Nursing Process + Models

Question 1

Identify the 5 stages of the Nursing Process

Answer 1

1. Assess
2. Nursing diagnosis
3. Plan
4. Implement
5. Evaluate

Question 2

What occurs in the Assessment stage of the Nursing Process?

Answer 2

1. Ask Owner questions
2. Gather subjective + objective data
3. Ascertain normal habits + routine
4. Interpret information gathered

Question 3

What occurs in the Nursing diagnosis stage of the Nursing Process?

Answer 3

“Is a clincial judgement a nurse makes to identify client problems + their causes”

• Determination made about the patient’s illnesss + therefore subsequent needs or problem that affects them
• Created by clinical decision making based on the analysis of data
• Includes possible causes of or factors related to identified need

Question 4

What occurs in the Plan stage of the Nursing Process?

Answer 4

• Plan nursing interventions
• Set nursing goals + desired outcomes
• Smart goals:
• S - specific
• M - measurable
• A - achievable
• R - reaslistic
• T - time-bound

Question 5

What occurs in the Implement stage of the Nursing Process?

Answer 5

• Act on nursing interventions!

Question 6

What occurs in the Evaluate stage of the Nursing Process?

Answer 6

• How to measure the effectiveness of the nursing interventions used
• Evaluate patient’s current status + condition
• Reflect + assess on previous nursing interventions
• Tailor nursing interventions further

Question 7

List these in correct order.

1. Intervention/Implementation
2. Planning
3. Assessment
4. Evaluation
5. Nursing diagnosis

Answer 7

1. Assessment
2. Nursing diagnosis
3. Planning
4. Intervention/Implementation
5. Evaluation

Question 8

What stage provides a holistic view of the physical, emotional, social + environmental factors?

Answer 8

The Nursing diagnosis

Question 9

List the 3 types of nursing models

Answer 9

1. Orpet + Jeffery Ability Model (2007)
2. Roper, Logan + Tierany Model
3. Orem’s Self-Care Theory

Question 10

What nursing model assess the 10 abilities of the patient?

Answer 10

Orpet + Jeffery Ability Model 2007

Question 11

List the 10 abilities

Answer 11

Ability to…
1. Eat adequate amounts
2. Drink adequate amounts
3. Urinate normally
4. Defecate normally
5. Breathe normally
6. Maintain body temperature
7. Groom self
8. Mobilise adequately
9. Sleep/rest
10. Express normal behaviour

Question 12

What are the 4 advantages of Care bundles?

Answer 12

1. Standardisation between patients
2. Evidence of improved patient outcomes when bundles are used
3. Promote efficient use of resources by utilising proven and effective interventions
4. Can potentially limit fringe practices which may be unproven or dangerous (+ frequently expensive)

Question 13

What are the 7 disadvantages of Care bundles?

Answer 13

1. May not take into account individual patient
2. May limit individual clinician’s autonomy + independence
3. An unintended side effect of standardisation may be that it discourages excellent or exceptional clinical practice
4. May be unduly influenced by external forces such as government or industry
5. Some individual bundle elements may have limited evidence; and evidence may change with time
6. Result in additional administrative burdern of staff

Question 14

What are Care bundles?

Answer 14

A group of 3-5 evidence based interventions for a particularr situation/condition

Question 15

What is the aim of a Care bundle?

Answer 15

To improve consistency + efficacy of care

Question 16

What are Care bundles designed to provide?

Answer 16

Better patient outcomes, used together rather than interventions used individually

Question 17

Explain the difference between the ‘Medical model’ + ‘Nursing model’

Answer 17

• The medical model =

Is a diagnosis of a condition from clinical signs + tests, with treatment prescribed to rectify complaints

• The nursing model =

Is the identification of patient need’s to assist in carrying out it’s normal daily activities

Question 18

Describe 4 sources of information required to effectively asses a patient

Answer 18

1. Owner providing information on normal activiites
2. Nurse observations + Clinical examination
3. Vet’s diagnosis + treatment plan
4. Patient history + records

Question 19

What is the nursing diagnosis?

Answer 19

A nurse identifying the patient’s actual + potential needs

Question 20

What is a nursing model?

Answer 20

A system that can be used to provide a structure for assessing the patient + standardising the nursing care planned

Question 21

How does effective goal setting assist in devising a care plan?

