Nursing Process – Implement

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Jon Haws
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Included In This Lesson

Study Tools For Nursing Process – Implement

Nursing Process (Cheatsheet)
Steps in the Nursing Process 1 (Mnemonic)
Steps in the Nursing Process 2 (Mnemonic)
Steps In The Nursing Process 3 (Mnemonic)
Survival Guide for Nurses (Book)
The Nursing Process (Picmonic)
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Outline

Overview

  1. Implementation
    1. Phase Information
    2. Interventions

Nursing Points

 

General

  1. Phase Information
    1. Fourth Phase
    2. Begins after planning
  2. Implementation
    1. Execute Care
      1. Actual delivery of the care or intervention
    2. Deliver care
      1. The first two phases of the nursing process prepares for implementation, in addition to solid knowledge base
      2. Be confident in how you deliver your car.  You have the knowledge to back up what you’re doing, so go in as if you’ve done that intervention hundreds of times.
      3. Monitor for safety before, during and after interventions
        1. Requires reassessment, changing plan of care if necessary
      4. Continuous, cyclical process
        1. Always assessing, analyzing and changing care plans if necessary
    3. Sometimes interventions do not work
      1. Not a sign of a bad nurse
      2. Maybe a better intervention is available
      3. Follow up with resources available to you
        1. Charge nurse
        2. Veteran nurses
        3. Physicians

Nursing Concepts

  1. Professionalism
  2. Clinical Judgment

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Transcript

The implementation phase is the fourth step in the nursing process. I’m not gonna beat a dead horse here too much guys, this is where you do it, this is where you do the interventions that you have planned.

Let’s talk about it really quick though, like I said it’s the fourth phase of the nursing process, this begins right after we plan our care. The RN is gonna evaluate the interventions and if they worked in the next phase. What we do here guys is we basically execute our care, we do our planned interventions. One thing I want you to keep in mind here guys is that you need to be confident.

All right what can happen here is during this first phase of the nursing process the assess, diagnose, this planning, all these different phases we’ve been gathering all this data, we’ve collected all this information, and now it’s time for us to go do what we need to do. You need to do these things confidently, don’t walk in there scared, don’t walk in there timid, walk in there confident. You’ve made your decision go in there and perform your care as if you’ve done it 100 times. Your patient doesn’t want to see you walk in there all scared, they want to see you walk in there confident, comfortable in what you’re doing so have confidence of this phase. You’ve collected the data, you’ve made your decision, now go in there and do it.

Sometimes these things that we plan to do, these things that we implement they just don’t work. That doesn’t mean that you’re a bad nurse, you’re not a bad nurse if your interventions don’t work. Okay sometimes world class athletes trip on a hurdle in the Olympics, that doesn’t mean that they’re bad runners or they’re slow, that means it just didn’t work that time. Okay? An intervention might not be available, the patient might have an unexpected reaction to something we didn’t know about, so if it doesn’t work that doesn’t reflect poorly on you, the patient might be dehydrated, you might not be able to get a vein, nobody might be able to get a vein, so just be easy on yourself during this phase especially if interventions don’t work.

You can follow up with people if they aren’t working, follow up with your charge nurse first, you can follow up with other veteran nurses who maybe have more experience on the floor or who have done this before, you can follow up with other providers or physicians. If you say you know this is what we planned to do and it just didn’t work and here’s all the data I’ve gathered and this is why I did this and it just didn’t seem to work follow up with these people and they’re gonna be willing to help you, we all want the patient to be good, we all want the patient to get healthy, so follow up with these people they’re gonna help you out. Now the nursing concept you need to keep in mind here are professionalism and clinical judgment. Again using your judgment, using all this data, all this information that you’ve gathered to then go implement the care that you have determined is best for your patient.
The key points out here guys, biggest thing is just do it. Right? Just do it, don’t tell Nike, I don’t want them to sue me. But once you’ve decided what you’re gonna do go do it, that’s as easy as it is. Deliver the care with confidence, the first thing here guys is you need to know your stuff. Learn all that you can, practice all that you can, and then when these interventions arise for you on the floor go in there and do your stuff. Then be humble, sometimes the interventions don’t work, that doesn’t mean you’re a bad nurse sometimes things just don’t work, sometimes there might be a different option or something might work better for a patient.

