Chapter 6: Implementation and Evaluation
Which statement is true regarding construction and utilization of nursing care plans?
Nursing students use nursing care plans for their assigned patients. Nursing students use nursing care plans and concept maps for their assigned patients. Not all care plans use Maslow's hierarchy of needs. When an RN is not available, a preliminary plan may be constructed by an LPN/LVN. Re-ordering of priorities is necessary when patient problems and/or new situations occur.
At a minimum, long-term care facilities require written documentation of a client's problem or nursing diagnosis every:
week. Long-term care facilities require a written note every 7 days or when the patient's condition changes.REF: Page 73
Which is an independent nursing action?
Giving a back massage. An independent nursing action does not require a physician's order but does require critical thinking and nursing judgment. Giving a back massage would be an independent nursing action. Medication administration and ordering and applying a heating pad are dependent nursing actions. Assisting a physical therapist is an interdependent action.
In which step of the nursing process are nursing interventions carried out?
Implementation. During implementation, nursing actions are carried out. Nursing diagnosis indicates the patient's actual health status or the risk of a problem developing and is the second step of the nursing process. Planning is the identification of health goals and is the third step of the nursing process. Evaluation is judgment of the effectiveness of the intervention and is the last step of the nursing process.
Which statement is true regarding implementation of care in long-term care facilities?
The nurse performs all sterile procedures. The nurse performs any invasive procedure and any sterile procedure. Routine care is assigned to nursing assistants. Nursing assistants may become certified in medication administration. The LPN/LVN on duty is responsible for overseeing the nursing assistants.
Before carrying out a specific intervention in the patient plan of care, a nurse should:
identify the reason for the intervention. identify the rationale for the intervention. identify the usual standard of care. identify any potential dangers.
The goal of an outcome-based quality improvement (OBQI) program is to:
improve nursing practice. OBQI programs are used to evaluate nursing care delivered to patients. The goal of these programs is to improve nursing practice. The program is usually agency-wide, incorporating nursing audits and evaluation regarding compliance with standards for every department. The audits are based on whether outcomes are being met. The purpose of evaluating nursing care is to achieve quality improvement by identifying specific areas that need changes.
Revision of the nursing care plan involves:
inactivating resolved problems. Ineffective interventions on the nursing care plan must be revised, not eliminated. If the interventions have been so effective that the problem is resolved and the nursing diagnosis is no longer appropriate, it is marked "resolved" on the nursing care plan. Addition of new problems may occur during revision. Progress toward outcomes must be evaluated on an ongoing basis.
A nursing audit must:
occur in every hospital to maintain accreditation. Every hospital must perform both medical and nursing audits to achieve and maintain accreditation. Most often, an audit is performed on records of discharged patients. An audit will determine if nursing care met particular standards and particular outcomes, which may be good or bad. A nursing audit may be completed by LPNs/LVNs.