question

What is to feel interest or concern?

answer

caring

question

What is caring?

answer

to feel interest or concern

question

What is an interpretation or conclusion about a patient's needs, concerns, or health problems, and/or the decision to take action (or not), use or modify standard approaches, or improve new ones as deemed appropriate by pt's response?

answer

clinical judgement

question

What is clinical judgement?

answer

an interpretation or conclusion about a patient's needs, concerns, or health problems, and/or the decision to take action (or not), use or modify standard approaches, or improve new ones as deemed appropriate by pt's response

question

What is the active, organized, cognitive process used to examine one's thinking?

answer

critical thinking

question

What is critical thinking based on?

answer

-reason and reflection -knowledge -instinct derived from experience

question

What are the levels of critical thinking?

answer

-basic -complex -commitment

question

What happens at the basic level of critical thinking?

answer

-thinking is concrete -answers to complex problems are either right or wrong -accepts the opinions and values of experts not necessarily their own

question

Which level of critical thinking is a nurse whose thinking is concrete, whose answers to complex problems are either right or wrong and accepts opinions and values of experts, not their own?

answer

Basic level

question

What are characteristics of a complex level critical thinker?

answer

-begin to detach from authorities and become more independent -realize there are options -become more creative and innovative

question

Which level of critical thinking is a nurse who becomes more independent, realizing there are options and becomes more creative and innovative?

answer

Complex level

question

What are characteristics of a commitment level critical thinker?

answer

-anticipates and makes independent decisions and then assumes accountability -chooses the action or belief baseline on alternatives and stands by it

question

Which level of critical thinking is a nurse who anticipates and makes independent decisions, then assumes accountability and chooses the action or belief baseline on alternatives and stands by it?

answer

commitment level

question

What are obstacles to high level thinking?

answer

-habits and ruts -anxiety

question

A nurse who has worked on the same floor for 20 years approaches her care with the same routine every shift. Which obstacle to high level thinking is this nurse experiencing?

answer

habits and ruts

question

What is the thinking process by which the nurse reaches a clinical judgement?

answer

clinical reasoning

question

What is clinical reasoning?

answer

reasoning in transition with a fine attunement to the patient and how the patient responds to the nurse's action

question

What are the attributes of clinical judgement?

answer

-holistic view of patient situation -circular process -requires reasoning and interpretation of data

question

What is needed before you can make a clinical judgement?

answer

-nursing knowledge -experience -ethical perspective -know the patient situation

question

What are the steps in the clinical judgement process?

answer

-noticing -interpreting -responding -reflecting

question

A nurse is looking for patterns in her patients that are consistent with previous experiences so she can use that information to guide her care. Which step in the clinical judgement process is she in?

answer

noticing

question

A nurse is taking all of the information he gathered while assessing his patient and is trying to make sense of it. Which step in the clinical judgement process is he in?

answer

interpreting

question

A nurse is implementing the actions and interventions for her patient, based on the pts needs. Which step in the clinical judgement process is she in?

answer

responding

question

A nurse is thinking about whether or not her actions and interventions were appropriate or effective for her patient. Which step in the clinical judgement process is she in?

answer

reflecting

question

A patient calls for her nurse to say she has a pain of 8. The nurse administers the prescribed pain medicine to the patient. After 30 min, the nurse comes back to reassess the patient's pain level. Which part of the clinical judgement process is the nurse in when she reassess the pain level?

answer

reflection-in-action

question

A nurse just got home from her shift at work. She is thinking about her patient who coded that afternoon. She is replaying her patient care in her head to try to figure out if there was something more she could have done to prevent the code, or if she could have missed something. Which part of the clinical judgement process is this nurse in?

answer

reflection-on-action

question

What is critical for development of knowledge and improvement in reasoning?

answer

reflecting

question

What is an example of a patient interaction that does not require critical thinking?

answer

-vital signs are normal

question

How does the environment you are in have an affect on clinical judgement?

