Health Safety Excelsior College

Front 1

What are the 5 steps of the nursing process?

Back 1

Assessment
Diagnosis
Outcomes Identification
Planning
Implementation
Evaluation

Front 2

actual diagnosis

Back 2

A human response to a health condition or life process that is
happening at the present time.

Front 3

assessment

Back 3

The systematic and ongoing collection of comprehensive data
relevant to a patient’s health or to the situation or ambience
influencing the patient’s health.

Front 4

audit

Back 4

A record or chart review.

Front 5

baseline data

Back 5

Data taken at the time of the first encounter with the patient.

Front 6

defining
characteristics

Back 6

The manifestations, or signs and symptoms, of a diagnosis.

Front 7

dependent
interventions

Back 7

Nursing interventions that are ordered by a physician or carried out
under a physician’s supervision for the treatment of a medical
diagnosis.

Front 8

diagnosis

Back 8

A clinical judgment about the client’s response to actual or
potential health conditions or needs.

Front 9

emergency nursing
assessment

Back 9

The data collection process that occurs in a life-threatening
situation.

Front 10

evaluation

Back 10

The process of determining both the client’s progress toward the
attainment of expected outcomes and the effectiveness of nursing
care.

Front 11

focused health
data assessment

Back 11

The performance of selected portions of the patient history and
examination process whenever specific conditions warrant this
action.

Front 12

implementation

Back 12

The process of carrying out the plan of care, which may include
any or all of the following activities: providing, monitoring,
delegating, coordinating, teaching, and counseling.

Front 13

independent
interventions

Back 13

Nursing interventions that are initiated by the nurse and that
address nursing diagnoses.

Front 14

Maslow’s
hierarchy of needs

Back 14

A tool for prioritizing nursing diagnoses; according to this
hierarchy, a patient’s basic physical needs must be met before his
or her safety needs, then social needs, then esteem needs, then selfactualization
needs.

Front 15

nursing

Back 15

The protection, promotion, and optimization of health and
abilities; prevention of illness and injury; alleviation of suffering
through the diagnosis and treatment of human response; and
advocacy in the care of individuals, families, communities, and
populations.

Front 16

nursing process

Back 16

A process for the delivery of nursing care that involves the
following steps: assessment, diagnosis, outcomes identification,
planning, implementation, and evaluation.

Front 17

objective data

Back 17

Signs or observations made directly by the nurse that are capable
of being verified by another person.

Front 18

outcome
evaluation

Back 18

An examination of quality indicators such as number of patient
falls, number of new pressure ulcers formed, number of
postoperative wound infections, and number of tube-fed patients
developing aspiration pneumonia.

Front 19

policies

Back 19

Written instructions designed to address a commonly occurring
problem in an institutionally approved manner.

Front 20

possible diagnosis

Back 20

A diagnosis that is being investigated but has not yet been
confirmed.

Front 21

primary data

Back 21

Data that the nurse derives directly from interaction with the
patient.

Front 22

procedures

Back 22

Institutionally approved, preprinted, detailed instructions on how
to perform specific clinical tasks.

Front 23

process

Back 23

The appropriateness of the care given and whether policies and
procedures were followed to maximize patient safety, minimize
medication error, minimize infectious contamination, and ensure
that patients and families feel welcome.

Front 24

protocols

Back 24

Institutionally approved, preprinted instructions governing
interventions or actions to be taken in the care of groups of
patients with particular problems.

Front 25

quality
improvement (QI)

Back 25

Methods that focus on diagnosing system problems and suggesting
interventions to address those problems.

Front 26

risk diagnosis

Back 26

A diagnosis that is likely to occur in a vulnerable person.

Front 27

risk factors

Back 27

Those variables that increase a patient’s vulnerability to
developing an actual nursing diagnosis.

Front 28

secondary data

Back 28

Data derived from sources other than direct interaction with the
patient.

Front 29

standing orders

Back 29

Institutionally and departmentally approved instructions granting
the nurse the authority to act in the absence of a physician.

Front 30

state nurse
practice act

Back 30

A legal act that regulates the practice of nursing within each state.

Front 31

structure

Back 31

The setting or the environment in which care is given.

Front 32

subjective data

Back 32

Data that relies on a conscious patient providing a narrative
statement or report.

Front 33

syndrome

Back 33

A cluster of diagnoses that are linked to a patient’s condition.

Front 34

terminal
evaluation

Back 34

Evaluation of patient outcomes prior to discharge of the patient
from the hospital or prior to a case being closed in a community
setting.

Front 35

time-lapsed
nursing
assessment

Back 35

A repeated assessment obtained to compare data collected at one
or more points in time with baseline data.

Front 36

wellness diagnosis

Back 36

A human response to achieve an even greater level of wellness.

Front 37

Health

Back 37

a freedom from symptoms of disease, the ability to be active, and a state of being in good spirits.

Front 38

absorption

Back 38

the process by which a drug passes into the bloodstream

Front 39

Additional factors concerning BP

Back 39

age, stress, gender (men usually higher than women before menopause), race (BP higher in blacks, 2x higher complications), daily variation (peaks in late eve), meds, activity

Front 40

Adverse effects

Back 40

more severe side effects which may justify the d/c of a drug

Front 41

Agonist

Back 41

a drug that interacts with a receptor to produce a response

Front 42

Ampule

Back 42

A small glass container for ind. doses of liquid meds

Front 43

Anaphylactic RX

Back 43

A severe allergic rx usually occurs immediately after the administration of the drug

Front 44

Another name for a 1mL syringe?

Back 44

A TB syringe

Front 45

Apnea

Back 45

Absence of respirations

Front 46

Are all syringes marked in mL?

Back 46

No, some are marked in cc's, which are interchangeable

Front 47

Arterial BP

Back 47

the force exerted on the walls of an artery created by the pulsing of blood under pressure from the heart