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Nursing > Chp 15-20 > Flashcards

Chp 15-20 Flashcards

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1
Q

The nurse is preparing to change a patient’s wound dressing. Which action will the nurse take first before embarking on this procedure?

A

Check the patient’s readiness for the procedure

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2
Q

What should be considered mostly by a nurse when using critical thinking to make clinical decisions?

A

in any given situation, consider what is most important

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3
Q

To establish a patient database, what method of data collection is appropriate?

A

performing a physical examination

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4
Q

A nurse is assigned to care for a patient receiving enteral feeding, the nurse planes her care knowing that what risk is the highest priority for the client?

A

risk of aspiration

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5
Q

Information regarding patients habits and lifestyle patterns will be best obtained via:

A

nursing health history

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6
Q

Pain related to surgical incision as manifested by moaning, guarding the incision site, pain 10/10.
What is the etiology?
What is the problem?
What are the sign/symptoms?

A

etiology - surgical site
problem - pain
signs/symptoms - moaning/guarding

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7
Q

What does etiology mean?

A

cause

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8
Q

What is the SMART approach to writing goals and expected outcomes?

A 
Specific
Measurable
Attainable
Realistic
Timed
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9
Q

What is a possible nursing diagnosis for a patient who has a trache?

A

Difficulty breathing

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10
Q

What is a possible nursing diagnosis for a patient who has a stroke?

A

Impaired mobility

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11
Q

What is a possible nursing diagnosis for a patient who is post op?

A

Pain

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12
Q

After a nurse assessed a patient and gave prescribed ibuprofen for headache, what would be the next priority?

A

Re-evaluate (ask the patient how he feels in 30 min)

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13
Q

pulse rate of 150 and irregular is an example of:

A

assessment

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14
Q

ambulate patient TID is an example of:

A

intervention

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15
Q

What are some attitudes of critical thinking?

A
  • Confidence: speak w/honesty and conviction, be prepared, encourage a patient to ask questions.
  • Thinking independently: Read literature, talk w/other nurses and share ideas.
  • Fairness - listen to both sides of any discussion
  • Responsibility and authority: Ask for help if you are uncertain, refer to a policy procedure manual, report problems, follow standards
  • Risk taking: Question provider if knowledge warrants it, be willing to recommend alternative approaches.
  • Discipline: Be thorough, double check, take time, use known and scientific based criteria.
  • Perseverance: be cautious of an easy answer, clarify information, continue to address issues until they are solved.
  • Creativity: look for different approaches if interventions are not working.
  • Curiosity: Always ask why, explore.
  • Integrity:do not compromise nursing standards or honesty in delivering nursing care.
  • Humility: Recognize when you need more info to make a decision, ask RNs regularly assigned to the area for assistance.
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16
Q

DEFINE CRITICAL THINKING

A

the ability to think in a systematic and logical manner with openness to question and reflect on the reasoning process.

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17
Q

What are the 3 levels of critical thinking?

A
  1. basic: asks questions, lacks case knowledge, lacks experience.
  2. complex: new nurse, some independence but still asks questions
  3. commitment: competently practicing independently, implementing doctor’s orders but also taking the lead and requesting orders from the doctor due to what you see the patient needs
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18
Q

Diagnostic reasoning

A

the analytical process for determining a patients health problems

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19
Q

Clinical decision making

A

a problem-solving activity that goes beyond diagnostic reasoning when you focus on defining a problem or diagnosis and selecting appropriate nursing interventions - occurs through knowing the patient

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20
Q

What type of data is part of the nursing assessment?

A

Subjective data - patient’s complaints

Objective data - factual information

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21
Q

What are the components of the critical thinking model for clinical decision making?

A 
specific knowledge base
experience
Nursing process competency
Attitudes for critical thinking
Professional standards
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22
Q

What are some good methods for developing critical thinking skills?

A

reflective journaling
meeting with colleagues
concept mapping

23
Q

What are the 6 critical thinking and clinical judgement skills?

A 
interpretation
analysis
inference
evaluation
explanation
self-regulation
24
Q

What are the applications of the CT skill of interpretation:

A

Be orderly in collection data about patients, Apply reasoning while looking for patterns to emerge. gather additional data or clarify any data about which you are uncertain.

25
Q

What are the applications of the CT skill of analyis:

A

be open-minded as you look at information about a patient. do not make careless assumptions

26
Q

What are the applications of the CT skill of inference:

A

look at the meaning and significance of findings. are there relationships among findings? does the data about the patient help you see that a problem exists?

27
Q

What are the applications of the CT skill of evaluation:

A

look at all situations objectively. use criteria to determine results of nursing actions. reflect on your own behavior.

