NUR207b

NURSING
THERAPEUTICS I
CA comments + SA consultation
 GENERAL
COMMENTS ON SKILL
TEST
Draw up the appropriate volume of drug
1. Pick up the syringe and remove the needle cap
2. Pull back on the plunger to draw a volume of air into the syringe equivalent to the volume of
medication to be aspirated from the vial
3. With the vial on a flat surface, firmly insert the tip of the needle through the center of the rubber
seal
4. Inject air into the vial’s air space, holding onto the plunger with firm pressure
5. Invert the vial while keeping a firm hold on the syringe and plunger
6. Hold the vial with the nondominant hand. Grasp the end of the syringe barrel and plunger with the
dominant hand to counteract pressure in the vial
7. Keep the tip of the needle in the fluid while withdrawing liquid
Expel air

1. Tap the barrel to dislodge any

air bubbles
2. Draw back slightly on the
plunger and then push it
upward to eject air. Do not
eject fluid.
◦ Provide privacy
◦ Disinfect the skin
◦ Pinch up the fat
◦ Proper angle of injection ( 45 degree
/ 90 degree: depends on skin fold)
◦ Stabilize the syringe
◦ Inject slowly
◦ Lightly press on the injection site
after injection
◦ Never re-cap the needle after
injection
◦ Sign on MAR (correct date
and time) and ask assessor
to counter-sign with you
◦ Aftercare – discard the
syringe in sharp box
◦ Report
GROUP ASSIGNMENT
 Collect, organize and
record data

Nurses should

Assessment •Obtain health history of

client (health interview)
•Conduct physical
assessment
•Review records
•Document data
 Analyze data

Identify health problems & risks

of the client

Nursing Formulate nursing diagnoses

diagnosis
Nurses should

• Interpret and analyze client’s data

• Determine client’s strengths, risks and
problems
• Document diagnostic statements
 Prioritize health problems /
diagnoses

Determine how to prevent, reduce or

resolve the identified problems

Formulate goal & expected

outcomes
Planning
Nurses should

•Set priorities, formulate goals & expected

outcomes
•Select interventions
•Write interventions with rationales
•Communicate with other health professionals
 Prioritizing nursing care diagnoses

High priority Medium priority Low priority

•Life-threatening, •Problems that •Problems that can

threats to client’s could result in be resolved with
safety, pain, unhealthy minimal
anxiety, unstable consequences, interventions and
or changes in e.g., emotional or have little
condition physical potential to cause
impairment, but dysfunction
no threat to life
 Carry out nursing
interventions

Document nursing
interventions
Implementation
Nurses should

•Perform planned interventions

•Document nursing activities
•Monitor and reassess the client
 Measure the degree to which goal /
expected outcomes have been achieved

Identify factors that influence goal

achievement

Evaluation Nurses should

• Collect data related to expected outcomes
• Judge whether goal / expected outcomes have
been achieved
• Review, modify or terminate nursing care
• Document achievement of expected outcomes &
modification of the care plan
Nursing care plan – health assessment

Subjective data Objective data

• Data obtained from client’s own • Data observable and/or obtainable

perception on their conditions
and/or feelings
• E.g., Mr. Wong verbalized that …
by the HCPs from sources other
than direct answers from the client
• E.g., The nurse observed that Mr.
Wong had grimace facial
expression
• E.g., Mr. Wong’s vital signs is …
 Actual nursing
diagnosis
Nursing care •PES format (Problem +
plan – Etiology + Symptom)
diagnostic
statement Risk nursing diagnosis
•PE format (Problem +
Etiology)
Avoid errors in diagnostic statements
Incorrect Correct
Risk for infection related to diabetes mellitus Risk for infection related to increased
(medical diagnoses) microorganism activity with hyperglycemia
secondary to diabetes mellitus
Imbalanced nutrition related to feeding tube Impaired comfort related to irritation of feeding
(equipment or treatment) tube
Dying (a situation) Powerlessness related to the course of terminal
illness
 Goal

