Comprehensive Nursing Care Chapter 5 Practical And Vocational Nurses And The Nursing Process

Front 1

assessment

Back 1

systematic collection, organization, validation (proving or supporting), and documentation of data (information)

Front 2

care plan

Back 2

written guide that organizes information about a client's care

Front 3

collaborate

Back 3

to cooperate, to work together with someone in a different position or specialty

Front 4

collaborative actions

Back 4

nursing activities that reflect the overlapping responsibilities between health personnel

Front 5

data collections

Back 5

process of gathering information

Front 6

database

Back 6

baseline data; information about a client gathered from many sources; a reference point to assess changes in the client's condition

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desired outcome

Back 7

goal, a description, in terms of observable client responses, or what the nurse hopes the client will achieve by implementing the nursing orders

Front 8

diagnosis

Back 8

econd phase of the nrusing process. In this phase, nurses use critical-thinking skills to interpret assessment data and identify client strengths and problems

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etiology

Back 9

identification of factors contributing to, or probable causes of, a health problem

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evaluation

Back 10

review of interventions to determine their effectiveness

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examination

Back 11

physical assessment; a systematic methos of collecting physical data about a client

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implementation

Back 12

fourth step of nursing process, in which selected nursing interventions (actions) are performed

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interventions

Back 13

actions performed by a nurse 1. independent interventions; activities nurses are licensed to initiate on the basis of their knowledge and skills 2. Dependent interventions: activities carried out under the physician's order or supervision, or according to specified routines

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interview

Back 14

planned communication; conversation with a purpose

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manifestations

Back 15

combination of subjective and objective data

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nursing diagnosis

Back 16

clinical judgement about individual, family, or community responses to actual and potential health problems or life processes

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nursing interventions

Back 17

actions initiated by the nurse to achieve client goals

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nursing process

Back 18

systematic, logical methods of providing individualized nursing care; it includes assessment, diagnosis, planning, implementation, and evaluation

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observation

Back 19

process of gathering data by using the senses

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planning

Back 20

third step of nursing process; decision making, prioritizing, and problem solving to achieve desired client outcomes

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priority-setting

Back 21

process of identifying most important to least important

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procedures

Back 22

technical, psychomotor (hands-on) skills that involve nursing actions such as manipulating equipment, giving injections, or repositioning clients

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rationale

Back 23

scientific principle given as the reason for selecting a particular nursing intervention

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symptoms

Back 24

subjective data apparent only to the person affected

Front 25

ADPIE

Back 25

Assess/gather data
Diagnose/Problem
Plan (goals)
Implement
Evaluate