320 Q11t. '!<ti1mnt1i N'. PAR Q. ·n1is wr1s d. :,·cfopcd by British Columbia Ministry of H..-alth tll lklt>m1in<' a l"'Crson's n. ndincss for participntion in a progrmn for ~,,,rcb<'. (Cnrbin '..!l H>O: 46) The nsc of vnrious physic. 11 fitness tests and sllmts: r. 1rcii1,,·nsrnh1r fitn.-s.-.. fle.,ibility, muscular endurance, strength, n. 5ility. b:ilan<·c co<1n Hn:ition. po"·er. reaction time and speed also helped in appn1i,-ing Raqn<'rs st-. 11m:. The w~llness di:l!:nosis that was Ul't. >d for Rnquel was E_{fectiue Health . \!ai J11r1m111 't' a Jl(f ;\fu11ag.-111ent. ESTABLISHING THE OUTCOMES OF CARE 'Kllo"-ing the ex JX.--cted outcomes of care is critical in independent nursing practice. This 1,i U make the al:tlinmcnt of goals clear and precise. 'Wben botb the nurse and client are aware of what needs 10 change. the expectations become c. lear. The inputs from other health profesfilonals can be identified. Consider this client: Client Bis a 16-year-oldadolescent \\ith obesity and hyperglycemia. She is using insulin and oral hypoglycemics nod verbalizes great difficulty in maintaining the dfobetic diet and exercise. The mother e.,-pressed her great concern for tbe daughter's oon-compliance. Aft. er the assessment, the nurse and the client agreed on these e.,-pected outcomes of Deza: o lose 1 kg of body weight for the first week o maintain CBG within the normal range The:e outcomes im·oked acfo,ities that both nurse and the client listed. Monitori ng of dafly blood gluco..~ level9,,,;n be done and communicated to the nurse by phone ca Jls. Weighing \1il] be done at the end of the week. There was a need to work closely with her physician to adjust the insulin dose, as needed: 't\1hen the outcomes are dear, the nurse will have an estimate of the number of visits required and the type of monitoring that is needed. Having clear outcome s of care also makes reimbursement and pa}ment for services easier. THE NURSING CONSULTATION AND ITS COMPONENTS The challeoge of independent practice is learning the boundaries of nursing practice. 1bis is based on the legal expectati,J n among nurses to develop a plan of care to anain expected outcome$. Titese expectations are enshrined in the professio nal standards of care. Independent practice enhances awareness of interventions that are independent. ·. rnese. :. re actions smd acthitie. s thnt a nvrsc L. ; licensed l'o prescribe, perform and de J1:g;ile ba:. w 1111 knowl:::dgu and :-..kilb. Dependen t interventions are those prescribed hy !he phrsic-ian and carried out by the nurse. Cofiaborative interventions, also called intl!rdependcmt, arc carri"d oui "itl1 other members of the health team. Iney may include cormlirwtiun of health ca re: scndccs. 