NUR 155 Exam 1 Study Guide
Table of Contents
Critical Thinking:.................................................................................1
Critical thinking techniques.................................................................2
Nursing process..................................................................................3
ADPIE.................................................................................................4
Step 1: Assessment.............................................................................5
Step 2: Diagnosis................................................................................6
Maslow’s Hierarchy.............................................................................8
Step 3: Planning..................................................................................9
Step 4: Implementation.....................................................................10
Step 5: Evaluation.............................................................................10
Assessment.......................................................................................10
Pt positions and body areas assessed.................................................12
Methods (IPPA)..................................................................................13
Integumentary..................................................................................15
Head.................................................................................................16
Thorax and lungs...............................................................................17
Adventitious breath sounds...............................................................18
Cardiovascular and peripheral............................................................18
Abdomen..........................................................................................19
Musculoskeletal.................................................................................21
Neurologic........................................................................................21
Cranial Nerves...................................................................................22
Gross motor and balance tests...........................................................23
Breasts and axillae............................................................................23
Female genitals and inguinal area......................................................23
Male genitals and inguinal area..........................................................23
Assessing the anus............................................................................23
AWIPE...............................................................................................24
DHCOW.............................................................................................24
Vital signs.........................................................................................24
, Body temperature / Fever..................................................................24
Heart rate (pulse)..............................................................................27
Respirations......................................................................................28
Blood pressure..................................................................................30
5th vital sign......................................................................................31
Ch 15 Documenting and Reporting.....................................................31
Ethical and legal considerations.........................................................32
Other types of documentation............................................................33
SBAR................................................................................................34
Preventing infection by asepsis..........................................................35
Types of infection..............................................................................35
Method of transmission.....................................................................35
Infection control precautions.............................................................36
Personal protective equipment (PPE)..................................................37
The communication processes............................................................37
Delegation........................................................................................40
Abbreviations....................................................................................40
Galen Standardized Values.................................................................44
Precautions.......................................................................................49
Precaution acronyms.........................................................................50
Review:.............................................................................................51
Conversion List..................................................................................52
1
,
, Exam One Study Guide
Critical Thinking:
What are your responsibilities as a nurse?
Recognize health problems
Anticipate and plan for problems
Initiate actions to ensure appropriate and timely treatment, patient safety, and optimal
health outcomes
Critical thinking defined
Intentional higher-level reasoning
Influenced by knowledge, experience, skills, attitudes, and interpersonal skills
Used as a guide for rational judgment and action
Takes time and practice to develop
Critical thinking attitudes
Independence – think for themselves
Fair-mindedness – assesses all viewpoints
Insight into egocentricity – biases
Intellectual humility – knows the limit of
one’s own knowledge
Intellectual courage to challenge status
quo
Integrity – apply the same rigorous
standards of proof to their own knowledge and beliefs as they apply to the knowledge and
beliefs of others
Perseverance – show perseverance in finding effective solutions to the client and nursing
problems
Confidence – leads to trustworthy conclusions
Curiosity – the mind of a critical thinker is filled with questions
Diagnostic reasoning
Making sense of the data you collected
Requires critical thinking
Improves with experience, knowledge, and skill
Requires the creation of a diagnostic (working) hypothesis
Consider what is important in a given situation
1
Table of Contents
Critical Thinking:.................................................................................1
Critical thinking techniques.................................................................2
Nursing process..................................................................................3
ADPIE.................................................................................................4
Step 1: Assessment.............................................................................5
Step 2: Diagnosis................................................................................6
Maslow’s Hierarchy.............................................................................8
Step 3: Planning..................................................................................9
Step 4: Implementation.....................................................................10
Step 5: Evaluation.............................................................................10
Assessment.......................................................................................10
Pt positions and body areas assessed.................................................12
Methods (IPPA)..................................................................................13
Integumentary..................................................................................15
Head.................................................................................................16
Thorax and lungs...............................................................................17
Adventitious breath sounds...............................................................18
Cardiovascular and peripheral............................................................18
Abdomen..........................................................................................19
Musculoskeletal.................................................................................21
Neurologic........................................................................................21
Cranial Nerves...................................................................................22
Gross motor and balance tests...........................................................23
Breasts and axillae............................................................................23
Female genitals and inguinal area......................................................23
Male genitals and inguinal area..........................................................23
Assessing the anus............................................................................23
AWIPE...............................................................................................24
DHCOW.............................................................................................24
Vital signs.........................................................................................24
, Body temperature / Fever..................................................................24
Heart rate (pulse)..............................................................................27
Respirations......................................................................................28
Blood pressure..................................................................................30
5th vital sign......................................................................................31
Ch 15 Documenting and Reporting.....................................................31
Ethical and legal considerations.........................................................32
Other types of documentation............................................................33
SBAR................................................................................................34
Preventing infection by asepsis..........................................................35
Types of infection..............................................................................35
Method of transmission.....................................................................35
Infection control precautions.............................................................36
Personal protective equipment (PPE)..................................................37
The communication processes............................................................37
Delegation........................................................................................40
Abbreviations....................................................................................40
Galen Standardized Values.................................................................44
Precautions.......................................................................................49
Precaution acronyms.........................................................................50
Review:.............................................................................................51
Conversion List..................................................................................52
1
,
, Exam One Study Guide
Critical Thinking:
What are your responsibilities as a nurse?
Recognize health problems
Anticipate and plan for problems
Initiate actions to ensure appropriate and timely treatment, patient safety, and optimal
health outcomes
Critical thinking defined
Intentional higher-level reasoning
Influenced by knowledge, experience, skills, attitudes, and interpersonal skills
Used as a guide for rational judgment and action
Takes time and practice to develop
Critical thinking attitudes
Independence – think for themselves
Fair-mindedness – assesses all viewpoints
Insight into egocentricity – biases
Intellectual humility – knows the limit of
one’s own knowledge
Intellectual courage to challenge status
quo
Integrity – apply the same rigorous
standards of proof to their own knowledge and beliefs as they apply to the knowledge and
beliefs of others
Perseverance – show perseverance in finding effective solutions to the client and nursing
problems
Confidence – leads to trustworthy conclusions
Curiosity – the mind of a critical thinker is filled with questions
Diagnostic reasoning
Making sense of the data you collected
Requires critical thinking
Improves with experience, knowledge, and skill
Requires the creation of a diagnostic (working) hypothesis
Consider what is important in a given situation
1
