clinical judgement process

Question 1

what is the nursing process

Answer 1

The Nursing Process is key to helping nurses make appropriate clinical judgments for clients.
- Requires critical thinking to make clinical decisions using
- Experience
- Evidence-based practice
Holistic Process
- Physical
- Spiritual
- Mental well-being

Question 2

what is spiritual well being

Answer 2

religious practice, providing time for meditation, praying with the client

Question 3

what is mental well being

Answer 3

teaching relaxation techniques, taking walks outdoors, maintaining relationships

Question 4

what is physical well being

Answer 4

nutritious diet, assist in being physically active, educate about recommended health screenings

Question 5

the steps of the nursing process (exam)

Answer 5

Assessment: Assess the objective and subjective data that pertains to the client.
Analysis/ diagnosis: Determine the client’s problems.
Planning: Create a plan to address client problems.
Implementation: Take action to provide care as outlined in planning.
Evaluation: Evaluate the interventions’ effectiveness and document the client’s response.

Question 6

what steps does interpreting data fall under

Answer 6

analysis (know for test)

Question 7

what step of the nursing process does formulating goals fall under

Answer 7

planning (know for the test)

Question 8

clinical judgement action model (exam)

Answer 8

• recognize cues (assessment)
  - Filter information from different sources (e.g., signs, symptoms, health history, environment).
• analyze cues (analysis)
  - Link recognized cues to a client’s clinical presentation and establish probable client needs, concerns, or problems.
• prioritize hypotheses (analysis)
  - Establish priorities of care based on the client’s health problems (e.g., environmental factors, risk assessment, urgency, signs/symptoms, diagnostic tests, lab values).
• generate solutions (planning)
  - Identify expected outcomes and related nursing interventions to meet clients’ needs.
• take actions (implementation)
  - Implement appropriate interventions based on nursing knowledge, priorities of care, and planned outcomes to promote, maintain, or restore a client’s health.
• evaluate outcomes (evaluation)
  - Evaluate a client’s response to nursing interventions and reach a nursing judgment regarding the extent to which outcomes have been met.

Question 9

what is critical thinking (exam)

Answer 9

The skill of learning to analyze and interpret data to solve a problem to achieve a desired outcome.
Includes questioning, synthesis, interpretation, inference, inductive and deductive reasoning, intuition, application, and creativity.

Question 10

what does critical thinking involve (exam)

Answer 10

Type of higher-order thinking
Foundation for clinical decision making
Use of logic and reasoning to identify areas of need
Takes into consideration alternative approaches and solutions
Critical thinking guides the nursing process

Question 11

clinical reasoning

Answer 11

The mental process used when analyzing all the data of a clinical situation to decide based on that analysis.
Requires the nurse to assess and compile data, select and discard various pieces of information based on relevance, and make decisions regarding client care based on nursing knowledge.
Applies critical thinking abilities to the practice setting.

Question 12

clinical judgement

Answer 12

Clinical reasoning across an expanse of time that happens repetitively and improves with practice.

Question 13

what is clinical judgement (exam)

Answer 13

The visible or observed outcome of critical thinking and decision-making that considers nursing knowledge, client situations, and prioritization of client problems and concerns while utilizing evidence-based practice.

Question 14

how is clinical judgement used (exam)

Answer 14

• Constant and repetitive action used in practice
• Staffing shortages and caring for patients with multiple medical problems can challenge clinical judgment
• Medications that cause adverse effects, but those same effects could be caused by another condition

Question 15

what is delegation (exam)

Answer 15

Nurses must remember that clinical reasoning and judgment cannot be delegated.
- assigning a nursing task or procedure to another person who has the training appropriate for that task or procedure

Question 16

some things that the RN can delegate to the assistive personel

Answer 16

Ambulating to the bathroom
Measure Urine
I & O
VS – when is this not appropriate to delegate
Collecting stool or urine sample
weighing a person