Fund: Unit 2 Chapter 4

Front 1

Objective data

Back 1

data that can be assessed through the senses

Front 2

Subjective date

Back 2

symptoms knowable only by patient

Front 3

critical thinking

Back 3

using competent reasoning and logical though processes to determine the merit of a belief or action

Front 4

validate

Back 4

nurses should do this to avoid making decesions based on assumptions

Front 5

nursing process

Back 5

an overlapping five step method for decision making

Front 6

rapport

Back 6

creating a relationship of mutual trust

Front 7

nursing diagnosis

Back 7

the concise statement of a problem that the patient is experiencing as a result of his or her medical diagnoses

Front 8

assessment

Back 8

gathering of information through signs and symptoms, patient history and objective finding

Front 9

3 components of assessment

Back 9

interviewing, performing head to toe assessment, and reviewing lab and diagnostic tests

Front 10

Diagnosis

Back 10

formulation of nursing diagnoses though analysis od the assessment information that you have gathered.

Front 11

Planning

Back 11

process of determining priorities and what nursing actions should be performed to help resolve or manage each patient problem

Front 12

Implementation

Back 12

process of taking actions to resolve the patients problems, the nursing diagnoses also called interventions

Front 13

Evaluation

Back 13

performed when the nurse reflects on the intervention he or she has performed and decides if they have brought the patient closer to achieving the goals and outcomes set in the planning step

Front 14

who is responsible for care plan?

Back 14

RN

Front 15

who contributes to the care plan

Back 15

LPN

Front 16

Assessment, Diagnosis, Planning, Implementation, Evaluation

Back 16

Steps of the nursing process

Front 17

When the patient provides information it is called?

Back 17

Primary data

Front 18

When the information is obtained through family members or friends and the patients chart it is considered?

Back 18

Secondary data

Front 19

Inspection

Back 19

the visual examination of the patients body for rashes, breaks in skin, and normal appearance of eyes, ears, nose, mouth, limbs, and genitals.

Front 20

Palpatation

Back 20

with is touching or feeling the torso and limbs for pulses, abnormal lumps, temp, moisture, and vibrations

Front 21

Ausculation

Back 21

listening for abnormal sounds in the lungs, heart, or bowels. Listening to body organs.

Front 22

Percussion

Back 22

using tapping movement to detect abnormalities of the internal organs

Front 23

Nursing Diagnoses address?

Back 23

Physical, psychosocial, and environmental needs.

Front 24

Maslow's Hierarchy of human needs

Back 24

Physiological, Safety and security, Love and belonging, self esteem, cognitive, aesthetic, self actualization, transcendence.

Front 25

physiological

Back 25

food, air, water, temp, regulation elimination, rest, sex and physical activity

Front 26

Safety and security

Back 26

protection, emotional and physical safety, order, law, stability, shelter

Front 27

love and belonging

Back 27

giving and receiving affection, meaningful relationships, belonging to groups

Front 28

self esteem

Back 28

pride, sense of accomplishment, recognition by others,

Front 29

cognitive

Back 29

knowledge, understanding, exploration

Front 30

aesthetic

Back 30

symmetry, order, beauty

Front 31

self actualization

Back 31

person growth, reaching potential

Front 32

Transcendence

Back 32

of self, helping others self-actualize

Front 33

defining characteristics

Back 33

signs and symptoms exhibited by the patient

Front 34

NANDA-I

Back 34

North American Nursing Diagnosis Assiociation-International

Front 35

NANDA-I

Back 35

is responsible for creating and maintaining an approved list of nursing diagnoses

Front 36

THREE PART STATMENTS ARE ALSO CALLED

Back 36

PES statements

Front 37

PES Statements

Back 37

problem, etiology, and signs and symptoms

Front 38

In some cases, all three parts of the statement will not apply

Back 38

TRUE

Front 39

TWO part statement

Back 39

nursing diagnosis is one that expresses the risk for a problem, a possible problem, or certain actual problems. This is used.

Front 40

referred to a PE statement, problem and etiology only

Back 40

Two part statement

Front 41

When the NANDA-I diagnosis falls into the category of wellness, syndrome, or specified what is used

Back 41

One part statement

Front 42

Planning includes

Back 42

Patient Goals= setting long term and short term goals, planning outcomes for each nursing diagnosis, and planning the interventions you will use in the implementation step.

Front 43

nursing goal

Back 43

the overall direction in which one must progress to improve a problem

Front 44

Expected outcomes

Back 44

statement of measurable action for the patient within a specific time frame, in response to nursing interventions

Front 45

Direct Patient care

Back 45

performed when the nurse interacts directly with the patient and includes such activities as bathing, teaching, listeneing, and administering meds.

Front 46

Indirect patient care

Back 46

performed when the nurse provide assistance in a setting other than with the patients

Front 47

independent interventions

Back 47

physician's order not required

Front 48

dependent intervention

Back 48

requires doctor order.

Front 49

collaborative intervention

Back 49

involve working with other health care professionals

Front 50

considered in evaluation

Back 50

are the nursing diagnosis correct?

have you established realistic, reachable goals?

have you determined the correct priorities for your ND?

Have you selected and implemented the correct interventions?

Has the patients condition changes?

Front 51

types of care plans

Back 51

computerized, standardized, Multidisciplinary, critical pathway, student

Front 52

concept maps

Back 52

mind maps, can be used to diagram and connect data about any subject