Running head: APPLICATION OF THE NURSING PROCESS1

Application of the Nursing Process

Joycelyn Ramoso
NorQuest College
0248914
4 February 2016

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Scenario
Your roommate is a student in the Practical Nurse program. She confides in you the
following:
It is the middle of November and she has one month left to complete her course work,
study for finals and finish buying her Christmas presents for family and friends. She is having
difficulty maintaining her part-time job at Sportcheck since she is working three 12-hr shifts in
the clinical setting each week, plus she is taking an English course one evening a week. She has
been up several nights trying to complete a scholarly paper and is having difficulty writing it.
She has contemplated seeking help from the college tutor for this. She has been eating take-out
pizza and coffee to keep herself going but has talked to one of her instructors about how best to
eat healthy on a student budget. Two of her peers just called in sick to clinical complaining of
vomiting and diarrhea and she had spent the previous afternoon with them in a study group. On
top of all this, her boyfriend is pressuring her to spend more time with him. She is finding it
difficult to juggle all of these responsibilities and is feeling very anxious.
As she is your roommate, you are also aware of the following:
She is 19 years old, has two younger siblings and both parents are living. She has moved
from New Brunswick to Alberta with her boyfriend. Her family remains in New Brunswick.
She is allergic to shell fish
She has been diagnosed with Asthma as a child and uses Ventolin puffers occasionally
when needed. She takes no other regularly scheduled medications.

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Application of the Nursing Process

Actual Nursing Diagnosis

Insomnia related to lack of sleep as evidenced by clients feeling anxious and staying up all
night secondary to multiple stressors such as school assignments, work, and social
relationships.
Potential Nursing Diagnosis (risk of)
Risk for obesity related to lack of sleep.

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Nursing Care Plan

PRIORITY NURSING DIAGNOSIS
WITH RATIONALE

CLIENT-CENTRED OUTCOME
Write one outcome statement that meets the
SMART criteria
SMART criteria:
Specific
Measurable
Attainable
Realistic
Time-based
All SMART criteria in one sentence
EVALUATION
Write one evaluation statement describing
how you plan to evaluate if the goal/outcome
was met or not met.

My priority nursing diagnosis is insomnia.

Sleep according to Potter and Perry, is a
basic necessity of life and is as important as
air, food, and water (p. 993, 2014).
Therefore, it is important for my clients,
internal and external factors, well-being.

Within a month, my client will learn time

management skills and coping techniques to
reduce her anxiety and increase sleep.

After a month, the outcome will be met once

client verbalization of feeling rested,
increased knowledge of time management
skills, and reduced anxiety.

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IDENTIFY THREE
(3) NURSING
INTERVENTIONS
Select nursing
interventions to meet
the goals set, and to
change or maintain
health status

1) Assist client
in identifying
ways to
manage time,
by listing and
prioritizing
the activities
that needs to
be done.

2) Encourage
client to have
a bedtime
routine and to
limit
consumption
of caffeinated
drinks.

RATIONALE FOR
INTERVENTIONS
Provide rationale for
selection of nursing
interventions and use
appropriate literature
such as text, articles,
and internet sites to
support internet sites
to support choices

According to Walton
and Reeves (1996),
Managing your time
involves planning
ahead and realising
that unforeseen
events may disrupt
this plan. Walton
and Reeves (1996),
suggest the
mnemonic LEAPS to
follow for time
management:
List the
activities to
be done
Estimate time
needed to
carry out each
activity
Allow time
for
unscheduled
activities or
errors
Prioritize
activities
Study the
activities of
the day
By educating the
client the importance
of time management,
I am hopeful that she
will eliminate

As stated in Potter
and Perry (2014), A
persons daily routine
influences sleep
patterns and
excessive intake of
alcohol and caffeine
can cause transient
insomnia.
By instructing my
client, to maintain a
bedtime schedule and
to avoid and/or
reduce intake of
caffeinated drinks
both daytime and
nighttime. My
clients sleep hygiene
will improve.

3) Teach client
relaxation
techniques
such as music
therapy,
simple
exercises, and
muscle
relaxation to
reduce
anxiety.
Comfort measures
promote sleep and
improve patients
sense of well-being
(Potter and Perry,
2014). Education on
different techniques
to promote sleep
and/or to reduce
stress is important for
ones well-being.
Techniques such as
back massages, soft
music, and relaxation
exercises can reduce
stress by increase
comfort. A warm
bath or shower
before bedtime can
promote this as well.
By doing so, I am
positive that once my
clients utilizes the
technique she will
reduce the feeling of
anxious greatly.

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stressful concerns
about school
assignments, work,
and social
relationships. She
will be able to utilize
a schedule that will
work best for her in
managing the
activities she needs to
do and stick to that
schedule.

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Summary
When it comes to decision-making a nurse uses the Nursing Process; it is the plan of
action to a specific care our client is to receive from us. According to Potter and Perry (2014),
the purpose of the nursing process is to assist nurses in identifying and treating patients healthrelated concerns and to help patients meet agreed-upon outcomes for better health. It is a fivestep process of getting a data base for the clients needs. It consists of an assessment, a clinical
nursing diagnoses, planning, implementation, and evaluation. Therefore, it is unique to the
discipline of nursing and provides a common language and process for nurses to think through
patients clinical problems. (Kataoka-Yahiro &Saylor, 1994).
Assessment
The most critical time to gather information about our client is through the assessment
phase. Here we gather any information, it can be subjective or objective, about our client. The
information is verified through family members, health records, and from the client itself. We
then examine the information we collected about our clients health status so that we can develop
a nursing diagnoses. Our critical thinking skills comes in to good use along with our clinical
experience during this time. The purpose of assessment is to establish a database about the
clients perceived needs, health problems, and responses to these problems. (Potter and Perry,
2014).
Nursing Diagnoses
After gathering all the data regarding the clients health problems, we can formulate a
nursing diagnoses. This is usually an independent decision made by the nurse but can also be a
collaborative work when there is a problem that requires a specific treatment. A nursing
diagnoses according to Potter and Perry is a diagnostic conclusions that determine the nursing

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care that a client receives. It is also a clinical judgement about individual, family, or
community responses to actual and potential health problems or life processes that is within the
domain of nursing. (NANDA International, 2009). As a nurse, we focus on our clients health
problem, both actual and potential, to which we are accountable for. Our critical thinking skills
allow us to map out clinical criteria. When we formulate a nursing diagnoses, we need to have an
actual and potential nursing diagnoses.
Planning
Prioritizing the clients health problems comes during the third stage of the nursing
process. According to Potter and Perry, planning is category of nursing behavior in which a
nurse sets client-centered goals, outlines expected outcomes, plans nursing interventions, and
selects interventions that will resolve the clients problems and achieve the goals and outcomes.
Implementation
This is the direct care our clients will receive in order to achieve the expected outcomes
of our goals in improving our clients health. Thus, a nursing intervention is any treatment,
based on clinical judgement and knowledge, to enhance client outcomes. (Bulechek et al.,
2008). An intervention can also be indirect such as making the clients environment safe and
clean.
Evaluation
The last process is to evaluate the condition of the client and to see if our intervention has
helped to promote or maintain the health of our client. Our evaluation is a success when we meet
the desired outcomes for our goals because it shows the effectiveness of the work we did earlier
in assessment, diagnoses, planning, and intervention.

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SMART Criteria
By using SMART, in setting goals and outcome criteria, we are giving structure to our
ideas. The goals and outcomes becomes attainable because there is a clear vision of how to attain
that goal in a timely manner. In the end of that time period, we can then evaluate whether the
SMART approach was a success in attaining that effective outcome for the clients well-being or
not.
Nursing Metaparadigm Concepts
This is the conceptual framework that includes the concepts of person, environment,
health care, and nursing care. (Fawcett, 1992, p. 56). By using the metaparadigm concept for
nursing, one is able to focus on a specific topic to collect and understand clinical situations. The
person, environment, and health is all interrelated. It shows that to give the proper care for the
client is to also understand the clients environment/situation and how this can affect the clients
health.
In conclusion, the ability to reason and be logical is required to make a good nursing process. We
need to keep the metaparadigm in mind when assessing our clients because factors such as
environment and health determines the care we need to use. By following the nursing process,
we are able to formulate this care by drawing a blueprint of our clients needs base on his/her
current status. We set our goals and outcomes by using the SMART criteria to achieve it. In the
end, we continually develop and modify our nursing process to deliver the right care for the
specific needs of our patients.

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References
Potter, P., & Perry, A. (2014). Canadian Fundamentals of Nursing (5th Canadian ed.). Elsevier
Canada.
Retrieved from http://www.nottingham.ac.uk/nursing/practice/resources/management/time/

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