A nurse is preparing a diagnostic statement for a client who has chronic obstructive pulmonary disease (COPD) and reports shortness of breath and fatigue with minimal exertion. Which of the following formats should the nurse use to write the statement?

Choice A reason:

The nurse reports any changes in the client's vital signs, weight, or fluid status to the primary provider. This action demonstrates the skill of collaborating and communicating with other health care providers because it involves sharing relevant and timely information about the client's condition and needs with the primary provider, who can then make appropriate decisions or adjustments to the plan of care. Reporting changes in vital signs, weight, or fluid status is especially important for a client who has chronic heart failure, as these indicators can reflect worsening or improving cardiac function. Reporting changes also follows the ISBARR format of communication, which is a standardized method of exchanging patient information between health care team members.

Choice B reason:

The nurse administers prescribed medications, such as diuretics, beta blockers, and ACE inhibitors. This action does not demonstrate the skill of collaborating and communicating with other health care providers because it is a routine nursing task that does not involve direct interaction or exchange of information with other health care team members. Administering medications is part of the nurse's scope of practice and responsibility, and does not require collaboration or communication with other providers, unless there are questions, concerns, or issues regarding the medication orders.

Choice C reason:

The nurse educates the client about lifestyle modifications, such as sodium restriction, exercise, and smoking cessation. This action does not demonstrate the skill of collaborating and communicating with other health care providers because it is a nursing intervention that focuses on the client's education and self-management, not on the interaction or exchange of information with other health care team members. Educating the client about lifestyle modifications is part of the nurse's role in promoting health and preventing complications, and does not require collaboration or communication with other providers, unless there are discrepancies or inconsistencies in the education materials or messages.

Choice D reason:.

The nurse assesses the client's cardiac function, such as heart sounds, rhythm, and peripheral pulses. This action does not demonstrate the skill of collaborating and communicating with other health care providers because it is a nursing assessment that does not involve direct interaction or exchange of information with other health care team members. Assessing the client's cardiac function is part of the nurse's role in monitoring and evaluating the client's response to treatment, and does not require collaboration or communication with other providers, unless there are abnormal findings that need to be reported or documented.

Choice A reason:

A well-written outcome should be specific, meaning it should clearly state what is expected to be achieved, by whom, and under what conditions. A specific outcome helps to focus the actions and resources needed to accomplish it. For example, an outcome that states "Students will improve their writing skills”. is too vague and does not specify how the improvement will be measured or what level of improvement is expected. A more specific outcome would be "Students will demonstrate an increase in their average writing score by 10% on the final exam.".

Choice B reason:

A well-written outcome should also be measurable, meaning it should have a quantifiable indicator that can be used to assess the progress and achievement of the outcome. A measurable outcome helps to determine whether the outcome has been met or not, and to what extent. For example, an outcome that states "Students will enjoy the course”. is not measurable because it does not have a clear criterion for evaluating the students' satisfaction. A more measurable outcome would be "At least 80% of the students will rate the course as satisfactory or higher on the course evaluation survey.".

Choice C reason:

Another characteristic of a well-written outcome is that it should be realistic, meaning it should be achievable within the given time frame, resources, and constraints. A realistic outcome helps to set reasonable expectations and avoid frustration or disappointment. For example, an outcome that states "Students will master all the topics covered in the course”. is not realistic because it is too ambitious and unrealistic for a single course. A more realistic outcome would be "Students will demonstrate proficiency in at least 75% of the topics covered in the course.".

Choice D reason:

Finally, a well-written outcome should be time-bound, meaning it should have a specific deadline or target date for completion. A time-bound outcome helps to create a sense of urgency and motivation, and to monitor the progress and results of the outcome. For example, an outcome that states "Students will apply their knowledge to real-world problems”. is not time-bound because it does not indicate when or how often the students will do so. A more time-bound outcome would be "By the end of the semester, students will complete at least two projects that require them to apply their knowledge to real-world problems.".

Choice E reason:

A well-written outcome should not be broad, meaning it should not be too general or vague that it does not provide any guidance or direction for action. A broad outcome makes it difficult to plan, implement, and evaluate the outcome. For example,.