A nurse has designed an individualized nursing care plan for a patient, but the patient is not meeting goals. Further assessment reveals that the patient is not following through on many items
Which action by the nurse would be best for determining the cause of the problem?
a. Assess whether the actions were too hard for the patient.
b. Determine whether the patient agrees with the care plan.
c. Question the patient's reasons for not following through.
d. Reevaluate data to ensure the diagnoses are sound.
ANS: B
Having patient and/or family provide input to the care plan is vital in order to gain support for the plan of action. The actions may have been too difficult for the patient, but this is a very narrow item to focus on. The nurse might want to find out the rationale for the patient not following through, but instead of directly questioning the patient, which can sound accusatory, it would be best to offer some possible motives. Reevaluation should be an ongoing process, but the more likely cause of the patient's failure to follow through is that the patient did not participate in making the plan of care.
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