answer

-more demanding environments such as critical care or emergency department can influence what a nurse notices -can add an increased burden on making clinical judgements -can interfere with competent clinical judgement

question

What are the concepts related to clinical decision making?

answer

-Managing Care -Accountability -Collaboration -Communication -Oxygenation

question

What are examples of managing care in relation to clinical decision making?

answer

-care coordination -cost-effective care -delegation

question

How does managing care relate to clinical decision making?

answer

patient care is organized to include patient preferences, time constraints, resources, and expertise of other available disclipines

question

What are the nursing implications of managing care in relation to clinical decision making?

answer

nursing care is achieved through the coordination of many factors that influence outcomes for the patient

question

What falls under accountability in relation to clinical decision making?

answer

competence

question

How does accountability relate to clinical decision making?

answer

standards o are set benchmarks for nursing performance expectations

question

What are the nursing implications of accountability in relation to clinical decision making?

answer

nurses are responsible for the clinical decisions and judgements they make to support desired patient outcome

question

What are examples of collaboration in relation to clinical decision making?

answer

-case management -interdisciplinary teams

question

How does collaboration relate to clinical decision making?

answer

many disciplines contribute to the care of a patient

question

What are the nursing implications of collaboration in relation to clinical decision making?

answer

nurses participate in a collaborative team approach when caring for patients

question

What are examples of communication in relation to clinical decision making?

answer

-documentation -reporting

question

How does communication relate to clinical decision making?

answer

priorities of patient care need to be communicated to achieve continuity of care

question

What are the nursing implications of communication in relation to clinical decision making?

answer

-Nurses use the patient's plan of care to communicate priority needs of the patient

question

How does oxygenation relate to clinical decision making?

answer

nurses use clinical decision making following assessment of airway patency to identify: a) additional assessment data essential to determine care needs b) priority interventions necessary to promote effective respiration and gas exchange

question

What are the nursing implications of oxygenation in relation to clinical decision making?

answer

-knowledge of oxygenation, patient history, and facility protocols is necessary when making decisions about the nursing care of patients with alterations in oxygenation -examples include prioritizing assessment data to gather relative to oxygenation, and anticipating appropriate physician orders, such as supplemental oxygen, encouragement of oral fluids and IV antibiotics

question

In any clinical circumstances, patient outcome improves when the nurse uses _____________.

answer

critical thinking

question

What is the ability to learn and understand knowledge; the capacity for thinking and reasoning intelligently?

answer

Intellect

question

What are common attitudes of the critical thinker?

answer

-independence -fair-mindedness -aware of self-limits -integrity -perseverance -confidence

question

A nurse who does her own thinking, objectively and honestly is exhibiting which of the common attitudes of a the critical thinker?

answer

independence

question

A nurse who is open to new ideas and ways of doing things is exhibiting which of the common attitudes of a the critical thinker?

answer

fair-mindedness

question

A nurse who looks for the facts and is not easily swayed by opinions is exhibiting which of the common attitudes of a the critical thinker?

answer

independence

question

A nurse who has neutral judgments without bias is exhibiting which of the common attitudes of a the critical thinker?

answer

fair-mindedness

question

A nurse who considers opposing views to understand all aspects before making decisions is exhibiting which of the common attitudes of a the critical thinker?

answer

fair-mindedness

question

A nurse who knows her limits of intellect and experience is exhibiting which of the common attitudes of a the critical thinker?

answer

aware of self-limits

question

A nurse who seeks new knowledge or skills in current evidence is exhibiting which of the common attitudes of a the critical thinker?

answer

aware of self-limits

question

A nurse who expresses a willingness to self-reflect on her own beliefs and ideas is exhibiting which of the common attitudes of a the critical thinker??

answer

aware of self-limits

question

A nurse who challenges their own ideas and methods of doing nursing care is exhibiting which of the common attitudes of a the critical thinker?

answer

integrity

question

A nurse who evaluates inconsistencies within their own nursing practice is exhibiting which of the common attitudes of a the critical thinker?

