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Each student should focus on what it takes to be competent and confident in using the nursing process:
Each student should focus on what it takes to be competent and confident in using the nursing process:
- Knowledge
- Skills
- Attitude
- Caring
- Critical Thinking
- Clinical Reasoning
- Effective Communication
- Effective Decision Making
Clustering the following data based on history, demographics (client profile) and a head to toe physical assessment by system.
- Patient's: age 40, male
- Exercise tolerance
- Widow with 4 children ranging from age 4 to 17 years old
- Medical Diagnosis: pneumonia
- Surgical History: Tracheostomy, Peg
- T-100.8, P-98, R-24, BP - 106/70
- Pt states: "I am concerned about who is going to care my children"
- Religion: Catholic
- Occupation: RN
- Pt states: " I feel weak and tired all the time, but cannot seem to rest with this constant cough"
- Appetite poor
- Smoked a pack of cigarettes a day, but quit 2 weeks ago
- Lungs have bilateral rhonchi
- Productive cough of thick yellow mucus
- Chest X-ray shows improvement over the past 3 days
- WBC is 15,000
- Allergic to penicillin
- Erythema to bilateral elbows
- Foley catheter draining clear yellow urine
- Spontaneous respirations
I. Use the following terms to describe each of the findings above (each may have 1 or more categories).
- Body system: which one (nervous, respiratory, cardiovascular, GI, GU, musculoskeletal, integumentary, reproductive)
- Maslow's Hierarchy of Needs (physiological, safety & security, love and belonging, self-esteem, and self-actualization)
- Brief client profile (name, age, chief complaint, vital signs, surgical or medical history, allergies, diet, etc.
- Determine if the information is relevant or irrelevant (does it need follow-up).
For example: copy and paste this assignment on a word document. First one done for you.
Therefore, next to Patient's age/gender: Student entered: Vital statistic, reproductive system
Patient's age/gender: vital statistic, reproductive system
