Chapters 2 & 4 Flashcards
What is the skill of learning to analyze and interpret data to solve a problem?
Critical Thinking
You have two patients to care for in the ICU on your shift. What skill will you use to determine how to prioritize their care?
Critical Thinking
What is the mental process used when analyzing all data of a clinical situation to make a decision?
Clinical reasoning
A nurse has worked on her unit for nearly a year. She has started to see repetitive outcomes related to care given to patients with similiar situations. This is an example of?
Clinical Judgement
It is time to pass BP meds to a pt for high blood pressure. What do you need to do first?
Check the current BP
A patient complains of nausea so you bring them an anti-nausea med you know causes dry mouth. When you pass the med you also bring a cup of water instead of waiting for the pt to ask later. This is an example of?
Clinical Judgement
Clinical reasoning over an expanse of time that happens repetitively and improves with practice is?
Clinical judgement
Clinical Judgement or not?
The nurse gathers equipment for the insertion of a Foley catheter, obtains a verbal consent from the client, and follows the agency’s procedure to complete the task.
Not - because the nurse is completing a task that follows a specific step-by-step procedure and thus does not require clinical judgment.
Clinical Judgement or not?
The nurse discovers abnormal findings when performing a physical assessment. She reviews the electronic health record, comparing the findings, and calls the healthcare provider with the contrasting information. The nurse practitioner then gives new medication orders.
Clinical Judgement
Clinical Judgement or not?
The student explores the client’s health record, reads the history and physical examination, and records the information on the nursing care plan.
Not - The process of data collection and recording does not require critical-thinking skills
Clinical Judgement or not?
The nurse recognizes that the client has crackles in the lower lung fields from an accumulation of fluid. He further explores the patient’s weight, intake and output, and medication list before documenting the findings.
Clinical Judgement - Further inquiry allows the nurse to determine the severity of the findings and whether additional intervention is necessary
Clinical Judgement or not?
The unlicensed assistive personnel reports to the nurse that the blood pressure for a client is very low. The nurse reports the information to the next shift.
Not - A critical-thinking nurse would question the results, reevaluate the findings, and confirm that the information is correct. If the findings are correct, the critical-thinking nurse would then determine next steps.
Clinical Judgement or not?
A nurse decides to place the intravenous catheter into the client’s left arm because he is right handed.
Clinical Judgement
Clinical Judgement or not?
The nurse delivers the first dose of a new blood pressure medicine that the client has not taken previously. She assesses the blood pressure before delivery of the medication and 1 hour afterward. Prior to the second dosage, the patient’s blood pressure is very low and the nurse decides to hold the medication.
Clinical Judgement
Clinical Judgement or not?
A client tells the nurse that the hospital food is “terrible.” The nurse asks what foods the client would prefer based on his cultural customs. She then contacts the dietary department to determine whether adjustments can be made. After the next meal, the nurse asks the client whether the food has improved.
Clinical Judgement - The nurse has identified a problem, assessed the client’s individual needs, made adjustments to care, and evaluated whether the changes were effective.
Is critical thinking occurring in this scenario? Juan arrives for the start of his shift at a skilled nursing facility. He arrives at the unit at 0700 for the start of day shift. After hearing the shift change report, he prepares to give his client a bed bath per unit policy.
No, he is only following policy
Critical thinking or not?
Lily is going over her patients medications before discharge when he states there are too many and it’s too confusing. Lily devises a schedule and info sheets to give to the patient. She reviews it all with the patient and his wife before discharge.
Critical thinking! From her assessment she plans and implements a solution to the problem.
Critical Thinking or not?
You are walking down the hall on a hospital unit and hear a patient call out, “nurse!” When you enter the room, you notice that the bedside is crowded with equipment. The patient is getting many IV fluids and a unit of blood hanging from the IV pole. Bc you have limited experience as a student you tell the patient you will get them some help.
No - there was no critical thinking and no information was collected about what the patient needed.
Quantitative or Qualitative?
Gather data from enough subjects, report as #’s, analyzable data, closed-ended questions
Quantitative
Quantitative or Qualitative?
Not generalized data, but shared experiences of those involved in a study
Qualitative
What is an IRB?
Institution of Review Board
a combination of reasoned thinking, an openness to alternatives, an ability to reflect, and a desire to seek truth
Critical thinking
_____ knowledge considers the “why” of what we do
Theoretical
_____ knowledge pertains to the “what” and “how” of nursing interventions
Practical
______ knowledge accounts for the nurse’s self-awareness about a situation
Self
_____ knowledge addresses the “right and wrong” of nursing behaviors.
Ethical
What are the two major categories of research?
Quantitative and Qualitative
Every hospital, university, and other healthcare facility where federal funds are involved has a(n) _______
IRB (International Review Board)
What does PICO stand for?
Patient or population, Intervention, Comparison intervention, and Outcome
