Graded A+ assured 100%
2 sources of data -ANSprimary & 2ndary
3 helpful guides in prioritizing needs -ANS1-Maslow 2- Pt preference what does the pt think is important 3-
Anticipation or future problems
actual dx -ANSRepresents a problem that has been validated by the
presence of defining characteristics (signs and
symptoms).
clustering of data often contains -ANSdefining characteristics which are specific assessment findings that
support a
nursing diagnosis.
collect the data then BLANK the data -ANSVALIDATE
‐Confirm and verify the information.
‐ Keep it free from errors, bias, or misinterpretation.
components of a correctly written goal -ANSinclude expected outcomes or
measurable criteria to evaluate the achievement of the goal.
Data is 1,2,3 -ANScollected, validated, then clustered
define a goal -ANS" a broad statement that describes the desired change in a client's condition or behavior."
Define the nursing process -ANSa systematic problem solving approach toward providing individualized nursing
care.
, during the clustering of data what is used -ANScritical thinking is used to analyze and synthesize the
information that is
collected. The data is then put into specific clusters that describe a specific client problem.
Emergency assessment -ANSPerformed to identify a life ‐threatening problem (choking, stab wound, heart
attack).
focused assessment -ANSCollects data about a problem that has already been identified. This type of
assessment determines whether
the problem still exists, or any changes.
focused assessment questions -ANS‐ What are your symptoms?
‐ When did they start?
‐ What activity were you doing ?
‐ What makes it better or worse?
‐ What are you doing to relieve the symptom?
guidelines to remember when writing goals -ANS1-client centered 2-singular 3-observable 4-measurable 5-time
limited 6-mutual 7-realistic
health promotion dx -ANSClinical judgment of a person, family, or community desire to enhance their well
being and readiness to implement health behaviors of a higher level. Ex. nutrition
how do you formulate a risk dx? what does a risk dx consist of? -ANSconsist of a problem and the etiology only
- there are NO signs & sypmtoms because it hasn't happened yet
how do you formulate an actual nursing dx; what does it consist of -ANSA nursing diagnosis consists of 3 parts
or what is referred to PES format: