subjective and objective data; information acquired through the five senses
Cues
interpretation or perception of a cue; the conclusion you draw; influenced by observational skills, experience
inferences
Organizing the information you obtain so related or similar data is together, the basis of making nursing judgments; groups of data that aupport nursing conclusions
clustering data
Looking at your cluster to gain more information/ insight into the situation....Decide what's relevant; make tentative decisions about what data
Identifying patterns/ testing first impressions
2 important steps to remember when Reporting and recording data....
1. Report ANYTHING you suspect is abnormal right away.