Module 03: Fundamental Nursing Process (Part 01) Flashcards
Who introduced the concept “Thinking like a nurse?”
Dr.Christine Tanner
What does the concept “Thinking like a nurse” include?
(1) Critical Thinking
(2) Clinical Reasoning
Critical Thinking + Clinical Reasoning = Clinical Judgement
This is the process of international higher level of thinking to define a client’s problem, examine evidence-based practice in caring for the patient and making choices in the delivery of care.
Critical Thinking (Something that accrues as you gain more experience)
This is the cognitive process that uses thinking strategies to gather and analyze client information, evaluate its relevance and decide on nursing actions to improve outcomes
Clinical Reasoning (things that you perceive needs to be done and the reason why it should be done)
This is the observed outcome of
critical thinking and decision making
Clinical Judgement
Under the clinical judgement model, what makes a clinical judgement?
(1) Based on the patient’s needs
(2) Clinical Decisions
What is the result of clinical judgement?
Conclusion about a patient’s needs or health problems that leads to taking or avoiding action, using or modifying standard approaches or creating new ones based on patient’s responses.
(Nurses are proactive, hence approaches are always modifiable)
What is the correlation of clinical judgement and the nursing process?
Your clinical judgement is the product of your nursing process.
Under the clinical judgement model, what constitutes critical thinking?
(1) Critical Thinking Competence Knowledge Base
(a) Basic and nursing science
(b) Nursing and health care theory
(c) Patient data
(2) Experience
(a) Personal
(b) Clinical practice
(c) Skill competence
(3) Environment
(a) Time pressure
(b) Setting
(c) Task Complexity
(d) Interruptions
(4) Critical Thinking Attitudes Standards
(a) Intellectual
(b) Professional
What constitutes the nursing process?
(1) Assessment
(2) Analysis or Diagnosis
(3) Evaluation
(4) Planning
(5) Implementation
Critical Thinking is a process that requires the nurse to what?
(1) Think Ahead
(2) Apply Thinking While Acting (thinking on the possible problems and procedures)
(3) Think Back (assessing and modifying interventions)
What constitutes your 4-circle Critical Thinking (CT) model?
(1) Critical Thinking Characteristics (attitudes or behaviors)
(2) Theoretical and experiential knowledge intellectual skills or competencies
(3) Interpersonal and Self-Management Skills (time management and own reflective thinking)
(4) Technical Skills and competencies (practice)
Under the process of critical thinking, this is how the nurse begins to be proactive.
Think Ahead
Under the process of critical thinking, this is how the nurse enacts reflective thinking.
Think Back
This is the application of a set of questions to a particular situation or idea to determine essential information and ideas and discard unimportant ones.
Critical Analysis (Assessment - what are the subjective and objective cues, what are the important ones, eliminate those that entail less attention)
This is the technique one can use to look beneath the surface, recognize and examine assumptions, search for inconsistencies, examine multiple points of view and differentiate what one knows from what one believes
Socratic Questioning (continuous questioning)
These are the generalizations formed from a set of facts or observations (from specific to general)
Inductive Reasoning
This is the reasoning from general premise to specific conclusions
Deductive Reasoning
What are the levels of critical thinking?
(3) Commitment (consider wide array of clinical alternatives, apply all elements of clinical judgment model automatically
(2) Complex (independent decision-making, creativity, with initiative to look beyond expert opinion, consideration of different solutions, options and approaches
(1) Basic (answers are either right or wrong, single solution to a problem
Under the levels of critical thinking, this consider wide array of clinical alternatives, apply all elements of clinical judgment model automatically
Commitment (using different clinical judgements to make a SPECIFC solution to the SPECIFC need of the client)
Under the levels of critical thinking, this is independent decision-making, creativity, with initiative to look beyond expert opinion, consideration of different solutions, options and approaches
Complex (using personal understanding to creating solutions)
Under the levels of critical thinking, the answers are either right or wrong, single solution to a problem
Basic (student nurse, no creativity in answering, basing on textbooks)
What constitutes clinical decision making under the nursing process?
(1) Recognize cues
(2) Analyze cues
(3) Prioritize hypotheses
(4) Generate solutions
(5) Take action
(6) Evaluate Outcomes
What constitutes knowledge base under clinical decision making?
(1) Basic Science: anatomy, physiology, microbiology, underlying disease process
(2) Nursing theory supporting health and wellness
(3) Communication and patient education principles
(4) Normal assessment findings or patient assessment findings
What constitutes environment under clinical decision making?