answer

integrity

question

A nurse who chooses the right thing to do over the popular thing to do is exhibiting which of the common attitudes of a the critical thinker?

answer

integrity

question

A nurse who has a stick-with-it motivation to find the best solution for quality patient outcomes is exhibiting which of the common attitudes of a the critical thinker?

answer

perseverance

question

A nurse who is patient with processes is exhibiting which of the common attitudes of a the critical thinker?

answer

perseverance

question

A nurse who knows that he knows what he knows is exhibiting which of the common attitudes of a the critical thinker?

answer

confidence

question

A nurse who trusts the skills and abilities of intellect, creativity, inquiry, reasoning, reflection, and intuition is exhibiting which of the common attitudes of a the critical thinker?

answer

confidence

question

What are the skills and abilities necessary to develop critical thinking?

answer

-intellect -creativity -inquiry -reasoning -reflection -intuition

question

What is the leading, most noticeable, or most important information about a patient's health status?

answer

salient cue

question

What is a salient cue?

answer

the leading, most noticeable, or most important information about a patient's health status

question

What can cluster to form a pattern that can be translated into a priority problem for a patient?

answer

salient cue

question

What can a salient cue do?

answer

-can indicate a negative or positive change in a patient's health status or pattern -varies from the norms of the patient population -can indicate a developmental delay

question

What is finding unique solutions to unique problems when traditional interventions are not effective?

answer

creativity

question

What is creativity?

answer

finding unique solutions to unique problems when traditional interventions are not effective

question

What is a search for knowledge or facts?

answer

inquiry

question

What is inquiry?

answer

a search for knowledge or facts

question

Helping a patient newly diagnosed with diabetes learn what foods are appropriate is an example of which skill or ability of critical thinking?

answer

creativity

question

Finding alternatives for an IV tubing label when not traditional label is available is an example of which skill or ability of critical thinking?

answer

creativity

question

Using tape and tongue blades to make a toy house for a young child is an example of which skill or ability of critical thinking?

answer

creativity

question

A nurse who examines objective information to gain clarification and find solutions to problems exhibits which skill or ability of critical thinking?

answer

inquiry

question

A nurse who asks "Why do we always need to apply the dressing this way?" is exhibiting which skill or ability of critical thinking?

answer

inquiry

question

A nurse who asks "Is there something else we can try?" is exhibiting which skill or ability of critical thinking?

answer

inquiry

question

What are the two forms of logical reasoning?

answer

-deductive reasoning -inductive reasoning

question

What is deductive reasoning?

answer

-starting with the conclusion and analyzing it for valid significant cues -top down approach

question

The nurse concludes a newly admitted patient with pneumonia would have the typical symptoms of pneumonia. This is an example of which form of logical reasoning?

answer

deductive reasoning

question

A nurse is familiar with typical symptoms of pneumonia, and observes her patient has these symptoms. She concludes that her patient has a strong probability of pneumonia. This is an example of which form of logical reasoning?

answer

inductive reasoning

question

What is inductive reasoning?

answer

-put significant cues together to reach a conclusion -bottom up approach

question

What is the action of making sense of occurrences, situations, or decisions by carefully considering the totality of the experience?

answer

reflection

question

What is the use of nursing knowledge, experience, and expertise for understanding without the conscious use of reasoning?

answer

intuition

question

What is the purpose of noticing in the nursing process?

answer

to establish a database about the patient's response to health concerns or illness and the ability to manage health care needs

question

What is the purpose of patient problem identification in the nursing process?

answer

-To identify patient strengths and health problems that can be prevented or resolved by collaborative and nursing interventions -to develop a list of nursing and collaborative problems

question

What is the purpose of interpreting in the nursing process?

answer

to develop an individualized plan of care that specifies patient goals/desired outcomes, and related priority nursing interventions

question

What is the purpose of implementation/responding in the nursing process?

answer

-to assist the patient to meet desired goals/desired outcomes -promote wellness -prevent illness and disease -restore health -facilitate coping with altered functions

question

What is the purpose of reflection in the nursing process?

