N 141 Ch. 19

Front 1

1. Explain the relationship of implementation to the nursing diagnostic process.

Back 1

a

Front 2

Describe the association between critical thinking and selecting nursing interventions.

Back 2

b

Front 3

Discuss the differences between protocols and standing orders.

(Potter, 2013, p. 253)Potter, P., Perry, A., Stockert, P., Hall, A. (2013). Fundamentals of Nursing, 8th Edition [VitalSource Bookshelf version]. Retrieved from http://pageburstls.elsevier.com/books/978-0-323-07933-4

Front 4

Identify preparatory activities to use before implementation.

(Potter, 2013, p. 253)Potter, P., Perry, A., Stockert, P., Hall, A. (2013). Fundamentals of Nursing, 8th Edition [VitalSource Bookshelf version]. Retrieved from http://pageburstls.elsevier.com/books/978-0-323-07933-4

Front 5

Discuss the value of the Nursing Interventions Classification system in documenting nursing care.

(Potter, 2013, p. 253)Potter, P., Perry, A., Stockert, P., Hall, A. (2013). Fundamentals of Nursing, 8th Edition [VitalSource Bookshelf version]. Retrieved from http://pageburstls.elsevier.com/books/978-0-323-07933-4

Front 6

Discuss the steps for revising a plan of care before performing implementation.

(Potter, 2013, p. 253)Potter, P., Perry, A., Stockert, P., Hall, A. (2013). Fundamentals of Nursing, 8th Edition [VitalSource Bookshelf version]. Retrieved from http://pageburstls.elsevier.com/books/978-0-323-07933-4

Front 7

Define the three implementation skills.

(Potter, 2013, p. 253)Potter, P., Perry, A., Stockert, P., Hall, A. (2013). Fundamentals of Nursing, 8th Edition [VitalSource Bookshelf version]. Retrieved from http://pageburstls.elsevier.com/books/978-0-323-07933-4

Front 8

Describe and compare direct and indirect nursing interventions.

(Potter, 2013, p. 253)Potter, P., Perry, A., Stockert, P., Hall, A. (2013). Fundamentals of Nursing, 8th Edition [VitalSource Bookshelf version]. Retrieved from http://pageburstls.elsevier.com/books/978-0-323-07933-4

Front 9

Select appropriate interventions for an assigned patient.

(Potter, 2013, p. 253)Potter, P., Perry, A., Stockert, P., Hall, A. (2013). Fundamentals of Nursing, 8th Edition [VitalSource Bookshelf version]. Retrieved from http://pageburstls.elsevier.com/books/978-0-323-07933-4

Front 10

When does implementation, the 4th step of the nursing process, occur? pg. 253

Back 10

It occurs right after the nurse develops a plan of care.

Front 11

What is a nursing intervention? pg. 253

Types of intervention?

Back 11

Any treatment based on clinical judgment/evidence and knowledge that a nurse performs to enhance patient outcomes.

Two types of intervention: direct and indirect

Front 12

Direct care and examples: pg. 253

Back 12

Direct care interventions are treatments through interactions with patients.

Example: med. admin., insertion of an intravenous (IV) fusion, counseling.

Front 13

Indirect care and examples: pg. 253

Back 13

Indirect care are treatments performed away from the patients.

Example: Managing patient's environment, documentation, and interdisciplinary collaboration.

Front 14

The focus of implementation is always: pg. 254

Back 14

the patient

Front 15

What kind of questions to ask yourself when considering an intervention? pg. 254

Back 15

1. Who is the patient?

2. What does this illness mean to the patient and family?

3. What clinical situation requires you to intervene?

4. Will any cultural considerations influence your approach?

Front 16

CRITICAL THINKING IN IMPLEMENTATION

Before implementing a planned intervention use: pg 254

Back 16

1. Critical thinking to confirm if intervention is correct/appropriate still, as conditions for a patient change by the minute.

Front 17

4 tips for making decisions during implementation: pg. 254

Back 17

1. Review all possible nursing interventions for patient's problem.

2. Review all possible consequences (analgesic meds can have adverse effects)

3. Determine probability of these consequences (chance of bad things happening)

4. Make judgment of the value of the consequence.

Front 18

When you proceed with an intervention, consider: pg. 254

Back 18

1. the purpose of it

2. steps in performing it

3. the medical condition of the patient

4. the patient's expected response

Front 19

Clinical Practice Guidelines and Protocols: Pg. 255

What is a clinical practice guideline?

Back 19

1. Protocol; set of statements that helps nurses make decisions about appropriate health care for specific clinical situations.

Based off of current scientific evidence.

Front 20

GNIRC: PG. 256

Back 20

Gerontological Nursing Interventions Research Center: helps create clinical practice guidelines.

Front 21

Standing Order? Pg. 256

1. Define

2. What does a standing order direct?

3. Who approves it?

4. Example:

Back 21

1. Preprinted document containing orders for the conduct of routine therapies, monitoring guidelines, and diagnostic procedures for specific patients w/ identified clinical problems.

2. Directs the conduct of patient care in a specific clinical setting.

3. Licensed healthcare providers in charge of care approve it.

4. A patient with a history of an irregular heart rhythm is given a standing order for lidocaine or propranolol. After the nurse visits the patient and identifies a irregular heart rhythm, the critical care nurse gives the specified medication without having to notify the physician first due to this.