(1) Time pressure
(2) Setting
(3) Task complexity
(4) Interruptions
What constitutes experience under clinical decision making?
(1) Personal
(2) Clinical experience
(3) Skill competence
What constitutes attitudes under clinical decision making?
(1) Perseverance
(2) Fairness
(3) Confidence
(4) Conciseness
What constitutes standards under clinical decision making?
(1) Intellectual standards in measurement
(2) Evidence-based criteria for evaluation
(3) Professional
(a) Standards of care
(b) Ethical standards
What is the importance of concept mapping in nursing?
This allows the nurse to map words on a page and focus on concepts and relationships
This is a technique that uses a
graphic depiction of nonlinear and linear relationships to represent critical thinking
Concept Mapping
This is a systematic, rational method of planning and providing individualized nursing care.
Nursing Process
What is the purpose of nursing process?
Purposes to identify a client’s health status and actual or potential healthcare problems or needs, establish plans, and to deliver specific nursing interventions
What are the elements under a nursing process?
(1) Assessment - information collection or gathering data
(2) Diagnosis - information interpretation or stating problems and strengths
(3) Outcome or Planning - setting nursing goals desired outcomes and planning interventions
(4) Implementation - performing nursing interventions
(5) Evaluation - patient’s status and effectiveness of nursing interventions
Under the nursing process, this is the act of collecting, organizing, validating, and documenting client data.
Assessment
What is the purpose of assessment?
To establish a database about the client’s response to health concerns or illness and the ability to manage healthcare needs
What are the activities that the nurse should execute under assessment?
(1) Establish a database:
(a) Obtain a nursing health history.
(b) Conduct a physical assessment.
(c) Review client records.
(d) Review nursing literature.
(e) Consult support persons.
(f) Consult health professionals.
(2) Update data as needed.
(3) Organize data.
(4) Validate data.
(5) Communicate and document data.
(6) Interpret and analyze data:
Under the nursing process, this is the act of analyzing and synthesizing data
Diagnosis
What is the purpose of diagnosis?
(1) To identify client strengths and health problems that can be prevented or resolved by collaborative and independent nursing interventions
(2) To develop a list of nursing and collaborative problems
What are the activities that the nurse should do under diagnosis?
(1) Interpret and analyze data:
(a) Compare data against standards.
(b) Cluster or group data (generate tentative hypotheses).
(c) Identify gaps and inconsistencies.
(2) Determine client’s strengths, risks, and problems.
(3) Formulate nursing diagnoses and collaborative problem statements.
(4) Document nursing diagnoses on the care plan.
Under the nursing process, this is the act of determining how to prevent, reduce, or resolve the identified priority client problems; how to support client strengths; and how to implement nursing interventions in an organized, individualized, and goal-directed manner
Planning
Under the nursing process, this is the act of carrying out (or delegating) and documenting the planned nursing interventions
Implementing
What is the purpose of planning?
To develop an individualized care plan that specifies client goals or desired outcomes and related nursing interventions
What is the purpose of implementing?
To assist the client to meet desired goals or outcomes; promote wellness; prevent ill- ness and disease; restore health; and facilitate coping with altered functioning
Under planning, what are the activities that the nurse should do?
(1) Set priorities and goals or desired outcomes in collaboration with client. Write goals or desired outcomes.
(2) Select nursing strategies and interventions. Consult other health professionals.
(3) Write nursing interventions and nursing care plan.
(4) Communicate care plan to relevant health- care providers.
Under implementing, what are the activities that the nurse should do?
(1) Reassess the client to update the database. Determine the nurse’s need for assistance. Perform planned nursing interventions. Communicate what nursing actions were implemented:
(a) Document care and client responses to care.
(b) Give verbal reports as necessary.
Under the nursing process, this is the act of measuring the degree to which goals or outcomes have been achieved and identifying factors that positively or negatively influence goal achievement
Evaluating
What is the process of evaluation?
To determine whether to continue, modify, or terminate the plan of care
Which nursing process is used in the statement, “Nurse medina observed reveals that Margaret’s vital signs are: Temperature 39.4 C (103F); pulse 92 beats/min; respirations 28/min; and blood pressure, 122/80 mmHg. Nurse Medina observes that Margaret’s skin is dry, her cheeks are flushed, and she is experiencing chills. Auscultation reveals inspiratory crackles with diminished breath sounds in the right lung.”
Assessment
Which element of the nursing process was used in the statement “After analysis, Nurse Medina formulates a nursing diagnosis: altered respiratory status related to accumulated mucus obstructing airways.”
Diagnosing