answer

to determine whether to continue, modify, or terminate the plan of care

question

-obtaining health history -review pt records -speak with family members and significant support persons -speak with appropriate health professionals These are examples of which phase of the nursing process?

answer

noticing

question

-compare data against standards -cluster or group data -identify pts strengths, risks, and problems -documenting priority problem These are examples of which phase of the nursing process?

answer

Problem identification

question

-setting priorities and goals/outcomes in collaboration with patient -write goals/desired outcomes -select nursing interventions -consult other health professionals These are examples of which phase of the nursing process?

answer

Interpreting

question

-reassess the patient to update the database to keep it current -communicate what nursing actions were implemented -perform priority nursing interventions These are examples of which phase of the nursing process?

answer

Responding

question

-judge whether goals/outcomes have been achieved -relate nursing actions to patient outcomes -make decisions about problem status -review and modify plan of care

answer

-refletion

question

What are the types of nursing problems?

answer

-actual problems -risk problems -wellness problems -health promotion problems

question

Which type of nursing problem is a current, right now problem?

answer

actual problem

question

Which type of nursing problem is a potential/probable problem?

answer

risk probolem

question

Which type of nursing problem address the enhancement of an individual, family or community?

answer

wellness problem

question

Which type of nursing problems involve motivating the patient to have a healthier lifestyle?

answer

health promotion

question

What must happen for patient goals to be effective?

answer

the patient/family must agree upon the goals to be acheived

question

What acronym helps us write patient goals?

answer

SMART -Single specific action -Measurable -Attainable -Relevant -Time limited

question

What are the guidelines of writing a patient goal?

answer

-write in terms of the patient responses -must be realistic -ensure compatible with other therapies -derived from only one problem -urse observable, measurable terms -make sure pt considers the goal to be important

question

What are the types of nursing interventions?

answer

-independent -dependent -collaborative

question

Which type of nursing intervention is the nurse licensed to initiate?

answer

independent

question

What is an independent nursing intervention?

answer

-nurse is licensed to initiate

question

Which type of nursing intervention is carried out under physician's orders, supervision?

answer

dependent

question

What is a dependent nursing intervention?

answer

-carried out under physician's orders, supervisions

question

Which type of nursing intervention reflects overlapping responsibilities of the healthcare team?

answer

-collaborative

question

What is collaborative nursing interventions?

answer

-reflet overlapping responsibilities of healthcare team

question

What do nursing interventions focus on?

answer

-assessments to observe for changes in pt's status -prevention to avoid complications -reduction of risk factors -treatment through teaching and providing physical care -improvement of health through health promotion and achieving higher levels of wellness

question

Who mandates the use of a plan of care?

answer

The Joint Commission

question

What determines the format of the plan of care?

answer

the facility

question

Why are concept maps ideal for creating a plan of care?

answer

the show a more holistic view of patient

question

What is the difference between effectiveness and efficiency?

answer

effectiveness- doing the right thing efficiency- doing things right

question

What is the key to prioritization?

answer

assessment, you can't prioritise what you don't know

question

What are the levels of priorities?

answer

-low -medium -high

question

Problems that can be delegated are which level of priority?

answer

low

question

Problems that cannot be delegated and will have unhealthy physical or emotional consequences if not addressed are which level of priority?

answer

medium

question

Problems that are life threatening are which level of priority?

answer

high

question

What is a way to illustrate how much time can safely lapse before doing interventions without compromising patient outcomes?

answer

urgency factor

question

What are the levels of urgency?

answer

-nonacute -acute -critical -imminent death

question

What is the process of identifying priorities for implementing care in emergency situations?

answer

triage

question

What are the categories patients can be placed into when triaged?

answer

-emergent- life threatening issues -urgent- serious conditions where delay would not result in life-threatening situation -nonurgent-pt can ambulate, is stable

question

Where can a nurse find what can be delegated and to whom it can be delegated?

answer

-The PA State Code -Nurse Practice Act

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