Nursing 109

N109: Foundations in Nursing Practice Study Guide The nursing diagnoses that are developed may include diagnoses such as: • Risk for ineffective community coping related to violence, lack of healthcare, high level of homeless population, etc. • Risk for ineffective family coping related to violence, lack of healthcare, nutritional issues, etc. • Delayed growth and development related to nutritional issues • Risk-prone health behaviors related to drug/alcohol abuse • Knowledge deficit about infant/child care related to inadequate training resources in the community • Impaired social interaction related to homelessness Planning When planning interventions, the community nurse must understand the beliefs and health goals of the individual within the context of the family, and the family within the context of the community. Expected outcomes will be related to health promotion, maintenance, and restoration and might include: • The incidence of infectious disease will decrease • The child will be immunized on the appropriate schedule • The child will develop within normal guidelines • Environmental hazards will be identified and ameliorated The community nurse must know when and how to act in each of these roles using established standards of care and evidence-based practice while integrating the factors that influence community care. The nurse should plan for anticipated healthcare needs for the members of the community. Community nursing allows the nurse to delegatenon-nursing functions (house cleaning or shopping) to other members of the healthcare team. Implementation In a community setting, the nurse must implement interventions that will promote, maintain, and improve health for the individual, family, and community. Implementation may include community outreach programs, educational activities and programs, development of healthcare resources in the community, and other programs that allow the community to access the resources and services to maintain or regain health. The nurse in the community may act as an advocate, counselor, case manager, consultant, organizer, team builder, collaborator, teacher, treatment provider, referral agent, surveillance agent, andhealthcare screener. Evaluation The community nurse must continually reassess the patient, family, and community to determine the effectiveness of interventions. The responses must be documented and shared with other health team members as appropriate. If the intervention was effective, it should be continued and expanded as appropriate. Ineffective interventions should be altered or replaced in collaboration with the individual, family, or community. If care has been delegated to others, the nurse must be responsible for evaluating the care and effectiveness of interventions delivered by others.

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