A nurse is evaluating the effectiveness of a plan of care for a client with hypertension. Which of the following actions should the nurse take first?

Choice A reason:

The client has achieved partial resolution of the problem. This statement is not accurate because it implies that the client's problem is no longer present or significant, which is not the case for COPD. COPD is a chronic and progressive disease that causes irreversible lung damage and airflow limitation. The client may have improved symptoms or reduced exacerbations, but the problem is still present and requires ongoing management.

Choice B reason:

The client has met all the goals and no longer needs nursing care. This statement is not correct because it suggests that the client has fully recovered from COPD, which is not possible. COPD is a lifelong condition that cannot be cured, only managed. The client will always need nursing care to monitor their condition, prevent complications, educate them on self-care, and provide emotional support.

Choice C reason:

The client has not made any progress and requires a different approach. This statement is not valid because it indicates that the client has failed to respond to the current plan of care, which may not be true. COPD is a variable disease that can have periods of stability and exacerbation. The client may have made some progress in achieving their goals, such as improving their gas exchange, airway clearance, breathing pattern, activity tolerance, or quality of life. A different approach may not be necessary unless the client's condition worsens or does not improve despite optimal treatment.

Choice D reason:

The client has shown improvement but needs more time to reach the goals. This statement is the best one to make because it reflects the realistic and positive outcome of the evaluation for a client with COPD. COPD is a complex and chronic disease that requires long-term and individualized care. The client may have shown improvement in some aspects of their condition, such as reducing their dyspnea, cough, or sputum production, increasing their oxygen saturation, or enhancing their exercise capacity. However, they may still need more time to reach their full potential or maintain their progress. The nurse should acknowledge the client's improvement but also encourage them to continue with their plan of care and follow-up. I hope this answer helps you with your question. If you need more information on COPD or nursing care plans, you can check out these.

Choice A:

The client will demonstrate correct use of a glucometer by discharge. This is not an example of evaluative criteria or standards, but rather an expected outcome. Evaluative criteria or standards are the attributes or measures that are used to determine if the expected outcomes have been met. Expected outcomes are the specific, measurable, and realistic statements of goal attainment that are derived from the nursing diagnoses.

Choice B:

The client will maintain blood glucose levels between 70 and 130 mg/dL. This is an example of evaluative criteria or standards, because it specifies a measurable and objective indicator of the patient's progress toward the goal of managing diabetes mellitus. Blood glucose levels are a common evaluative measure for patients with diabetes mellitus.

Choice C:

The nurse will administer insulin as prescribed and monitor for adverse effects. This is not an example of evaluative criteria or standards, but rather a nursing intervention. Nursing interventions are the actions or treatments that nurses perform to help patients achieve the expected outcomes. Evaluative criteria or standards are not about what the nurse does, but about what the patient achieves.

Choice D:

The client will report increased energy and improved appetite after 2 weeks of treatment. This is an example of evaluative criteria or standards, because it specifies a measurable and subjective indicator of the patient's progress toward the goal of improving quality of life with diabetes mellitus. Patient-reported outcomes are a valid and reliable source of evaluative data.

Choice E:

The nurse will provide education on dietary modifications and physical activity. This is not an example of evaluative criteria or standards, but rather a nursing intervention. Nursing interventions are the actions or treatments that nurses perform to help patients achieve the expected outcomes. Evaluative criteria or standards are not about what the nurse does, but about what the patient achieves.