NURS 6700- EXAM 3 QUESTIONS AND ANSWERS 100% CORRECT.
Medical Diagnosis - (answer)Is a concept that defines a disease process or injury
Nursing Diagnosis - (answer)Describe human responses to potential or actual health problems and life
processes; is a clinical judgment about actual or potential individual, family, or community
experiences/responses to health problems/life processes; provides the basis for selection of nursing
interventions to achieve outcomes for which the nurse has accountability
Why do we have nursing diagnosis? - (answer)It is used to determine the appropriate plan of care for
the patient. The nursing diagnosis drives interventions and patient outcomes, enabling the nurse to
develop the patient care plan. Nursing diagnoses also provide a standard nomenclature for use in the
Electronic Health Record, enabling clear communication among care team members and the collection
of data for continuous improvement in patient care - drives the nursing care plan for the patient
How to write a nursing diagnosis? - (answer)-Rules
-Must use from the NANDA list
-Cannot add/remove "risk for" for any diagnosis- must use as written
Components of Nursing Diagnosis - (answer)-NANDA
-PATHO
-As evidenced by statement - evidence you see supporting your diagnosis
Variations (Actual vs. Risk) - (answer)-Risk for nursing Dx. has a r/t (related to) statement followed by
risk factors
-Actual risk nursing Dx has a r/t (related to) statement followed by evidence statement
-To differentiate between evidence and risk factors you may use "risk factors"
Care Plan Building - (answer)-Nursing diagnoses are the foundation of care plans
-Review your nursing diagnosis book for details to assist you in building a solid plan
Care Plans Include - (answer)1. Assessment
2. Planning
, NURS 6700- EXAM 3 QUESTIONS AND ANSWERS 100% CORRECT.
3. Interventions
4. Evaluation
Assessment - (answer)Subjective/Objective information - complete head to toe and collect all
assessment and chart data needed. How do you know these things? Did you get the information with
your 5 senses (objective)? Or did the patient tell you about is (subjective)?
Planning - (answer)Short-term and long-term goals
Think of these as during shift or less and those things which go beyond your 12 hour day
Interventions - (answer)What will you DO to achieve these goals?
Evaluation - (answer)Why will you do these things? Did the things you did help your patient meet the
goals?
Care Plan Steps - (answer)1. Collect Information
2. Analyze
3. Think About How
4. Translate
5. Transcribe
Collect Information - (answer)-Get information from all sources together
-Your head to toe assessment
-Conversations with patient and loved ones
-Observations (lab values, vital signs)
-Report (or your report sheet)
-Chart review and notes
-Discussions with healthcare team members
Medical Diagnosis - (answer)Is a concept that defines a disease process or injury
Nursing Diagnosis - (answer)Describe human responses to potential or actual health problems and life
processes; is a clinical judgment about actual or potential individual, family, or community
experiences/responses to health problems/life processes; provides the basis for selection of nursing
interventions to achieve outcomes for which the nurse has accountability
Why do we have nursing diagnosis? - (answer)It is used to determine the appropriate plan of care for
the patient. The nursing diagnosis drives interventions and patient outcomes, enabling the nurse to
develop the patient care plan. Nursing diagnoses also provide a standard nomenclature for use in the
Electronic Health Record, enabling clear communication among care team members and the collection
of data for continuous improvement in patient care - drives the nursing care plan for the patient
How to write a nursing diagnosis? - (answer)-Rules
-Must use from the NANDA list
-Cannot add/remove "risk for" for any diagnosis- must use as written
Components of Nursing Diagnosis - (answer)-NANDA
-PATHO
-As evidenced by statement - evidence you see supporting your diagnosis
Variations (Actual vs. Risk) - (answer)-Risk for nursing Dx. has a r/t (related to) statement followed by
risk factors
-Actual risk nursing Dx has a r/t (related to) statement followed by evidence statement
-To differentiate between evidence and risk factors you may use "risk factors"
Care Plan Building - (answer)-Nursing diagnoses are the foundation of care plans
-Review your nursing diagnosis book for details to assist you in building a solid plan
Care Plans Include - (answer)1. Assessment
2. Planning
, NURS 6700- EXAM 3 QUESTIONS AND ANSWERS 100% CORRECT.
3. Interventions
4. Evaluation
Assessment - (answer)Subjective/Objective information - complete head to toe and collect all
assessment and chart data needed. How do you know these things? Did you get the information with
your 5 senses (objective)? Or did the patient tell you about is (subjective)?
Planning - (answer)Short-term and long-term goals
Think of these as during shift or less and those things which go beyond your 12 hour day
Interventions - (answer)What will you DO to achieve these goals?
Evaluation - (answer)Why will you do these things? Did the things you did help your patient meet the
goals?
Care Plan Steps - (answer)1. Collect Information
2. Analyze
3. Think About How
4. Translate
5. Transcribe
Collect Information - (answer)-Get information from all sources together
-Your head to toe assessment
-Conversations with patient and loved ones
-Observations (lab values, vital signs)
-Report (or your report sheet)
-Chart review and notes
-Discussions with healthcare team members