One thing to keep in mind here guys as you’re taking NCLEX questions what should the nurse do next doesn’t always mean implementation, make sure that you’re following the nursing process don’t just jump to action means implement. Your first action might be an assessment or something like that so don’t get caught in that NCLEX trap, we do talk about that in the test taking course.

All right guys I hope that helps. Dive into the other lessons here and just realize and what I want you to keep in mind here is have confidence when you implement, talk to your patient clearly, talk to them cleanly, and then go in and just do it and be humble if things don’t work. You guys can do this, I know you can, go out and be your best selves today. Happy nursing.

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Concepts Covered:

  • Basics of NCLEX
  • Test Taking Strategies
  • Prioritization
  • Studying
  • Fundamentals of Emergency Nursing
  • Developmental Considerations
  • Developmental Theories
  • Communication
  • Concepts of Mental Health
  • Health & Stress
  • Neurological Emergencies
  • Emotions and Motivation
  • Pregnancy Risks
  • Cardiac Disorders
  • Renal Disorders
  • Childhood Growth and Development
  • Prenatal and Neonatal Growth and Development
  • Adulthood Growth and Development
  • Respiratory Disorders
  • Noninfectious Respiratory Disorder
  • Eating Disorders
  • Shock
  • Urinary System
  • Integumentary Disorders
  • Labor Complications
  • Disorders of Pancreas
  • Acute & Chronic Renal Disorders
  • Liver & Gallbladder Disorders
  • Hematologic Disorders
  • Medication Administration
  • Urinary Disorders
  • Intraoperative Nursing
  • Lower GI Disorders
  • Gastrointestinal Disorders
  • Upper GI Disorders
  • Vascular Disorders
  • Sexually Transmitted Infections
  • Neurologic and Cognitive Disorders
  • Microbiology
  • Hematologic Disorders
  • Disorders of the Adrenal Gland
  • Disorders of the Posterior Pituitary Gland
  • Disorders of the Thyroid & Parathyroid Glands
  • Central Nervous System Disorders – Brain
  • Central Nervous System Disorders – Spinal Cord
  • Peripheral Nervous System Disorders
  • Immunological Disorders

