ENGLISH FOR NURSES

NURSING PROCESS


I. The Components of Nursing Process
The nursing process is a systematic, rational method of providing nursing care. Today, the nursing process is usually described as having five steps or phases : assessment, nursing diagnosis, planning, nursing intervention, and evaluation.
1. Assessment is collecting and organizing data about a patient or client. Data are gathered from a variety of sources and are the basis for action and decisions taken in subsequent steps.
2. Nursing diagnosis is the identification and delineation of a pationt’s response to her or his situation. The diagnosis is stated as actual or potensial problems within the scope of nursing practice.
3. Planning includes validating the nursing diagnosis and then planning how best to help the patient.
4. Nursing intervention is the implementation of the planned nursing care. Intervention may be carried out by the nurse responsible for assessment, diagnosis, and planning, intervention also may be delegated to other nursing personnel.
5. Evaluation is comparing the patient’s response to the intervention with predetermined standars, often referred to as outcome criteria or evaluative criteria


II. Characteristics of the Nursing Process
The nursing process has these functional characteristics, they are :
1. It can be viewed from a systems and a humanistic perspective
2. The system is open, flexible, and dynamic.
3. Feedback is important in the process.
4. The nurse is permitted maximum flexibility and creativity








III. Evaluation

Task 1
Read the phrases written above correctly!!

Task 2
Analize the phrases above and answer these questions below accordingly!!
1. What do you know obout the nursing process?
2. How many phases are the nursing process?
3. Define each component of the nursing process!
4. Outline activities involved in each component of the nursing process!
5. Identify essential characteristics of the nursing process
6. Describe the humanistic approach to the nursing process

The objectives for student after learning this subject
1. Exercise reading ability (reading)
2. Know essential terms and fact related to the nursing process (understanding)
a. Understanding the nursing process
b. Understanding the phases of the nursing process
c. Defining each component of the nursing process
d. Outlining activities involved in each component of the nursing process
e. Identifying essential characteristics of the nursing process
f. Describing the humanistic approach to the nursing process
3. Understanding the grammer focus (article)

Although nurses have always assesed their patients conditions, increasingly specific techniques are being employed to determine health status. These techniques include those that assess physical health status. An outline of the physical assessment techniques to determine vital signs as well as influencing factors and points of emphasis follows :
1. body temperature
a. Influencing factors
i. Age
1. Newborns :fluctuations between 36.1 and 37.7 C
2. 2 years : 37.2 C
3. 6 years : 37.0 C
4. 12 years : 37.0 C
5. Adult : 37.0 C
6. Elderly : 36 C
ii. Time of day
1. Lowest in the morning
2. Highest in the evening
iii. Sex : body temperature increased by ovulation
iv. Emotions : temperature increased by heightened emotions
v. Exercise : elevates body temperature
vi. Temperature of environment : direct relationship to body temperature
b. Sites of measurement
i. Oral
1. Taken for 2 to 8 minutes
2. contraindicated for infants, young children, nose breather, the confused, those with oral surgery, and in some agencies, for patients receiving oxygen by cannula or mask
ii. Rectal
1. Indicated for the very young, unconscious, or confused patient
2. Contraindicated for patients with rectal pathologic conditions or trauma
3. Taken for 2 or 3 minutes
4. must be held in place
iii. Axilla
1. Least accurate of the three methods
2. Taken for 10 minutes
c. Types of fever
i. Intermitten
ii. Remittent
iii. Relapsing
d. Symptoms of fever
i. During fever onset
1. shivering and chills
2. increased pulse rate
3. pallor and skin coldness
4. gooseflesh
5. convulsions with high temperature
ii. during fever cours
1. skin feels warm
2. flushing
3. headache, irritability, restlessness
4. disorientation with hight temperature
5. weakness
6. dehydration
iii. during fever termination
1. increased diaphoresis
2. skin redness
2. Pulse measurement
a. Pulse sites
i. Temporal
ii. Carotid
iii. Brachial
iv. Radial
v. Femoral
vi. Popliteal
vii. Dorsalis pedis
viii. Apical
b. Factors influencing pulse rate per minute
i. Age
1. newborns : fluctuates between 70 and 170 beats per minute
2. 2 years : 80 to 130
3. 12 years : boys , 65 to 105, girls, 70 to 110
4. 18 years : boys, 50 to 90, girls, 70 to 110
5. adults : same as 18 years
6. elderly : 70 to 80 or same as 18 years
ii. Sex : lower pulse rates in men than women
iii. Exercise : increases pulse rate
iv. Emotions : tachycardia with sympathetic nervous system stimulation
v. Heat : pulse rate elevated by prolonged external heat
vi. Body position : pulse rate increased by prolonged horizontal position
3. Respirations
a. Variations in respiratory rate by age
i. Newborn : 30 to 40 breath per minute, irregular and shallow
ii. Adult : 16 to 20
iii. Elderly : same as adult or increased rate and shallow
b. Measurements in addition to rate
i. Depth : observed by movement of the chest or by the use of pulmonary equipment
ii. Rhthm : normally regular
iii. Character : normally silent and effortless
4. Blood pressure
a. Measured in mm Hg
i. Systolic pressure
ii. Dyastolic pressure
b. Factors controlling blood pressure
i. Cardiac output
ii. Bood volume
iii. Elasticity of arterial walls
iv. Size of arterioles and capillaries
c. Factors influencing blood pressure
i. Age
1. newborn has systolic pressure of 65 to 90 mm Hg and a diastolic pressure of 30 to 60 mm Hg
2. adult has systolic pressure of 110 to 140 and a diastolic pressure of 60 to 80
ii. Exercise increases blood pressure
iii. Stress : moderate stress increases blood pressure, but severe stress may lower the pressure
d. Methods of measurement
i. Direct
ii. Indirect
e. Abnormalities
i. Hypertension : above 140 systolic
ii. Hypotension : below 100 systolic