Lecture 1 Flashcards
Critical Thinking
Looking beyond the obvious, exploring patient responses and seeing what needed to benefit patient
Characteristics of Critical Thinkers: 6
- Raise questions and anticipate questions
- Willingness to search for answers
- Are inquisitive
- Eager to acquire new knowledge
- Consider multiple perspectives
- Explore ideas in new ways
- Are open-minded
Critical Thinking =
Character + Knowledge + Skills
Critical Thinking requires the habit to…
Ask questions to be well informed, being honest in facing biases and to reconsider and think differently about issues
Critical thinking is a…
Multidimensional Thinking process
Critical Thinking Skills
- Identify assumptions
- Identify an organized and comprehensive approach to assessment
- Validate
- Normal vs Abnormal
- Make interferences
- Cluster related clues
- Relevant vs Irrelevant
- Recognize inconsistencies
- Identify patterns
- Missing information
- Promote Health
- Diagnosis actual/potential problems
- Set Priorities
- Identify patient- centred expected outcomes
- Determine specific interventions
- Evaluate/ revise your thinking
- Determine a comprehensive plan
Set Priorities
1st Level (ABCDS)
- Airway
- Breathing
- Circulations
- Deficit (losing consciousness)
2nd Level
- Acute pain
- Abnormal Lab Values
3rd Level
-Anything that doesn’t fit
Nursing Process…
a thoughtful, informed, evidence-based, and ethical nursing practice
AD PIE
(DYNAMIC, MOVES BACK AND FOURTH, NOT LINEAR)
Assessment
Collection of data relating to clients health status
a. Collect and verify Data
- Physical exams
- Family info
- Old charts
- Asking them
- Blood
b. Analyse the data
- think holistically
Types of Data
Subjective
Objective
Constant
Variable Data
Create data cluster
Subjective
Pt States (symptoms)
Objective
Observations (signs)
- Vital signs
- What you observe
Constant
Data that cannot change
- Name
- Gender
Variable Data
Data that can Change
- Weight
- Pain
Sources of Data
Primary source
-pt
Secondary Source
-Family, support people
AOVD
Analyse
Organize (data cluster)
Validate (double check)
Document
Nursing DIAGNOSIS
Clinical judgement about individual, family, or community responses to actual or potential health problems/ life processes.
Provides basis for selection of interventions to achieve outcomes for which the nurse is accountable
(NOT A MEDICAL DIAGNOSIS, relates to it but not the actual diagnosis)
Nursing Diagnosis Types
- Actual (existing problem)
- Risk (Potential problem pt vulnerable to)
- Health Promotion (focus on being healthy)
- (based on group of S&S that occur together, provide clinical picture)
PES (how to write nursing diagnosis)
Problem - Diagnosis Label
Etiology - Cause/ contributor to problem ( R/T)
(as evidenced by)
Symptoms
EXAMPLE:
P: Acute pain -> E: Abdominal discomfort -> S: Patient stating “this pain in my stomach is unbearable”
Planning (with outcomes
Use priority setting - attend to the most important needs first
Combine goal with stated outcome and timeframe:
- goals = broad statements
- Outcomes = Specific, observable data
Can be as many outcomes as goals
Example: Patient will have decreased pain as evidenced by
Verbalization of pain rated less than 9/10 in 1 hour.
SMART (goal setting)
Singular Measurable Attainable Realistic Timed (short or long-term)
nursing Interventions
Used to achieve Client goals
Direct or in direct
- Independent: Initiated and carried out by nurses alone
- Dependent: Dependent on physician’s orders (giving meds)
- Collaborative: Carried out by working with other health care pro’s
Must indicate rationale: significance?
Criteria when selecting interventions:
- Safe and appropriate
- Achievable considering available resources
- Congruent with values/beliefs/culture
- Congruent with other therapies
- Based on evidence/research
- Within our scope of practice
Implementation (acting on Nursing interventions)
- Reassess the pt (review/revise)
- Determine need for assistance
(Prevent complications, safety and lack of knowledge)
- Organize Resources
Evaluation (6)
- Identify outcome criteria
- Collect data and compare with desired outcomes
- Interpret and summarize findings
- Document findings
- Continue/ revise/ terminate care plan
- Document evaluation.
Example: 19/09/14 Goal met: Pt states “I feel better now” after having a bowel movement.
