NANDA nursing diagnoses and care plans study guide
This study guide covers essential NANDA nursing diagnoses and care plans, providing students with key terms and concepts necessary for effective nursing practice.
Quiz(52 questions)
1. What does Ineffective Airway Clearance indicate?
Terms in this Study Set(52)
NANDA Nursing Diagnoses Overview(16)
What is NANDA?
NANDA stands for North American Nursing Diagnosis Association, a professional organization that sets standards for nursing diagnoses.
Define nursing diagnosis.
A nursing diagnosis is a clinical judgment about an individual's response to actual or potential health problems.
True or False: NANDA diagnoses are only used in hospitals.
False. NANDA diagnoses are applicable in various healthcare settings, including clinics and home care.
List three types of nursing diagnoses.
- Actual - Risk - Wellness
How do NANDA diagnoses improve patient care?
They provide a standardized language, facilitate communication, and guide nursing interventions.
What is an actual nursing diagnosis?
An actual diagnosis describes a human response to a health condition that is currently happening.
Fill in the blank: Risk diagnoses identify potential problems that may occur if ___.
interventions are not implemented.
Compare wellness and actual diagnoses.
Wellness diagnoses focus on patient strengths and readiness for enhancement, while actual diagnoses focus on current health issues.
What does PES stand for in nursing diagnoses?
PES stands for Problem, Etiology, and Symptoms, a format for structuring nursing diagnoses.
Cause → Effect: What is the effect of inadequate nutrition?
It can lead to weight loss, muscle weakness, and increased risk of infection.
What is the role of evidence in NANDA diagnoses?
Evidence-based practice supports the validity of diagnoses and guides appropriate interventions.
True or False: NANDA diagnoses are static and do not change.
False. Nursing diagnoses are dynamic and can change as the patient's condition evolves.
Example of a risk nursing diagnosis.
Risk for Falls: Related to impaired mobility and environmental hazards.
What is a standardized nursing language?
A systematic way to communicate nursing diagnoses, like NANDA, ensuring consistency in practice.
Define the term ‘related factors’ in NANDA.
Related factors are the underlying causes or contributing factors of a nursing diagnosis.
What are the components of a NANDA diagnosis?
1. Problem 2. Etiology 3. Symptoms
Care Planning Fundamentals(12)
What is the first step in care planning?
Assessment: Gather comprehensive data about the patient's health status and needs.
True or False: Planning comes before assessment.
False: Assessment is the foundational step that informs planning.
Define nursing diagnosis in care planning.
A nursing diagnosis identifies the patient's health issues and guides the care plan. It is based on assessment data.
List key components of a care plan.
- Nursing Diagnosis - Goals/Outcomes - Interventions - Evaluation - Patient Education
Fill in the blank: Goals must be ______ and measurable.
Specific: Goals should be clearly defined and quantifiable to track progress.
Compare short-term and long-term goals.
Short-term goals are achieved within days to weeks, while long-term goals take months to achieve.
What role do nursing interventions play?
Interventions are actions taken to achieve the goals outlined in the care plan, tailored to the patient’s needs.
Write a simple example of a nursing intervention.
Example: Administer prescribed medication as per the schedule to manage pain.
How do you evaluate the care plan's effectiveness?
Evaluate by comparing the patient’s progress against the established goals and making necessary adjustments.
What is the purpose of patient education in care planning?
To empower patients to manage their health effectively, providing them with knowledge and resources.
True or False: Care plans remain static throughout patient care.
False: Care plans should be updated regularly based on patient progress and changing needs.
What is a key factor in creating effective nursing interventions?
Interventions should be evidence-based, taking into account current best practices and patient preferences.
Common Nursing Diagnoses(14)
Ineffective Airway Clearance → Definition?
Inability to clear secretions or obstructions from the respiratory tract. - Signs: wheezing, coughing, abnormal breath sounds.
What is Risk for Infection?
Increased susceptibility to infection due to compromised immune function. - Common causes: surgical wounds, catheters.
True or False: Acute Pain is a chronic condition.
False. Acute pain is temporary and usually related to injury or surgery.
Impaired Skin Integrity → Example?
Occurs when skin is damaged or disrupted. - Example: pressure ulcers from prolonged immobility.
What does Risk for Falls mean?
Increased likelihood of falling due to factors like age, medications, or mobility issues.
Fill in the blank: __________ is a nursing diagnosis for patients with difficulty managing emotions.
Ineffective Coping.
Compare: Chronic Pain vs. Acute Pain.
Chronic pain lasts longer than 6 months, while acute pain is short-term and often from injury.
What is Activity Intolerance?
Insufficient physiological or psychological energy to endure or complete required or desired daily activities.
True or False: Impaired Physical Mobility includes a patient who can walk but prefers to sit.
False. It refers to limited ability to move due to physiological factors.
Sensory Perception Disturbance → Definition?