Answer 21

• Assists in identifying nursing priorities + long-term aims
• Provides structure for evaluation
• Aids in identifying most appropriate nursing intervention for a particular problem

Question 22

What 4 factors influence the timescale for evaluation of each nursing intervention?

Answer 22

1. Severity of patient’s condition
2. Age of patient
3. Normal frequency of the acitivity
4. Timescale of each goal/aim

Question 23

What 3 pieces of information may be required in order to effectively evaluate the efficacy of the nursing intervention?

Answer 23

1. Goals set in the planning stage to identify if they are met
2. Nursing observations + clincial examination
3. Vet information

Question 24

How is the information from the evaluation used?

Answer 24

• It identifies which nursing interventions have been successful + by how much
• This is then used to decide whether to:
  1. Change the intervention
  1. Alter the frequency
  1. Adapt it
  1. Stop it completely
• Therefore revising the care plan

Question 25

Again, what is the nursing diagnosis?

Answer 25

Identifying the actual + potential problems of the patient's needs!

Question 26

What are these 2 examples of? * 'Imbalanced nutrition: less than body requirements' * 'Risk of deficient fluid volume'

Answer 26

Nursing diagnoses

Question 27

List 4 **active failures** of causes of error, when providing care to patients, by nurses in the VP

Answer 27

1. Cognitive limitations - i.e; mistakes, lapses, slips, distractions, stress + bias 2. Individual factors 3. Lack of tehcnical ability 4. Inadequate care

Question 28

List 6 **system failures** of causes of error, when providing care to patients, by nurses in the VP

Answer 28

1. Communication 2. Leadership 3. Design of product or equipment 4. Productivity 5. Organizational failure - i.e; management, workflow, staffing 6. Clients

Question 29

List 6 benefits of utilising patient **Checklists**

Answer 29

1. Creates memory recall i.e; users are less likely to overlook simple steps 2. Creates a culture of accountability 3. Standardises care 4. Reduces patient harm 5. Improve consistency of care 6. Helps avoid mdical errors

Question 30

List 6 benefits of utilising patient **Care Bundles**

Answer 30

1. Maintains consistency in patient care 2. Sets patient care standards 3. Improves overall quality of the nursing care provided 4. Establishes best clinical practices 5. Improves clinical effectiveness 6. Reduces morbidity + mortality by promoting all-inclusive approach to patient care

Question 31

What is this an example of?

Answer 31

A surgical saftey checklist

Question 32

What is this?

Answer 32

Kirby's Rule of 20! A checklist created that lists the patient's 20 parameters that should be evaluated daily, in critically ill patients, to ensure gold standard care

Question 33

What is Kirby's Rule of 20?

Answer 33

A checklist created that lists the patient's 20 parameters that should be evaluated daily, in critically ill patients, to ensure gold standard care

Question 34

What is this?

Answer 34

The 5 key elements of the Suriving Sepsis Campaign, used in human + veterinary patients

Question 35

What is this?

Answer 35

A RCVS Peripheral venous catheter care bundle checklist

Question 36

What is this?

Answer 36

A Naso-oesophageal tube placement checklist

Question 37

Who first introduced the Nursing Process + when?

Answer 37

Yura + Walsh in 1967

Question 38

Who is NANDA? + What was their aim?

Answer 38

1. North American Nurse Diagnosis Association 2. To standardize nurse terminology

Question 39

What 4 aspects does NANDA catagorise the nursing diagnoses into?

Answer 39

1. Problem-focused nursing diagnosis 2. Risk 3. Health promotion 4. Syndrome

Question 40

List 5 examples of a Nursing diagnosis

Answer 40

1. Acute pain 2. Impaired gas exchange (i.e; Respiratory issues) 3. Activity intolerance (i.e; Mobility issues) 4. Impaired skin integrity (i.e.; Pressure sores) 5. Anxiety/fear

Question 41

What type of ink should you use when writing care plans?

Answer 41

Permanent black ink

Question 42

What is meant by SMART goals?

Answer 42

Goals are; * **S pecific** (Be objective, outcome should be related to a number, %, fraction or frequency) * **M easurable** (Can a judgement be made using a numerical element?) * **A chievable** (Any contraindications?) * **R ealistic** (patient-specific, taken into account) * **T ime-focused** (include date + time to complete)

Question 43

What is an Integrated Care Pathway (ICP) ?

Answer 43

A document that stays with the patient throughout their care, as opposed to a care bundle, which is implemented for a specific care need