28
Q

What are the applications of the CT skill of explanation:

A

support your finding and conclusions. use knowledge and experience to choose strategies to use in the care of patients.

29
Q

What are the applications of the CT skill of self-regulation:

A

reflect on your experiences. be responsible for connecting your actions with outcomes.

30
Q

What are the 7 concepts for a critical thinker?

A
  • Truth-seeking: seek the true meaning. be courageous, honest and objective about asking questions
  • Open-mindedness: be tolerant of different views
  • Analyticity: analyze potentially problematic situations, anticipate possible results or consequences
  • Systematicity: be organized, focused, work hard in any inquiry
  • Self-confident: trust in your own reasoning process
  • Inquisitiveness: be eager to acquire knowledge and learn explanations
  • Maturity: multiple solutions are acceptable. Reflect on your own judgments.
31
Q

What is basic critical thinking?

A

a learner trusts that experts have the right answers for every problem

32
Q

What is complex critical thinking?

A

you learn to deviate from the “expert way” in order to incorporate your own knowledge and experience about the situation in order to improve the care and outcome

33
Q

What is a nurse’s specific knowledge base?

A

information and theory from the basic sciences, humanities, behavioral sciences, and nursing.

34
Q

Nursing Process =

A

scientific method + critical thinking

35
Q

What is the assessment step of the nursing process and what does it involve?

A

a systematic and continuous collection of data that involves conduction the initial inquiry.

36
Q

What is the Nursing Diagnosis step of the nursing process?

A

the statement of the clients actual or potential problem (what is the problem?)

37
Q

What are the 5 kinds of nursing diagnosis?

A
  1. Actual diagnosis
  2. Risk Potential diagnosis
  3. Possible diagnosis
  4. Wellness diagnoses
  5. Syndrome diagnosis
38
Q

What is an actual nursing diagnosis? How many parts does it have?

A

the persons data base contains evidence of signs and symptoms or defining characteristics of the diagnosis.
(ex. Impaired physical mobility related to incisional pain as evidenced by restricted turning and positioning)
3 part statement

39
Q

What is a risk potential nursing diagnosis? How many parts does it have?

A

the persons data base contains evidence of related risk factors of the diagnosis but no evidence of the defining characteristics
(ex. risk for injury related to disorientation)
2 part statement

40
Q

What is a wellness nursing diagnosis? How many parts does it have?

A

based on recognizing when healthy clients indicate a desire to achieve a higher level of function in a specific area
(ex. potential for enhanced parenting)
1 part statement

41
Q

What is a syndrome diagnoses? How many parts does it have?

A

a diagnosis associated with a cluster of other diagnosis (often seen in bedridden nursing care residents) - for these simply name the syndrome
1 part statement

42
Q

What are the parts of a 3 part nursing diagnosis?

A

Problem (impaired physical mobility)
“related to”
Etiology/related factor (incisional pain)
“as manifested by”
Symptoms/evidence (restricted turning and positioning)

43
Q

What are the parts of a 2 part nursing diagnosis?

A

Problem (risk for injury)
“related to”
Etiology/related factor (disorientation)

44
Q

Why would the nursing diagnosis: “risk for injury related to lack of the side rails on bed” be an incorrect diagnosis?

A

Because the focus should always be on the patient, not the environment. Instead of the issue being the lack of side rails, the issue should be focused on the patient, such as “disorientation”

45
Q

What is the planning stage of the nursing process?

A

the development of goals for care and possible activities to meet them. (how do I address the problem?)

46
Q

What are the components of a written expected outcome?

A 
Subject
Verb - use measurable verbs
Condition
Performance
Target time
(ex. patient ambulates in the hall 3 times a day by 4/22)
47
Q

When writing a nursing plan, where should the focus be?

A

on the patient, not the nurse

(ex. “Patient will be able to” rather than “nurse will provide…”

48
Q

What are measurable verbs?

A

verbs you can witness taking place such as “patient will demonstrate” rather than “patient will know”

49
Q

What is the intervention/implementation part of the nursing process?

A

the giving of the actual nursing care (what are we going to do?)

50
Q

What are some important factors to keep in mind when writing the intervention/implementation part of the nursing process?

A

It should be based on your scope of practice.
You need to know the rationale for it.
It should include a health teaching.

51
Q

How would you write a nursing intervention?

A

written as intervention/rational

ex. elevate the head of the bed to 90 degrees as sitting up will help to relieve breathing

52
Q

What is the evaluation step of the nursing process?

A

The measurement of the effectiveness of nursing care (did my intervention work?)
Either goal met, partially met, or not met.

53
Q

How do you write a nursing care plan?

A

by using the data obtained thought the nursing process.

Nursing (26 decks)

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