a
1. Care planning 5 steps: Assessment, nursing, diagnosis, planning, implementa- tion,
evaluation
2. Nursing diagnosis: describes a health problem that can be treated by nursing measures;
a step in the nursing process
3. medical diagnosis: the identification of a disease or condition by a doctor
4. Planning involves...: Setting priorities and goals and developing measures or actions to
help the client meet these goals
5. Intervention: Action or measure taken by the nursing team to help the client reach a goal
6. ADL: activities of daily living
7. BDL: Behaviours of daily living
8. CCL: Continency care level ( size of depends)
9. Cognitive level: Memory and orientation
10. CCAC: Community Care Access Centre, arrange for community in home sup- ports as
well as admission into LTC facilities
11. Care plan: Document that details the care and services the client must receive each
shift
12. Evaluation: To measure and assess the clients progress toward meeting goals that are
outlined in the care plan
13. Objective data: information that is seen, heard, felt, or smelled by an observer; signs
14. Subjective data: things a person tells you about that you cannot observe through
your senses; symptoms
1/5
, 15. Graphic sheets: are used to record measurements and observations made daily,
every shift , or 3-4 times a day
16. Kardex: A type of card file that summarizes information found in the medical record-
drugs, treatments, diagnoses, routine care measures, equipment, and spe- cial needs
17. Charts: A written account of the clients condition, illness, the care and treatment given to
a client and the clients response to care
18. SOAP: subjective, objective, assessment, plan
19. PIE: Problem, intervention, evaluation
20. Restorative care: Maintaining the current level of functioning while preventing decline
21. Rehabilitation: Restore function to former levels
22. ABI: acquired brain injury
23. Acute care: Hospital, less than 6 months
24. Transition: Moving a client from one area to another
2/5