Front 22

Standing order from Katrina

Back 22

A doctor orders it but doesn't release it as it is in place as a precaution

Example: history of something needed due to history, but the doctor orders it just in case of emergency.

Front 23

NIC Interventions: pg. 256

1. NIC interventions helps with what?

2. How does it link with diagnoses?

Back 23

1. It helps with standardization of communication across nursing care.

2. Helps nurses learn common interventions that link with various NANDA-I nursing diagnoses.

Front 24

Standards of Practice pg. 256

1. What organization sets this standard of practice?

2. What are the 4 things the newest standards include?

Back 24

1. The ANA Standards of Professional Nursing Practice

2. The newest standards include:

1. Competencies for establishing professional and caring relationships

2. Using evidence-based interventions and technologies

3. Holistic care across the life span to diverse groups

4. Using community resources and systems.

Front 25

List the 5 things to do to prepare for the implementation ? Pg. 256

Back 25

1. Reassessing the patient

2. Reviewing and revising nursing care plan

3. organizing resources and care delivery

4. Preventing complications

5. Implementing nursing interventions.

Front 26

Reassessing the Patient Pg. 256

Back 26

Reassessing isn't evaluation, but assessing more info and deciding if the nursing actions are still appropriate for the patient

Front 27

Reviewing and Revising the Existing Nursing Care Plan Pg. 257

Back 27

After reassessing the patient, review/revise the care plan to determine if the nursing interventions are still appropriate.

Front 28

Modification of an existing written care plan includes what four steps? Pg. 258

Back 28

1. Review data in assessment column. Date new data.

2. Revise nursing diagnoses. Delete irrelevant ones. Revise related factors and patient's goals, outcomes, and priorities. Date revisions.

3. Revise specific interventions that correspond to new nursing diagnoses and goals. Must reflect patient's present status.

4. Choose method of evaluation; see patient outcomes.

Front 29

Organizing Resources and Care delivery Pg. 258

1. Equipment

2. Personnel

3. Environment

4. Patient

Back 29

1. Equipment: gather/make sure available

2. Personnel: Use NAP's when needed, but also know when to take over their responsibilities in certain cases.

3. Environment: reduce distractions, respect privacy.

4. Patient: comfortability with intervention. Awareness of patient's psychosocial needs: example: have a sig. other there during surgery.

Front 30

Anticipating and Preventing Complications: Pg. 258

Back 30

Nurses are often the first to detect problems: ulcers, obesity problems, etc.

Example: a patient who just underwent surgery may not recover well if in too much pain. Nurse will anticipate when pain may be aggravated, and administers analgesics.

Front 31

Identifying Areas of Assistance Pg. 259

Steps to follow when asked to administer new medication.

Back 31

Always request assistance if needed.

1. Seek info/check literature for evidence-based information

2. Collect all equipment beforehand

3. Have guidance from another nurse who has completed the procedure.

Front 32

Activities of Daily Living (ADLs): pg. 259

Back 32

1. Daily activities: ambulation, eating, bathing. grooming.

2. Can be complete assistance or partial care.

Front 33

Instrumental Activities of Daily Living Pg. 260

Back 33

1. Include skills such as shopping, making meals, house cleaning, checks, taking meds.

Illness/disabled people

Front 34

Physical Care Techniques: pg. 260

Back 34

1. Physical care techniques involve safe/competent administration of nursing procedures.

Front 35

To carry out a procedure, you need to be:

Back 35

1. Knowledgeable about the procedure

2. the standard frequency

3. the steps

4. the expected outcomes

Front 36

Lifesaving measure: pg. 260

Back 36

A physical care technique used when patient is physiologically/psychologically threatened.

Measures to do so include: emergency meds, resuscitation, etc.

Front 37

Counseling: pg. 260

Back 37

Direct care method. Helps patient manage stress/etc. Counseling terminally ill.

Front 38

Teaching: pg 261

Back 38

1. Different from counseling, which focuses on changes in attitude and feelings.

Teaching focuses on development of intellectual growth/psychomotor skills.

Front 39

Controlling forAdverse Reactions: pg. 261

Back 39

A harmful or unintended effect of a medication, diagnostic test, or therapeutic intervention.

Always know a counteract for any medication. Ex: man takes meds for pain, develops hives, then you administer something for the hives after consulting with physician.

Front 40

Preventive Measures: pg. 261

Preventive Nursing Actions:

Back 40

1. Promotes health/prevents illness to avoid need for acute or rehabilitative health care.

Front 41

Indirect Care measures include: pg. 261

Back 41

1. nurse actions aimed at management of patient care environment/interdisciplinary collaborative actions that support direct care interventions.

Front 42

Communicating Nursing Interventions: Pg. 262

Interdisciplinary care plans

Back 42

1. Plans representing all disciplines caring for a patient.

2. Part of patient's permanent medical record.

Front 43

Delegating, Supervising, and Evaluating the Work of Other Staff Members Pg. 262

When a nurse delegates aspects of a patient's care to another staff member:

Back 43

They are still responsible for it.

Front 44

Patient adherence: pg. 262

Back 44

Means that patients and families invest time in carrying out required treatments.