BAKERSFIELD COLLEGE

LICENSED VOCATIONAL NURSING PROGRAM

1ST SEMESTER FUNDAMENTALS

CRITICAL THINKING IN NURSING PRACTICE

CHAPTER 18 - Nursing Process: PLANNING NURSING CARE

INTRODUCTION

Once the nursing assessment has been completed and nursing diagnoses are formulated, the nurse must be able to determine client goals related to each nursing diagnoses. Determine priorities among nursing diagnoses, select appropriate nursing interventions to deal with each diagnosis, and develop projected outcomes in order to evaluate the nursing care to be given. In other words, the nurse must plan the care for each client based upon that individual’s nursing diagnoses.

OBJECTIVES

Upon completion of this unit, the student will be able to:

A. 1. List the purposes of the nursing care plan.

2. Discuss the differences between care plans used in the hospital and community health settings.

3. Describe the difference between short-term and long-term goals.

4. Define scientific rationale.

5. Identify correct nursing interventions developed during the planning component.

6. Discuss the differences between dependent, independent, and interdependent intervention.

ASSIGNMENT

A.  Read Chapter 18 - Potter & Perry – Critical Thinking Exercise # 1, #3 and Review Questions

B.  Study Guide for Chapter 18

  Chapter 18 Planning Nursing Care

  Establishing Priorities

  Helps nurses to anticipate and sequence nursing interventions

  Classification of priorities:

Ø  High

Ø  Intermediate

Ø  Low

  Time Factor in Setting Priorities

  The planning of nursing care occurs in three phases:

Ø  Initial

Ø  Ongoing

Ø  Discharge planning

  Critical Thinking in Establishing Goals and Expected Outcomes

  Goal

Ø  A broad statement that describes the desired change in a client’s condition or behavior

Ø  An aim, intent, or end

  Expected outcome

Ø  Measurable criteria to evaluate goal achievement

  Goals of Care

  Client-centered goal

Ø  A specific and measurable behavior or response

  Short-term goal

Ø  An objective behavior or response expected within hours to a week

  Long-term goal

Ø  An objective behavior or response expected within days, weeks, or months

Expected Outcomes

  A specific, measurable change in a client’s status

  Provide focus or direction

  Determine when a specific, client-centered goal has been met

  Guidelines for Writing Goals

  Types of Interventions

  Nurse initiated

Ø  Independent

  Physician initiated

Ø  Dependent

  Collaborative

Ø  Interdependent

  Selection of Interventions

  Six factors to include

Ø  Characteristics of nursing diagnosis

Ø  Goals and expected outcomes

Ø  Evidence base for interventions

Ø  Feasibility of the intervention

Ø  Acceptability to the client

Ø  Nurse’s competency

  Planning Nursing Care

  Nursing care plan

  Student care plan

  Institutional care plan

  Concept map

  Consulting Other Health Care Professionals

Consultation is a process in which you seek the expertise of a specialist to identify ways to handle problems in client management or the planning and implementation of therapies.