Nursing Process

Content "filtered", Please subscribe for FULL access.

Chapter 3 : Nursing Process

Nursing Process arrow_upward

  • The Nursing Process is a systematic problem solving approach used to identify, prevent and treat actual or potential health problems and promote wellness
  • The nursing process is based on a nursing theory developed by Ida Jean Orlando
  • The nursing process is used by nurses every day to help patients improve their health and assist doctors in treating patients
  • It is a systematic way to plan, implement and evaluate care for individuals, families, groups, and communities
  • Nursing knowledge is used throughout the process to formulate changes in approach to the patient's changing condition

  • Purpose of Nursing Process arrow_upward

  • The purposes of the nursing process are as follows:
    • To identify a client’s health status, health care problems or needs
    • To establish plans to meet the identified needs
    • To deliver specific nursing interventions to meet needs
    • To help nurses in arriving at decisions and in predicting and evaluating consequences

    Phases of the Nursing Process arrow_upward

  • Phases of the nursing process include:
    • Assessment of the patient's needs
    • Diagnosis of human response needs that nurses can deal with
    • Plan for caring of patient
    • Implementation of care
    • Evaluation of the success of the implemented care

    Assessment arrow_upward

  • Assessment is the systematic and continuous collection, organization, validation and documentation of data
  • Assessment is a continuous process carried out during all phases of nursing process
  • Assessment is done for following purposes:
    • To establish baseline information on the client
    • To determine the client’s normal function
    • To determine the client’s risk for diagnosis function
    • To determine presence or absence of diagnosis function
    • To determine client’s strengths
    • To provide data for the diagnostic phase

    Activities of Assessment arrow_upward

  • Following are the steps of assessment:
    • Collection of data
    • Validation of data
    • Organization of data
    • Documentation/ recording of data

    Collection of Data arrow_upward

  • It is the gathering of information about the client
  • It includes not only physiological data, but also psychological, sociocultural, spiritual, economic, and life-style factors that may affect client’s health status
  • It includes present problems of clients

  • Validation of Data arrow_upward

  • The information gathered during the assessment phase must be complete, factual, and accurate because the nursing diagnosis and interventions are based on this information

  • Organization of Data arrow_upward

  • The nurse uses a written or computerized format that organizes the assessment data systematically

  • Documentation of Data arrow_upward

  • To complete the assessment phase, the nurse records client’s data
  • Accurate documentation is essential and should include all the data collected about the client’s health status

  • Types of Assessment arrow_upward

  • There are four types of assessment as follows:
    • Initial Assessment
    • Focused Assessment
    • Time-Lapsed Assessment
    • Emergency Assessments

    Initial Assessment arrow_upward

  • Initial Assessment helps to determine the nature of the problem and prepares the way for the ensuing assessment stages
  • Components may include obtaining:
    • A patient's medical history or putting him through a physical exam
    • Preparing a psychosocial assessment for a mental health patient

    Focused Assessment arrow_upward

  • The focused assessment is the stage in which the problem is exposed and treated
  • The goal of the focused assessment is to diagnose and treat the patient in order to stabilize the condition

  • Time-Lapsed Assessment arrow_upward

  • Once treatment has been implemented, a time-lapsed assessment must be conducted to ensure that the patient is recovering from his malady and his condition has stabilized

  • Emergency Assessment arrow_upward

  • During emergency procedures, a nurse is focused on rapidly identifying the root causes of concern for the patient and assessing the airway, breathing and circulation (ABCs) of the patient

  • Nursing Diagnosis arrow_upward

  • The Nursing Diagnosis is the nurse’s clinical judgment about the client’s response to actual or potential health conditions or needs
  • A Nursing Diagnosis is used to identify the specific diagnostic conditions based on the patient problems, signs and symptoms, and/or assessed care components that require nursing care

  • Planning arrow_upward

  • Setting goals to improve the outcomes for the patient is a primary focus of the nursing process
  • Planning involves making plans to carry out the necessary interventions to achieve those goals
  • The nurse sets measurable and achievable short- and long-range goals for this patient

  • Implementation arrow_upward

  • Nursing care is implemented according to the care plan, so continuity of care for the patient during hospitalization and in preparation for discharge needs to be assured

  • Evaluation arrow_upward

  • Evaluation involves not only analyzing the success of the current goals and interventions, but also examining the need for adjustments and changes
  • Both the patient’s status and the effectiveness of the nursing care must be continuously evaluated, and the care plan modified as needed.

  • Thank You from Kimavi arrow_upward

  • Please email us at and help us improve this tutorial.

  • Mark as Complete

    Kimavi Logo

    Terms and conditions, privacy and cookie policy

    YouTube | FaceBook | @Email | Paid Subscription
    Science | Engineering | Math | Business | English | Medicine | History | Languages | Law | Animals | Social-Studies

    Tutorials, Videos and Quizzes - Real Simple Education

    humanSuccess = (education) => { `Life, Liberty, and the pursuit of Happiness` }