•Statement that contains a broad

direction of achievement(s) expected
Nursing care after delivery of nursing care

plan – goal & Expected outcomes

expected •Statements that describe
outcomes measurable behaviours of the clients
that denote conditions favorable
towards the goal
•Usually contain both short-term &
long-term outcomes
SMART criteria of expected outcomes
◦ Specific – response to client’s need (individualized care)
◦ Measurable – action verbs, e.g., verbalize, report, demonstrate
◦ Achievable – based on client’s ability & resources available
◦ Realistic – according to normal, natural progression of humans & events
◦ Timeframe – clearly set the time to event to accomplish
 Goal:
Mr. Chan will demonstrate
progressive healing of pressure
injury over the sacral area

Example of
goal &
expected Expected
outcomes:
Mr. Chan will be able to explain 3 rationales for
the development of pressure injury by

outcomes
30/7/2023.
Mr. Chan will be able to state 3 factors that
promote wound healing by 31/7/2023.

Mr. Chan will have his sacral wound healed by

10/8/2023.
 ◦ The client will accept the death of his wife

Are these ◦ The client will state the signs and

symptoms of high blood glucose
expected ◦ The client will know the signs and

outcomes symptoms of high blood pressure

◦ The client will administer insulin correctly
measurable? ◦ The client will understand the importance
of a low-fat diet
 Nursing care plan – nursing
interventions
Assessment & Physician-prescribed Multidisciplinary
Nurse-prescribed
monitoring (delegated) care
•E.g., vital signs, •Prescriptions that •Prescriptions for •E.g., Consult
specific signs & nurses formulate clients that physiotherapist for
symptoms for themselves or physicians walking exercise
•Data for outcome other nursing staff formulate for
evaluation to implement nursing staff to
•E.g., turn the client implement
every 2 hours •E.g., Administer
•Health education, Panadol 500mg
routine QID according to
modification, doctor’s
lifestyle changes prescription

**Support each intervention with rationale**

 Nursing care plan - evaluation
Method of evaluation (set on the
date of writing the care plan)
Follow the SMART criteria
(Actual) evaluation
Can have multiple times of evaluation for short-
term & long-term outcomes
State whether the outcomes are achieved or
not
Propose revision of
interventions/goal/expected outcomes if
needed
 Example of evaluation
The nurse will:
1. Ask Mr. Chan to explain 3 rationales for the development of pressure injury on 13/4/2023.
2. Ask Mr. Chan to state 3 factors that promote wound healing on 14/4/2023.
3. Evaluate Mr. Chan’s wound condition every day.

If you have conducted an actual evaluation, you can write:

On 14/4/2023:
1. Achieved. Mr. Chan explained 3 rationales for the development of pressure injury
2. Achieved. Mr. Chan stated 3 factors that promote wound healing
3. The wound size is …
SA – INDIVIDUAL
ASSIGNMENT
◦ Due date: 14th Aug 2023 at 17:00
◦ Word count: 1200 words +/- 10% of word count (exclude table of nursing care plan)

◦ Submission of the assignment:

1. Each student is required to send a soft copy of the assignment to the course Moodle assignment box
on or before 14/8/2023 (Mon) 1700. The file name should be written as “NUR207b_SA_student id
2. Assignment without a completed cover page (with signed declaration) will NOT be marked by the
teacher.
3. Assignment which is submitted late will result in a mark deduction of 5% of the total mark for each
calendar day of lateness.
4. Zero mark for no submission of the assignment.
Marking criteria
Introduction
• Clearly state the admission information and past history of the client
• State the flow of the assignment
Main Body
• Identify six nursing diagnoses (actual and potential nursing diagnoses) of the client
• Describe the relevant subjective and objective data specifically to support each of the identified nursing
diagnoses
• Prioritize all the nursing diagnoses of the client with reasons (explain the priority of each identified nursing
diagnoses)
• Formulate NANDA approved nursing diagnostic statement in PES format for the top prioritized nursing
diagnosis
• Provide a clear and detailed health education plan to the client and his caregiver
Marking criteria
Nursing Care plan table
• Establish 1 goal that is appropriate for the top prioritized nursing diagnosis
• Establish 3 expected outcomes (specific, measurable, achievable, realistic and with appropriate time
frame) for the top prioritized nursing diagnosis
• Select appropriate nursing interventions with rationales (9 interventions) to achieve the proposed
expected outcomes
• Evaluate the achievement of the proposed expected outcomes
Format and style
• Writing style (concise, correct grammar, use of appropriate subheadings and proper APA referencing
style (7th edition) for the citation of the references)