When evaluating a client's plan of care, the nurse determines that a desired outcome was not achieved. Which action will the nurse implement first?

When evaluating a client's plan of care, the nurse determines that a desired outcome was not achieved. Which action will the nurse implement first?

• A. Establish a new nursing diagnosis.
• B. Note which actions were not implemented.
• C. Add additional nursing orders to the plan.
• D. Collaborate with the healthcare provider to make changes.

Answer: (B)

When evaluating a client’s plan of care, the first step is to determine what was actually carried out. If the desired outcome isn’t met, the immediate question is: were all planned interventions implemented as intended? Noting which actions were not implemented identifies gaps or omissions that could explain why the outcome wasn’t achieved. This information is essential before making any changes to the plan, adding orders, or consulting with the provider. If all actions were performed and the outcome still isn’t achieved, then you would analyze other factors and consider modifying the plan with the provider.

When evaluating a client’s plan of care, the first step is to determine what was actually carried out. If the desired outcome isn’t met, the immediate question is: were all planned interventions implemented as intended? Noting which actions were not implemented identifies gaps or omissions that could explain why the outcome wasn’t achieved. This information is essential before making any changes to the plan, adding orders, or consulting with the provider. If all actions were performed and the outcome still isn’t achieved, then you would analyze other factors and consider modifying the plan with the provider.