Evaluating

The terms "criteria" and "standards" are often used interchangeably, but they actually have distinct definitions. "Measurable qualities, attributes, or characteristics that identify knowledge or health status" are known as:

Criteria

The client identifies three strategies for minimizing leakage of an ileostomy bag. This is an example of what type of outcome?

cognitive outcomes Cognitive outcomes demonstrate increases in client knowledge, such as strategies for minimizing leakage of an ileostomy bag. An affective outcome involves changes in the client's values, beliefs, and attitude. Physiologic outcomes are physical changes in the client. Psychomotor outcomes describe the client's achievement of new skills.

Quality Assurance

focuses on organization structure and individuals and is externally driven.

The nurse is caring for a client who has a fractured left femur. He will be discharged home this afternoon. The outcome on the plan of care state "Client will demonstrate appropriate cast care prior to discharge" This is an example of what type of evaluative statement?

psychomotor

A nursing student asks the clinical instructor to explain the difference between quality improvement and quality assurance. Which response by the clinical instructor is appropriate?

"Quality improvement focuses on processes, data, and statistical thinking."

The nurse is collecting data on a client presenting to the medical short-stay unit for a colonoscopy. A client reports to the nurse that he quit smoking six months ago after being diagnosed with lung cancer. The nurse recognizes this change in behavior is which type of outcome?

Affective outcome Affective outcomes pertain to changes in client values, beliefs, and attitudes and are more complex to evaluate. Changes in behaviors, such as the cessation of smoking or nutritional changes that lead to weight loss, are examples of affective outcomes. Cognitive outcomes involve an increase in client knowledge and are evaluated by asking the client to repeat information or perform a skill. Psychomotor outcomes describe the client's achievement of a new skill. Physiologic outcomes result in physical changes and are evaluated through physical assessment.

A client comes into the clinic for a routine postoperative visit. While the nurse is assessing the level of pain, the client states that there is occasional discomfort but that pain levels have improved daily since returning home from the hospital. What should the nurse's response be regarding the client's plan of care?

Continue plan of care The nurse should continue the plan of care, as the client is progressing toward the ultimate outcome—the healing of the surgical site. There is no need to modify the plan, as the client is responding. The client is still having some pain so it would not be appropriate to discontinue the plan of care. With the improvement in the client's pain, there is no need to increase pain medication; the nurse should just remind the client to take it when pain is uncomfortable.

Which expected client outcome is an example of a psychomotor outcome? Select all that apply.

Safely ambulating using a walker. Accurately drawing up insulin. Examples of psychomotor outcomes include accurately drawing up insulin and ambulating safely using a walker. Identifying signs and symptoms of infection is an example of a cognitive outcome. Rating pain as a 2 on a 10-point scale is a physiologic outcome. An example of an affective outcome is reporting increased confidence in testing blood sugar.

The health care team has convened to discuss the care of an end-of-life client who is not able to achieve an acceptable level of comfort. The physician asks for the nurse's perspective of the situation. Which standard for establishing and sustaining healthy work environments does this action represent?

True collaboration True collaboration involves skilled communication, mutual respect, shared responsibility, and decision making among nurses, and between nurses and other health team members. Skilled communication requires health team members to communicate in a non-intimidating manner with colleagues, allowing all voices to be heard regarding a matter. Effective decision making ensures nurses are valued and active partners in making policy, directing and evaluating clinical care, and leading organizational operations.

For a client with self-care deficit, the long-term goal is that the client will be able to dress himself by the end of the 6-week therapy. For best results, when should the nurse evaluate the client's progress toward this goal?

as soon as possible Evaluating the progress of a long-term goal prior to the end date will encourage and motivate the client to continue working towards the goal. Waiting until the client is discharged or at the end of the 6 weeks does not provide the client the opportunity to feel a sense of accomplishment and motivation to continue working towards the goal. Only evaluating when the client shows progress may lead to the client becoming discouraged.

The nurse in a Burn Intensive Care Unit (BICU) is caring for a 3-year-old boy who was burned with scalding hot water. He has burns covering 75 percent of his body. His condition is critical but stable. At 1000, the nurse reassesses the client and finds that he is agitated and pulling at his endotracheal tube. What would be the nurse's priority?

ensuring that the endotracheal tube is secure

Quality Improvement

focuses on processes, data, statistical thinking, and client satisfaction and promotes empowerment and collaboration.

Standards

the "levels of performance accepted by, and expected of, nursing staff or other health team members."