exam 2 Flashcards
What the clinical judgement model is not…
-The nursing process, instead it aims to help the nurse apply the nursing process to patient care
-Diagnose or use NANDA diagnosis
-A theory but a way of processing information
Clinical judgement model?
-Recognize cues
-Analyze cues
-Prioritize hypotheses
-Generate solution/ expected outcomes
-Take action/ interventions
-Evaluate outcomes
why does clinical judgement work?
-By following this model you become a self-directed thinker
-You don’t need a set nursing diagnosis to tell you how to analyze the data, you can do this yourself by applying all the content you have learned to situation you are in
what is step 1 of clinical judgement?
recognize cues: gathering data phase, validate information, vital signs, scanning your environment
why can we not believe report at face value?
many things are passed nurse to nurse, and not validated, changes no one has seen, always check your orders, new lab values, bias, patient can change in minutes
step 2 of clinical judgement?
analyzing cues: cluster data in groups, distinguish relevant and irrelevant data, label each group
step 3 of clinical judgement?
prioritize: which is more important, always pick airway, breathing, and circulation first, judgement call after ABCs
step 4 of clinical judgement?
generate outcomes/solutions: providing quality patient care to improve patient, create solutions, timeframe, must be appropriate for nurse, scope of practice
step 5 of clinical judgement?
interventions: how do you plan to accomplish a goal, assessing patient, tasks, teaching
step 6 of clinical judgement?
evaluate: early and often, reduce healthcare errors, include assessment, state improving, unchanged, suggest modification
drug nomenclature
chemical name, generic name, official name, trade name
Drug classification?
-Drugs are classified by their effect on the body, chemical composition, clinical indication, or therapeutic action
-Two primary classifications: pharmaceutical class and therapeutic class
six rights of medication administration?
right client, medication, dose, route, time, and documentation
additional patient rights related to medication administration?
right to refuse, right assessment, right education, right response/evaluation
Additional safety strategies for medication administration:
Checking the medication against the MAR and dispensing device, checking the drug once prepared, checking the drug again prior to administration
medication reconciliation?
preformed every time the patient is transferred from one healthcare professional to another (readmissions or transfer within hospital)
pharamcodynamics:
study of how a drug effects the body
Therapeutic actions: medications
-Drugs turn on, off, promote, or block responses that are part of body’s processes
-Drug receptor interaction ?
-Drugs can also combine with other molecules to achieve their effect
-Other drugs act on cell membranes or alter the cell environment to achieve their effect
Factors affecting drug action:
developmental, weight, gender, cultural/ genetic, psychological, pathology, environment, timing of admin.
Therapeutic range:
concentration of drug in the blood serum that produces the desired effect without causing toxicity
Half-life:
amount of time it takes for 50% of blood concentration of a drug to be eliminated from the body
Peak plasma level:
when a drug is at its highest concentration, does not mean it is at its most therapeutic level
Trough serum level:
the lowest levels of concentration of a medication that correlates to the rate of elimination
Drug reactions:
side effects, allergic reactions, drug tolerance, toxic effect, idiosyncratic effect, drug interactions
Serious adverse drug event (ADE):
life threatening reaction that requires medical intervention to prevent death or permanent disability
Allergic reactions:
allergic or hypersensitivity, develops when body perceives a foreign substance as an allergen
Pharmacokinetics:
study of ADME, of drugs in the human body, what the body does to the drug
Absorption:
route of administration, lipid solubility, pH, blood flow, local conditions at site of admin., drug dosage
Metabolism:
biotransformation is the process of converting a medication to a form that is easily excreted , liver is where most metabolized, kidneys and small intestine too
