A nurse is using evaluative criteria and standards to measure the outcomes of a plan of care for a client with diabetes mellitus. Which of the following are examples of evaluative criteria and standards? (Select all that apply.)

Choice A reason:

The nurse should compare the client's blood pressure readings with the expected outcomes to evaluate the effectiveness of the plan of care. This is the first step in the evaluation process, according to the nursing process framework. Comparing the actual outcomes with the expected outcomes allows the nurse to determine if the plan of care was successful or if it needs to be modified.

Choice B reason:

The nurse should identify the factors that influenced the client's blood pressure control, such as medication adherence, lifestyle changes, stress levels, and comorbidities. This is an important step in the evaluation process, but it is not the first one. The nurse should first compare the outcomes before analyzing the factors that affected them.

Choice C reason:

The nurse should document the results of the evaluation in the client's chart to communicate the findings to other members of the health care team and to provide evidence of quality care. This is also an essential step in the evaluation process, but it is not the first one. The nurse should document after comparing and analyzing the outcomes.

Choice D reason:

The nurse should modify the plan of care based on the evaluation findings to improve the client's blood pressure control and prevent complications. This is the final step in the evaluation process, after comparing, analyzing, and documenting the outcomes. The nurse should revise the plan of care as needed to meet the client's changing needs and goals.

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.