AND WELL DETAILED ANSWERS|LATEST
5 steps nursing process
- ANSWER
Assess- gather info about patient
Diagnose- identify pt prob
Plan- set goals and outcomes
Implement-preform plan
Evaluate-determine if goals are met
or known as ADOPIE
Phases of assessment - ANSWER collect data: gather info
identify cues: if abnormal data
validate data: factual and complete
cluster related data: group related info
identify patterns/test first impressions: look for patterns to focus your assessment
Report and record data: abnormal data and document on pt record
Collecting data
(starts and admission and ends at discharge) - ANSWER use resources e.g.
1
,-pt and significant other
-assessment technology
-electronic and print health records
-consultations with other experts
-additional key stakeholders (caregivers, primary care, insurance)
what is the number one rule always - ANSWER ALWAYS assess the pt first
(then refer to technology)
Types of assessments- Database - ANSWER -Comprehensive info you gather on initial
contact with the patient to assess all aspects of health status
-Often called the minimum data set
Takes up multiple computer screens
-Frequently termed "admission assessment" in hospitals
Types of assessment- focus - ANSWER -Info you gather to determine the status of a
specific issue—for example, how a patient manages his diabetes
-Can be included as part of a database assessment
-Questions:
---What are your symptoms?
---When did they start?
---What makes them better/worse?
---What meds are you taking?
---What else?
2
, types of assessments- quick priority QPA - ANSWER -Short, focused, priority
assessments that you do to gain the most important info you need to have first
-Assessment priorities:
Risks for infection, injury, violence
Problems with breathing, comfort, VS or communication
Allergies
Current meds/treatments
Admitting diagnosis
Current and past medical problems
Current and past nursing problems
Your ability to identify cues and make correct inferences is influenced by -
ANSWER Observational skills
Nursing knowledge
Clinical expertise
Values and beliefs (avoid value judgments)
Validating data saying - ANSWER "more than one cue, more likely it's true...more than
one source, more likely of course"
Clustering data- 3 frameworks - ANSWER Gordon's functional health pattern
Maslow's human needs
body systems
maslow's human needs - ANSWER Physiologic (priority #1)
Safety/security (priority #2)
3
5 steps nursing process
- ANSWER
Assess- gather info about patient
Diagnose- identify pt prob
Plan- set goals and outcomes
Implement-preform plan
Evaluate-determine if goals are met
or known as ADOPIE
Phases of assessment - ANSWER collect data: gather info
identify cues: if abnormal data
validate data: factual and complete
cluster related data: group related info
identify patterns/test first impressions: look for patterns to focus your assessment
Report and record data: abnormal data and document on pt record
Collecting data
(starts and admission and ends at discharge) - ANSWER use resources e.g.
1
,-pt and significant other
-assessment technology
-electronic and print health records
-consultations with other experts
-additional key stakeholders (caregivers, primary care, insurance)
what is the number one rule always - ANSWER ALWAYS assess the pt first
(then refer to technology)
Types of assessments- Database - ANSWER -Comprehensive info you gather on initial
contact with the patient to assess all aspects of health status
-Often called the minimum data set
Takes up multiple computer screens
-Frequently termed "admission assessment" in hospitals
Types of assessment- focus - ANSWER -Info you gather to determine the status of a
specific issue—for example, how a patient manages his diabetes
-Can be included as part of a database assessment
-Questions:
---What are your symptoms?
---When did they start?
---What makes them better/worse?
---What meds are you taking?
---What else?
2
, types of assessments- quick priority QPA - ANSWER -Short, focused, priority
assessments that you do to gain the most important info you need to have first
-Assessment priorities:
Risks for infection, injury, violence
Problems with breathing, comfort, VS or communication
Allergies
Current meds/treatments
Admitting diagnosis
Current and past medical problems
Current and past nursing problems
Your ability to identify cues and make correct inferences is influenced by -
ANSWER Observational skills
Nursing knowledge
Clinical expertise
Values and beliefs (avoid value judgments)
Validating data saying - ANSWER "more than one cue, more likely it's true...more than
one source, more likely of course"
Clustering data- 3 frameworks - ANSWER Gordon's functional health pattern
Maslow's human needs
body systems
maslow's human needs - ANSWER Physiologic (priority #1)
Safety/security (priority #2)
3
