Question

1. You are a nurse admitting a patient to the hospital from the emergency department (ED) with shortness of breath and recent weight loss. After receiving a report from the ED nurse, you ready the patient’s room according to unit specifications and collect the necessary equipment and forms. When the patient arrives, she is using oxygen via a nasal cannula and seems to be comfortable. As you begin your admission activities and paperwork, you note that her shortness of breath slightly increases as she answers your questions. Accompanying the patient is her daughter, who comments, “This is the fourth time she’s been admitted to this hospital in the past year.” The patient and her daughter demonstrate a close, loving relationship. The daughter not only encourages her mother, but also sets boundaries regarding her mother’s anxiety.

a. How would you evaluate the patient’s achievement of cognitive, affective, and physiologic outcomes?

b. Describe factors that could derail the attainment of expected patient outcomes.

c. List common plan of care problems encountered during evaluation and how you might respond.

Answer 1

a.

Answer: cognitive, affective and physiologic outcomes evaluate to identify the patient's achievement specified in the plan of intervention or care by the nurse.

Cognitive outcome can be assess by identifying the increase in patient knowledge.

In affective outcome, assessment should be done base on the changes in the patient's beliefs,values and his or her attitude but this is the most complex outcome to evaluate.

In physiologic outcome, the assess mainly focus on physical changes in the patient like subside of the sign and symptoms of the disease condition.

b.

The factors that interrupt in attaining the expected patient outcomes are

1. Lack of resources: if the resources needed for the plan of care or the equipment needed for the intervention are not provided properly may leads to interrupt in identifying the expected patient outcomes.

2. Lack of knowledge: the staff or nurses who are going to provide intervention, care and education, if they do not have adequate knowledge or skill may interrupt in the attaining the expected patient outcome.

3. Lack of communication: the nurse is not communicating or not explaining properly to the patient regarding the care to be provided may leads to decrease the knowledge of the patient regarding the care may leads to interrupt in getting the expected patient outcome.

4. Lack of nurse patient therapeutic relationship

There should proper maintain of therapeutic relationship with the patient and the nurse. This will increase the trust of the patient towards the nurses. Lack of therapeutic relationship leads to lack of co ordination and interrupt in attaining the goal.

c.

Answer: common problem faces during the plan of care that encounter the evaluation are

-lack of co ordination by the patient

- improper documentation by the staff

-misinterpretation of the documentation or data

- failure to update the document by the staff due to busy schedule

- documentation of irrelevant or duplicate information.