How to use the nursing process

Moved to our Nursing Student Assistance forum for help with nursing program assignents

You might want to check out the FAQ section link for great resources on care planning, nursing diagnosis etc.

You are putting the cart before the horse a bit.....Here are the steps of the nursing process and what you should be doing in each step: ADPIE from our Daytonite

1. Assessment
   (collect data from medical record, do a physical assessment of the patient, assess ADLS, look up information about your patient's medical diseases/conditions to learn about the signs and symptoms and pathophysiology)
   
   
2. Determination of the patient's problem(s)/nursing diagnosis
   (make a list of the abnormal assessment data, match your abnormal assessment data to likely nursing diagnoses, decide on the nursing diagnoses to use)
   
   
3. Planning
   (write measurable goals/outcomes and nursing interventions)
   
   
4. Implementation
   (initiate the care plan)
   
   
5. Evaluation
   (determine if goals/outcomes have been met)
   
   

The steps of the scientific method are to:

• Ask a Question
  
• Do Background Research
  
• Construct a Hypothesis
  
• Test Your Hypothesis by Doing an Experiment
  
• Analyze Your Data and Draw a Conclusion
  
• Communicate Your Results
  

from: Steps of the Scientific Method

The first 2 steps comprise the assessment, the hypothesis is analogous to the diagnosi; you plan the intervention, and analyze the outcomes as an experiment, and then reevaluate and document your results.

#1. Take a look at the information you collected on the patient during your physical assessment and review of their medical record. Start making a list of abnormal data which will now become a list of their symptoms.

#2. Don't forget to include an assessment of their ability to perform adls (because that's what we nurses shine at). The ADLS are bathing, dressing, transferring from bed or chair, walking, eating, toilet use, and grooming. and, one more thing you should do is to look up information about symptoms that stand out to you.

#3. What is the physiology and what are the signs and symptoms (manifestations) you are likely to see in the patient. Did you miss any of the signs and symptoms in the patient? If so, now is the time to add them to your list.

This is all part of preparing to move onto the next step of the process which is

#4. Determining your patients problem and choosing nursing diagnoses. but, you have to have those signs, symptoms and patient responses to back it all up.

#5. How are all your interventions changing/helping this patient.

You, I and just about everyone we know have been using a form of the scientific process, or nursing process, to solve problems that come up in our daily lives since we were little kids.

For example: As a contributor to AN....Daytonite said best.

You are driving along and suddenly you hear a bang, you start having trouble controlling your car's direction and it's hard to keep your hands on the steering wheel. You pull over to the side of the road. "What's wrong?" You're thinking. You look over the dashboard and none of the warning lights are blinking. You decide to get out of the car and take a look at the outside of the vehicle. You start walking around it. Then, you see it..............a huge nail is sticking out of one of the rear tires and the tire is noticeably deflated.

What you have just done is.......

Step #1 of the nursing process--performed an assessment. You determine that you have a flat tire. You have just done.....

Step #2 of the nursing process--made a diagnosis. The little squirrel starts running like crazy in the wheel up in your brain. "What do i do?" You are thinking. You could call AAA. No, you can save the money and do it yourself. You can replace the tire by changing out the flat one with the spare in the trunk. .......Good thing you took that class in how to do simple maintenance and repairs on a car!

You have just done.....

Step #3 of the nursing process--planning (developed a goal and intervention). You get the jack and spare tire out of the trunk, roll up your sleeves and get to work. You have just done.....

Step #4 of the nursing process--implementation of the plan. After the new tire is installed you put the flat one in the trunk along with the jack, dust yourself off, take a long drink of that bottle of water you had with you and prepare to drive off. You begin slowly to test the feel as you drive....... Good....... Everything seems fine. The spare tire seems to be ok and off you go and on your way. You have just done

Step #5 of the nursing process--evaluation (determined if your goal was met).

Does this make more sense? Can you relate to that? That's about as simple as the nursing process can be simplified to... BUT........ you have the follow those 5 steps in that sequence or you will get lost in the woods and lose your focus of what you are trying to accomplish.

critical thinking involves knowing:

• the proper sequence of steps in the nursing process
  
• the normal anatomy and physiology of the human body
  
• how the normal anatomy and physiology are changed by the medical and disease process that are going on
  
• the normal medical treatment that the doctor(s) are likely to order to treat the medical and disease process going on
  
• the nursing interventions that you have learned for the things that support the medical and disease process that is going on
  
• making the connection (this is the critical thinking part) between the disease, the treatment and the nursing interventions and where on the sequence of the nursing process you are
  

step #2 - determine the patient's problem(s)/nursing diagnosis/part 1 - make a list of the abnormal assessment data

step #3 - determine the patient's problem(s)/nursing diagnosis/part 2 - match your abnormal assessment data to likely nursing diagnoses, decide on the nursing diagnoses to use

Again, I think you are putting the cart before the cart.

Well...it is essentially the same. You look at the question. You look at what information is provided...you look at the disease process and what information they provided. The you think according to Maslows hierarchy of needs...and the ABC's. You look at what is the MOST important and what you should do FIRST.

These critical thinking, or application type, questions require you to draw from a number of disciplines and knowledge. the basic strategy for answering critical thinking (application type) questions is as follows, you must:

• know and consider the normal anatomy and physiology
  
• know and consider abnormal anatomy for the disease in question
  
• know and consider the resulting signs and symptoms when the disease occurs and how they proceed from mild to fatal - each sign and symptom can be related back to the pathophysiology of the disease
  
• know and consider how the doctor diagnoses and treats the disease in question
  
• know nursing interventions for the signs and symptoms you are being asked about
  
• know the steps of the nursing process and what goes on in each of the steps and consider how they are affecting the question you are being asked
  
• know and consider the principles behind the actions being done - there are many kinds of principles: principles of nursing, principles of biology, principles of chemistry, principles of physics, etc.
  
• read the stem of the question carefully and answer that because the test makers try to trip you up by distracting you with conflicting information they give you in the answer choices that sounds good but has no relationship to what the question is asking for
  
• ask yourself "why" a patient is experiencing some sign or symptoms to get at the underlying problem. nursing like other disciplines treats the problem/signs and symptoms.
  

http://www.amazon.com/fundamentals-success-applying-critical-thinking/dp/0803610564/ref=pd_sim_b_3/002-1123730-3462415

I wish you would of used a test question from an nclex book as an example. Also how do you know if it's a nursing process question or not?

It is admirable that you want a jump start....but you are going to get so overwhelmed. Try looking at the book that might help.