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Exam (elaborations)

Potter/Perry Fundamentals of Nursing Exam| Questions with 100% Solutions | Verified

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Potter/Perry Fundamentals of Nursing Exam| Questions with 100% Solutions | Verified

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Potter/Perry Fundamentals of Nursing
Exam| Questions with 100% Solutions |
Verified

Identify the step to take to avoid the diagnostic errors in interpretation and analysis of data. -
ANSWER Review your data base to decide if it is accurate and complete; be careful to consider
any conflicting cues or if there is insufficient cues to confirm a diagnosis.



Identify the step to take to avoid the diagnostic errors in data clustering - ANSWER Avoid
premature clustering of data; always identify the nursing diagnosis from the data, not the
reverse.



Identify the step to take to avoid the diagnostic errors in the diagnostic statement: - ANSWER
- Word the diagnostic statement in appropriate, concise, and precise language;
-use correct terminology;
-identify the client problem rather than the goal;

-make professional rather than prejudicial judgments; avoid legally inadvisable statements.



Actual problem nursing diagnosis - ANSWER -describes human response to health conditions
or life processes.



The first part of the nursing diagnosis statement identifies what? - ANSWER An actual or
potential health problem



"Related to" - ANSWER Connects the second part of the nursing diagnosis statement to the
first part



Clinical criteria - ANSWER Objective or subjective signs and symptoms that lead to a
diagnostic conclusion

,Concept map - ANSWER Visual representation of client problems and interventions that
shows their relationships to each other.



Steps of Nursing Diagnosis - ANSWER identify defining characteristics, list symptoms,
cluster symptoms, analyze, select the nursing diagnosis label



Problem-focused nursing diagnosis - ANSWER -describes a clinical judgement concerning
an undesirable human response to a health condition/life process that exists in an
individual, family, or community.


Data clusters - ANSWER -is a set of cues, the signs and symptoms gathered during assessment

-each cue is an objective and subjective sign, symptom, or risk factor that when analyzed
with other cues, begin to lead to diagnostic conclusions.

-analysis and interpretation of assessment data begin by organizing all patient's data into
meaningful and usable data clusters.



The defining characteristic of deficient knowledge - ANSWER 1. inaccurate follow-through of
instruction
2. inaccurate performance on a test
3. inappropriate behavior (ex: hostile, agitated, hysterical)
4. insufficient knowledge.



Diagnostic Label - ANSWER -describes the essence of a patient's response to health
conditions in as few words as possible.



Parts of the Nursing diagnosis - ANSWER 1. problem- identified by nurses
throughout assessment

2. Related to- risk factor, related factor, etiology of problem/cause (how is this contributing to
the problem)
3. As evidenced by- defining characteristics (what do you see, hear, smell, touch,
observe......proof to support your choice)

,Example of nursing diagnosis - ANSWER 1. Problem- ineffective airway clearance
2. Related to- pain
3. As evidenced by- increased mucus production and ineffective coughing.


it is then written like this----> ineffective airway clearance related to pain as evidenced by
increased mucus production and ineffective coughing.


Example of nursing diagnosis - ANSWER 1. Problem- acute pain
2. Related to-trauma of incision
3. As evidenced by- patient states he is experiencing 8/10 on pain scale



it is written as: Acute pain related to trauma of incision as evidenced by patient states he
is experiencing 8/10 on pain scale.


Types of nursing diagnosis - ANSWER 1. Actual problem nursing diagnosis.
2. Risk problem nursing diagnosis
3. Health promotion behavior nursing diagnosis


Sources of diagnostic error - ANSWER 1. collecting
2. interpreting
3. clustering
4. labeling
5. documentation and informatics


- ANSWER -lack of knowledge or skill
-inaccurate data
-missing data

, -disorganization
-failure to validate


Errors in interpretation and analysis of data - ANSWER -inaccurate interpretation of cues
-failure to consider conflicting cues
-using an insufficient number of cues
-using unreliable or invalid cues
-failure to consider cultural influence or developmental stage


Errors in clustering - ANSWER -insufficient cluster of cues
-premature or early closure
-incorrect clustering



Errors in labeling - ANSWER -wrong diagnostic label selected
-evidence that another diagnosis is more likely -condition is
a collaborative problem'

-failure to validate nursing diagnosis with
patient -failure to seek guidance



The purpose of conducting evaluative measures is - ANSWER To determine if you met the
expected outcomes, not if the nursing interventions were completed. They are the
standards against which the nurse judges if goals have been met and if care is successful



Identify the five elements of the evaluation process - ANSWER 1. identifying evaluative criteria
and standards
2. collecting data to determine whether the criteria or standards are met
3. interpreting and summarizing findings
4. documenting findings and any clinical judgment

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