The Nursing Process and Nursing Care Plans

These flashcards cover key vocabulary and concepts related to the nursing process and nursing care plans.

Assessment

The deliberate and systematic collection of data to determine a patient’s current and past health status.

Nursing Diagnosis

Focuses on a patient’s actual or potential response to a health problem rather than the physiological event.

Prioritization

The classification of nursing diagnoses into high, intermediate, and low priorities to help sequence nursing interventions.

Nursing Interventions Classification (NIC)

A set of nursing interventions that standardizes communication of nursing care across health care settings.

Goals of Care

Specific and measurable behavioral responses reflecting the highest level of wellness and independence expected from patients.

Implementation

The initiation or completion of planned actions or nursing interventions.

Evaluation

The final step of the nursing process involving examination of a condition and a judgment as to whether change has occurred.

Patient-Centered Goals

Goals that are established collaboratively with the patient, focusing on their individual needs and outcomes.

Expected Outcomes

Specific, measurable changes in a patient’s status that are expected in response to nursing care.

Critical Thinking

A complex phenomenon that can be viewed as a process and a set of skills important for nurses in planning and evaluation.

Assessment

The deliberate and systematic collection of data to determine a patient’s current and past health status.

Nursing Diagnosis

Focuses on a patient’s actual or potential response to a health problem rather than the physiological event.

Prioritization

The classification of nursing diagnoses into high, intermediate, and low priorities to help sequence nursing interventions.

Nursing Interventions Classification (NIC)

A set of nursing interventions that standardizes communication of nursing care across health care settings.

Goals of Care

Specific and measurable behavioral responses reflecting the highest level of wellness and independence expected from patients.

Implementation

The initiation or completion of planned actions or nursing interventions.

Evaluation

The final step of the nursing process involving examination of a condition and a judgment as to whether change has occurred.

Patient-Centered Goals

Goals that are established collaboratively with the patient, focusing on their individual needs and outcomes.

Expected Outcomes

Specific, measurable changes in a patient’s status that are expected in response to nursing care.

Critical Thinking

A complex phenomenon that can be viewed as a process and a set of skills important for nurses in planning and evaluation.

Planning

A step in the nursing process where the nurse develops a care plan, establishing goals and identifying appropriate nursing interventions.

Subjective Data

Information provided by the patient or their family about their perceptions, feelings, and symptoms.

Objective Data

Observable and measurable information obtained through observation, physical examination, and diagnostic tests.

Nursing Process

A systematic, five-step method for providing patient care: Assessment, Nursing Diagnosis, Planning, Implementation, and Evaluation (ADPIE).