Nursing Process: Addressing the application of the nursing process to a patient care scenario (Term Paper Sample)
Using APA format, the information from this course, and your assigned readings write a six (6) to ten (10) page paper (excludes cover and reference page) addressing the application of the nursing process to a patient care scenario. Use these directions and the scoring rubric as you develop the paper. Outlines and abstracts are NOT required with this paper. Do not include the scenario in the paper A minimum of three (3) current professional references must be provided excluding a nursing diagnosis book. Current references include professional publications or valid and current websites dated within five (5) years. Additionally, a textbook that is no more than one (1) edition old may be used. Do not use abbreviations…write out everything. The paper consists of three (3) parts: 1.The meaning and use of the nursing process in making good nursing judgments that effect patient care 2.The development of a plan of care using the nursing process for a specific patient situation 3.The preparation stage for a teaching plan to prevent a recurrence of a similar situation The following sheet will assist you when composing the plan of care for the paper: Overview of the Nursing Process. Part 1 (3-4 pages) Review the required readings about the nursing process. In your own words, define each step of the process and provide an example for each step. In the implementation step, what is meant by direct and indirect care as described by the Nursing Intervention Classification (NIC) project? Discuss the three (3) types of nursing interventions (nurse-initiated, dependent, and interdependent) that applies to the patient care situation. Provide an example of each (refer to your textbook). Explain how the nursing process provides the basis for the registered nurse to make a nursing judgment that results in safe patient care with good outcomes. Discuss how the registered nurse evaluates the overall use of the nursing process. Identify three (3) variables that may influence the ability to achieve the desired outcomes for the patient. How is the plan of care modified when the outcomes are not met? How does the RN use the nursing process to make decisions about the priority of care? Part 2 (3 pages) Patient scenario A 78-year-old man is living in an assisted living facility. He is able to walk very short distances and uses a wheelchair to transport himself to the communal dining room. He administers his own medications independently and bathes himself. Over the last year he prefers to remain in the wheelchair even when in his room. He has a history of CHF, hypertension, hyperlipidemia and lower extremity weakness. He is able to state his current medications include metoprolol (Lopressor) 50 mg once daily by mouth, furosemide (Lasix) 20 mg once daily by mouth, Quinapril (Acupril) 20 mg once daily by mouth, atorvastatin (Lipitor) 20 mg once daily by mouth. During a routine examination, his physician noted a pressure ulcer over the ischium on the right buttocks. The wound is oval about 10mm x 8 mm, with red and yellow areas in the middle and black areas on some surrounding tissue. It has a foul odor. The patient had been padding the area so “it doesn’t get my pants wet”. The physician arranged for him to be admitted to the hospital in order for intravenous antibiotic therapy and wound care to be initiated. After being admitted to the hospital his medications are: metoprolol (Lopressor )50 mg orally every 12 hours, furosemide (Lasix ) 40mg once daily by mouth, quinapril HCl (Accupril) 40 mg once daily by mouth, cefazolin (Ancef)1.5 Grams in 50 mL 0.9 % Normal Saline intravenously three times a day. The result of the wound culture identified Methicilin-resistant staphylococcus aureus. After a surgical debridement of the black tissue a SilvaSorb® (antimicrobial gel) dressing was ordered daily. Develop a Plan of Nursing Care for this patient that includes all steps of the nursing process: •One (1) actual NANDA-I nursing diagnosis statement addressing the priority problem the patient is experiencing. You need to provide the entire nursing diagnosis statement. For example: Acute pain, related to tissue trauma, as evidenced by patient rating pain at 7 on the 0-10 verbal pain scale. Provide a rationale, with evidence, why this nursing diagnosis is the priority for this patient. •What is the assessment data that supports the use of this nursing diagnosis? These are the assessments you will collect to determine if the patient has this nursing diagnosis. For example: Will assess the patient's pain using the 0-10 verbal pain scale. •One (1) expected outcome (realistic, measureable and contains a time frame). that addresses the diagnosis and meets the criteria for an expected patient outcome. Discuss whether the outcome is a cognitive, psychomotor, affective or physiologic outcome. Discuss why the time frame selected for the evaluative criteria was selected. Use evidence as the basis for the time frame and criteria. You need to be specific to this particular patient. For example: Patient will rate pain at 3 on the 0-10 verbal pain scale. Of course, you would also need to answer the rest of the items in this section. •Four (4) nursing interventions that includes at least one (1) nurse-initiated, one (1) dependent, one (1) interdependent intervention. Label your interventions as above. Provide a rationale for each intervention that is evidence-based. Lastly, your interventions must be able to move the patient toward the achievement of the outcome. Select interventions, you as the RN can perform, that could reduce the pain and provide the rationale as to why; be sure they are evidence-based. For example: Teach patient guided imagery to distract attention and reduce tension. Part 3 (1-2 pages) To assist the patient in preventing a recurrence of a similar incident once he returns to the assisted living environment, the RN needs to develop a teaching plan. Use the nursing process to