Study Plan Lessons

Overview of the Nursing Process
Nursing Process – Assess
Nursing Process – Diagnose
Nursing Process – Plan
Nursing Process – Implement
Nursing Process – Evaluate
Critical Thinking
Thinking Like a Nurse
The Nurse Routine
Prioritization
Triage
Cultural Awareness and Influences on Development
Developmental Considerations for the Hospitalized Individual
Family Structure and Impact on Development
Kohlberg’s Theory of Moral Development
Erikson’s Theory of Psychosocial Development
Piaget’s Theory of Cognitive Development
Body Image Changes Throughout Development
Nurse-Patient Relationship
Therapeutic Communication
Defense Mechanisms
Self Concept
Patients with Communication Difficulties
Maslow’s Hierarchy of Needs in Nursing
Nutrition Assessments
Nutrition (Diet) in Disease
Specialty Diets (Nutrition)
Developmental Stages and Milestones
Cultural Awareness and Influences on Development
Environmental and Genetic Influences on Growth & Development
Growth & Development – Late Adulthood
Developmental Considerations for End of Life Care
Growth & Development -Transitioning to Adult Care
ABGs Nursing Normal Lab Values
ABG (Arterial Blood Gas) Interpretation-The Basics
ROME – ABG (Arterial Blood Gas) Interpretation
ABGs Tic-Tac-Toe interpretation Method
Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Alkalosis
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic Alkalosis
ABG (Arterial Blood Gas) Oxygenation
Lactic Acid
Base Excess & Deficit
Fluid & Electrolytes Course Introduction
Fluid Compartments
Fluid Pressures
Fluid Shifts (Ascites) (Pleural Effusion)
Isotonic Solutions (IV solutions)
Hypotonic Solutions (IV solutions)
Hypertonic Solutions (IV solutions)
Potassium-K (Hyperkalemia, Hypokalemia)
Sodium-Na (Hypernatremia, Hyponatremia)
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Chloride-Cl (Hyperchloremia, Hypochloremia)
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Phosphorus-Phos
Calcium Acetate (PhosLo) Nursing Considerations
Epoetin (Epogen) Nursing Considerations
Enalapril (Vasotec) Nursing Considerations
Calcium Carbonate (Tums) Nursing Considerations
Epoetin Alfa
Acute Renal (Kidney) Module Intro
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Nursing Care and Pathophysiology of Nephrotic Syndrome
Nursing Care and Pathophysiology of Glomerulonephritis
Nursing Care and Pathophysiology of Urinary Tract Infection (UTI)
Nursing Care and Pathophysiology of Renal Calculi (Kidney Stones)
Chronic Renal (Kidney) Module Intro
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of BPH (Benign Prostatic Hyperplasia)
Dialysis & Other Renal Points
Peritoneal Dialysis (PD)
Hemodialysis (Renal Dialysis)
Continuous Renal Replacement Therapy (CRRT, dialysis)
Anesthetic Agents
Anesthetic Agents
Epidural
Patient Controlled Analgesia (PCA)
Bismuth Subsalicylate (Pepto-Bismol) Nursing Considerations
Bisacodyl (Dulcolax) Nursing Considerations
Clindamycin (Cleocin) Nursing Considerations
Proton Pump Inhibitors
Atenolol (Tenormin) Nursing Considerations
Captopril (Capoten) Nursing Considerations
Amlodipine (Norvasc) Nursing Considerations
Azithromycin (Zithromax) Nursing Considerations
Cephalexin (Keflex) Nursing Considerations
Ampicillin (Omnipen) Nursing Considerations
Ciprofloxacin (Cipro) Nursing Considerations
Acyclovir (Zovirax) Nursing Considerations
Anti-Infective – Antivirals
Anti-Infective – Antifungals
Cefdinir (Omnicef) Nursing Considerations
Cefaclor (Ceclor) Nursing Considerations
Parasympatholytics (Anticholinergics) Nursing Considerations
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Hematology Module Intro
Thrombocytopenia
Ferrous Sulfate (Iron) Nursing Considerations
Nursing Care and Pathophysiology for Anemia
Nursing Care and Pathophysiology for Sickle Cell Anemia
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Iron Deficiency Anemia
Hemophilia
Hemoglobin (Hbg) Lab Values
Hematocrit (Hct) Lab Values
Platelets (PLT) Lab Values
Diabetes Mellitus (DM) Module Intro
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Diabetes Management
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
Hypoglycemia
Addisons Disease
Nursing Care and Pathophysiology for Cushings Syndrome
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)
Insulin Drips
Antidiabetic Agents
Thrombolytics
Iodine Nursing Considerations
Propylthiouracil (PTU) Nursing Considerations
Glucagon (GlucaGen) Nursing Considerations
Insulin – Mixtures (70/30)
Insulin – Intermediate Acting (NPH) Nursing Considerations
Insulin – Short Acting (Regular) Nursing Considerations
Insulin – Long Acting (Lantus) Nursing Considerations
Insulin – Rapid Acting (Novolog, Humalog) Nursing Considerations
Nursing Care and Pathophysiology for Cholecystitis
Nursing Care and Pathophysiology for Cirrhosis (Liver Disease, Hepatic encephalopathy, Portal Hypertension, Esophageal Varices)
Nursing Care and Pathophysiology for Hepatitis (Liver Disease)
Nursing Care and Pathophysiology for Pancreatitis
Nursing Care and Pathophysiology for Appendicitis
Hiatal Hernia
Nursing Care and Pathophysiology for Diverticulosis – Diverticulitis
GERD (Gastroesophageal Reflux Disease)
Gastritis
Bariatric Surgeries
Nursing Care and Pathophysiology for Peptic Ulcer Disease (PUD)
Nursing Care and Pathophysiology for Inflammatory Bowel Disease (IBD)
Nursing Care and Pathophysiology for Ulcerative Colitis(UC)
Nursing Care and Pathophysiology for Hemorrhoids
Nursing Care and Pathophysiology for Crohn’s Disease
Appendicitis
Pantoprazole (Protonix) Nursing Considerations
Omeprazole (Prilosec) Nursing Considerations
Pancrelipase (Pancreaze) Nursing Considerations
Ondansetron (Zofran) Nursing Considerations
Vasopressin
Proton Pump Inhibitors
Parasympatholytics (Anticholinergics) Nursing Considerations
Nursing Care and Pathophysiology for Multiple Sclerosis (MS)
Nursing Care and Pathophysiology for Myasthenia Gravis
Nursing Care and Pathophysiology for Parkinsons
Essential NCLEX Meds by Class