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Fundamentals-Ch 15

Chapter 15 Review from Potter and Perry Book

QuestionAnswer
Gather information about the client's condition Assess
Identifying the client's problems Diagnose
Set goals of care and desired outcomes and identify appropriate nursing actions Plan
Implement Perform the nursing actions identified in planning
Evaluate Determine if goals met the outcomes achieved
Three things that allow you to complete a successfy]ul comprehensive database Critical thinking attitudes such as curiousity, perseverance, and confidence
Information that you obtain through the use of your senses Cue
Your judgement or interpretations of those cues Inference - Like when you see a client crying (cue) you assume that it implies fear or sadness.
Two approaches to a comprehensive exam Functional health patters (Gordon) and a problem-oriented approach
Health perception - health managenent how client's manade health; knowledge of preventtive health practices
Nutritional-metabolic patter describes the client's daily/weekly pattern of food and fluid intake. actualy weight, weight loss or gain.
Elimination pattern Patterns of excretory function (bowel, bladder, and skin)
Activity - exercise pattern Describes patters of exercise, activity, leisure, and recreation; ability to perform activities of daily living
Sleep-rest pattern describes patterns of sleep, rest, and relaxation
Cognitive-perceptual pattern Describes sensory perceptual patterns; language adequacy, memory, decision-making ability
Self-perception-self concept pattern Descripes the client's self-concept pattern and perceptions of self
Role-relationship patter Descrieps the client's patters of role engagements and relationships
Sexuality-reproductive patterns The client's patterns of satisfaction and dissatisfaction with sexuality patter; client's reporductive patterns; premenopausal and postmenopausal patterns
Coping-stress tolerance pattern Describe the client's ability to manage stress; sources of support; effectiveness of the patterns in terms of stress tolerance
Value-belief pattern Patterns of values, beliefs, and goals that guide the client's choices of decisions
Focused Assessment - pain Question -Describe your pain for me. Place your finger over the area that is uncomfortable."Rate pain 1-10" (Observe nonverbal cues.Observe where the client points to,note if it radiates or is localized.Inspect area of discomfort, palpate for tenderness)
Family members help during assessment by telling when changes in the client's status occured
Created by: Sarahmarie001
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