nursing process

nursing process,

the process that serves as an organizational framework for the practice of nursing. It encompasses all of the steps taken by the nurse in caring for a patient: assessment, nursing diagnosis, planning, implementation, and evaluation. The rationale for each step is founded in nursing theory. The process requires a systematic approach to the person's situation, beginning with assessment and including an evaluation and reconciliation of the perceptions by the person, the person's family, and the nurse. A plan for the nursing actions to be taken may then be made, and, with the participation of the person and the person's family, the plan may be set. The plan developed with the person and the person's family is then implemented. The outcome is evaluated with the person and the person's family. The steps follow each other at the start of the process but may need to be taken concurrently in some situations. The process does not reach completion with evaluation. The steps are begun again, allowing recurrent evaluation of the assessment, plan, goals, and actions. See also five-step nursing process, nursing.

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process [pros´es]

1. a prominence or projection, as from a bone.

2. a series of operations or events leading to achievement of a specific result.

3. to subject to such a series to produce desired changes.

acromial process acromion.

altered family p's former name for the nursing diagnosis interrupted family processes.

alveolar process the part of the bone in either the maxilla or mandible that surrounds and supports the teeth.

basilar process a quadrilateral plate of the occipital bone projecting superiorly and anteriorly from the foramen magnum.

calcaneal process of cuboid bones a process projecting posteriorly from the inferomedial angle of the cuboid bone that supports the anterior calcaneus.

caudate process the right of the two processes on the caudate lobe of the liver.

ciliary p's meridionally arranged ridges or folds projecting from the crown of the ciliary body.

clinoid process any of three processes of the sphenoid bone (anterior, medial, and posterior).

coracoid process a curved process arising from the upper neck of the scapula and overhanging the shoulder joint; called also coracoid.

coronoid process

1. the anterior part of the upper end of the ramus of the mandible.

2. a projection at the proximal end of the ulna.

disturbed thought p's a nursing diagnosis approved by the North American Nursing Diagnosis Association, defined as the experiencing by an individual of disruption in cognitive operations and activities; it is related to various mental and personality disorders. Contributing factors include physiologic changes, psychologic conflicts, memory loss, impaired judgment, and sleep deprivation. Defining characteristics include inaccurate interpretation of the environment; cognitive dissonance; distractibility; decreased ability to grasp ideas; impaired ability to make decisions, solve problems, or reason; disorientation to time, place, person, circumstances, or events; and inappropriate or nonreality-based thinking.

dysfunctional family p's: alcoholism a nursing diagnosis approved by the North American Nursing Diagnosis Association, defined as psychosocial, spiritual, and physiological functions of the family unit that are chronically disorganized, leading to conflict, denial of problems, resistance to change, ineffective problem solving, and a series of self-perpetuating crises. See also alcoholism.

ensiform process xiphoid process.

ethmoid process a bony projection above and behind the maxillary process of the inferior nasal concha.

family p's the psychosocial, physiological, and spiritual functions and relationships within the family unit; nursing diagnoses include dysfunctional family processes: alcoholism and interrupted family processes.

frontonasal process frontonasal prominence.

interrupted family p's a nursing diagnosis accepted by the North American Nursing Diagnosis Association, defined as a change in family relationships and/or functioning.

malar process zygomatic process of the maxilla.

mammillary process a tubercle on each superior articular process of a lumbar vertebra.

mandibular process mandibular prominence.

mastoid process a conical projection at the base of the mastoid portion of the temporal bone.

maxillary process

1. maxillary prominence.

2. a bony process descending from the ethmoid process of the inferior nasal concha.

nursing process see nursing process.

odontoid process a toothlike projection of the axis that articulates with the atlas.

pterygoid process either of the two processes of the sphenoid bone, descending from the points of junction of the great wings and the body of the bone, and each consisting of a lateral and a medial plate.

spinous process of vertebra a part of a vertebra projecting backward from the arch, giving attachment to muscles of the back.

styloid process a long, pointed projection, particularly a long spine projecting downward from the inferior surface of the temporal bone.

temporal process the posterior blunt process of the zygomatic bone that articulates with the zygomatic process of the temporal bone to form the zygomatic arch.

uncinate process any hooklike process, as of vertebrae, the lacrimal bone, or the pancreas.

xiphoid process the pointed process of cartilage, supported by a core of bone, connected with the lower end of the sternum; called also xiphoid.

The xiphoid process. Redrawn from Applegate, 1995.

zygomatic process a projection in three parts, from the frontal bone, temporal bone, and maxilla, by which they articulate with the zygomatic bone (see Appendix 3-3).

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nurs·ing pro·cess

a five-part systematic decision-making method focusing on identifying and treating responses of individuals or groups to actual or potential alterations in health. Includes assessment, nursing diagnosis, planning, implementation, and evaluation. The first phase of the nursing process is assessment, which consists of data collection by such means as interviewing, physical examination, and observation. It requires collection of both objective and subjective data. The second phase is nursing diagnosis, a clinical judgment about individual, family, or community nursing responses to actual or potential health problems/life processes. Provides the basis for selection of nursing intervention to achieve outcomes for which the nurse is accountable (NANDA, 1990). The third phase is planning, which requires establishment of outcome criteria for the client's care. The fourth phase is implementation (intervention). This phase involves demonstrating those activities that will be provided to and with the client to allow achievement of the expected outcomes of care. Evaluation is the fifth and final phase of the nursing process. It requires comparison of client's current state with the stated expected outcomes and results in revision of the plan of care to enhance progress toward the stated outcomes.

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nurs·ing pro·cess

nŭrs'ing pros'es

Structured, organized, and systematic approach to developing and delivering patient care including assessment, diagnosis, planning, implementation, and evaluation; series of nursing actions for meeting patient's needs and promoting better health. This problem-solving approach has four steps: assess, plan, implement, and evaluate. Nursing theories and conceptual frameworks guide each step of the nursing process.