Question

Think like a nurse

(1) What is the primary problem that your patient is most likely presenting?

(2) what nursing priorities will give your plan of care?( if more than one list in order of priority)

(3) What interventions will you initiate based on this priority?(a) Nursing intervention (b) Rationale (c) Expected outcome

(4) What is the rationale for treatment and expected outcomes for medical management of the priority problem?(a) Care provider orders (b) rationale (c) expected outcome

Answer 1

1. The primary problem more patients are presenting now a days :

symptomatic conditions such as cough, back pain, abdominal symptoms, pharyngitis, dermatitis, fever, headache, leg symptoms, unspecified respiratory concerns and fatigue are the most common primary problem which patients are presenting. Globally, upper respiratory tract infection and hypertension were the most common clinical conditions . In developed countries the next most common conditions are depression or anxiety and back pain. ln developing countries they were pneumonia and tuberculosis.

2.nursing priorities in plan of health care are :

The nurse should plan care to meet physiological needs first, followed by safety needs, and belonging needs and so on. As a care taker, one can use Maslow's Hierarchy of Needs to helps to decide which to choose.

Maslow’s pyramid is designed to show that things at the base of the pyramid are higher priority than those at the top.

The order of priority according to Maslow pyramid is as follows :

1.Physiological needs refer to things we need to live. Examples are air, water and food.

2.Safety needs refer to things like being free from danger and having adequate shelter.

3.Love and belonging include the need for affection and belonging to a group (like family).

4.Esteem includes self esteem and approval from others.

5.Self-actualization means meeting an individual’s full potential.

3.nursing interventions -Nursing interventions are the actual treatments and actions that are performed to help the patient to reach the goals that are set for them. The nurses uses their knowledge, experience and critical thinking skills to decide which interventions will help the patient the most.

The Nursing Interventions Classification is a care classification system which describes the activities that nurses perform as a part of the planning phase of the nursing process associated with the creation of a nursing care plan.

Examples are :

1.Sleep pattern control.

2.Mobility therapy.

3.Compliance with diet.

4.Infection control.

5.Alcohol abuse control.

6.Positioning therapy.

7.Bedbound care.

8.Energy conservation

4.rationale for medical management of priority problem :

A nursing rationale is a stated purpose for carrying out a nursing intervention. Nursing interventions are actions that nurses perform to help patients achieve specified health goals. A nursing rationale is written next to each nursing intervention in the nursing care plan. With the nursing diagnosis.

Care plans by student nurses are usually required to be handwritten and have an additional column for Rationale or Scientific Explanation after the nursing interventions column. Rationales are scientific principles that explains the reasons for selecting a particular nursing interventions.

Care providers order must include the following elements in order to be considered valid:

Reason for ordering the test or service (diagnosis description, ICD-9 code, sign(s), symptoms), Test or service requested, Provider's name, rovider's signature, Patient complete name and patient date of birth.

Expected out come :

Goals or desired outcomes are the nurse hopes to achieve by implementing the nursing interventions and are derived from the client’s nursing diagnoses. Goals provide direction for planning interventions, serve as criteria for evaluating client progress, enable the patient and nurse to determine which problems have been resolved and help motivate the patient and nurse by providing a sense of achievement.

Goals can be short term or long term. In an acute care setting most goals are short-term since much of the nurse’s time is spent on the patient's immediate needs. Long-term goals are often used for clients who have chronic health problems or who live at home, in nursing homes, or extended care facilities.