NSG 2113 Lecture Notes - Lecture 5: Nursing Interventions Classification, Nursing Care Plan, Nursing Diagnosis
9 Feb 2017
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Data analysis: formulating nursing judgements, data clustering, and data documentation. Methods of data collection: nursing health history (components) interview (orientation, working and termination phases, physical examination (client behavior diagnostic and laboratory data) Readiness to learn: emotional capability, physical capability, cognitive capability, developmental stage. What to avoid when getting a health history: using authority, using professional jargon, using leading questions, talking too much, interrupting, asking (cid:498)why(cid:499) questions. Steps in data analysis: recognize pattern or trend by cues, patterns of knowing (empirical, personal, ethical, aesthetical, compare with normal standards, make a reasoned decision. Concept mapping: a visual representation that allows nurses to graphically illustrate the connections between a client"s health problems and allows nurses to obtain a holistic perspective of health care needs. Data documentation: legal and professional responsibility, subjective vlient info should be in quotation marks, accurate and approved terminology and abbreviations must be used nursing diagnosis. Medical diagnosis: identification of a disease condition based on specific subjective and objective data.
