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38 Cards in this Set
- Front
- Back
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What are the purposes of goals/outcomes?
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they are measuring sticks for the plan of care
they direct interventions they motivate people to get things done |
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What five things are priority ratings influenced by?
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1. patient perception
2. how well you understand the whole picture 3. overall health status 4. expected length of stay 5. existence of standard plans or guideline policy protocols, standards of care, care maps, or critical pathways |
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What is time frame for a short term goal?
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less than a week
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Goals and objectives refer to......
while outcomes and indicators refer to.... |
goals and objectives refer to intent
outcomes and indicators refer to...results (more patient focused) |
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What type of goals are discharge goals?
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STG and LTG
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What part of the nursing diagnosis are goals written toward?
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goals are written toward the left side...toward the problem
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Give the goal for this ND:
Risk for infection related to... |
goal: patient will be free from infection.....
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What must a goal be?
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measurable. It has to be documented in measurable terms.
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Who is involved in formulating the goal?
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both the nurse and patient (if possible)
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What must be included in a goal?
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a time frame. A time estimate for attainment. It provides a direction for continuity of care. This is the date that the goal will be evaluated by.
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When you see outcome, you should think:
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goal
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What must a goal reflect?
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accepted standards of care....(agency standards, ANA, etc...)
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What is the goal for a ND of acute pain?
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Pt pain will be reduced to a 4/10 by......
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Three main concepts of a goal:
Goal should be 1. 2. 3. |
specific
measurable realistic |
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What five things should be included in a goal?
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subject (who is the person expected to achieve the goal?)
verb (What actions must the person do to achieve the goal?) condition (under what circumstances is the person to perform the action???) criteria (how is person to perform the action?) time (when is person expected to peform the action by?) |
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What is the memory situation for what the goals must have?
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who what when how when
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When you make goals, make sure the verbs are.....
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measurable. Don't use the word understand. It is too vague. Use words like....
identify, list, hold, peform, state, communicate, will gain. Don't use these verbs: know, think, understand, appreciate, accept, feel |
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What is the signifigance of affective, cognitive and psychomotor when it applies to goals?
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verbs used in goals will dictate what type of learning is going on.
Affective: valuing, attitudes, feelings Cognitive: intellectual skills, knowledge psychomotor: motor skills |
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What CAN be included in a goal that can not be in a diagnosis?
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AS EVIDENCED BY
Patient will be free of infection 3.10/08 as evidenced by |
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What does the date on a goal insure?
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continuity of care...that it will be addressed again and not forgot
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Interventions are written toward what part of the nursing diagnosis?
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toward the right side...toward the cause
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What are some other terms used for nursing interventions?
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actions, measures, orders, strategies, tasks, skills
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What are the types of nursing interventions?
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dependent (doctor prescribed)
independent(nurse prescribed) overlap(combo...doctor might write things that we can do on our own) |
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What is a direct care intervention vs. an indirect care intervention?
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direct care - action performed through direct interaction with patient
indirect care is doing something away from th epatient but on behalf of the patient |
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What are the key questions to ask about interventions?
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What action is being performed?
Why the action is being performed? How it is to be performed. When and how often its to be performed. How much, how long and by what route will the intervention be performed |
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What should you focus on with defining an intervention?
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look for interventions that prevent or minimize the underlying causes of a problem and help achieve the expected out come.
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When you assess if the problem is being solved by the intervention, what type of assessment do you perform?
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focus assessment
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What should interventions include? when you write them, make sure they have these parts....
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one verb
a prescribed activity specific times to be done a number by each intervention specifics as who, what when where how if needed for clarity |
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If you can't do anything about the cause or risk factor, what should you do?
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focus on the problem....ex: if someone is terminally ill and has death anxiety, you can't do anything about the fact that the person is going to die, but you can address the problem side (anxiety) through counseling and therapy
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Before you perform any intervention, what must you do?
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you must reassess
and while performing the interventions, continue to collect data....then when you are done, reassess to identify client response. |
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What are the types of verbs or types of nursing interventions that you can do?
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directing PERFORMING an activity for someone
ASSISTING client to perform activity SUPERVISING client while he performs activity TEACHING client/family about cath care COUNSELING people in making choices about healthcare MONITORING for potential complications |
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What is the difference between counseling and advising?
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advising implies personal opinion and should not be given
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What is VERY IMPORTANT to remember about the implementing stage of the nursing process/nursing care plan?
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documenting client response to the plan of care and interventions is part of the IMPLEMENTATION stage
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When do you actually DO the documenting?
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in every step, but it is filed under IMPLEMENTATION
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Coordinating care is part of IMPLEMENTATION
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yep
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What are the four ways you evaluate a student care plan?
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was goal met/partially met/not met
identify specific client data to support conclusion evaluate effectiveness of the intervention make recommendations for change as appropriate |
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Other than doing the task or goal, what else is considered part of the implementation stage?
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preparing for report and getting report
setting daily priorities assessing appropriateness of and readiness for interventions performing interventions reassessing to determine initial responses making immediate changes as needed charting giving report |
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What is the first thing you do before implementing?
Then what do you do? |
b e prepared...get a report, get up to date data
then you prioritize what to do (either each patient or within each patient) |