consider the information the RN would need prior to development of the plan. Respond to the following and be able to support your answers. You will not be developing a teaching-learning plan but demonstrating using the teaching-learning process to prepare for an individualized plan. •How does the RN decide the format of the teaching plan, i.e., written, verbal, or other? •How does the RN know which information needs to be included? •When does the RN determine how and when to evaluate the teaching-learning process? Compose your work using a word processor (or other software as appropriate) and save it frequently to your computer. Use a 12 font size, double space your work and use APA format for citations, references, and overall format. Information on how to use the Excelsior College Library to help you research and write your paper is available through the Library Help for AD Nursing Courses page. Assistance with APA format, grammar, and avoiding plagiarism is available for free through theExcelsior College Online Writing Lab(OWL). Be sure to check your work and correct any spelling or grammatical errors before you submit your assignment. You are required to submit your paper toTurnitin(a plagiarism prevention service) prior to submitting the paper in the course submission area for grading.Access is provided by email to the email address on record in your MyExcelsior account during week 2 of the term. Once you submit your paper to Turnitin check your inbox in Turnitin for the results. After viewing your originality report correct the areas of your paper that warrant attention. You can re-submit your paper to Turnitin after 24-hours and continue to re-submit until the results are acceptable. Acceptable ranges include a cumulative total of less than 15% for your entire paper, and no particular area greater than 2% (excluding direct quotes and/or references). See the videos below for instructions on how to submit your paper to Turnitin and view your Originality Report. Video - Submitting a Paper Video - Viewing Your Originality Report When you're ready to submit your work for grading, click Browse My Computer and find your file. Once you've located your file click Open and, if successful, the file name will appear under the Attached files heading. Scroll to the bottosource..
The nursing process is basically a systematic method that registered nurses use in ensuring the quality of patient care. It could be broken down into 5 distinct steps or phases. (1) Assessment – in this step, the nurse will gather information about the client’s spiritual, sociological, physiological as well as psychological status. It is notable that this data could be gathered in many different ways (Meehan, 2012). For example, the nurse would carry out a patient interview. Other examples of gathering assessment data include the use of physical exams, general observation, referencing the health history of the client, and obtaining the client’s family history. (2) Diagnoses – in this step, the nurse will make an educated judgment with regard to an actual or possible health problem. Sometimes, several diagnoses are made for one patient. For example, these diagnoses include an actual description of the client’s health problem for instance sleep deprivation, as well as whether or not the client has a risk of developing more health problems. In addition, the nurse uses these diagnoses in determining the client’s readiness for health improvement and if the client might have developed any syndrome. This second step is used in determining the course of treatment.
(3) Planning – a plan of action is developed as soon as the nurse and the patient agree on the diagnoses. If a number of diagnoses have to be addressed, the head nurse prioritizes every assessment and devotes attention to high risk factors and severe symptoms (White, Duncan & Baumle, 2012). During planning for example, the nurse assigns every problem an understandable, measurable goal for the anticipated beneficial outcome. As a resource for planning, the Nursing Interventions Classification might be utilized.
(4) Implementing – during this step, the nurse will follow through on the plan of action that was decided earlier. This plan of the action is unique to every client and is focused on attainable outcomes. Examples of actions which are involved in a nursing care plan are as follows: directly caring for the client, monitoring the client for any signs of improvement or change, carrying out necessary medical tasks, contacting or referring the client for follow-up, instructing and educating the client as regards further health management (White, Duncan & Baumle, 2012).
(5) Evaluation – after every nursing intervention has been implemented, the nurse will complete an evaluation in order to determine whether or not the goals for patient wellness have actually been reached (Meehan, 2012). During evaluation for example, the nurse evaluates every care plan in turn and by number. The nurse writes a general statement regarding the condition of the client, for instance worse, same, or better. It is worth mentioning that if the wellness goals were not achieved or if the client’s condition has not improved, the nursing process will begin once more from the initial step. The care plans are discontinued if the goals have been realized.
Direct care: in the implementation step, the Nursing Intervention Classification (NIC) project noted that direct care denotes treatment which is carried out through interactions with the patient. Indirect care: this denotes treatment that is done away from the client, but on his or her behalf (Williams, 2015).
Types of nursing interventions
Nurse-initiated interventions – performed basing upon the clinical judgment of the nurse. Examples include initiating protective skin care for an area which may break down. Dependent interventions – the registered nurse performs these actions as a result of a doctor’s order. Examples include administering analgesics...
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