Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RNSG 1126 > Test 1 > Flashcards

Test 1 Flashcards

1
Q

Tanners four domains of clinical judgement

A
  1. Noticing
  2. interpreting
  3. responding
  4. reflecting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Noticing

A

background of nurse, nurse relationship with pt, context of care. step one. know expectations of pt and medical staff before step 2.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Interpreting

A
  1. includes reasoning, patterns, analytic, intuitive and narrative-use data plus theoretical knowledge plus experience to make sense. interpret all data before next step
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

responding

A
  1. actions/ outcomes/ reflection in action
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

reflecting

A
  1. challenges one to use critical thinking to examine presented information, question validity, and draw conclusions based on the resulting ideas. reflection can lead to greater self awareness.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

hypothetico-deductive

A

a reasoning pattern might be triggered, through which interpretive or diagnostic hypotheses are generated. Additional assessment is performed to help rule out hypotheses until the nurse reaches an interpretation that supports most of the data collected and suggests an appropriate response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

to arrive at conclusions in clinical judgement process need

A

reflection in action AND reflection on action
IN- how is client responding,do i need to change what I’m doing
ON-final outcome, how did my actions influence outcome, what might i have done differently and in what part of process could my thinking have been more clear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

preoperative nurse responsibilities

A 
consents signed (and witness)
Hx and P in chart and signed
Dx and radiologic test in chart
prophylactic antibiotic is give if ordered
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

time out

A 
correct pt (2 ID)
correct procedure (orders and consent same)
Correct site (marked and initialed)
Correct client position, correct diagnostic radiology tests, prophylactics given? RN and Surgen verbal verify visual of site, safety precautions, RN docs time out
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Circulating RN pre op room

A

ID pt, confirm orders, consent, verify site marked, verify client position, equipment availability and test result availability, communicate all drug related issues and antibiotic admin prior to surgery.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

core measure

A

evidence based, scientifically researched standard of care which has been shown to result in improved clinical outcomes. reduces morbidity, mortality complications and readmissions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

heart failure measures

A

complete discharge instructions
Left ventricular systolic function assessment
ace inhibitor or ARB for LVS dysfunction
smoking cessation counseling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

heart failure discharge instructions

A

activity level, diet/fluid
med reconciliation, follow up with dr
worsening sxs, weight monitoring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

acute MI measures arrival

A

ASA (75-325mg) on arrival or before
EKG timing (with in 10 mins)
Thrombolysis (within 30 mins)
Percutaneous Coronary Intervention within 90

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

acute MI measures discharge

A

beta blocker prescribed
ace inhibitor/ carb prescribed for left ventricular systolic dysfunction
ASA prescribed and adult smoking cessation counseling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

pneumonia prevention

A

antibiotic timing within 6 hrs of arrival, blood culture before antibiotic
influenza and pneumonia vaccine- given, refused or contraindicated, smoking cessation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

surgical infection prevention

A

antibiotic 1 hour prior to surgery
antibiotic DC’d w/in 24 after end of surgery
appropriate hair removal (no razors)
urinary cath removal on pod1 or2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Surgical venous thromboembolism prophylaxis

A

pharmacologic and mechanical phrophylaxis ordered and administered within 24 hrs end of surgery. if pt takes beta blockers daily, need to take day prior to, day of, pod1and2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Donning PPE

A

hand hygiene, gown, mask, eyes, gloves

20
Q

removing ppe

A

gloves, mask, gown, eyes, hand hygiene

21
Q

use avoidance when

A

time is needed to collect additional data before decision is made. prolongs resolution which can worsen prob

22
Q

competitive conflict strategy

A

use when making an unpopular decision that needs to be implemented. hostility from losing side. result is goal oriented and quick

23
Q

collaborative conflict strategy

A

when time available compromise, creative solution acceptable to everyone, integrates ideas from all

24
Q

harmonizing conflict strategy

A

used in pt service- if safe do it patient’s way instead of nurses, puts relationship before conflict, allows relationship to remain positive

25
Q

compromising conflict

A

each party giving up something they want, best for issues of mild to moderate importance and when both parties are equal and there is no simple solution

26
Q

core measure

A

evidence based, scientifically researched standard of care which has been shown to result in improved clinical outcomes- protocols- if this then do x, y, z. TJC mandates organizations to track to monitor quality care

27
Q

group process

A

2 or more persons in face-to-face interaction. aware in a group, aware of others and of positive collaboration . example surgical team function as a single unit- trust cooperation, understanding and consideration of other team members

28
Q

Background

A

What is the background or circumstances leading up to the situation? State pertinent background information related to the situation that may include
• Admitting diagnosis and date of admission
• List of current medications, allergies, IV fluids
• Most recent vital signs
• Date and time of any laboratory testing and results of previous tests for comparison. Synopsis of treatment to date
• Code status (Lewis 15)

29
Q

Assessment

A

State what you think the problem is:
Changes from prior assessments
Patient condition unstable or worsening

30
Q

Situation

A

I am Jackie, I just assessed pt so and so in room number_ I am concerned about_ov

31
Q

Recommendation

A

What should we do to correct the problem? What is your recommendation or request? State your request.
Specific treatments
Tests needed
Patient needs to be seen now (Lewis 15)

32
Q

documented benefits of collaboration

A

shorter length of stays, increased job retention and less job turnover, increased job satisfaction and increase in problem solving skills

33
Q

8 national pt safety goals

A

improve effectiveness of communication
improve safety of using meds
improve accuracy of pt ID
reduce risk of harm from falls
accurate and complete reconciliation of meds across continuum of care
prevent health care related pressure ulcers
organizations ID safety risks to pt (suicide, O2 at home)

34
Q

Universal Protocol (UP)

A

preprocedure verification, mark site, perform time out, conduct time out before invasive or surgical, confirm correct pt, procedure, and site

35
Q

shock

A 
not circulating enough blood
low bp, fast irregular heart beat
weak rapid absent pulse
restlessness, confusion, anxiety
cool clay skin, rapid shallow breaths, chest pain nausea, lightheaded
36
Q

clinical decision process steps

A

ID, analyze, logical inferences, list all poss actions, evaluate options, select options

37
Q

critical thinking concepts/behaviors

A

truth seeking, analyticity, self confidence, maturity, open mindedness, systematically, inquisitiveness

38
Q

how to manage caring for a group of patients

A

ID dx for each, find most urgent, how to cluster care, consider help resources (assistants, family), delegate

39
Q

clinical reasoning is and supports clinical decision process with (3 things)

A

rule based/ analytical to reach judgment

  1. guidance (assessment, data collection)
  2. Selection (discard irrelevant data)
  3. providing correct decision
40
Q

commitment level of critical thinking

A

anticipate when to make choices without assistance and accept accountability

41
Q

interpretist

A

uses context of care and what the nurse brings (knowledge of standards or care) and understanding individual client situation-recognize one restricted approach not for all- does not use info from chart

42
Q

contact precautions

A

incontinance of stool, drainage of body fluids, skin infection/ rash. wear gloves. wear gown if lots of interaction

43
Q

droplet precautions

A

respiratory viruses, rsv, influenza, bordetella, first 24 hours of strep a. facemark. also gown and googles if spraying. pt wear mask out of room

44
Q

airborn precautions

A

TB, measles, chicken pox. own special room, disposable n95 respirator

45
Q

holistic

A

influenced by complex factors surrounding pt circumstances

46
Q

process orientation

A

uses experimental knowledge

RNSG 1126 (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions