the client's health
problems
Assessment definition - The systematic gathering of information related to the physical, mental,
spiritual, socioeconomic, and cultural status of an individual, group, or community
What is the difference between a medical diagnosis and a nursing diagnosis? - Medical- focus on disease
and pathology
, Nursing- focus on the client's response to illness
A professional nurse must perform what portion of the nursing process? - Assessment
While nurse aides, LPNs, and other personnel can collect information such as vital signs, pain reports,
and finger-stick glucose levels, It is the responsibility of the professional nurse to... - Assign those tasks,
validate the data collected, conduct the interview, and complete the physical assessment
Assessment involves collecting information from... - -the patient
-secondary sources
-interpreting information
-validating the information
Types of data - -subjective: what the patient says
-objective: what can be observed or measured
-primary: obtained directly from the patient
-secondary: obtained through the medical record or another person
Types of assessment - -initial
-ongoing
-comprehensive
-focused
-special needs
Types of special needs assessments - -Nutritional
-Pain
-Cultural
-Spiritual health
-Psychosocial
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