Need help with the Nursing process...suprise, suprise

Hello hollysaad

This post by Daytonite is probably the one you are referring to.

https://allnurses.com/general-nursing-student/nursing-process-359656.html

hearing about the nursing process is often new to many people. i am the author of that car analogy. here it is again for you:

another similar analogy of critical thinking and adaptation of the scientific process is how the criminal justice system works. when a crime is discovered police officers and detectives begin an investigation. their data collection process (assessment) is well known to us because of programs like csi. that data is extremely important because it proves the crime and connects the criminal to the act. the crime (diagnosis) unlike in nursing is already known for these professionals. their work involves data collection. but, you see, without that data, they wouldn't have a case. data is always the foundation of what follows. once the data and problem (crime) are established, the process moves onward into the court system where interventions are made and something gets done about the problem (planning). the criminal get punished, the victim gets relief, etc. the criminal has their day in court and their case goes to trial. if they are found guilty, sentence is passed and the intervention is implemented. evaluation may be handled differently. jailed criminals may get parole for good behavior.

the nursing process also expand on the 5 steps of the nursing process into what needs to be done for care planning. however, in reality, the nursing process is just a problem solving methid whose steps can be adapted to solving any problem. here is how it is adapted to solving patient's nursing problems:

1. assessment (collect data from medical record, do a physical assessment of the patient, assess adl's, look up information about your patient's medical diseases/conditions to learn about the signs and symptoms and pathophysiology)
   
   • a physical assessment of the patient
     
   • assessment of the patient's ability and any assistance they need to accomplish their adls (activities of daily living) with the disease
     
   • data collected from the medical record (information in the doctor's history and physical, information in the doctor's progress notes, test result information, notes by ancillary healthcare providers such as physical therapists and dietitians
     
   • knowing the pathophysiology, signs/symptoms, usual tests ordered, and medical treatment for the medical disease or condition that the patient has. this includes knowing about any medical procedures that have been performed on the patient, their expected consequences during the healing phase, and potential complications. if this information is not known, then you need to research and find it.
     
     • use: https://allnurses.com/forums/f205/medical-disease-information-treatment-procedures-test-reference-websites-258109.html - medical disease information/treatment/procedures/test reference websites
       

[*]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). it helps to have a book with nursing diagnosis reference information in it. there are a number of ways to acquire this information.

• your instructors might have given it to you.
  
• you can purchase it directly from nanda. nanda-i nursing diagnoses: definitions & classification 2007-2008 published by nanda international. cost is $24.95 http://www.nanda.org/html/nursing_diagnosis.html
  
• many authors of care plan and nursing diagnosis books include the nanda nursing diagnosis information. this information will usually be found immediately below the title of a nursing diagnosis.
  
• the nanda taxonomy and a medical disease cross reference is in the appendix of both taber's cyclopedic medical dictionary and mosby's medical, nursing, & allied health dictionary
  
• there are also two websites that have information for about 75 of the most commonly used nursing diagnoses that you can access for free:
  
  • http://www1.us.elsevierhealth.com/evolve/ackley/ndh7e/constructor/
    
  • http://www1.us.elsevierhealth.com/merlin/gulanick/constructor/index.cfm
    

[*]planning (write measurable goals/outcomes and nursing interventions)

• goals/outcomes are the predicted results of the nursing interventions you will be ordering and performing. they have the following overall effect on the problem:
  
  • improve the problem or remedy/cure it
    
  • stabilize it
    
  • support its deterioration
    

  [*]how to write goal statements: see post #157 on thread https://allnurses.com/general-nursing-student/careplans-help-please-121128.html

  [*]interventions are of four types

  • assess/monitor/evaluate/observe (to evaluate the patient's condition)
    
    • note: be clear that this is assessment as an intervention and not assessment done as part of the initial data collection during step 1.
      

    [*]care/perform/provide/assist (performing actual patient care)

    [*]teach/educate/instruct/supervise (educating patient or caregiver)

    [*]manage/refer/contact/notify (managing the care on behalf of the patient or caregiver)

[*]implementation (initiate the care plan)

[*]evaluation (determine if goals/outcomes have been met)

for more information about the nursing process, see

• http://home.cogeco.ca/~nursingprocess/index.htm
  
• https://nursing.advanceweb.com/common/ce/course.aspx?courseid=504&creditid=1 - nursing process - click on the link to "read the article".
  
• http://www.mac.edu/faculty/nursingdepartment/200%20level/nursing_process.htm#return%20to%20top - the nursing process - a short introductory tutorial of what it is
  
• http://www06.homepage.villanova.edu/elizabeth.bruderle/1103/nursingprocess.htm - the nursing process