Introduction To Nursing Process (NP) : Presenter:M.Salman Alam Nursing Instructor, RCN Acknowledgement: FON Team
Introduction To Nursing Process (NP) : Presenter:M.Salman Alam Nursing Instructor, RCN Acknowledgement: FON Team
Introduction To Nursing Process (NP) : Presenter:M.Salman Alam Nursing Instructor, RCN Acknowledgement: FON Team
Process(NP)
Presenter :M.Salman Alam
Nursing Instructor, RCN
Acknowledgement: FON team
1
Objectives:
🞇 At the end of the session, learners will be able to:
1. Define nursing process and its components
2. Describe purposes and advantages of NP
3. Perform assessment by utilizing FHP tool
4. List down problem statement, long term and short term
goals and evaluation
5. Integrate five components of NP
6. Begin to use nursing process to deliver safe nursing care
to individual and participate in safe patient care delivery.
2
Nursing Process
Nursing Process define as:
🞇 “The nursing process is a systematic, client centered
method for structuring the delivery of nursing care.
The nursing process entails gathering and analyzing
data in order to identify client strengths and
potential or actual health problems, and developing
and continually reviewing a plan of nursing
interventions to achieve mutually agreed
outcomes”. (Erb & Kozier, 2008)
3
Purposes:
Assessment
Evaluation Nursing
diagnosis
Implementation Planning/
5 NP
Goals
Represents the cognitive (thinking, reasoning),
psychomotor (physical), and affective
(emotion,
feelings, and values) skills and abilities used by
the nurse to plan care for a patient.
Works as a cyclic and dynamic process.
Serves as client-centered framework.
Permits holistic care delivery.
6
Scenario:
🞇 A 19 years old boy comes in emergency with
complain of vomiting and diarrheas since two
days. Doctors has ordered IV fluids Dextrose
5% immediately , send blood CBC, urine DR
and chest X-ray. Investigations reports reveals
RBS 260 (high) and glucose +1 in urine .
Doctor orders Inj. insulin 2units stat.
1. What should a nurse do in above scenario?
2. What is the rational for nurse intervention?
3. What could be the appropriate action in above
scenario?
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8
"Critical thinking in nursing practice is a discipline
specific, reflective reasoning process that guides a nurse in
generating, implementing, and evaluating
approaches for dealing with client care and professional
concerns“
9 NP
(National League for Nursing,
2000)
Nurses use critical-thinking skills in a variety
of ways:
Nurses use knowledge from other subjects
and fields in problem solving.
Nurses deal with change in stressful
environments. Nurses make important decisions.
What is the issue?
What information do I need and how do I get
it? Is my data valid?
What do the data mean, based on the
facts? What should I do?
Are there other questions I should ask?
Is this the best way to deal with the
issue?
Nursing process:
First component:
Assessment
Assessment
Assessment is the systematic and
continuous collection, organization,
validation, and documentation of data
(information).
B. Physical Examination:
• General appearance ,height weight ,proper clothing,
orientation with environment
C. Patient's documentation
🞇 Physician notes, physiotherapist notes , dietition notes
🞇 Investigations reports
🞇 Nursing notes
A 24-year-old girl is admitted in the
emergency department for abdominal pain. During
history taking she verbalized “ I have severe pain in
my upper abdomen and said a pain score of 8 (0-10)”.
She is awake and alert, but crying due to pain. On
head to toe assessment nurse found hard abdomen,
pain on palpation and bowel sounds two per minute.
Subjective Data Objective Data
Patient verbalized “ I have severe 24 years old female admitted
pain in my upper abdomen. to ED with abdominal pain.
Further she rated her pain score Patient was awake and
8 on the pain scale of (0-10) ” alert but crying because
of sharp pain. on head to
toe assessment it was found
that
•Abdomen was hard
•Pain on palpation
•Bowel sounds below
normal (2/min)
Vital signs of patient were
Temp: 36 C,RR : 22,Pulse:
20 NP
102/min, Bp: 123/89
mmHg
Practice time:
Label)
The Etiology (Cause) i.e.
related to
The Defining Characteristics
Acute pain
Hyperthermia
Constipation
Impaired urinary elimination
Ineffective individual coping
(Carpenito, 2002)
A 10 years old boy studying in grade IV,
h a n d washing practices.
7/ 10 /2 018
From the given scenario, you are required
to: Identify the problem.
Stomach Ache
Explore the cause or etiology of the problem.
Improper Hygiene practices
Ingestion of Unhygienic food
List the defining characteristics or sign and
symptoms of the problem.
Facial Expressions
Pain scale
32 N Tenderness (pain on touching)
P
(P) related to (E) as evidenced by
(S)
From case 2:
Acute Pain (i.e. stomach ache) related to ingestion of
unhygienic junk food as evidenced by client’s intense
facial expressions and pain score of 9.
33 NP
Did the Scenario reflect one problem only?
The answer is NO. The scenario reflected many
other problems responsible for Furqaan’s condition.
For example:
Unhygienic practices which may cause
potential
alteration in Furqaan’s health in a long
run.
34 aAltered
ttentio Family Processes i.e. lack of
NP
nmotherly
Ms. Maria admitted with the complain of urinary
retention. while history taking, she verbalized to
the nurse that she is experiencing difficulty in
passing urine and her normal urinary elimination
pattern was not normal as before. On examination
nurse found distention of lower abdomen.
Ultrasound of whole abdomen showed calculi in
urinary tract.
(P) related to (E) as evidenced by
(S)
From case 3:
Impaired urinary elimination (i.e. urinary retention)
related to obstruction (stones) in the urinary tract
evidenced by lower abdominal distention and
patient verbalization of difficulty in passing urine
Planning is the process of designing
nursing strategies to prevent, reduce, or
eliminate a client’s health problems.
Goals/ Expected outcomes (interchangeably
used)and is a desired out come or change in
clients behavior
Goals:
1. Short term
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2. Long term
NP
Long-Term Goals:
Is one that will take time to achieve (weeks to
months). Long-term goals are often used for
clients who live at home or have chronic health
problems, for clients in nursing homes,
extended care facilities, and rehabilitation
centers. E.g.
“Client will regain full use of right arm in
6 weeks.”
Short-Term Goal:
Is one that can be achieved relatively quickly
(usually within a week or two). Short-term goals
are useful for clients who require health care for
a short time and who are frustrated by long-term
goals that seem difficult to achieve. E.g. “Client
will raise right arm to shoulder height by Friday.”
Essentials of outcome measures
Short Term Goal:
By the end of my clinical hours Patients pain score
will be 2 from 9 on the pain scale of 0-10.