Altered ability to receive or process sensory input. - Example: visual or auditory hallucinations.
Stress Overload → What does it indicate?
Inability to cope with cumulative stressors, leading to physical and emotional exhaustion.
What is Ineffective Therapeutic Regimen Management?
Inability to manage prescribed health regimen due to lack of knowledge or resources.
Nutrition: Less than Body Requirements → Example?
Inadequate intake of necessary nutrients. - Example: malnutrition in elderly patients.
What does Disturbed Sleep Pattern imply?
The disruption in normal sleep patterns affecting daily functioning and well-being.
Implementation and Evaluation(10)
Implementation phase in nursing care plans
The implementation phase involves executing nursing interventions to achieve patient goals. - Action-oriented - Patient-centered - Team collaboration
True or False: Evaluation is a one-time process.
False: Evaluation is ongoing. It requires continuous assessment of patient responses to interventions and revisions to care plans as needed.
Key elements of implementation
- Communication - Documentation - Patient education - Coordination with team members
What is the purpose of nursing interventions?
To promote health, prevent disease, and manage health conditions through evidence-based actions.
Fill in the blank: After implementing a care plan, nurses must __________ to determine its effectiveness.
evaluate
Cause → Effect: Poor patient education leads to...
Increased readmission rates, misunderstanding of medication protocols, and noncompliance with treatment.
Comparison: Implementation vs. Evaluation
Implementation: Putting the care plan into action. Evaluation: Assessing the effectiveness of the care provided.
Steps in the evaluation process
1. Assess patient outcomes 2. Compare outcomes to expected goals 3. Revise care plan if necessary
What should be documented after implementing an intervention?
- Patient response - Effectiveness of intervention - Any changes made to the care plan
Example of a nursing intervention
Provide education on diabetes management to enhance understanding and self-care.
Questions in this Study Set(52)
1. What does Ineffective Airway Clearance indicate?
2. What does NANDA stand for?
3. What is the primary focus during the implementation phase of nursing care plans?
4. What is the primary purpose of a nursing diagnosis in care planning?
5. What is a primary cause of Risk for Infection?
6. Which of the following best defines a nursing diagnosis?
7. True or False: The evaluation process in nursing is completed after the first assessment of patient outcomes.
8. In care planning, which component outlines what the patient aims to achieve?
9. True or False: Acute Pain is a long-lasting condition.
10. True or False: NANDA diagnoses are limited to use in acute care settings.
11. Which of the following is NOT a key element of implementation in nursing care plans?
12. Which of the following is NOT a key component of a care plan?
13. What does Impaired Skin Integrity refer to?
14. Which of the following is NOT a type of nursing diagnosis?
15. What is the purpose of nursing interventions?
16. What does evaluation in a care plan involve?
17. Which of the following describes Risk for Falls?
18. How do NANDA diagnoses enhance patient care?
19. Fill in the blank: After implementing a care plan, nurses must __________ to ensure patient goals are being met.
20. True or False: Goals in a care plan should be vague and open to interpretation.
21. Fill in the blank: __________ is a nursing diagnosis for patients struggling with emotional management.
22. What characterizes an actual nursing diagnosis?
23. What is a potential consequence of poor patient education regarding their treatment plan?
24. How often should a care plan be reviewed and updated?
25. How is Chronic Pain different from Acute Pain?
26. Fill in the blank: Risk diagnoses identify potential problems that may occur if ___.
27. How does implementation differ from evaluation in nursing care?
28. What is a short-term goal in a care plan?
29. What does Activity Intolerance indicate?
30. How do wellness diagnoses differ from actual diagnoses?
31. Which of the following is one of the steps in the evaluation process?
32. Which nursing intervention is an example of patient education?
33. True or False: Impaired Physical Mobility includes patients who choose to sit rather than walk.
34. What does the PES format stand for in nursing diagnoses?
35. What should be documented after implementing a nursing intervention?
36. What is the significance of evidence-based interventions in a care plan?
37. Sensory Perception Disturbance can involve what kind of experiences?
38. Which is a potential effect of inadequate nutrition?
39. Provide an example of a nursing intervention related to patient education.
40. Which option describes the role of nursing interventions?
41. What does Stress Overload indicate about a patient?
42. What role does evidence play in NANDA diagnoses?
43. What should be included in the assessment step of care planning?
44. What is Ineffective Therapeutic Regimen Management?
45. True or False: NANDA diagnoses remain unchanged throughout a patient's care.
46. True or False: Planning in care planning occurs before assessment.
47. Nutrition: Less than Body Requirements often leads to what condition?
48. What is an example of a risk nursing diagnosis?
49. Disturbed Sleep Pattern can affect which aspect of a patient's life?
50. Which of the following best describes standardized nursing language?
51. What are related factors in NANDA diagnoses?
52. What are the components of a NANDA diagnosis?
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